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Sample records for liver biopsy specimens

  1. Liver Biopsy

    MedlinePlus

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

  2. Liver biopsy

    MedlinePlus

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

  3. LIVER BIOPSY: IMPORTANCE OF SPECIMEN SIZE IN THE DIAGNOSIS AND STAGING OF CHRONIC VIRAL HEPATITIS

    PubMed Central

    CORAL, Gabriela P.; ANTUNES, Aline Dal Pozzo; SERAFINI, Ana Paula Almeida; ARAUJO, Fernanda B.; de MATTOS, Angelo Alves

    2016-01-01

    Liver biopsy is the gold standard method for the grading and staging of chronic viral hepatitis, but optimal biopsy specimen size remains controversial. The aim of this study was to evaluate the quality of liver specimen (number of portal tracts) and to evaluate the impact of the number of portal tracts in the staging of chronic hepatitis. Material and Methods: 468 liver biopsies from consecutive patients with hepatitis C virus and hepatitis B virus infection from 2009 to 2010 were evaluated. Results: The length of fragment was less than 10 mm in 43 cases (9.3%), between 10 and 14 mm in 114 (24.3%), and ≥ 15 mm in 311 (64.4%); of these, in 39 (8.3%) cases were ≥ 20 mm. The mean representation of portal tracts was 17.6 ± 2.1 (5-40); in specimens ≥ 15 mm the mean portal tract was 13.5 ± 4.7 and in cases ≤ 15 mm was 11.4 ± 5.0 (p = 0.002). Cases with less than 11 portal tracts were associated with F3, and cases with 11 or more portal tracts with F2 (p = 0.001). Conclusion: this study demonstrated the good quality of liver biopsy and a relationship between the macroscopic size of the fragment and the number of portal tracts. PMID:26910447

  4. Liver Biopsy

    MedlinePlus

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

  5. Diffuse reflectance spectroscopy as a possible tool to complement liver biopsy for grading hepatic fibrosis in paraffin-preserved human liver specimens.

    PubMed

    Fabila-Bustos, Diego A; Arroyo-Camarena, Ursula D; López-Vancell, María D; Durán-Padilla, Marco A; Azuceno-García, Itzel; Stolik-Isakina, Suren; Ibarra-Coronado, Elizabeth; Brown, Blair; Escobedo, Galileo; de la Rosa-Vázquez, José Manuel

    2014-01-01

    A diffuse reflectance spectroscopy-based method to score fibrosis in paraffin-preserved human liver specimens has been developed and is reported here. Paraffin blocks containing human liver tissue were collected from the General Hospital of Mexico and included in the study with the patients' written consent. The score of liver fibrosis was determined in each sample by two experienced pathologists in a single-blind fashion. Spectral measurements were acquired at 450-750 nm by establishing surface contact between the optical probe and the preserved tissue. According to the histological evaluation, four liver samples showed no evidence of fibrosis and were categorized as F0, four hepatic specimens exhibited an initial degree of fibrosis (F1-F2), five liver specimens showed a severe degree of fibrosis (F3), and six samples exhibited cirrhosis (F4). The human liver tissue showed a characteristic diffuse reflectance spectrum associated with the progressive stages of fibrosis. In the F0 liver samples, the diffuse reflection intensity gradually increased in the wavelength range of 450-750 nm. In contrast, the F1-F2, F3, and F4 specimens showed corresponding 1.5-, 2-, and 5.5-fold decreases in the intensity of diffuse reflectance compared to the F0 liver specimens. At 650 nm, all the stages of liver fibrosis were clearly distinguished from each other with high sensitivity and specificity (92-100%). To our knowledge, this is the first study reporting a distinctive diffuse reflectance spectrum for each stage of fibrosis in paraffin-preserved human liver specimens. These results suggest that diffuse reflectance spectroscopy may represent a complementary tool to liver biopsy for grading fibrosis.

  6. Testing Biopsy and Cytology Specimens for Cancer

    MedlinePlus

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

  7. Proteome Analysis of Liver Cells Expressing a Full- Length Hepatitis C Virus (HCV) Replicon and Biopsy Specimens of Posttransplantation Liver from HCV-Infected Patients

    SciTech Connect

    Jacobs, Jon M.; Diamond, Deborah L.; Chan, Eric Y.; Gritsenko, Marina A.; Qian, Weijun; Stastna, Miroslava; Baas, Tracey; Camp, David G.; Carithers, Jr., Robert L.; Smith, Richard D.; Katze, Michael G.

    2005-06-01

    The development of a reproducible model system for the study of Hepatitis C virus (HCV) infection has the potential to significantly enhance the study of virus-host interactions and provide future direction for modeling the pathogenesis of HCV. While there are studies describing global gene expression changes associated with HCV infection, changes in the proteome have not been characterized. We report the first large scale proteome analysis of the highly permissive Huh-7.5 cell line containing a full length HCV replicon. We detected > 4,400 proteins in this cell line, including HCV replicon proteins, using multidimensional liquid chromatographic (LC) separations coupled to mass spectrometry (MS). The set of Huh-7.5 proteins confidently identified is, to our knowledge, the most comprehensive yet reported for a human cell line. Consistent with the literature, a comparison of Huh-7.5 cells (+) and (-) the HCV replicon identified expression changes of proteins involved in lipid metabolism. We extended these analyses to liver biopsy material from HCV-infected patients where > 1,500 proteins were detected from 2 {micro}g protein lysate using the Huh-7.5 protein database and the accurate mass and time (AMT) tag strategy. These findings demonstrate the utility of multidimensional proteome analysis of the HCV replicon model system for assisting the determination of proteins/pathways affected by HCV infection. Our ability to extend these analyses to the highly complex proteome of small liver biopsies with limiting protein yields offers the unique opportunity to begin evaluating the clinical significance of protein expression changes associated with HCV infection.

  8. Liver biopsy for parenchymal liver disease - is routine real time image guidance unnecessary?

    PubMed

    John, Anil; Al Kaabi, Saad; Soofi, Madiha Emran; Mohannadi, Muneera; Kandath, Salva Manam; Derbala, Moataz; Yakoub, Rafie; Al-Ahdal, Esra Mohammed; Sharma, Manik; Wani, Hamid; Dweik, Nazeeh; John, Anjum; Butt, Mohammed Tariq

    2014-01-01

    Liver biopsy even today remains the standard of care for grading and staging chronic hepatitis despite advances in noninvasive markers of liver fibrosis. Literature suggests an expanding role for real-time image guided liver biopsy and declining trend for blind liver biopsies. In our center, where we perform around 400 liver biopsies per year, we performed a prospective clinical audit of our practice of blind outpatient percutaneous liver biopsies. Patients requiring histological grading and staging of chronic hepatitis routinely undergo blind outpatient percutaneous liver biopsies in our endoscopy unit unless there is a definite indication for real-time image guidance. All procedures were assessed for safety, and all specimens were evaluated by a specimen quality grading score for adequacy for grading and staging of chronic hepatitis. Of the 446 patients referred for histological grading and staging of chronic hepatitis C by liver biopsy, only 42 patients (9.5 %) required real-time ultrasound for liver biopsy. The remaining 404 patients underwent blind outpatient percutaneous liver biopsies which were found to be extremely safe with no major complications, yielding adequate liver tissue with high specimen quality score allowing optimal grading and staging of chronic hepatitis.

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

    PubMed Central

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

    2013-01-01

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

  10. 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.

  11. Liver biopsy and prognosis in acute liver failure

    PubMed Central

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

    1973-01-01

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

  12. Midazolam sedation for percutaneous liver biopsy.

    PubMed

    Alexander, J A; Smith, B J

    1993-12-01

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

  13. Role of liver biopsy in nonalcoholic fatty liver disease

    PubMed Central

    Nalbantoglu, ILKe; Brunt, Elizabeth M

    2014-01-01

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

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

    SciTech Connect

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

    1996-11-15

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

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

    SciTech Connect

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

    2011-04-15

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

  16. Single-Pass Percutaneous Liver Biopsy for Diffuse Liver Disease Using an Automated Device: Experience in 154 Procedures

    SciTech Connect

    Rivera-Sanfeliz, Gerant Kinney, Thomas B.; Rose, Steven C.; Agha, Ayad K.M.; Valji, Karim; Miller, Franklin J.; Roberts, Anne C.

    2005-06-15

    Purpose: To describe our experience with ultrasound (US)-guided percutaneous liver biopsies using the INRAD 18G Express core needle biopsy system.Methods: One hundred and fifty-four consecutive percutaneous core liver biopsy procedures were performed in 153 men in a single institution over 37 months. The medical charts, pathology reports, and radiology files were retrospectively reviewed. The number of needle passes, type of guidance, change in hematocrit level, and adequacy of specimens for histologic analysis were evaluated.Results: All biopsies were performed for histologic staging of chronic liver diseases. The majority of patients had hepatitis C (134/153, 90.2%). All patients were discharged to home after 4 hr of postprocedural observation. In 145 of 154 (94%) biopsies, a single needle pass was sufficient for diagnosis. US guidance was utilized in all but one of the procedures (153/154, 99.4%). The mean hematocrit decrease was 1.2% (44.1-42.9%). Pain requiring narcotic analgesia, the most frequent complication, occurred in 28 of 154 procedures (18.2%). No major complications occurred. The specimens were diagnostic in 152 of 154 procedures (98.7%).Conclusions: Single-pass percutaneous US-guided liver biopsy with the INRAD 18G Express core needle biopsy system is safe and provides definitive pathologic diagnosis of chronic liver disease. It can be performed on an outpatient basis. Routine post-biopsy monitoring of hematocrit level in stable, asymptomatic patients is probably not warranted.

  17. Regeneration of Human Liver After Hepatic Lobectomy Studied by Repeated Liver Scanning and Repeated Needle Biopsy

    PubMed Central

    Lin, Tien-Yu; Lee, Chue-Shue; Chen, Chiou-Chiang; Liau, Kuong-Yi; Lin, Wen-Shih-Jen

    1979-01-01

    Regeneration of the residual lobe of the liver after hepatic lobectomy in humans was studied by repeated liver scanning in seven noncirrhotic and three cirrhotic patients. Each patient was studied for several months during the study which lasted from 1-12 years. Regeneration was apparent in noncirrhotic liver remnants following hepatic lobectomy. In the case of a long standing, space occupying lesions such as benign giant cysts, the liver remnant would complete its regeneration process rather early, usually within a few months of hepatic lobectomy. In hepatoma cases, however, regeneration of the residual lobe after hepatic resection usually took five or six months for completion. On the contrary, no definite increase in the size of the liver remnant was seen on repeated liver scanning in cirrhotic patients. Histologic study of the residual lobe was repeated on needle biopsy specimens in two noncirrhotic and four cirrhotic patients. Regenerative hyperplasia of liver cells with large hyperchromatic, or double nuclei never seen in the preresection liver appeared in the liver remnant five, 11, and 27 days after hepatic lobectomy in noncirrhotic patients. In cirrhotics, however, there were no histologic changes between the preresection liver and the postresection remnant studied three, five, 15, 40 days or even two years and 8 months after hepatic lobectomy. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6. PMID:464678

  18. Rapid observation of unfixed, unstained human skin biopsy specimens with confocal microscopy and visualization

    NASA Astrophysics Data System (ADS)

    Masters, Barry R.; Aziz, David J.; Gmitro, Arthur F.; Kerr, James H.; O'Grady, Terence C.; Goldman, Leon

    1997-10-01

    The use of reflected light confocal microscopy is proposed to rapidly observe unfixed, unstained biopsy specimens of human skin. Reflected light laser scanning confocal microscopy was used to compare a freshly excised, unfixed, unstained biopsy specimen, and in vivo human skin. Optical sections from the ex vivo biopsy specimen of human skin and in vivo human skin were converted to red-green anaglyphs for 3D visualization. Contrast was derived from intrinsic differences in the scattering properties of the organelles and cells within the tissue. Individual cellular layers were observed in both tissues from the surface to the papillary dermis. Confocal microscopy of an unfixed, unstained biopsy specimen showed cells and cell nuclei of the stratum spinosum. Confocal microscopy of in vivo human skin demonstrated optical sectioning through a hair shaft on the upper hand. The combination of reflected light confocal microscopy and 3D visualization with red-green anaglyphs provides a rapid technique for observing fresh biopsies of human skin.

  19. Ideal number of biopsy tumor fragments for predicting HER2 status in gastric carcinoma resection specimens.

    PubMed

    Ahn, Sangjeong; Ahn, Soomin; Van Vrancken, Michael; Lee, Minju; Ha, Sang Yun; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Kim, Jae J; Choi, Sunkyu; Jung, Sin-Ho; Choi, Min Gew; Lee, Jun-Ho; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung; Kim, Kyoung-Mee

    2015-11-10

    Intratumoral heterogeneity of HER2 expression is common in gastric cancers and pose a challenge for identifying patients who would benefit from anti-HER2 therapy. The aim of this study is to compare HER2 expression in biopsy and resection specimens of gastric carcinoma by immunohistochemistry (IHC) and to find the ideal number of biopsy tumor fragments that can accurately predict HER2 overexpression in the corresponding surgically resected specimen. The HER2 IHC results of 702 paired biopsy and resection specimens of gastric cancer were compared.The mean number of biopsy fragments among all cases was 4.3 (range 1-11). HER2 was positive in 130 (18.5%) endoscopic biopsies and in 102 (14.5%) gastrectomy specimens. Intratumoral heterogeneity of HER2 was found in 80 (61.5%) biopsies and 70 (68.6%) resection specimens. Out of the 70 surgical specimens with intratumoral heterogeneity, 24 (34.3%) of the corresponding biopsies were categorized as negative (positive conversion). In the 86 (12.3%) discrepant cases, negative conversion was observed in 57 (66.3%) cases and positive conversion in 29 (33.7%). The fragment numbers were significantly correlated with the discrepancy of results and positive predictability (P = 0.0315 and P = 0.0052). ROC curve analysis and positive predictability showed that 4 fragments should be obtained to minimize the differences in HER2 scores between biopsy and resection specimen.In gastric carcinomas with discrepant HER2 results between biopsy and surgical resection specimens, intratumoral heterogeneity is common with most of them showing positive conversion. To predict HER2 status precisely, at least 4 biopsy fragments containing tumor cells are required.

  20. Ideal number of biopsy tumor fragments for predicting HER2 status in gastric carcinoma resection specimens

    PubMed Central

    Lee, Minju; Ha, Sang Yun; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Kim, Jae J.; Choi, Sunkyu; Jung, Sin-Ho; Choi, Min Gew; Lee, Jun-Ho; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung; Kim, Kyoung-Mee

    2015-01-01

    Intratumoral heterogeneity of HER2 expression is common in gastric cancers and pose a challenge for identifying patients who would benefit from anti-HER2 therapy. The aim of this study is to compare HER2 expression in biopsy and resection specimens of gastric carcinoma by immunohistochemistry (IHC) and to find the ideal number of biopsy tumor fragments that can accurately predict HER2 overexpression in the corresponding surgically resected specimen. The HER2 IHC results of 702 paired biopsy and resection specimens of gastric cancer were compared. The mean number of biopsy fragments among all cases was 4.3 (range 1–11). HER2 was positive in 130 (18.5%) endoscopic biopsies and in 102 (14.5%) gastrectomy specimens. Intratumoral heterogeneity of HER2 was found in 80 (61.5%) biopsies and 70 (68.6%) resection specimens. Out of the 70 surgical specimens with intratumoral heterogeneity, 24 (34.3%) of the corresponding biopsies were categorized as negative (positive conversion). In the 86 (12.3%) discrepant cases, negative conversion was observed in 57 (66.3%) cases and positive conversion in 29 (33.7%). The fragment numbers were significantly correlated with the discrepancy of results and positive predictability (P = 0.0315 and P = 0.0052). ROC curve analysis and positive predictability showed that 4 fragments should be obtained to minimize the differences in HER2 scores between biopsy and resection specimen. In gastric carcinomas with discrepant HER2 results between biopsy and surgical resection specimens, intratumoral heterogeneity is common with most of them showing positive conversion. To predict HER2 status precisely, at least 4 biopsy fragments containing tumor cells are required. PMID:26460823

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

    PubMed

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

    2017-03-03

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

  2. Contribution of Transjugular Liver Biopsy in Patients with the Clinical Presentation of Acute Liver Failure

    SciTech Connect

    Miraglia, Roberto Luca, Angelo; Gruttadauria, Salvatore; Minervini, Marta Ida; Vizzini, Giovanni; Arcadipane, Antonio; Gridelli, Bruno

    2006-12-15

    Purpose. Acute liver failure (ALF) treated with conservative therapy has a poor prognosis, although individual survival varies greatly. In these patients, the eligibility for liver transplantation must be quickly decided. The aim of this study was to assess the role of transjugular liver biopsy (TJLB) in the management of patients with the clinical presentation of ALF. Methods. Seventeen patients with the clinical presentation of ALF were referred to our institution during a 52 month period. A TJLB was performed using the Cook Quick-Core needle biopsy. Clinical data, procedural complications, and histologic findings were evaluated. Results. Causes of ALF were virus hepatitis B infection in 7 patients, drug toxicity in 4, mushroom in 1, Wilson's disease in 1, and unknown origin in 4. TJLB was technically successful in all patients without procedure-related complications. Tissue specimens were satisfactory for diagnosis in all cases. In 14 of 17 patients the initial clinical diagnosis was confirmed by TJLB; in 3 patients the initial diagnosis was altered by the presence of unknown cirrhosis. Seven patients with necrosis <60% were successfully treated with medical therapy; 6 patients with submassive or massive necrosis ({>=}85%) were treated with liver transplantation. Four patients died, 3 had cirrhosis, and 1 had submassive necrosis. There was a strict statistical correlation (r = 0.972, p < 0.0001) between the amount of necrosis at the frozen section examination and the necrosis found at routine histologic examination. The average time for TJLB and frozen section examination was 80 min. Conclusion. In patients with the clinical presentation of ALF, submassive or massive liver necrosis and cirrhosis are predictors of poor prognosis. TLJB using an automated device and frozen section examination can be a quick and effective tool in clinical decision-making, especially in deciding patient selection and the best timing for liver transplantation.

  3. Incidental healed postinfectious glomerulonephritis: a study of 1012 renal biopsy specimens examined by electron microscopy.

    PubMed

    Haas, Mark

    2003-01-01

    Glomerulonephritis (GN) characterized by immune complex deposits typical of postinfectious GN but with a paucity or absence of overt clinical symptoms and/or urinary abnormalities may occur after a group A streptococcus infection. The overall incidence of this type of subclinical GN is not known. To address this question, electron microscopy findings in 1012 consecutive renal biopsy specimens (952 native kidney, 60 transplant) examined by a single renal pathologist from August 1999 to April 2002 were retrospectively reviewed for the presence of distinct subepithelial and intramembranous deposits indicative of postinfectious GN. Such deposits were noted in 83 biopsy specimens, including 26 with a primary diagnosis of postinfectious GN (acute, persistent, or latent) and 57 in which these deposits were an incidental finding. In each of the latter 57 cases, some or all of the deposits showed partial or extensive loss of electron density typical of partially or largely resorbed deposits. A diagnosis of incidental postinfectious GN was not made in any biopsy specimen exhibiting another immune complex-related glomerular disease that could possibly account for the deposits, composing 443 of the 1012 biopsy specimens examined. Thirty of the 57 biopsy specimens with incidental postinfectious GN showed mesangial hypercellularity, although this was focal and segmental in all but 3 cases and was not accompanied by the endocapillary hypercellularity typical of acute postinfectious lesions. Immunofluorescence microscopy revealed glomerular deposits of C3 in >90% of these biopsy specimens and IgM deposits in 66%, but only rare IgG, IgA, and Cq deposits. Twenty-three (40%) of these 57 biopsy specimens exhibited diabetic nephropathy, either alone or in combination with another lesion; for perspective, only 128 (13%) of the 1012 biopsy specimens examined showed evidence of diabetic nephropathy. In summary, incidental evidence of resolving or largely healed postinfectious GN was noted

  4. Prevalence of the parvovirus B19 genome in endomyocardial biopsy specimens.

    PubMed

    Pankuweit, Sabine; Moll, R; Baandrup, U; Portig, Irene; Hufnagel, Günter; Maisch, Bernhard

    2003-05-01

    Although enteroviruses have long been considered the most common cause of inflammatory heart muscle diseases, parvovirus B19 (PVB19) is emerging as a new and important candidate for myocarditis and dilated cardiomyopathy with inflammation (DCMi) and without inflammation (DCM). We investigated left ventricular endomyocardial biopsy specimens from 110 patients with suspected inflammatory heart disease for the presence of PVB19, Coxsackie virus (CVB), and adenovirus (Ad2) genome by polymerase chain reaction. Diagnosis of myocarditis (36 patients), DCM (18 patients), DCMi (13 patients), and perimyocarditis (12 patients) was made by immunohistochemical and histopathological investigation of endomyocardial biopsy specimens. A control group consisting of patients with arterial hypertension was also investigated. Prevalence of the PVB19 genome in endomyocardial biopsy specimens was highest in patients with DCMi (3 of 13) and patients with myocarditis (7 of 36); in patients with DCM and perimyocarditis, prevalence was 3 of 13 and 2 of 12, respectively. In patients with resolved myocarditis, no PVB19 DNA was detected; in patients with no inflammation and controls, prevalence was only 4% and 7%, respectively. CVB-RNA was detected in endomyocardial biopsy specimens from 3 of 37 patients with myocarditis; Ad2-DNA was found in 1 patient with DCM and 1 patient with perimyocarditis. These findings suggest an association of the PVB19 genome in endomyocardial biopsy specimens of adults with the development of DCM, DCMi, and chronic myocarditis more frequently than previously expected. PVB19 should therefore be recognized as a potential cardiotropic pathogen in patients of all ages.

  5. Comparison of small biopsy specimens and surgical specimens for the detection of EGFR mutations and EML4-ALK in non-small-cell lung cancer

    PubMed Central

    Xiao, DeSheng; Lu, Can; Zhu, Wei; He, QiuYan; Li, Yong; Fu, ChunYan; Zhou, JianHua; Liu, Shuang; Tao, YongGuang

    2016-01-01

    Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) fusion genes represent novel oncogenes that are associated with non–small-cell lung cancers (NSCLC). The feasibility of detecting EGFR mutations and ALK fusion genes in small biopsy specimens or surgical specimens was determined. Of the 721 NSCLC patients, a total of 305 cases were positive for EGFR mutations (42.3%). The rate of EGFR mutations in women was significantly higher than that in men. Histologically, the EGFR mutation rate in adenocarcinomas was significantly higher than that in squamous cell carcinomas. No difference in the EGFR mutation rate was observed between surgical specimens (42.1%) and small biopsy specimens (42.4%), which indicated that the EGFR mutation ratios in surgical specimens and small biopsy specimens were not different. In 385 NSCLC patients, 26 cases were positive for EML4-ALK (6.8%). However, 11.7% of the surgical specimens were EML4-ALK-positive, whereas the positive proportion in the small biopsy specimens was only 4.7%, which indicated that EML4-ALK-positive rate in the surgical specimens was significantly higher than that in the small biopsy specimens. Detection of EGFR gene mutations was feasible in small biopsy specimens, and screening for EML4-ALK expression in small biopsy specimens can be used to guide clinical treatments. PMID:27322143

  6. Radiofrequency identification specimen tracking in anatomical pathology: pilot study of 1067 consecutive prostate biopsies.

    PubMed

    Bostwick, David G

    2013-10-01

    Improved methods such as radiofrequency identification (RFID) are needed to optimize specimen tracking in anatomical pathology. We undertook a study of RFID in an effort to optimize specimen tracking and patient identification, including the following: (1) creation of workflow process maps, (2) evaluation of existing RFID hardware technologies, (3) creation of Web-based software to support the RFID-enabled workflow, and (4) assessment of the impact with a series of prostate biopsies. We identified multiple steps in the workflow process in which RFID enhanced specimen tracking. Multiple product choices were found that could withstand the harsh heat and chemical environments encountered in pathology processing, and software that was compatible with our laboratory information system was designed in-house. A total of 1067 prostate biopsies were received, and 78.3% were successfully processed with the RFID system. Radiofrequency identification allowed dynamic specimen tracking throughout the workflow process in anatomical pathology.

  7. Immunocytochemical localization of peroxisomal enzymes in human liver biopsies.

    PubMed Central

    Litwin, J. A.; Völkl, A.; Müller-Höcker, J.; Hashimoto, T.; Fahimi, H. D.

    1987-01-01

    The immunocytochemical localization of catalase and three enzymes of the peroxisomal lipid beta-oxidation system--acyl-CoA oxidase, the bifunctional protein enoyl-CoA hydratase, 3-hydroxyacyl-CoA dehydrogenase, and 3-ketoacyl-CoA thiolase--in human liver biopsies was investigated by means of light and electron microscopy. The antisera raised against all four enzymes from rat liver cross-reacted with the corresponding proteins in homogenates of human liver as revealed by immunoblotting. For light-microscopic localization in glutaraldehyde-fixed Epon-embedded material, the removal of resin and controlled digestion with trypsin was necessary. At the ultrastructural level specific labeling for all four antigens was found by the protein A-gold technique in peroxisomes of liver parenchymal cells fixed with formaldehyde-low glutaraldehyde concentrations and embedded in Lowicryl K4M. In biopsies fixed with glutaraldehyde and embedded in Epon, treatment with metaperiodate or etching with sodium ethoxide improved the immunolabeling. After such treatment catalase showed the most intense labeling and acyl-CoA oxidase the weakest, the two other proteins exhibiting an intermediate immunoreaction. In material postfixed with osmium only catalase could be visualized in peroxisomes. The immunocytochemical investigation of peroxisomal proteins in human liver biopsies provides a simple and highly promising approach for further elucidation of the pathophysiology of peroxisomal disorders. Images Figures 2 and 3 Figure 4-7 Figures 9-12 Figure 1 Figure 8 Figure 13 Figure 14 Figure 15 Figure 16 PMID:2886050

  8. Optimal combination of media for primary isolation of Helicobacter pylori from gastric biopsy specimens.

    PubMed Central

    Piccolomini, R; Di Bonaventura, G; Festi, D; Catamo, G; Laterza, F; Neri, M

    1997-01-01

    The aim of the present study was to compare eight media, four nonselective and four selective media, to determine the best combination of media for the primary isolation of Helicobacter pylori. Over a period of 5 months, mucosal antral biopsy specimens were obtained from 222 consecutive dyspeptic patients undergoing endoscopy. Biopsy samples were plated in parallel on all eight media. Egg yolk emulsion agar (EYE), Skirrow's medium, Dent's medium, and modified Thayer-Martin medium were used as selective media; modified chocolate agar (MCHOC), Triptycase soy agar (TSA), brucella agar, and brain heart infusion agar were used as nonselective media. Overall, by using these eight media, H. pylori was recovered from biopsy specimens from 114 of 222 patients, yielding an isolation rate of 51%. Comparison of all possible combinations of the eight media showed that the highest rate of isolation of H. pylori was 100% (114 of 114) with EYE-MCHOC, followed by 96.5% (110 of 114) when EYE-TSA was used. Conversely, it was found that none of the media used alone yielded a 100% rate of recovery (the maximum recovery rate was 95%, which was achieved with EYE). These results indicate that the association of EYE and MCHOC yielded the maximum recovery of H. pylori from gastric biopsy specimens. Therefore, the use of selective and nonselective media in parallel offers optimal recovery rates with only a slight increase in costs. PMID:9163478

  9. Liver biopsy histopathology for diagnosis of Johne's disease in sheep.

    PubMed

    Smith, S L; Wilson, P R; Collett, M G; Heuer, C; West, D M; Stevenson, M; Chambers, J P

    2014-09-01

    Sheep with Johne's disease develop epithelioid macrophage microgranulomas, specific to Mycobacterium avium subsp. paratuberculosis (Map) infection, in the terminal ileum, mesenteric lymph nodes, and organs distant to the alimentary tract such as the liver. The objectives of this study were to determine whether liver pathology was present in ewes affected by Map and whether liver cores provide adequate tissue for this potential diagnostic marker. One hundred and twenty-six adult, low body condition ewes were euthanized, necropsied, and underwent simulated liver biopsy. Ileal lesions typical of Map were found in 60 ewes. Hepatic epithelioid microgranulomas were observed in all ewes with Type 3b (n = 40) and 82% (n = 11) with Type 3c ileal lesions. None were found in ewes unaffected by Map or with Type 1, 2, or 3a ileal lesions. Liver biopsy core samples provided adequate tissue for histopathology with a sensitivity and specificity of 96% (95% confidence interval [CI], 0.87-0.99) and 100% (95% CI, 0.95-1), respectively for detection of types 3b and 3c ileal lesions.

  10. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy

    PubMed Central

    Kayacetin, Ertugrul; Kayacetin, Serra

    2004-01-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. Usually the diagnosis is made by operation or autopsy. Clinical and laboratory data were no specific. A 64-year-old man was admitted with upper gastrointestinal bleeding. Hepatic penetration was diagnosed as the cause of bleeding. Endoscopy showed a large gastric ulcer with a pseudotumoral mass protruding from the ulcer bed. Definitive diagnosis was established by endoscopic biopsies of the ulcer base. PMID:15188520

  11. Telangiectatic variant of hepatic adenoma: clinicopathologic features and correlation between liver needle biopsy and resection.

    PubMed

    Mounajjed, Taofic; Wu, Tsung-Teh

    2011-09-01

    Telangiectatic hepatic adenoma (THA) is a benign neoplasm treated by resection. The role of liver needle biopsy in identifying THA before resection has not been evaluated. We identified 55 patients who have undergone resection for hepatic adenoma (HA), THA, or focal nodular hyperplasia (FNH) after needle biopsy. Needle biopsies and resections were evaluated for the following: (1) abortive portal tracts; (2) sinusoidal dilatation; (3) ductular reaction; (4) inflammation; (5) aberrant naked vessels; (6) nodules, fibrous septa, and/or central stellate scar. THA diagnosis was made if the lesion had the first 4 criteria and lacked criterion 6. Most patients (36 of 55), including patients with THA (12 of 16), had multiple lesions (0.2 to 14.4 cm). Patients with THA showed no difference in age, body mass index, prevalence of diabetes or glucose intolerance, or presence of oral contraceptive (OCP) use from patients with HA or FNH, but patients with THA had longer periods of OCP use than patients with HA. Thirty-one percent of THAs had tumor hemorrhage. Of sampled THAs, 27% showed steatosis compared with 76% of sampled HAs (P<0.05). All resected HAs and FNHs were correctly diagnosed on needle biopsy. Of 14 patients with resected THA, 3 histologic patterns were noted on needle biopsy: (1) All THA criteria and naked vessels were present in 6 patients (43%). (2) Consistent with HA: naked vessels only were present in 4 patients (29%). (3) Suggestive of THA: some but not all THA criteria were present in 4 patients (29%). No needle biopsy of a THA was misdiagnosed as FNH. Although evaluation of resection specimens is the gold standard for diagnosis of THA, liver needle biopsy is a useful diagnostic tool that leads to adequate treatment.

  12. MO-G-17A-09: Quantitative Autoradiography of Biopsy Specimens Extracted Under PET/CT Guidance

    SciTech Connect

    Fanchon, L; Carlin, S; Schmidtlein, C; Humm, J; Yorke, E; Solomon, S; Deasy, J; Kirov, A; Burger, I

    2014-06-15

    Purpose: To develop a procedure for accurate determination of PET tracer concentration with high spatial accuracy in situ by performing Quantitative Autoradiography of Biopsy Specimens (QABS) extracted under PET/CT guidance. Methods: Autoradiography (ARG) standards were produced from a gel loaded with a known concentration of FDG biopsied with 18G and 20G biopsy needles. Specimens obtained with these needles are generally cylindrical: up to 18 mm in length and about 0.8 and 0.6 mm in diameter respectively. These standards, with similar shape and density as biopsy specimens were used to generate ARG calibration curves.Quantitative ARG was performed to measure the activity concentration in biopsy specimens extracted from ten patients. The biopsy sites were determined according to PET/CT's obtained in the operating room. Additional CT scans were acquired with the needles in place to confirm correct needle placements. The ARG images were aligned with the needle tip in the PET/CT images using the open source CERR software. The mean SUV calculated from the specimen activities (SUVarg) were compared to that from PET (SUVpet) at the needle locations. Results: Calibration curves show that the relation between ARG signal and activity concentration in those standards is linear for the investigated range (up to 150 kBq/ml). The correlation coefficient of SUVarg with SUVpet is 0.74. Discrepancies between SUVarg and SUVpet can be attributed to the small size of the biopsy specimens compared to PET resolution. Conclusion: The calibration procedure using surrogate biopsy specimens provided a method for quantifying the activity within the biopsy cores obtained under FDG-PET guidance. QABS allows mapping the activity concentration in such biopsy specimens with a resolution of about 1mm. QABS is a promising tool for verification of biopsy adequacy by comparing specimen activity to that expected from the PET image. A portion of this research was funded by a research grant from

  13. Diagnosis of cutaneous tuberculosis in biopsy specimens by PCR and southern blotting.

    PubMed Central

    Quirós, E; Maroto, M C; Bettinardi, A; González, I; Piédrola, G

    1996-01-01

    AIMS: To evaluate the use of a gene amplification and hybridisation method for detecting mycobacterial nucleic acid as a possible diagnostic method for cutaneous tuberculosis infection. METHODS: Biopsy specimens from 20 patients with various skin conditions of possible tuberculous aetiology were studied. Six patients had ulcerative nodules, seven lupiform lesions, two non-necrotic granulomas, one scrofulous lichen, one impetigo, one erythematosus lesions, one warty lesions, and one suspected tuberculous lipoma. Biopsy specimens were stained using Ziehl-Neelsen stain and cultured in Lowenstein-Jensen medium. DNA was extracted and then amplified by PCR using primers specific for the Mycobacterium tuberculosis complex. Specificity was confirmed by Southern blotting. RESULTS: Of the specimens, 30% were positive for mycobacteria on staining with Ziehl-Neelsen stain, 60% were culture positive and 85% PCR positive. Only 35.2% of specimens were positive with all three techniques. A further 32.5% were both culture and PCR positive. All PCR negative samples were also negative when cultured or stained with Ziehl-Neelsen stain. Of the PCR positive specimens, 29.4% were negative when cultured or stained. CONCLUSIONS: PCR, using suitable primers, is an efficient and sensitive method for the diagnosis of cutaneous tuberculosis. PMID:8944606

  14. Routine Liver Biopsy During Bariatric Surgery: an Analysis of Evidence Base.

    PubMed

    Mahawar, Kamal K; Parmar, Chetan; Graham, Yitka; Abouleid, Ayman; Carr, William R J; Jennings, Neil; Schroeder, Norbert; Small, Peter K

    2016-01-01

    Non-alcoholic fatty liver disease and non-alcoholic steato-hepatitis are common in patients undergoing bariatric surgery. Non-alcoholic steato-hepatitis can progress to cirrhosis of the liver and hepatocellular carcinoma. Non-invasive methods of diagnosing non-alcoholic steato-hepatitis are not as accurate as liver biopsy, and bariatric surgery presents a unique opportunity to carry out a simultaneous liver biopsy. Routine liver biopsy can help early and accurate diagnosis of obesity-associated liver conditions. This has led some surgeons to argue for routine liver biopsy at the time of bariatric surgery. However, most bariatric surgeons remain unconvinced and liver biopsy is currently not routine practice with bariatric surgery. This review examines published scientific literature to ascertain the usefulness of routine liver biopsy at the time of bariatric surgery.

  15. [Cytomorphologic changes detected in bronchial biopsy specimens in patients with alveolitis].

    PubMed

    Makhmudova, S Iu

    2003-01-01

    Eighty-nine patients with alveolitis were followed up. Of them, 60 patients had exogenous allergic alveolitis (EAA) and 29 had idiopathic fibrosing alveolitis (IFA). Transbronchial lung biopsy (TLB) proved to be the most informative method for alveolitis. At the same time a cytomorphologic study of TLB specimens revealed exogenous allergic alveolitis in all phases of the disease in 91.2% of the cases. In idiopathic fibrosing alveolitis, the informative value of TLB was 59.7%.

  16. Non-invasive Markers of Liver Fibrosis: Adjuncts or Alternatives to Liver Biopsy?

    PubMed Central

    Chin, Jun L.; Pavlides, Michael; Moolla, Ahmad; Ryan, John D.

    2016-01-01

    Liver fibrosis reflects sustained liver injury often from multiple, simultaneous factors. Whilst the presence of mild fibrosis on biopsy can be a reassuring finding, the identification of advanced fibrosis is critical to the management of patients with chronic liver disease. This necessity has lead to a reliance on liver biopsy which itself is an imperfect test and poorly accepted by patients. The development of robust tools to non-invasively assess liver fibrosis has dramatically enhanced clinical decision making in patients with chronic liver disease, allowing a rapid and informed judgment of disease stage and prognosis. Should a liver biopsy be required, the appropriateness is clearer and the diagnostic yield is greater with the use of these adjuncts. While a number of non-invasive liver fibrosis markers are now used in routine practice, a steady stream of innovative approaches exists. With improvement in the reliability, reproducibility and feasibility of these markers, their potential role in disease management is increasing. Moreover, their adoption into clinical trials as outcome measures reflects their validity and dynamic nature. This review will summarize and appraise the current and novel non-invasive markers of liver fibrosis, both blood and imaging based, and look at their prospective application in everyday clinical care. PMID:27378924

  17. Cytometric measurement of cell proliferation in echo-guided biopsies from focal lesions of the liver.

    PubMed

    Faccioli, S; Chieco, P; Gramantieri, L; Stecca, B A; Bolondi, L

    1996-02-01

    Increased proliferative activity determined in surgical specimens of hepatocellular carcinoma (HCC) has been associated with tumor grade and patient survival. The measurement of cell proliferation in echo-guided biopsies of small focal liver lesions might provide useful information for the early recognition of malignancy and for predicting the aggressiveness of small HCCs. We assessed the diagnostic and prognostic value of cell proliferation in 91 echo-guided needle biopsies of focal liver lesions using the monoclonal antibody Ki-67, which detects a human nuclear antigen that is present in proliferating cells. Measurements were performed by image cytometry as the percentage of Ki-67 positive hepatocytes nuclei over total hepatocyte nuclei in the biopsy. At the histological examination, 27 lesions were diagnosed as chronic hepatitis, 10 as cirrhosis, 11 as macroregenerative nodule, and 43 as HCC in cirrhotic liver. Although the highest Ki-67 values (> 20%) were found in less-differentiated HCCs, most well-differentiated HCCs and nine borderline nodules were completely devoid of Ki-67-positive hepatocytes. A sustained Ki-67 labeling (up to 16%) was found in hepatitis and cirrhosis, similar to that found in several malignant tumors. In the HCC subset, Ki-67 labeling was strongly correlated to the Edmondson-Steiner histological grade. However, survival analysis did not indicate a better outcome for those patients with low-proliferating tumors.

  18. Biopsies

    MedlinePlus

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

  19. Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today?

    PubMed

    Teschke, Rolf; Frenzel, Christian

    For the pathologist, the diagnosis of drug induced liver injury (DILI) is challenging, because histopathological features mimic all primary hepatic and biliary diseases, lacking changes that are specific for DILI. Therefore, in any patient of suspected DILI who underwent liver biopsy, the pathologist will assure the clinician that the observed hepatic changes are compatible with DILI, but this information is less helpful due to lack of specificity. Rather, the pathologist should assess liver biopsies blindly, without knowledge of prior treatment by drugs. This will result in a detailed description of the histological findings, associated with suggestions for potential causes of these hepatic changes. Then, it is up to the physician to reassess carefully the differential diagnoses, if not done before. At present, liver histology is of little impact establishing the diagnosis of DILI with the required degree of certainty, and this shortcoming also applies to herb induced liver injury (HILI). To reach at the correct diagnoses of DILI and HILI, clinical and structured causality assessments are therefore better approaches than liver histology results obtained through liver biopsy, an invasive procedure with a low complication rate.

  20. Intestinal Bacterial Infection Diagnosed by Histological Examination of Endoscopic Biopsy Specimens

    PubMed Central

    Yuki, Michiko; Emoto, Yuko; Yoshizawa, Katsuhiko; Yuri, Takashi; Tsubura, Airo

    2016-01-01

    Intestinal spirochetosis (IS) in humans is characterized by spirochetal microorganisms attached to the luminal surface of the colonic epithelium. In the present case, attached organisms appeared as 3- to 4 μm-thick (average thickness, 3.4 μm) basophilic fringes or haze in HE-stained endoscopic biopsy specimens. The basophilic fringes were clearly labeled by Treponema pallidum antiserum. Because IS is relatively rare in developed countries, thin basophilic fringes characteristic of IS are readily overlooked. Thus, the recognition of histological characteristics of this disease is important for its diagnosis. PMID:27920653

  1. Marking planes of surgical excision on breast biopsy specimens: use of artists' pigments suspended in acetone.

    PubMed Central

    Paterson, D A; Davies, J D

    1988-01-01

    The performance of carbon and metallic inks, silver nitrate solution, and artists' pigments mounted in acetone was compared for marking the surface of surgical biopsy specimens. Using India ink is an unsatisfactory procedure because of slow drying, messiness, and spreading of the ink. It is concluded that use of artists' pigments has many advantages over other reagents, because of their rapid drying, resistance to tissue processing, and the ability to mark simultaneously many different planes of excision. Furthermore, the pigments are readily visible, are distinguishable from each other on microscopical examination, and the method entails little extra cost. Images Fig 1 Fig 2 PMID:3056982

  2. A comparison of transjugular and plugged-percutaneous liver biopsy in patients with contraindications to ordinary percutaneous liver biopsy and an "in-house" protocol for selecting the procedure of choice.

    PubMed

    Atar, Eli; Ben Ari, Ziv; Bachar, Gil N; Amlinski, Yelena; Neyman, Chaim; Knizhnik, Michael; Litvin, Sergey; Schmilovitz-Weiss, Hemda; Shapiro, Riki; Bruckhaimer, Elchanan; Tur-Kaspa, Ran; Belenky, Alexander

    2010-06-01

    The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.

  3. A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an 'In-House' Protocol for Selecting the Procedure of Choice

    SciTech Connect

    Atar, Eli; Ben Ari, Ziv; Bachar, Gil N.; Amlinski, Yelena; Neyman, Chaim; Knizhnik, Michael; Litvin, Sergey; Schmilovitz-Weiss, Hemda; Shapiro, Riki; Bruckhaimer, Elchanan; Tur-Kaspa, Ran; Belenky, Alexander

    2010-06-15

    The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.

  4. An autoradiographic study on the labeling index of biopsy specimens from gastric cancers

    SciTech Connect

    Sasaki, K.; Takahashi, M.; Ogino, T.; Okuda, S.

    1984-10-01

    With the aim of examining proliferative activity of gastric cancers of various histologic types, H3-thymidine labeling indices of biopsy specimens from 48 patients were examined using an in vitro labeling technique. The results indicated that the indices were greatly variable (1.4-40.8%) from case to case and from area to area, and could not be well correlated with either gross findings, histologic types, or the degree of tumor invasion. However, the distribution of the labeled cells within the tumor was somewhat characteristic to each histologic type. In adenocarcinomas, DNA-synthesizing cells were scattered at random over the entire tumor tissue. In signet-ring cell carcinomas, small tumor cells with dark-staining cytoplasm were preferentially labeled. In contrast, typical signet-ring cells had practically zero labeling index, suggesting that they are out-of-cycle cells and are functionally differentiated.

  5. Epstein-Barr virus detection in kidney biopsy specimens correlates with glomerular mesangial injury.

    PubMed

    Iwama, H; Horikoshi, S; Shirato, I; Tomino, Y

    1998-11-01

    To determine the relationship between the detection of Epstein-Barr virus (EBV)-specific DNA and glomerular injury, 33 renal needle-biopsy specimens that had been formalin-fixed and paraffin-embedded were analyzed using polymerase chain reaction (PCR) with subsequent nonradioactive Southern blot technique. Light microscopic examination and immunofluorescence were also performed. In 30 of 33 renal biopsy specimens, the beta globin gene could be successfully amplified as integrity controls. These 30 patients consisted of 12 patients with immunoglobulin A nephropathy (IgAN), 10 patients with minor glomerular abnormalities, 6 patients with membranous nephropathy, and 2 patients with focal/segmental lesions. EBV was detected in 7 of 12 patients with IgAN (58%), 3 of 6 patients with membranous nephropathy (50%), 0 of 10 patients with minor glomerular abnormalities (0%), and 2 of 2 patients with focal/segmental lesions. EBV detection was not disease specific. The EBV detection ratio of the group with glomerular mesangial lesions (64%; 9 of 14 patients) was significantly greater than those without (19%; 3 of 16 patients; P < 0.012, chi-square test). The EBV detection ratio of the group with glomerular lesions (60%; 12 of 20 patients) was significantly greater than those without (0%; 0 of 10 patients; P < 0.0016, Fisher's exact test), and the EBV detection ratio of the group with fibrinogen deposits observed in immunofluorescence (73%; 11 of 15 patients) was significantly greater than those without (7%; 1 of 15 patients; P < 0.0002, chi-square test). The EBV detection ratio of the group with immunoglobulin deposits (57%; 12 of 21 patients) was also significantly greater than those without (0%; 0 of 9 patients; P < 0.0040, Fisher's exact test). These data suggest that EBV can damage the glomerular mesangium beyond disease units and be mediated by immunoglobulin in patients with various chronic glomerulonephritides.

  6. Application of low-vacuum scanning electron microscopy for renal biopsy specimens.

    PubMed

    Miyazaki, Hiroki; Uozaki, Hiroshi; Tojo, Akihiro; Hirashima, Sayuri; Inaga, Sumire; Sakuma, Kei; Morishita, Yasuyuki; Fukayama, Masashi

    2012-09-15

    Low-vacuum scanning electron microscopy (LV-SEM) has been developed which enables the observation of soft, moist, and electrically insulating materials without any pretreatment unlike conventional scanning electron microscopy, in which samples must be solid, dry and usually electrically conductive. The purpose of this study was to assess the usefulness of LV-SEM for renal biopsy specimens. We analyzed 20 renal biopsy samples obtained for diagnostic purposes. The sections were stained with periodic acid methenamine silver to enhance the contrast, and subsequently examined by LV-SEM. LV-SEM showed a precise and fine structure of the glomerulus in both formalin fixed paraffin and glutaraldehyde-osmium tetroxide-fixed epoxy resin sections up to 10,000-fold magnification. The spike formation on the basement membrane was clearly observed in the membranous nephropathy samples. Similarly to transmission electron microscopy, electron dense deposits were observed in the epoxy resin sections of the IgA nephropathy and membranous nephropathy samples. LV-SEM could accurately show various glomerular lesions at high magnification after a simple and rapid processing of the samples. We consider that this is a novel and useful diagnostic tool for renal pathologies.

  7. The changing role of liver biopsy in diagnosis and management of haemochromatosis.

    PubMed

    Bassett, Mark L; Hickman, Peter E; Dahlstrom, Jane E

    2011-08-01

    Liver biopsy with histological examination of liver tissue was for many years the cornerstone of the diagnosis of haemochromatosis, allowing assessment of the degree of iron overload and examination of liver histology for the acute and chronic effects of iron overload. In the past two decades the role of liver biopsy in haemochromatosis has changed dramatically. Liver biopsy is rarely requested for two main reasons: (1) genetic testing for human haemochromatosis (HFE) mutations has proved to be very reliable in the diagnosis of haemochromatosis in Caucasian populations, and (2) the majority of patients with haemochromatosis are now diagnosed at an early stage well before permanent tissue damage occurs, so the need to assess tissue and organ damage has diminished. Liver biopsy continues to have a very important role in a small number of haemochromatosis patients for whom it has both diagnostic and prognostic implications. Liver biopsy is essential for the accurate assessment of patients with non-HFE haemochromatosis and in patients who have dual pathology. It is also useful where there appears to be a discrepancy between HFE genotypes and iron studies, particularly in HFE heterozygotes. Finally, liver biopsy is currently the 'gold standard' for the diagnosis of fibrosis and cirrhosis, although this is changing as non-invasive methods for assessing fibrosis become more reliable and available. Therefore, it is important that pathologists maintain their knowledge and skills in the use of liver biopsy in haemochromatosis and other iron storage disorders.

  8. Digital PCR Improves Mutation Analysis in Pancreas Fine Needle Aspiration Biopsy Specimens

    PubMed Central

    Court, Colin M.; Kim, Stephen; Braxton, David R.; Hou, Shuang; Muthusamy, V. Raman; Watson, Rabindra R.; Sedarat, Alireza; Tseng, Hsian-Rong; Tomlinson, James S.

    2017-01-01

    Applications of precision oncology strategies rely on accurate tumor genotyping from clinically available specimens. Fine needle aspirations (FNA) are frequently obtained in cancer management and often represent the only source of tumor tissues for patients with metastatic or locally advanced diseases. However, FNAs obtained from pancreas ductal adenocarcinoma (PDAC) are often limited in cellularity and/or tumor cell purity, precluding accurate tumor genotyping in many cases. Digital PCR (dPCR) is a technology with exceptional sensitivity and low DNA template requirement, characteristics that are necessary for analyzing PDAC FNA samples. In the current study, we sought to evaluate dPCR as a mutation analysis tool for pancreas FNA specimens. To this end, we analyzed alterations in the KRAS gene in pancreas FNAs using dPCR. The sensitivity of dPCR mutation analysis was first determined using serial dilution cell spiking studies. Single-cell laser-microdissection (LMD) was then utilized to identify the minimal number of tumor cells needed for mutation detection. Lastly, dPCR mutation analysis was performed on 44 pancreas FNAs (34 formalin-fixed paraffin-embedded (FFPE) and 10 fresh (non-fixed)), including samples highly limited in cellularity (100 cells) and tumor cell purity (1%). We found dPCR to detect mutations with allele frequencies as low as 0.17%. Additionally, a single tumor cell could be detected within an abundance of normal cells. Using clinical FNA samples, dPCR mutation analysis was successful in all preoperative FNA biopsies tested, and its accuracy was confirmed via comparison with resected tumor specimens. Moreover, dPCR revealed additional KRAS mutations representing minor subclones within a tumor that were not detected by the current clinical gold standard method of Sanger sequencing. In conclusion, dPCR performs sensitive and accurate mutation analysis in pancreas FNAs, detecting not only the dominant mutation subtype, but also the additional rare

  9. Is liver biopsy still needed in children with chronic viral hepatitis?

    PubMed Central

    Pokorska-Śpiewak, Maria; Kowalik-Mikołajewska, Barbara; Aniszewska, Małgorzata; Pluta, Magdalena; Marczyńska, Magdalena

    2015-01-01

    Liver biopsy is a standard method used for obtaining liver tissue for histopathological evaluation. Since reliable serological and virological tests are currently available, liver biopsy is no longer needed for the etiological diagnosis of chronic hepatitis B and C. However, liver histology remains the gold standard as a prognostic tool, providing information about the liver disease progression (grading of necroinflammatory activity and staging of fibrosis) and serving clinicians in the management and therapeutic decisions. In general, histopathological evaluation is indicated before starting the antiviral treatment. Main limitations of the liver biopsy include its invasive and painful procedure, sampling errors and the inter- and intra-observer variability. In addition, indications for the liver biopsy in pediatric patients with chronic viral hepatitis were questioned recently, and efforts have been made toward the development of non-invasive methods as an alternative to the liver biopsy. The most commonly used methods are novel imaging studies (elastography) and combinations of biomarkers. However, to date, none of these tests was validated in children with chronic viral hepatitis. In this review, we present the current status of the liver biopsy in the management of chronic viral hepatitis B and C in pediatric population, including specific indications, complications, contraindications, problems, limitations, and alternative non-invasive methods. PMID:26576098

  10. Is liver biopsy still needed in children with chronic viral hepatitis?

    PubMed

    Pokorska-Śpiewak, Maria; Kowalik-Mikołajewska, Barbara; Aniszewska, Małgorzata; Pluta, Magdalena; Marczyńska, Magdalena

    2015-11-14

    Liver biopsy is a standard method used for obtaining liver tissue for histopathological evaluation. Since reliable serological and virological tests are currently available, liver biopsy is no longer needed for the etiological diagnosis of chronic hepatitis B and C. However, liver histology remains the gold standard as a prognostic tool, providing information about the liver disease progression (grading of necroinflammatory activity and staging of fibrosis) and serving clinicians in the management and therapeutic decisions. In general, histopathological evaluation is indicated before starting the antiviral treatment. Main limitations of the liver biopsy include its invasive and painful procedure, sampling errors and the inter- and intra-observer variability. In addition, indications for the liver biopsy in pediatric patients with chronic viral hepatitis were questioned recently, and efforts have been made toward the development of non-invasive methods as an alternative to the liver biopsy. The most commonly used methods are novel imaging studies (elastography) and combinations of biomarkers. However, to date, none of these tests was validated in children with chronic viral hepatitis. In this review, we present the current status of the liver biopsy in the management of chronic viral hepatitis B and C in pediatric population, including specific indications, complications, contraindications, problems, limitations, and alternative non-invasive methods.

  11. The influence of multiple liver biopsies on hematologic and serum biochemical values of sheep.

    PubMed

    Harvey, R B; Lovering, S L; Bailey, E M; Norman, J O

    1984-10-01

    A rapid, simple liver biopsy technique for sheep was developed to obtain in situ liver samples for evaluation of histological tissue, enzyme assay, and ultrastructural changes that might occur during toxicological testing. The study was designed because repeated biopsies in the same individual could induce bias in hematologic, histological or serum biochemical parameters caused by the trauma of the biopsy procedure. In Experiment I, sheep were divided into a biopsied group (B), sham-operated group (SO), and a nonsurgical, untreated control group (C). Three liver biopsy samples per week were removed from each subject in Group B for five weeks. Biweekly blood samples were drawn for evaluation of hematologic and serum biochemical parameters. In Experiment II, Groups B and SO were dosed with CCl4 in order to validate the applicability of the biopsy procedure. Weekly biopsies were continued in Group B. Biweekly blood samples were evaluated for any hematologic or serum biochemical variations. Significant elevations of enzyme activities confirmed CCl4 hepatotoxicity in treated groups (B and SO) versus C group. Histological lesions in biopsy samples correlated closely with serum biochemical data in treated groups. It was concluded that the serial liver biopsy procedure causes negligible alterations in the hematologic, histological or serum biochemical parameters measured; is simple and rapid to perform, and provides a method for possible early detection of liver disease.

  12. Liver biopsies in the acquired immune deficiency syndrome: influence of endemic disease and drug abuse.

    PubMed

    Comer, G M; Mukherjee, S; Scholes, J V; Holness, L G; Clain, D J

    1989-12-01

    A retrospective review of 48 liver biopsies in 34 patients with acquired immune deficiency syndrome (AIDS) and 10 patients with AIDS-related complex (ARC) was performed at Harlem Hospital Center to assess the diagnostic yield of liver biopsies in this distinct patient population. Among the patients, 93.2% were black and 32 were males, with a mean age of 36.7 yr. Intravenous drug abuse was a risk factor for AIDS in 81.8% of patients. Liver biopsies were particularly useful in patients with fever of unclear origin, which was positively correlated with the presence of granulomas (p = 0.01). Granulomas due to mycobacteria were present in 16 (33.3%) of the biopsies. Liver biopsy proved to be clinically significant in 14 of 17 patients (82.3%) with mycobacterial disease, or 29.3% of the liver biopsies. Chronic active hepatitis was present in 12 (29.2%) of the biopsies, and in all but one was due to non-A non-B hepatitis viruses. All patients with chronic active hepatitis were intravenous drug abusers or the sexual partners of intravenous drug abusers. Liver biopsy can provide important diagnostic information in AIDS patients. The pathological findings in this series reflect the high risk of exposure to tuberculosis and hepatitis in the intravenous drug abusers in Harlem.

  13. Accuracy of Estrogen and Progesterone Receptor Assessment in Core Needle Biopsy Specimens of Breast Cancer

    PubMed Central

    Omranipour, Ramesh; Alipour, Sadaf; Hadji, Maryam; Fereidooni, Forouzandeh; Jahanzad, Issa; Bagheri, Khojasteh

    2013-01-01

    Background Diagnosis of breast cancer is completed through core needle biopsy (CNB) of the tumors but there is controversy on the accuracy of hormone receptor results on CNB specimens. Objectives We undertook this study to compare the results of hormone receptor assessment in CNB and surgical samples on our patients. Patients and Methods Hormone receptor status was determined in CNB and surgical samples in breast cancer patients whose CNB and operation had been performed in this institute from 2009 to 2011 and had not undergone neoadjuvant chemotherapy. Results About 350 patients, 60 cases met all the criteria for entering the study. The mean age was 49.8 years. Considering a confidence interval (CI) of 95%, the sensitivity of ER and PR assessment in CNB was 92.9% and 81%, respectively and the specificity of both was 100%. The Accuracy of CNB was 98% for ER and 93% for PR. Conclusions Our results confirm the acceptable accuracy of ER assessment on CNB. The subject needs further investigation in developing countries where omission of the test in surgical samples can be cost and time-saving. PMID:24349751

  14. Histopathological evaluation of colonic mucosal biopsy specimens in chronic inflammatory bowel disease: diagnostic implications.

    PubMed Central

    Seldenrijk, C A; Morson, B C; Meuwissen, S G; Schipper, N W; Lindeman, J; Meijer, C J

    1991-01-01

    In a prospective blind evaluation of multiple colonic mucosal biopsy specimens, 45 clinically well defined patients with chronic inflammatory bowel disease (21 Crohn's disease and 24 ulcerative colitis) and 16 control subjects (seven normal subjects and nine patients with diverticular disease) were studied to identify reproducible histopathological features which could distinguish chronic inflammatory bowel disease (CIBD) from non-CIBD and Crohn's disease from ulcerative colitis. Using kappa statistics 16 of 41 histological features were sufficiently reproducible for further stepwise discriminant analysis to differentiate between CIBD and non-CIBD, and between Crohn's disease and ulcerative colitis. Using the combination of three features (an increase of lymphocytes and plasma cells in the lamina propria, the presence of branching of crypts, and neutrophils in the crypt epithelium) we were able to distinguish CIBD from non-CIBD in 89% of the cases with high probability (p greater than 0.85). To separate Crohn's disease from ulcerative colitis three features (an excess of histiocytes in combination with a villous or irregular aspect of the mucosal surface and granulomas) had a high predictive value. Using these features 70% of Crohn's disease patients and 75% of ulcerative colitis patients were correctly classified with a high probability (p greater than 0.85). These findings indicate that the pathologist is dependent on the presence of only a few histological features for a reliable classification of Crohn's disease and ulcerative colitis. Images Figure 1 PMID:1773958

  15. Immunofluorescence in skin specimens from three different biopsy sites in patients with scleroderma.

    PubMed

    Chen, Z Y; Dobson, R L; Ainsworth, S K; Silver, R M; Rust, P F; Maricq, H R

    1985-01-01

    Immunofluorescence (IF) data from three different biopsy sites (nailfold, forearm, buttock) were studied in 18 patients with scleroderma (SD, systemic sclerosis) and the results compared with those obtained from 10 normal controls (NC) and 7 patients with systemic lupus erythematosus (SLE). Immunoglobulin (Ig) deposits were detected by direct IF technique at the dermo-epidermal junction (DEJ) in 8/14 nailfolds, 6/15 forearms and in none of the buttock specimens of SD patients. Epidermal nuclear staining was present in 6/14 nailfolds, and in 6/15 forearms and buttocks. The most prominent finding was the observation of multiple Ig deposits in the cuticle of 9/14 patients with SD. NC group was negative in all sites for epidermal nuclear staining and the only DEJ deposit occurred in the forearm of one subject. In conclusion, this study demonstrates that Ig deposits in SD, both at the DEJ and in the epidermal nuclei, occur more often than previously reported and are especially frequent in the nailfold & cuticle area.

  16. Complication Rate of Percutaneous Liver Biopsies among Persons with Advanced Chronic Liver Disease in the HALT-C Trial

    PubMed Central

    Seeff, Leonard B.; Everson, Gregory T.; Morgan, Timothy R.; Curto, Teresa M.; Lee, William M.; Ghany, Marc G.; Shiffman, Mitchell L.; Fontana, Robert J.; Di Bisceglie, Adrian M.; Bonkovsky, Herbert L.; Dienstag, Jules L.

    2013-01-01

    Background & Aims Although percutaneous liver biopsy is a standard diagnostic procedure, it has drawbacks, including risk of serious complications. It is not known whether persons with advanced chronic liver disease have a greater risk of complications from liver biopsy than patients with more mild, chronic liver disease. The safety and complications of liver biopsy were examined in patients with hepatitis C-related bridging fibrosis or cirrhosis that were enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial. Methods Standard case report forms from 2,740 liver biopsies performed at 10 study sites between 2000 and 2006 were reviewed for serious adverse events, along with information from questionnaires completed by investigators about details of biopsy techniques used at each hospital. Results There were 29 serious adverse events (1.1%); the most common was bleeding (16 cases, 0.6%). There were no biopsy-related deaths. The bleeding rate was higher among patients with platelet counts ≤60,000/mm3 and among those with an international normalized ratio (INR) ≥1.3, although none of the patients with an INR >1.5 bled. Excluding subjects with a platelet count ≤60,000/mm3 would have reduced the bleeding rate by 25% (4/16), eliminating only 2.8% (77/2740) of biopsies. Operator experience, the type of needle used, or the performance of the biopsy under ultrasound guidance did not influence the frequencies of adverse events. Conclusions Approximately 0.5% of persons with hepatitis C and advanced fibrosis experienced potentially serious bleeding after liver biopsy; risk increased significantly in patients with platelet counts ≤60,000/mm3.(K2). PMID:20362695

  17. Significance of liver biopsy for the evaluation of methotrexate-induced liver damage in patients with rheumatoid arthritis

    PubMed Central

    Osuga, Tatsuya; Ikura, Yoshihiro; Kadota, Chikara; Hirano, Seiichi; Iwai, Yasuhiro; Hayakumo, Takanobu

    2015-01-01

    It is well recognized that long-term administration of methotrexate (MTX) in patients with rheumatoid arthritis (RA) can induce liver fibrosis via a steatohepatitis-like inflammatory process. Several non-invasive tests have been investigated as alternatives to liver biopsy, which is, however, still recognized as a final diagnostic modality to detect the MTX-induced liver damage. To clarify whether there is a significant discrepancy between clinical estimations and pathologic findings of this hepatic condition, we performed a following comparative study. Four RA patients (4 women, age 67-80 yr) with MTX-induced liver damage were reviewed. The severity of hepatic damage estimated clinically was compared with histopathologic findings. Consequently, the liver biopsies showed the relatively earlier stages of and milder degrees of hepatic damages than the clinical estimations. The histopathologic findings were more reliable and useful than any other clinical examinations, to plan and modify the treatment strategies, especially in cases of liver damages with multiple etiologies besides MTX. These findings suggest that liver biopsy is an unavoidable examination to assess precisely MTX-induced liver damage. Non-invasive tests may be useful to monitor the hepatic condition of RA patients receiving MTX but do not constitute an acceptable alternative to liver biopsy. PMID:25973089

  18. Quantitative comparison of transient elastography (TE), shear wave elastography (SWE) and liver biopsy results of patients with chronic liver disease.

    PubMed

    Kim, Hyun-Jin; Lee, Hae-Kag; Cho, Jae-Hwan; Yang, Han-Jun

    2015-08-01

    [Purpose] The purpose of this study was to carry out a comparitive analysis of hepatic fibrosis results of the liver hardness of patients with chronic liver disease as measured by elastography (TE), shear wave elastography (SWE), and liver biopsy. [Subjects and Methods] This study was a retrospective analysis of 304 patients who underwent SWE and TE before and after liver biopsy, taken from among patients who had been checked for liver fibrosis by liver biopsy between August 2013 and August 2014. We used receiver operating characteristic (ROC) curve to prove the diagnostic significance of liver stiffness, and then analyzed the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE and TE, as well as the kappa index through cross-analysis of SWE, TE, and liver biopsy. [Results] For liver hardness, the sensitivity of SWE was 84.39%, the specificity of SWE was 97.92%, the accuracy of SWE was 87.33%, the positive predictive value of SWE was 99.32%, and the negative predictive value of SWE was 63.51%. The sensitivity of TE was 94.80%, the specificity of TE was 77.08%, the accuracy of TE was 90.95%, the positive predictive value of TE was 93.97%, and the negative predictive value of TE was 80.43%. [Conclusion] It is our opinion that SWE and TE are non-invasive methods that are more effective than the invasive methods used for diagnosing liver hardness. Invasive methods cover only a section of liver tissue, and are more likely to cause side effects during biopsy.

  19. Biopsy Specimens Obtained 7 Days After Starting Chemoradiotherapy (CRT) Provide Reliable Predictors of Response to CRT for Rectal Cancer

    SciTech Connect

    Suzuki, Toshiyuki; Sadahiro, Sotaro; Tanaka, Akira; Okada, Kazutake; Kamata, Hiroko; Kamijo, Akemi; Murayama, Chieko; Akiba, Takeshi; Kawada, Shuichi

    2013-04-01

    Purpose: Preoperative chemoradiation therapy (CRT) significantly decreases local recurrence in locally advanced rectal cancer. Various biomarkers in biopsy specimens obtained before CRT have been proposed as predictors of response. However, reliable biomarkers remain to be established. Methods and Materials: The study group comprised 101 consecutive patients with locally advanced rectal cancer who received preoperative CRT with oral uracil/tegafur (UFT) or S-1. We evaluated histologic findings on hematoxylin and eosin (H and E) staining and immunohistochemical expressions of Ki67, p53, p21, and apoptosis in biopsy specimens obtained before CRT and 7 days after starting CRT. These findings were contrasted with the histologic response and the degree of tumor shrinkage. Results: In biopsy specimens obtained before CRT, histologic marked regression according to the Japanese Classification of Colorectal Carcinoma (JCCC) criteria and the degree of tumor shrinkage on barium enema examination (BE) were significantly greater in patients with p21-positive tumors than in those with p21-negative tumors (P=.04 and P<.01, respectively). In biopsy specimens obtained 7 days after starting CRT, pathologic complete response, histologic marked regression according to both the tumor regression criteria and JCCC criteria, and T downstaging were significantly greater in patients with apoptosis-positive and p21-positive tumors than in those with apoptosis-negative (P<.01, P=.02, P=.01, and P<.01, respectively) or p21-negative tumors (P=.03, P<.01, P<.01, and P=.02, respectively). The degree of tumor shrinkage on both BE as well as MRI was significantly greater in patients with apoptosis-positive and with p21-positive tumors than in those with apoptosis-negative or p21-negative tumors, respectively. Histologic changes in H and E-stained biopsy specimens 7 days after starting CRT significantly correlated with pathologic complete response and marked regression on both JCCC and tumor

  20. Biopsy

    MedlinePlus

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

  1. CT-Guided Transthoracic Core Biopsy for Pulmonary Tuberculosis: Diagnostic Value of the Histopathological Findings in the Specimen

    SciTech Connect

    Fukuda, Hozumi Ibukuro, Kenji; Tsukiyama, Toshitaka; Ishii, Rei

    2004-09-15

    We evaluated the value of CT-guided transthoracic core biopsy for the diagnosis of mycobacterial pulmonary nodules. The 30 subjects in this study had pulmonary nodules that had been either diagnosed histopathologically as tuberculosis or were suspected as tuberculosis based on a specimen obtained by CT-guided transthoracic core biopsy. The histopathological findings, the existence of acid-fast bacilli in the biopsy specimens, and the clinical course of the patients after the biopsy were reviewed retrospectively. Two of the three histological findings for tuberculosis that included epithelioid cells, multinucleated giant cells and caseous necrosis were observed in 21 of the nodules which were therefore diagnosed as histological tuberculosis. Six of these 21 nodules were positive for acid-fast bacilli, confirming the diagnosis of tuberculosis. Thirteen of the 21 nodules did not contain acid-fast bacilli but decreased in size in response to antituberculous treatment and were therefore diagnosed as clinical tuberculosis. Seven nodules with only caseous necrosis were diagnosed as suspected tuberculosis, with a final diagnosis of tuberculosis being made in 4 of the nodules and a diagnosis of old tuberculosis in 2 nodules. Two nodules with only multinucleated giant cells were diagnosed as suspected tuberculosis with 1 of these nodules being diagnosed finally as tuberculosis and the other nodule as a nonspecific granuloma. When any two of the three following histopathological findings - epithelioid cells, multinucleated giant cells or caseous necrosis - are observed in a specimen obtained by CT-guided transthoracic core biopsy, the diagnosis of tuberculosis can be established without the detection of acid-fast bacilli or Mycobacterium tuberculosis.

  2. Hemobilia and other complications caused by percutaneous ultrasound-guided liver biopsy.

    PubMed

    Zhou, Hai-Bo

    2014-04-07

    Hemobilia accounts for approximately 3% of all major percutaneous liver biopsy complications, and rarely results from arterioportal fistula. We report a patient who suffered from four complications over 11 d after ultrasound-guided percutaneous liver biopsy: hemobilia, acute pancreatitis, acute cholecystitis, and multiple stomach ulcers. Digital subtraction angiography was done after consultation with doctors, and showed obvious arteriovenous fistula of the right liver. The hepatic artery was selected and embolized by spring orbs. The active bleeding was stopped after embolization of the hepatic artery. The patient was discharged home on day 12 after embolization and remained well.

  3. Hemobilia and other complications caused by percutaneous ultrasound-guided liver biopsy

    PubMed Central

    Zhou, Hai-Bo

    2014-01-01

    Hemobilia accounts for approximately 3% of all major percutaneous liver biopsy complications, and rarely results from arterioportal fistula. We report a patient who suffered from four complications over 11 d after ultrasound-guided percutaneous liver biopsy: hemobilia, acute pancreatitis, acute cholecystitis, and multiple stomach ulcers. Digital subtraction angiography was done after consultation with doctors, and showed obvious arteriovenous fistula of the right liver. The hepatic artery was selected and embolized by spring orbs. The active bleeding was stopped after embolization of the hepatic artery. The patient was discharged home on day 12 after embolization and remained well. PMID:24707158

  4. CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy

    SciTech Connect

    Stattaus, Joerg Kuehl, Hilmar; Ladd, Susanne; Schroeder, Tobias; Antoch, Gerald; Baba, Hideo A.; Barkhausen, Joerg; Forsting, Michael

    2007-09-15

    Purpose. Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Material and Methods. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Results. Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0-1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase. Conclusion. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results.

  5. Ultrastructural characteristics of novel epithelial cell types identified in human pathologic liver specimens with chronic ductular reaction.

    PubMed

    De Vos, R; Desmet, V

    1992-06-01

    Previous immunohistochemical studies on human liver biopsies with chronic ductular reaction revealed the presence of "small cells" with bile-duct type cytokeratin profile in the periportal area. This study identified similar cells by electron microscopy. The authors studied 13 human liver specimens with various liver diseases, but all characterized by chronic ductular reaction. In all specimens, variable numbers of "small cells" with common epithelial characteristics were identified in the periportal area. They could be classified into three types. Type I cells showed an oval cell shape and oval nucleus, early or established formation of junctional complexes with adjacent cells, a full assortment of cytoplasmic organelles, and bundles of tonofilaments. Type II cells showed features of bile-duct cell differentiation, including lateral interdigitations, apical microvilli, basal pinocytotic vacuoles, and basement membrane formation. In contrast, type III cells displayed additional features indicating hepatocellular differentiation, such as a more prominent nucleus, formation of a hemicanaliculus, and glycogen rosettes. It is concluded that these small cells of epithelial nature display variable differentiation characteristics of either bile-duct type cells or hepatocytes. These findings support the existence of bipotential progenitor epithelial cells in human liver. They may have implications for liver regeneration and carcinogenesis.

  6. Immunoglobulin G4-related sclerosing cholangitis diagnosed by liver biopsy: a case report.

    PubMed

    Furuta, Mitsuhiro; Eguchi, Hiroki; Takeda, Yoshiya; Fushiki, Kunihiro; Yasuda, Takeshi; Onozawa, Yuriko; Katayama, Masanobu; Tanaka, Motoo; Shigematsu, Tadashi; Bamba, Masamichi

    2017-01-01

    Patients with immunoglobulin (Ig) G4-related sclerosing cholangitis typically have a high serum IgG4 level. However, here we describe our experience of a patient with a normal serum IgG4 level for whom the cholangitis was diagnosed by liver biopsy. A 61-year-old male presented with elevated liver enzymes and a normal serum IgG4 level. The hilar, intrahepatic, and upper extrahepatic bile ducts were stenotic, with no evidence of a pancreatic lesion. We therefore performed a liver biopsy to differentiate between cholangiocarcinoma and primary sclerosing cholangitis. Pathological examination revealed lymphoplasmacytic infiltrates around the bile ducts with a storiform fibrosis. IgG4-positive plasma cells were also observed. These results fulfilled the Japanese diagnostic criteria for IgG4-related sclerosing cholangitis. When this condition is suspected, liver biopsy should be performed even when serum IgG4 levels are normal.

  7. Transjugular Core Liver Biopsy with a 19-Gauge Spring-Loaded Cutting Needle

    SciTech Connect

    Choh, Jeffery; Dolmatch, Bart; Safadi, Rami; Long, Phil; Geisinger, Michael; Lammert, Gary; Dempsey, James

    1998-01-15

    One hundred and five sequential transjugular core liver biopsies (TJLBx) were performed in 101 patients with coagulopathy and/or ascites using the 19-gauge Quick-Core Biopsy (QCB) needle. Two-hundred and seventy-three cores were obtained in 295 passes (92.5%). One-hundred and two of the 105 procedures (97.1%) led to a histopathologic diagnosis. One of the three nondiagnostic biopsies was done because of severe autolysis of the liver. There was one subcapsular hematoma, one hepatic arteriovenous fistula, and one liver capsular puncture. Two minor neck hematomas occurred. One death was reported (unrelated to the procedure). QCB needle TJLBx is an effective and relatively safe way to obtain core liver samples.

  8. 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.

  9. Analysis of ischemia/reperfusion injury in time-zero biopsies predicts liver allograft outcomes.

    PubMed

    Ali, Jason M; Davies, Susan E; Brais, Rebecca J; Randle, Lucy V; Klinck, John R; Allison, Michael E D; Chen, Yining; Pasea, Laura; Harper, Simon F J; Pettigrew, Gavin J

    2015-04-01

    Ischemia/reperfusion injury (IRI) that develops after liver implantation may prejudice long-term graft survival, but it remains poorly understood. Here we correlate the severity of IRIs that were determined by histological grading of time-zero biopsies sampled after graft revascularization with patient and graft outcomes. Time-zero biopsies of 476 liver transplants performed at our center between 2000 and 2010 were graded as follows: nil (10.5%), mild (58.8%), moderate (26.1%), and severe (4.6%). Severe IRI was associated with donor age, donation after circulatory death, prolonged cold ischemia time, and liver steatosis, but it was also associated with increased rates of primary nonfunction (9.1%) and retransplantation within 90 days (22.7%). Longer term outcomes in the severe IRI group were also poor, with 1-year graft and patient survival rates of only 55% and 68%, respectively (cf. 90% and 93% for the remainder). Severe IRI on the time-zero biopsy was, in a multivariate analysis, an independent determinant of 1-year graft survival and was a better predictor of 1-year graft loss than liver steatosis, early graft dysfunction syndrome, and high first-week alanine aminotransferase with a positive predictive value of 45%. Time-zero biopsies predict adverse clinical outcomes after liver transplantation, and severe IRI upon biopsy signals the likely need for early retransplantation.

  10. PRELIMINARY EVALUATION OF SPIROTOME® DEVICE FOR LIVER BIOPSY IN GREEN IGUANAS (IGUANA IGUANA): A PILOT STUDY.

    PubMed

    Nardini, Giordano; Origgi, Francesco C; Leopardi, Stefania; Zaghini, Anna; Saunders, Jimmy H; Vignoli, Massimo

    2016-06-01

    The aim of this study was to evaluate a large-core manual biopsy device (Spirotome(®), Medinvents, 3500 Hasselt, Belgium) for liver sampling and histologic diagnosis in green iguanas (Iguana iguana). The study included eight green iguanas, and two ultrasound-guided biopsies were collected for each lizard, for 16 biopsies in total. The procedure was carried out under general anesthesia induced by intravenous injection of propofol (10 mg/kg) maintained with a mixture of 2.0% isoflurane and 0.8-1.2 L/min oxygen after tracheal intubation. Fourteen (87.5%) of the 16 biopsies were considered diagnostic. Liver biopsy quality was assessed according to sample size and tissue preservation. In particular, mean length (16.2 ± 4.5 mm), width (2.2 ± 0.5 mm), area (34.8 ± 6.9 mm(2)), and number of portal areas (9.4 ± 3.9) of each biopsy were recorded for all green iguanas. The total available surface of the sections obtained from the biopsies and their grade of preservation enabled a satisfactory evaluation of the parenchymal architecture. One of the green iguanas in the study died the day after the procedure due to severe hemocoeloma. Risk assessment evaluation suggested that small green iguanas may not be suitable for this biopsy procedure.

  11. Usefulness of S100P in diagnosis of adenocarcinoma of pancreas on fine-needle aspiration biopsy specimens.

    PubMed

    Deng, Hongbing; Shi, Jianhui; Wilkerson, Myra; Meschter, Steven; Dupree, William; Lin, Fan

    2008-01-01

    Even though the cytologic criteria for pancreatic ductal adenocarcinoma (PDA) on fine-needle aspiration biopsy (FNAB) specimens have been well defined, a diagnostic challenge is still present. We immunohistochemically evaluated the diagnostic value of S100P on cell-block and/or smear preparations in 58 cases of FNAB specimens of the pancreas. The 58 cases were divided into 4 groups: 1, 32 cases of PDA; 2, 6 cases with an atypical or "suspicious" diagnosis; 3, 14 cases of benign or reactive ductal epithelium; and 4, 6 cases of endocrine tumor. Positive immunoreactivity for S100P was observed in all cases in groups 1 and 2, whereas only 1 of 14 cases in group 3 was positive for S100P. All cases in group 4 were negative for S100P. S100P is a sensitive and specific marker for the detection of PDA on FNAB specimens on cell-block and smear preparations.

  12. CLINICAL EVALUATION OF AN EPIGENETIC ASSAY TO PREDICT MISSED CANCER IN PROSTATE BIOPSY SPECIMENS.

    PubMed

    Partin, Alan W; VAN Criekinge, Wim; Trock, Bruce J; Epstein, Jonathan I; VAN Neste, Leander

    2016-01-01

    Approximately 1 million prostate biopsies are performed yearly in the United States, with only ~25% resulting in prostate cancer diagnosis. However, ~40% of men receive multiple biopsies for fear of cancer being missed. DNA hypermethylation is ideally suited for early disease detection and could be used to prevent unnecessary biopsies. Men with low-risk epigenetic signatures may forego subsequent biopsy and potential complications. A meta-analysis of two validation studies was conducted to gain additional insight into the benefits for patient risk stratification. In the Methylation Analysis to Locate Occult Cancer (MATLOC) study a negative predictive value of 90% was obtained, which represents a significant improvement over standard of care. This was confirmed in the Detection of Cancer Using Methylated Events in Negative Tissue (DOCUMENT) study (88% negative predictive value), which was designed to validate the performance in an independent cohort. The epigenetic assay, in combination with other known risk factors, may help reduce unnecessary repeat prostate biopsies and identify men at highest risk of harboring occult high-grade prostate cancer.

  13. CLINICAL EVALUATION OF AN EPIGENETIC ASSAY TO PREDICT MISSED CANCER IN PROSTATE BIOPSY SPECIMENS

    PubMed Central

    PARTIN, ALAN W.; VAN CRIEKINGE, WIM; TROCK, BRUCE J.; EPSTEIN, JONATHAN I.; VAN NESTE, LEANDER

    2016-01-01

    Approximately 1 million prostate biopsies are performed yearly in the United States, with only ~25% resulting in prostate cancer diagnosis. However, ~40% of men receive multiple biopsies for fear of cancer being missed. DNA hypermethylation is ideally suited for early disease detection and could be used to prevent unnecessary biopsies. Men with low-risk epigenetic signatures may forego subsequent biopsy and potential complications. A meta-analysis of two validation studies was conducted to gain additional insight into the benefits for patient risk stratification. In the Methylation Analysis to Locate Occult Cancer (MATLOC) study a negative predictive value of 90% was obtained, which represents a significant improvement over standard of care. This was confirmed in the Detection of Cancer Using Methylated Events in Negative Tissue (DOCUMENT) study (88% negative predictive value), which was designed to validate the performance in an independent cohort. The epigenetic assay, in combination with other known risk factors, may help reduce unnecessary repeat prostate biopsies and identify men at highest risk of harboring occult high-grade prostate cancer. PMID:28066067

  14. Prevalence of biopsy-proven non-alcoholic fatty liver disease in severely obese subjects without metabolic syndrome.

    PubMed

    Qureshi, K; Abrams, G A

    2016-04-01

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

  15. Unexplained gastrointestinal bleed due to arteriobiliary fistula after percutaneous liver biopsy.

    PubMed

    Smirniotopoulos, John; Barone, Paul; Schiffman, Marc

    We represent a case of a 54-year-old male who presented to the emergency department with right upper quadrant abdominal pain and melena three weeks after percutaneous liver biopsy. He was found to have anemia secondary to an upper gastrointestinal hemorrhage, unresponsive to multiple blood transfusions. Angiography later revealed an arteriobiliary fistula with contrast extravasation entering the duodenum. The fistula was successfully embolized and the patient was discharged without complication. This report demonstrates the importance in considering a vascular intrahepatic fistula in patients with right upper quadrant abdominal pain after remote liver biopsy.

  16. A comparison of the accuracy of peritoneoscopy and liver biopsy in the diagnosis of cirrhosis

    PubMed Central

    Bruguera, M.; Bordas, J. M.; Mas, P.; Rodes, J.

    1974-01-01

    The accuracy of peritoneoscopy and liver biopsy in the diagnosis of hepatic cirrhosis was compared in 473 consecutive patients submitted to both procedures. One hundred and fifty-two of them had cirrhosis diagnosed by one or both methods. There was 73% agreement between the two procedures. `Apparent' false-negative results were 17·7% for peritoneoscopy and 9·3% for liver biopsy. The incidence of false-negative results in the diagnosis of cirrhosis can be reduced by combining both procedures. PMID:4279817

  17. Ductal carcinoma in situ in core needle biopsies and its association with extensive in situ component in the surgical specimen

    PubMed Central

    2012-01-01

    Background We evaluated the presence of ductal carcinoma in situ (DCIS) in core needle biopsies (CNB) from invasive ductal lesions. Methods Retrospective study, which analyzed 90 cases of invasive ductal carcinoma lesions. The percentage of DCIS was quantified in each specimens obtained from CNB, which were compared to the surgical specimens. CNB and surgical specimens were evaluated by the same pathologist, and the percentage of DCIS in CNB was evaluated (percentage) and divided into categories. We considered the following parameters regarding the amount of DCIS: 1 = 0; 2 = 1 for 5%; 3 = 6 for 24%; 4 = 25 for 50%; 5 = 51 for 75% and 6 = 76 for 99%. The number of fragments and the histological pattern of DCIS was found. Results We found the following results regarding the distribution of the percentage of DCIS in the CNB: 1 = 63.3%; 2 = 12.2%; 3 = 12.2%; 4 = 5.6%; 5 = 1.1% and 6 = 5.6%. The logistic regression analysis showed that CNB percentages above 45% reflected the presence of DCIS in the surgical specimen in 100% of the cases (p < 0.001), with a specificity of 100%, accuracy of 83.3% and false positive rate of 0% (p <0.001). Conclusion There is direct relationship between extensive intraductal component in the surgical specimen when the core biopsy shows 45% or more of the DCI or microinvasive in the material examined. PMID:22715888

  18. Liver biopsy in children: position paper of the ESPGHAN Hepatology Committee.

    PubMed

    Dezsőfi, Antal; Baumann, Ulrich; Dhawan, Anil; Durmaz, Ozlem; Fischler, Björn; Hadzic, Nedim; Hierro, Loreto; Lacaille, Florence; McLin, Valérie A; Nobili, Valerio; Socha, Piotr; Vajro, Pietro; Knisely, Alexander S

    2015-03-01

    Liver biopsy (LB) is still the criterion standard procedure for obtaining liver tissue for histopathological examination and a valuable tool in the diagnosis, prognosis, and management of many parenchymal liver diseases. The aim of this position paper is to summarise the present practice of paediatric LB and make recommendations about its performance. Although histological evaluation of the liver is important in assessing prognosis and exploring treatment, noninvasive techniques (ie, imaging, laboratory markers) may replace use of liver histology. The indications for LB are changing as present knowledge of aetiologies, pathomechanism, and therapeutic options in paediatric liver disease is evolving. Adult and paediatric literature was reviewed to assess the existing clinical practice of LB with focus on the technique, indications, risk of complications, and contraindications in paediatrics. This position paper presents types of LB, indications, complications, contraindications, and an essential checklist for paediatric LB.

  19. Survival of captive and free-ranging Harlequin Ducks (Histrionicus histrionicus) following surgical liver biopsy

    USGS Publications Warehouse

    Mulcahy, D.M.; Esler, Daniel

    2010-01-01

    We measured intra- and postoperative mortality rates of captive and free-ranging Harlequin Ducks (Histrionicus histrionicus) undergoing surgical liver biopsy sampling for determination of the induction of cytochrome P4501A, a biomarker of oil exposure. Liver biopsies were taken from and radio transmitters were implanted into 157 free-ranging Harlequin Ducks over three winters (55 in 2000, 55 in 2001, and 47 in 2002). No birds died during surgery, but seven (4.5%) died during recovery from anesthesia (three in 2001 and four in 2002). None of the deaths could be attributed directly to the liver biopsy. Four of the 150 (2.7%) birds that were released died in the 2 wk period after surgery. All post-release deaths occurred in 2001; no birds died after release in 2000 or 2002. No mortalities of 36 captive birds occurred during surgery or recovery or in the 2 wk period following surgery. Hemorrhage was a minor problem with one captive bird. Surgical liver biopsies appear to be a safe procedure, but anesthetic complications may occur with overwintering ducks. ?? Wildlife Disease Association 2010.

  20. Survival of captive and free-ranging Harlequin Ducks (Histrionicus histrionicus) following surgical liver biopsy

    USGS Publications Warehouse

    Mulcahy, Daniel M.; Esler, Daniel N.

    2010-01-01

    We measured intra- and postoperative mortality rates of captive and free-ranging Harlequin Ducks (Histrionicus histrionicus) undergoing surgical liver biopsy sampling for determination of the induction of cytochrome P4501A, a biomarker of oil exposure. Liver biopsies were taken from and radio transmitters were implanted into 157 free-ranging Harlequin Ducks over three winters (55 in 2000, 55 in 2001, and 47 in 2002). No birds died during surgery, but seven (4.5%) died during recovery from anesthesia (three in 2001 and four in 2002). None of the deaths could be attributed directly to the liver biopsy. Four of the 150 (2.7%) birds that were released died in the 2 wk period after surgery. All post-release deaths occurred in 2001; no birds died after release in 2000 or 2002. No mortalities of 36 captive birds occurred during surgery or recovery or in the 2 wk period following surgery. Hemorrhage was a minor problem with one captive bird. Surgical liver biopsies appear to be a safe procedure, but anesthetic complications may occur with overwintering ducks.

  1. Recommended guidelines for submission, trimming, margin evaluation, and reporting of tumor biopsy specimens in veterinary surgical pathology.

    PubMed

    Kamstock, D A; Ehrhart, E J; Getzy, D M; Bacon, N J; Rassnick, K M; Moroff, S D; Liu, S M; Straw, R C; McKnight, C A; Amorim, R L; Bienzle, D; Cassali, G D; Cullen, J M; Dennis, M M; Esplin, D G; Foster, R A; Goldschmidt, M H; Gruber, A D; Hellmén, E; Howerth, E W; Labelle, P; Lenz, S D; Lipscomb, T P; Locke, E; McGill, L D; Miller, M A; Mouser, P J; O'Toole, D; Pool, R R; Powers, B E; Ramos-Vara, J A; Roccabianca, P; Ross, A D; Sailasuta, A; Sarli, G; Scase, T J; Schulman, F Y; Shoieb, A M; Singh, K; Sledge, D; Smedley, R C; Smith, K C; Spangler, W L; Steficek, B; Stromberg, P C; Valli, V E; Yager, J; Kiupel, M

    2011-01-01

    Neoplastic diseases are typically diagnosed by biopsy and histopathological evaluation. The pathology report is key in determining prognosis, therapeutic decisions, and overall case management and therefore requires diagnostic accuracy, completeness, and clarity. Successful management relies on collaboration between clinical veterinarians, oncologists, and pathologists. To date there has been no standardized approach or guideline for the submission, trimming, margin evaluation, or reporting of neoplastic biopsy specimens in veterinary medicine. To address this issue, a committee consisting of veterinary pathologists and oncologists was established under the auspices of the American College of Veterinary Pathologists Oncology Committee. These consensus guidelines were subsequently reviewed and endorsed by a large international group of veterinary pathologists. These recommended guidelines are not mandated but rather exist to help clinicians and veterinary pathologists optimally handle neoplastic biopsy samples. Many of these guidelines represent the collective experience of the committee members and consensus group when assessing neoplastic lesions from veterinary patients but have not met the rigors of definitive scientific study and investigation. These questions of technique, analysis, and evaluation should be put through formal scrutiny in rigorous clinical studies in the near future so that more definitive guidelines can be derived.

  2. Direct Identification of an HPV-16 Tumor Antigen from Cervical Cancer Biopsy Specimens

    PubMed Central

    Keskin, Derin B.; Reinhold, Bruce; Lee, Sun Young; Zhang, Guanglan; Lank, Simon; O’Connor, David H.; Berkowitz, Ross S.; Brusic, Vladimir; Kim, Seung Jo; Reinherz, Ellis L.

    2011-01-01

    Persistent infection with high-risk human papilloma viruses (HPV) is the worldwide cause of many cancers, including cervical, anal, vulval, vaginal, penile, and oropharyngeal. Since T cells naturally eliminate the majority of chronic HPV infections by recognizing epitopes displayed on virally altered epithelium, we exploited Poisson detection mass spectrometry (MS3) to identify those epitopes and inform future T cell-based vaccine design. Nine cervical cancer biopsies from HPV-16 positive HLA-A*02 patients were obtained, histopathology determined, and E7 oncogene PCR-amplified from tumor DNA and sequenced. Conservation of E7 oncogene coding segments was found in all tumors. MS3 analysis of HLA-A*02 immunoprecipitates detected E711–19 peptide (YMLDLQPET) in seven of the nine tumor biopsies. The remaining two samples were E711–19 negative and lacked the HLA-A*02 binding GILT thioreductase peptide despite possessing binding-competent HLA-A*02 alleles. Thus, the conserved E711–19 peptide is a dominant HLA-A*02 binding tumor antigen in HPV-16 transformed cervical squamous and adenocarcinomas. Findings that a minority of HLA-A*02:01 tumors lack expression of both E711–19 and a peptide from a thioreductase important in processing of cysteine-rich proteins like E7 underscore the value of physical detection, define a potential additional tumor escape mechanism and have implications for therapeutic cancer vaccine development. PMID:22566864

  3. Endometrial Intraepithelial Neoplasia (EIN) in endometrial biopsy specimens categorized by the 1994 World Health Organization classification for endometrial hyperplasia.

    PubMed

    Li, Xiao-Chao; Song, Wen-Jing

    2013-01-01

    Our study is to determine the presence of endometrial intraepithelial neoplasia (EIN) in endometrial biopsy specimens classified by the 1994 World Health Organization (WHO) criteria for endometrial hyperplasia. Endometrial biopsy specimens that were stained with hematoxylin and eosin (HE) were examined and categorized by the WHO 1994 criteria and for the presence of EIN as defined by the International Endometrial Collaborative Group. β-catenin expression was examined by immunohistochemistry. A total of 474 cases of HE stained endometrial biopsy tissues were reviewed. There were 379 cases of simple endometrial hyperplasia, 16 with simple atypical endometrial hyperplasia, 48 with complex endometrial hyperplasia, and 31 with complex atypical endometrial hyperplasia. Among the 474 endometrial hyperplasia cases, there were 46 (9.7%) that were classified as EIN. Of these 46 cases, 11(2.9%) were classified as simple endometrial hyperplasia, 1 (6.3%) as simple atypical endometrial hyperplasia, 6 (12.5%) as complex endometrial hyperplasia, and 28 (90.3%) as complex atypical endometrial hyperplasia. EIN was associated with a higher rate of β-catenin positivity than endometrium classified as benign hyperplasia (72% vs. 22.5%, respectively, P < 0.001), but a lower rate than endometrial adenocarcinoma (72% vs. 96.2%, respectively, P < 0.001). In benign endometrial hyperplasia, high β-catenin expression was noted in the cell membranes, whereas in EIN and endometrial adenocarcinoma high expression was noted in the cytoplasm. In conclusion, EIN is more accurate than the WHO classification for the diagnosis of precancerous lesions of the endometrium.

  4. Management of Suspicious Mucosa-Associated Lymphoid Tissue Lymphoma in Gastric Biopsy Specimens Obtained during Screening Endoscopy

    PubMed Central

    2016-01-01

    It is often difficult to differentiate gastric mucosa-associated lymphoid tissue (MALT) lymphoma from Helicobacter pylori-associated follicular gastritis, and thus, it becomes unclear how to manage these diseases. This study aimed to explore the management strategy for and the long-term outcomes of suspicious gastric MALT lymphoma detected by forceps biopsy during screening upper endoscopy. Between October 2003 and May 2013, consecutive subjects who were diagnosed with suspicious gastric MALT lymphomas by screening endoscopy in a health checkup program in Korea were retrospectively enrolled. Suspicious MALT lymphoma was defined as a Wotherspoon score of 3 or 4 upon pathological evaluation of the biopsy specimen. Of 105,164 subjects who underwent screening endoscopies, 49 patients with suspicious MALT lymphomas who underwent subsequent endoscopy were enrolled. Eight patients received a subsequent endoscopy without H. pylori eradication (subsequent endoscopy only group), and 41 patients received H. pylori eradication first followed by endoscopy (eradication first group). MALT lymphoma development was significantly lower in the eradication first group (2/41, 4.9%) than in the subsequent endoscopy only group (3/8, 37.5%, P = 0.026). Notably, among 35 patients with successful H. pylori eradication, there was only one MALT lymphoma patient (2.9%) in whom complete remission was achieved, and there was no recurrence during a median 45 months of endoscopic follow-up. H. pylori eradication with subsequent endoscopy would be a practical management option for suspicious MALT lymphoma detected in a forceps biopsy specimen obtained during screening upper endoscopy. PMID:27366005

  5. Liver steatosis in pre-transplant liver biopsies can be quantified rapidly and accurately by nuclear magnetic resonance analysis.

    PubMed

    Bertram, Stefanie; Myland, Cathrin; Swoboda, Sandra; Gallinat, Anja; Minor, Thomas; Lehmann, Nils; Thie, Michael; Kälsch, Julia; Pott, Leona; Canbay, Ali; Bajanowski, Thomas; Reis, Henning; Paul, Andreas; Baba, Hideo A

    2017-02-01

    Donor livers marginally acceptable or acceptable according to extended criteria are more frequently transplanted due to the growing discrepancy between demand and availability of donor organs. One type of marginally acceptable graft is a steatotic donor liver, because it is more sensitive to ischemia-reperfusion injury. Thus, quantitative assessment of steatosis is crucial prior to liver transplantation. Extent of steatosis of 49 pre-reperfusion liver biopsies from patients who received orthotopic liver transplantation was assessed by three techniques: semi-quantitative histological evaluation, computerized histomorphometry, and NMR-based estimation of fat content. The findings were correlated to clinical data and to histological examination of corresponding post-reperfusion biopsies for quantification of ischemia-reperfusion injury. We found that values obtained through all three assessment methods were positively correlated. None of the values obtained by the three applied methods correlated with clinical outcome or extent of ischemia-reperfusion injury. Quantitative evaluation of steatosis by NMR yields results comparable to histological and morphometrical assessment. This technique is rapid (<5 min), accurately quantifies fat in donor livers, and provides results that can be used when evaluation by a pathologist is not available.

  6. Immunohistological findings in lip biopsy specimens from patients with Crohn's disease and healthy subjects.

    PubMed

    Crama-Bohbouth, G; Bosman, F T; Vermeer, B J; van der Wal, A M; Biemond, I; Weterman, I T; Peńa, A S

    1983-03-01

    Biopsies of apparently normal buccal mucosa were taken from 14 patients with Crohn's disease and 13 healthy controls who were matched for dental status. Most patients had an increased number of lymphocytes around vessels in the subepithelial tissue and two showed fibrosis with moderate atrophy of minor glands. Plasma cells which contained immunoglobulin, predominantly IgA, were only found around minor salivary glands in both patients and controls. Quantitative studies showed a significant increase in the number of cells containing IgA in patients compared with controls. No correlation was found between immunoglobulin pattern and disease activity, age, sex, or duration of Crohn's disease. A significant correlation was found between the activity of the disease, as defined by the Crohn's Disease Activity Index, and the number of plasma cells containing IgM.

  7. Immunohistological findings in lip biopsy specimens from patients with Crohn's disease and healthy subjects.

    PubMed Central

    Crama-Bohbouth, G; Bosman, F T; Vermeer, B J; van der Wal, A M; Biemond, I; Weterman, I T; Peńa, A S

    1983-01-01

    Biopsies of apparently normal buccal mucosa were taken from 14 patients with Crohn's disease and 13 healthy controls who were matched for dental status. Most patients had an increased number of lymphocytes around vessels in the subepithelial tissue and two showed fibrosis with moderate atrophy of minor glands. Plasma cells which contained immunoglobulin, predominantly IgA, were only found around minor salivary glands in both patients and controls. Quantitative studies showed a significant increase in the number of cells containing IgA in patients compared with controls. No correlation was found between immunoglobulin pattern and disease activity, age, sex, or duration of Crohn's disease. A significant correlation was found between the activity of the disease, as defined by the Crohn's Disease Activity Index, and the number of plasma cells containing IgM. PMID:6826103

  8. Frequency of apoptotic keratinocytes in the feline epidermis: a retrospective light-microscopic study of skin-biopsy specimens from 327 cats with normal skin or inflammatory dermatoses.

    PubMed

    Vogel, Jeff W; Scott, Danny W; Erb, Hollis N

    2009-12-01

    A retrospective light-microscopic study was performed on 294 biopsy specimens of haired skin from cats with various feline inflammatory dermatoses and specimens from cats with normal skin. Conditions expected to frequently have apoptotic epidermal keratinocytes (AKs) (including erythema multiforme, systemic lupus erythematosus, thymoma-associated exfoliative dermatitis, solar dermatitis, and viral dermatopathies) were found to have significantly more AKs than other types of inflammatory dermatoses. Nevertheless, we found more than two AKs in many skin-biopsy specimens from inflammatory conditions not expected to have frequent AKs (especially those from ectoparasitic dermatoses). Only a single AK was found in 1/33 cats with normal skin.

  9. Recommendations for Diagnosis, Referral for Liver Biopsy, and Treatment of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis.

    PubMed

    Spengler, Erin K; Loomba, Rohit

    2015-09-01

    Nonalcoholic fatty liver disease (NAFLD) is the primary cause of chronic liver disease in the United States, afflicting an estimated 80 to 100 million Americans. Nonalcoholic fatty liver disease is a spectrum of liver diseases composed of nonalcoholic fatty liver and nonalcoholic steatohepatitis (NASH). Although nonalcoholic fatty liver has a negligible risk of progression, patients with NASH often develop cirrhosis or hepatocellular carcinoma. Although liver biopsy is required to diagnose NASH, only patients with a high risk of NASH or advanced fibrosis require this evaluation. Despite the high prevalence of NAFLD, well-defined screening recommendations are currently lacking. In this review, suggestions for screening, diagnosis, and initial work-up of NAFLD are given on the basis of established guidelines and recent publications. Proposed drug treatments of NASH are also discussed, highlighting the study outcomes, as well as proposed uses and limitations of these drugs. The literature was searched in PubMed using search terms nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, with filters of "English language." A date range of January 1, 2000, to May 1, 2015, was used for the search. The bibliographies of key references were also searched manually, and seminal publications before the year 2000 were included.

  10. Quality Evaluation of Cone Biopsy Specimens Obtained by Large Loop Excision of the Transformation Zone

    PubMed Central

    Garcia Ramos, Aristoteles Mauricio; Garcia Ramos, Erika Souza; dos Reis, Helena Lucia Barroso; de Rezende, Ricardo Bueno

    2015-01-01

    Background Large loop excision of the transformation zone (LLETZ) has been used for the diagnosis and treatment of precancerous cervical lesions, and it is the first choice of treatment in the majority of cervical pathology services. The aim of this study was to evaluate the presence of thermal artifacts, the need for serial sections, the percentage of clear and involved resection margins and the relationship between endocervical gland involvement and the severity of the lesion in samples resected using LLETZ. Methods A retrospective study was performed at Santa Casa de Misericordia School of Science (HSCMV), Vitoria, Espirito Santo, Brazil with a sample of 52 histopathology slides from patients submitted to conization because of abnormal cytology findings and a biopsy result of cervical intraepithelial neoplasia (CIN) 2, CIN 3 and adenocarcinoma in situ. Statistical analysis was performed using Student’s t-test. Results Serial sections were required to confirm diagnosis in four of 52 cases. Thermal artifacts were present in all cases, with grade I being the most common (94.2% of cases). Clear margins were found in 96.2% of cases. No association was found between glandular involvement and CIN 1 (P > 0.05); however, there was an association with CIN 2 and CIN 3 (P < 0.05). Conclusion The amount of excised tissue was sufficient, thermal artifacts were slight, resection margins were clear in most of cases, and a possible association was found between glandular involvement and the severity of the lesion. PMID:25699117

  11. Immunofluorescence on paraffin-embedded sections in evaluation of immune complex deposits in renal biopsy specimens.

    PubMed

    Wagrowska-Danilewicz, Małgorzata; Danilewicz, Marian

    2009-01-01

    The data focused on the value of immunofluorescence on paraffin-embedded sections are controversial, and it is still difficult to obtain reproducible results. The aim of our study was to evaluate the usefulness of immunofluorescence on paraffin-embedded renal section in detecting immune complex deposits in IgA nephropathy (n = 24), membranous glomerulopathy (n = 22) and lupus nephritis (n = 24). Our study revealed that direct immunofluorescence on paraffin-embedded sections pre-treated with proteinase K for 30 or 60 min is a less sensitive method than immunofluorescence on frozen sections; therefore a number of glomerulopathies may be overlooked. Immunofluorescence on paraffin sections showed dominant or co-dominant fluorescence of Riga only in 41.7% of cases of Riga nephropathy. In the studied glomerulopathies the number of positive immunofluorescences of IgA, IgG, IgM and C3 was significantly lower in immunofluorescence on paraffin sections in comparison with findings obtained from immunofluorescence on frozen sections. Irrespective of glomerular disease the rate of agreement between immunofluorescence on paraffin sections and immunofluorescence on frozen sections with respect to the presence of IgA was 56.5%, IgM - 44.4%, IgG - 73.9%, and C3 - 51.5%. In conclusion, our study revealed that immunofluorescence on paraffin sections cannot replace immunofluorescence on frozen sections in the assessment of human renal biopsies, and must be interpreted with great caution.

  12. Tumor Content Chart-Assisted HER2/CEP17 Digital PCR Analysis of Gastric Cancer Biopsy Specimens

    PubMed Central

    Matsusaka, Keisuke; Ishikawa, Shumpei; Nakayama, Atsuhito; Ushiku, Tetsuo; Nishimoto, Aiko; Urabe, Masayuki; Kaneko, Nobuyuki; Kunita, Akiko; Kaneda, Atsushi; Aburatani, Hiroyuki; Fujishiro, Mitsuhiro; Seto, Yasuyuki; Fukayama, Masashi

    2016-01-01

    Evaluating HER2 gene amplification is an essential component of therapeutic decision-making for advanced or metastatic gastric cancer. A simple method that is applicable to small, formalin-fixed, paraffin-embedded biopsy specimens is desirable as an adjunct to or as a substitute for currently used HER2 immunohistochemistry and in situ hybridization protocols. In this study, we developed a microfluidics-based digital PCR method for determining HER2 and chromosome 17 centromere (CEP17) copy numbers and estimating tumor content ratio (TCR). The HER2/CEP17 ratio is determined by three variables—TCR and absolute copy numbers of HER2 and CEP17—by examining tumor cells; only the ratio of the latter two can be obtained by digital PCR using the whole specimen without purifying tumor cells. TCR was determined by semi-automatic image analysis. We developed a Tumor Content chart, which is a plane of rectangular coordinates consisting of HER2/CEP17 digital PCR data and TCR that delineates amplified, non-amplified, and equivocal areas. By applying this method, 44 clinical gastric cancer biopsy samples were classified as amplified (n = 13), non-amplified (n = 25), or equivocal (n = 6). By comparison, 11 samples were positive, 11 were negative, and 22 were equivocally immunohistochemistry. Thus, our novel method reduced the number of equivocal samples from 22 to 6, thereby obviating the need for confirmation by fluorescence or dual-probe in situ hybridization to < 30% of cases. Tumor content chart-assisted digital PCR analysis is also applicable to multiple sites in surgically resected tissues. These results indicate that this analysis is a useful alternative to HER2 immunohistochemistry in gastric cancers that can serve as a basis for the automated evaluation of HER2 status. PMID:27119558

  13. Proteomic Profiling of Human Liver Biopsies: Hepatitis C Virus-Induced Fibrosis and Mitochondrial Dysfunction

    SciTech Connect

    Diamond, Deborah L.; Jacobs, Jon M.; Paeper, Bryan; Proll, Sean; Gritsenko, Marina A.; Carithers, Jr., Robert L.; Larson , Anne M.; Yeh, Matthew M.; Camp, David G.; Smith, Richard D.; Katze, Michael G.

    2007-09-01

    Liver biopsies from HCV-infected patients offer the unique opportunity to study human liver biology and disease in vivo. However, the low protein yields associated with these small samples present a significant challenge for proteomic analysis. In this study we describe the application of an ultra-sensitive proteomics platform for performing robust quantitative proteomic studies on microgram amounts of HCV-infected human liver tissue from 15 patients at different stages of fibrosis. A high quality liver protein data base containing 5,920 unique protein identifications supported high throughput quantitative studies using 16O:18O stable isotope labeling in combination with the accurate mass and time (AMT) tag approach. A total of 1,641 liver biopsy proteins were quantified and ANOVA identified 210 proteins exhibiting statistically significant differences associated with fibrosis stage. Hierarchical clustering revealed that biopsies representative of later fibrosis stages (e.g. Batts-Ludwig stages 3-4) exhibited a distinct protein expression profile indicating an apparent down-regulation of many proteins when compared to samples from earlier fibrosis stages (e.g. Batts-Ludwig stages 0-2). Functional analysis of these signature proteins suggests that impairment of key mitochondrial processes including fatty acid oxidation and oxidative phosphorylation, and response to oxidative stress and reactive oxygen species occurs during advanced stage 3-4 fibrosis. In conclusion, the results reported here represent a significant advancement in clinical proteomics providing to our knowledge, the first demonstration of global proteomic alterations accompanying liver disease progression in patients chronically infected with HCV. Our findings contribute to a generally emerging theme associating oxidative stress and hepatic mitochondrial dysfunction with HCV pathogenesis.

  14. Evaluation of Ultrasonic Fiber Structure Extraction Technique Using Autopsy Specimens of Liver

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Tadashi; Hirai, Kazuki; Yamada, Hiroyuki; Ebara, Masaaki; Hachiya, Hiroyuki

    2005-06-01

    It is very important to diagnose liver cirrhosis noninvasively and correctly. In our previous studies, we proposed a processing technique to detect changes in liver tissue in vivo. In this paper, we propose the evaluation of the relationship between liver disease and echo information using autopsy specimens of a human liver in vitro. It is possible to verify the function of a processing parameter clearly and to compare the processing result and the actual human liver tissue structure by in vitro experiment. In the results of our processing technique, information that did not obey a Rayleigh distribution from the echo signal of the autopsy liver specimens was extracted depending on changes in a particular processing parameter. The fiber tissue structure of the same specimen was extracted from a number of histological images of stained tissue. We constructed 3D structures using the information extracted from the echo signal and the fiber structure of the stained tissue and compared the two. By comparing the 3D structures, it is possible to evaluate the relationship between the information that does not obey a Rayleigh distribution of the echo signal and the fibrosis structure.

  15. Material characterization of liver parenchyma using specimen-specific finite element models.

    PubMed

    Untaroiu, Costin D; Lu, Yuan-Chiao

    2013-10-01

    The liver is one of the most frequently injured abdominal organs during motor vehicle crashes. Realistic car crash simulations require incorporating strain-rate dependent mechanical properties of soft tissue in finite element (FE) material models. This study presents a total of 30 tension tests performed on fresh bovine liver parenchyma at various loading rates in order to characterize the biomechanical and failure properties of liver parenchyma. Each specimen, cut in a standard dog-bone shape, was tested until failure at one of three loading rates (0.01 s(-1), 0.1s(-1), 1 s(-1)) using a tensile testing setup. Load and acceleration recorded from each specimen grip were employed to calculate the time history of force at specimen ends. The shapes of all specimens were reconstructed from laser scans recorded prior to each test and then used to develop specimen-specific FE models. A first-order Ogden material model and the time histories of specimen end displacement were assigned to each specimen FE model. The failure Green-Lagrangian strain showed averages around 50% and no significant dependence on loading rates, but the failure 2nd Piola-Kirchhoff stress showed rate-dependence with average values ranging from 33 kPa to 94 kPa. The FE models with material model parameters identified using a simulation-based optimization replicated well the time history of load recorded during the test. The FE simulations with model parameters identified using an analytical approach or based on the displacement of optical markers showed a significantly stiffer response and lower failure stress/strain than the FE specimen-specific models. This study provides novel biomechanical and failure data which can be easily implemented in FE models and used to assess injury risk in automobile collisions.

  16. MR-Guided Freehand Biopsy of Liver Lesions With Fast Continuous Imaging Using a 1.0-T Open MRI Scanner: Experience in 50 Patients

    SciTech Connect

    Fischbach, Frank; Bunke, Juergen; Thormann, Markus; Gaffke, Gunnar; Jungnickel, Kerstin; Smink, Jouke; Ricke, Jens

    2011-02-15

    The purpose of this study was to assess a new open system with a field-strength of 1.0 T for the feasibility of liver biopsy using the freehand technique with fast continuous imaging. Fifty patients with focal liver lesions measuring 5 to 30 mm in diameter were included in the study. Guidance and monitoring was performed using a 1.0-T open magnetic resonance (MR) scanner (Panorama HFO; Philips Healthcare, Best, The Netherlands). With fast continuous imaging using a T1-weighted (T1W) gradient echo (GRE) sequence after administration of gadolinium (Gd)-EOB-DTPA, the needle was placed into the lesion. An interface for interactive dynamic viewing in two perpendicular planes prevented needle deviations T2-weighted turbo spin echo (TSE) fat-suppressed sequence was added to rule out postinterventional hematoma or biloma. All lesions were visible on the interventional images. Biopsy was technically successful, and solid specimens were obtained in all cases. Forty-six patients showed a histopathologic pattern other than native liver tissue, thus confirming correct position of the needle. Time between determination of the lesion and performance of the control scan was on average 18 min. No major complications were recorded. MR guidance with the new 1-T open system must be considered an attractive alternative for liver punction. An interface for dynamic imaging of needle guidance and T1W-GRE imaging with administration of Gd-EOB-DTPA for contrast enhancement allows the pinpoint puncture of liver lesions.

  17. Rapid and high-resolution imaging of human liver specimens by full-field optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Zhu, Yue; Gao, Wanrong; Zhou, Yuan; Guo, Yingcheng; Guo, Feng; He, Yong

    2015-11-01

    We report rapid and high-resolution tomographic en face imaging of human liver specimens by full-field optical coherence tomography (FF-OCT). First, the arrangement of the FF-OCT system was described and the performance of the system was measured. The measured axial and lateral resolutions of the system are 0.8 and 0.9 μm, respectively. The system has a sensitivity of ˜60 dB and can achieve an imaging rate of 7 fps and a penetration depth of ˜80 μm. The histological structures of normal liver can be seen clearly in the en face tomographic images, including central veins, cords of hepatocytes separated by sinusoidal spaces, and portal area (portal vein, the hepatic arteriole, and the bile duct). A wide variety of histological subtypes of hepatocellular carcinoma was observed in en face tomographic images, revealing notable cancerous features, including the nuclear atypia (enlarged convoluted nuclei), the polygonal tumor cells with obvious resemblance to hepatocytes with enlarged nuclei. In addition, thicker fibrous bands, which make the cytoplasmic plump vesicular nuclei indistinct, were also seen in the images. Finally, comparison between the portal vein in a normal specimen versus that seen in the rare type of cholangiocarcinoma was made. The results show that the cholangiocarcinoma presents with a blurred pattern of portal vein in the lateral direction and an aggregated distribution in the axial direction; the surrounding sinusoidal spaces and nuclei of cholangiocarcinoma are absent. The findings in this work may be used as additional signs of liver cancer or cholangiocarcinoma, demonstrating capacity of FF-OCT device for early cancer diagnosis and many other tumor-related studies in biopsy.

  18. Diagnosis of Hepatocellular Carcinoma Complicating Liver Cirrhosis: Utility of Repeat Ultrasound-Guided Biopsy after Unsuccessful First Sampling

    SciTech Connect

    Caturelli, Eugenio; Biasini, Elisabetta; Bartolucci, Francesca; Facciorusso, Domenico; Decembrino, Francesco; Attino, Vito; Bisceglia, Michele

    2002-08-15

    Purpose: To evaluate the utility of a second ultrasound-guided fine-needle biopsy of liver nodules thought to be hepatocellular carcinoma when the original biopsy has failed to provide a reliable diagnosis. Methods: Thirty-seven cirrhotic patients underwent ultrasound-guided fine-needle biopsy of liver nodules that were subsequently diagnosed as hepatocellular carcinoma. Each biopsy involved a single puncture with a 20 G cutting needle, which yielded pathologic material used both for cytologic and histologic studies. In 23 cases (mean diameter of nodules 48 mm) the biopsy furnished exclusively necrotic material (non-diagnostic subgroup); in the other 14 cases (mean diameter 26 mm) the biopsy yielded no neoplastic elements (false-negative subgroup). All 37 nodules were subjected to repeat biopsies performed in the same manner. Results: The repeat biopsies provided a diagnosis of hepatocellular carcinoma in six of the 23 patients from the non-diagnostic subgroup and in seven of the 14 in the false-negative subgroup. Overall, repeat biopsy produced a diagnostic gain of 35.1%. Conclusion: The chance of success with repeat biopsy of hepatocellular carcinoma is limited and may depend to some extent on the characteristics of the lesions (i.e., areas of necrosis in large nodules, well-differentiated cellular populations in small ones)

  19. Failure to detect human herpes simplex virus, cytomegalovirus, and Epstein-Barr virus viral genomes in giant cell arteritis biopsy specimens by real-time quantitative polymerase chain reaction.

    PubMed

    Cankovic, Milena; Zarbo, Richard J

    2006-01-01

    A study provided evidence of human herpes simplex virus (HSV) DNA in giant cell arteritis (GCA) biopsy specimens. This prompted us to study our own GCA biopsy specimens using real-time quantitative polymerase chain reaction for the detection of HSV1, cytomegalovirus, and Epstein-Barr virus DNAs. Our study failed to confirm an association between HSV1 and GCA, revealing no viral genome in 35 biopsy specimens of histologically positive temporal arteries.

  20. Colorectal Liver Metastasis, Primary Gallbladder Carcinoma and Myelofibrosis Present Simultaneously in a Liver Resection Specimen

    PubMed Central

    Gray, Sophie A.; Raber, Menno H.; Provoost, Esther; Toes, Gert-Jan; Klaase, Joost M.

    2015-01-01

    Myelofibrosis and gallbladder carcinoma are both very rare diseases. This case report describes a patient with a history of myelofibrosis and colorectal carcinoma who was diagnosed with colorectal liver metastases. Surgery was performed to remove the metastases, and on site, the gallbladder was removed because of involvement in one of the liver lesions. After pathological examination, a primary gallbladder carcinoma and myelofibrosis were found in addition to the liver metastases. The combination of diseases was not likely to be interconnected but rather an unlucky course of events for the patient. PMID:26600770

  1. Ki-67 labeling index of neuroendocrine tumors of the lung has a high level of correspondence between biopsy samples and surgical specimens when strict counting guidelines are applied.

    PubMed

    Fabbri, Alessandra; Cossa, Mara; Sonzogni, Angelica; Papotti, Mauro; Righi, Luisella; Gatti, Gaia; Maisonneuve, Patrick; Valeri, Barbara; Pastorino, Ugo; Pelosi, Giuseppe

    2017-02-01

    Optimal histopathological analysis of biopsies from metastases of neuroendocrine tumor (NET) of the lung requires more than morphology only. Additional parameters such as Ki-67 labeling index are required for adequate diagnosis, but few studies have compared reproducibility of different counting protocols and modalities of reporting on biopsies of lung NET. We compared the results of four different manual counting techniques to establish Ki-67 LI. On 47 paired biopsies and surgical specimens from 22 typical carcinoids (TCs), 14 atypical carcinoids (ACs), six large cell neuroendocrine carcinomas (LCNECs), and five small cell carcinomas (SCCs) immunohistochemical staining of Ki-67 antigen was performed. We counted, in regions of highest nuclear staining (HSR), a full ×40-high-power field (diameter = 0.55 mm), 500 or 2000 cells, or 2 mm(2) surface area, including the HSR or the entire biopsy fragment(s). Mitoses and necrosis were evaluated in an area of 2 mm(2) or the entire biopsy fragment(s). Between the four counting methods, no differences in Ki-67 LI were observed. However, a Ki-67 LI higher than 5% was found in only four cases when in an HSR, 500 cells were counted (18%), five (23%) when in an HSR 2000 cells were counted, four (18%) when 2 mm(2) were counted, and one (5%) TC case when the entire biopsy was counted. A 20% cutoff distinguished TC and AC from LCNEC and SCC with 100% specificity and sensitivity, while mitoses and necrosis failed to a large extent. Ki-67 LI in biopsy samples was concordant with that in resection specimens when 2000 cells, 2 mm(2), or the entire biopsy fragment(s) were counted. Our results are important for clinical management of patients with metastases of a lung NET.

  2. Plasma phospholipids and fatty acid composition differ between liver biopsy-proven nonalcoholic fatty liver disease and healthy subjects

    PubMed Central

    Ma, D W L; Arendt, B M; Hillyer, L M; Fung, S K; McGilvray, I; Guindi, M; Allard, J P

    2016-01-01

    Background: There is growing evidence that nonalcoholic fatty liver disease (NAFLD) is associated with perturbations in liver lipid metabolism. Liver phospholipid and fatty acid composition have been shown to be altered in NAFLD. However, detailed profiles of circulating lipids in the pathogenesis of NAFLD are lacking. Objective: Therefore, the objective of the present study was to examine circulating lipids and potential mechanisms related to hepatic gene expression between liver biopsy-proven simple steatosis (SS), nonalcoholic steatohepatitis (NASH) and healthy subjects. Subjects: Plasma phospholipid and fatty acid composition were determined in 31 healthy living liver donors as healthy controls (HC), 26 patients with simple hepatic steatosis (SS) and 20 with progressive NASH. Hepatic gene expression was analyzed by Illumina microarray in a subset of 22 HC, 16 SS and 14 NASH. Results: Concentrations of phosphatidylethanolamine (PE) increased relative to disease progression, HC

  3. Diagnosis of occult hepatitis C without the need for a liver biopsy.

    PubMed

    Castillo, Inmaculada; Bartolomé, Javier; Quiroga, Juan Antonio; Barril, Guillermina; Carreño, Vicente

    2010-09-01

    The diagnosis of occult hepatitis C virus (HCV) infection is based on the presence of HCV-RNA in the liver. This study aimed to evaluate the use of combining non-invasive assays to diagnose occult HCV. A total of 122 patients with occult HCV (HCV-RNA in the liver without detectable anti-HCV and serum HCV-RNA) and 45 patients with cryptogenic chronic hepatitis (without HCV-RNA in the liver and negative for anti-HCV and serum HCV-RNA) were included. HCV-RNA was tested in peripheral blood mononuclear cells (PBMCs) and in 2 ml of ultracentrifuged serum. Anti-core HCV was examined by a non-commercial enzyme-linked immunosorbent assay. All controls were negative for the three HCV markers studied. Among patients with occult HCV, 36% were anti-core HCV positive, 57% had serum HCV-RNA after ultracentrifugation, and 61% had HCV-RNA in PBMCs. Combining the results of the assays, 91% of the patients were positive for at least one marker. Intrahepatic HCV-RNA load was significantly higher in patients who were positive simultaneously for the three HCV markers than in patients who were negative for all markers (P = 0.006) and than in those with one or two HCV markers (P = 0.039). Replication of HCV in liver was detected more frequently in patients with three (93%, P = 0.002), two (82%, P = 0.001), and one HCV marker (73%, P = 0.011) than in those without markers (27%). In conclusion, testing for all these markers allows diagnosis of occult HCV without the need for a liver biopsy and these assays may help to elucidate the clinical significance of occult HCV infection.

  4. Increased circulating zonulin in children with biopsy-proven nonalcoholic fatty liver disease

    PubMed Central

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

    2014-01-01

    AIM: To investigate the potential association of circulating zonulin with the stage of liver disease in obese children with biopsy-confirmed nonalcoholic fatty liver disease (NAFLD). METHODS: A case-control study was performed. Cases were 40 obese children with NAFLD. The diagnosis of NAFLD was based on magnetic resonance imaging (MRI) with high hepatic fat fraction (HFF ≥ 5%), and confirmed by liver biopsy with ≥ 5% of hepatocytes containing macrovesicular fat. Controls were selected from obese children with normal levels of aminotransferases, and without MRI evidence of fatty liver as well as of other causes of chronic liver diseases. Controls were matched (1-to 1) with the cases on age, gender, pubertal stage and as closely as possible on body mass index- standard deviation score. All participants underwent clinical examination, laboratory tests including zonulin, inflammatory and metabolic parameters, and MRI for measurement of HFF and visceral adipose tissue. RESULTS: Zonulin values were significantly greater in obese subjects with NAFLD than in those without NAFLD [median (interquartile range), 4.23 (3.18-5.89) vs 3.31 (2.05-4.63), P < 0.01]. In patients with NAFLD, zonulin concentrations increased significantly with the severity of steatosis and the Spearman’s coefficient revealed a positive correlation between zonulin values and steatosis (r = 0.372, P < 0.05); however, we did not find a significant correlation between zonulin and lobular inflammation (P = 0.23), ballooning (P = 0.10), fibrosis score (P = 0.18), or presence of nonalcoholic steatohepatitis (P = 0.17). Within the entire study population, zonulin levels were positively associated with gamma-glutamyl transferase, 2-h insulin, HFF, and negatively associated with whole-body insulin sensitivity index (WBISI), after adjustment for age, gender and pubertal status. When the associations were restricted to the group of NAFLD patients, 2-h insulin, hepatic fat, and WBISI retained statistical

  5. Flow cytometric analysis of kappa and lambda light chain expression in endoscopic biopsy specimens before the diagnosis of B-cell lymphoma.

    PubMed

    Oka, Satoko; Muroi, Kazuo; Sato, Kazuya; Fujiwara, Shin-ichiro; Oh, Iekuni; Matsuyama, Tomohiro; Ohmine, Ken; Suzuki, Takahiro; Ozaki, Katsutoshi; Mori, Masaki; Nagai, Tadashi; Fukushima, Noriyoshi; Fukushima, Noriyoshi; Tanaka, Akira; Ozawa, Keiya

    2012-01-01

    Forty-eight patients with gastrointestinal (GI) tract B-cell lymphoma (BCL) were analyzed retrospectively. The diagnosis was based on the histological examination of specimens obtained by endoscopic biopsy. Before the diagnosis was made, single-color flow cytometry was performed to analyze the expression of light chains and B-cell antigens including CD10 in the specimens. Restricted light chain (RLC) expression, a marker of B-cell clonality, was defined as κ and λ ratios of either more than 3.0 or less than 0.5. The specimens from 30 patients (62.5%) showed RLC expression. No RLC expression or RLC expression not examined was divided into two groups : those showing CD10 positivity in more than 20% of cells (4 patients, 8.3%) and those showing no positivity (14 patients, 29.2%). The cell number analyzed in the latter group was significantly smaller than that in the other two groups. Abnormal karyotypes were found in the specimens from 8 patients (16.7%). These results indicate that the flow cytometric analysis of endoscopic biopsy specimens is useful when BCL is suspected if an adequate number of cells are obtained.

  6. Direct detection of Helicobacter pylori resistance to macrolides by a polymerase chain reaction/DNA enzyme immunoassay in gastric biopsy specimens

    PubMed Central

    Marais, A; Monteiro, L; Occhialini, A; Pina, M; Lamouliatte, H; Megraud, F

    1999-01-01

    BACKGROUND—The increasing use of macrolides especially in the treatment of Helicobacter pylori infection has led to an increase in resistant strains. The resistance of H pylori to macrolides, especially clarithromycin, is one of the major causes of eradication failure. In H pylori, clarithromycin resistance is due to point mutations localised in domain V of 23S rRNA. 
AIM—To develop a molecular technique based on amplification of a relevant fragment of the 23S rRNA and colorimetric hybridisation in liquid phase to detect directly in biopsy specimens the type of mutation associated with resistance of H pylori to clarithromycin. 
METHODS—Gastric biopsy samples from 61 patients were submitted to this test. The results were compared with standard methods (determination of minimal inhibition concentration, polymerase chain reaction/restriction fragment length polymorphism, and/or DNA sequencing) in order to evaluate the test and to define the cut off values, specificity, and sensitivity. 
RESULTS—The 14 biopsy samples in which H pylori was not detected did not give a positive result in any assay, and the 14 samples harbouring strains susceptible to clarithromycin gave a positive result with the wild type probe as expected. The 33 biopsy specimens containing resistant strains always gave a positive signal with one of the probes detecting resistant organisms, but in eight cases they also reacted with the wild type probe, indicating that a mixture of resistant and susceptible organisms was present. 
CONCLUSION—The importance of this new assay is that it allows the detection of multiple genotypes corresponding to either heterogeneous genotypes or mixed infections. Moreover, it allows in a single step not only the detection of H pylori but also the determination of its susceptibility to clarithromycin directly in biopsy specimens without the need for culture. 

 Keywords: Helicobacter pylori; resistance; clarithromycin; macrolide; polymerase chain

  7. Evaluation of the Success Rate of Ultrasound-guided Transjugular Liver Biopsy (TJLB) and the Associated Complications

    PubMed Central

    Rad, Masoud Pezeshki; Sima, Hamidreza; Khazaeeian, Reza; Mohammadifard, Mahyar

    2016-01-01

    Introduction Transjugular liver biopsy (TJLB) is a diagnostic radiological intervention, applied to patients with contraindications to percutaneous or laparoscopic liver biopsy. The aim of this study was to determine the safety, effectiveness, complications, and pathological impact of TJLB. Methods This cross-sectional study was conducted on 24 consecutive patients, undergoing TJLB at Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences, from April 2010 to March 2011. The inclusion criteria were coagulopathy, thrombocytopenia, and ascites. TJLB was performed by a radiologist, and a guide wire was inserted in the right jugular vein. Right atrium and middle hepatic vein were catheterized, and then, Cook Quick-Core Biopsy Needle was used by ultrasound guidance. Data analysis was performed by SPSS version 16. Results The sample size included 24 subjects (54% males and 46% females). Success rate of TJLB was reported as 87.5% and the intervention duration was 23.89±9.34 min. No complications were reported in 37.5% of the patients; however, pain in the right upper quadrant (33.3%), leakage of contrast substance into the liver capsule (4.2%), and diffuse abdominal pain (4.2%). In 83% of biopsies, suitable samples were obtained for histopathological diagnosis, and 13% of patients were excluded from the study. According to the results, the mean central port track (CPT) was 6.75 ± 2.95. Conclusion TJLB is a relatively effective and safe procedure for patients with contraindications to percutaneous liver biopsy. PMID:28163865

  8. Two Cases of Lethal Complications Following Ultrasound-Guided Percutaneous Fine-Needle Biopsy of the Liver

    SciTech Connect

    Drinkovic, Ivan; Brkljacic, Boris

    1996-09-15

    Two cases with lethal complications are reported among 1750 ultrasound (US)-guided percutaneous fine-needle liver biopsies performed in our department. The first patient had angiosarcoma of the liver which was not suspected after computed tomography (CT) and US studies had been performed. The other patient had hepatocellular carcinoma in advanced hepatic cirrhosis. Death was due to bleeding in both cases. Pre-procedure laboratory tests did not reveal the existence of major bleeding disorders in either case. Normal liver tissue was interposed in the needle track between the liver capsule and the lesions which were targeted.

  9. New Radiofrequency Device to Reduce Bleeding after Core Needle Biopsy: Experimental Study in a Porcine Liver Model

    PubMed Central

    Lim, Sanghyeok; Lee, Min Woo; Song, Kyoung Doo; Kang, Tae Wook; Kim, Young-sun; Lim, Hyo Keun

    2017-01-01

    Objective To evaluate the in vivo efficiency of the biopsy tract radiofrequency ablation for hemostasis after core biopsy of the liver in a porcine liver model, including situations with bleeding tendency and a larger (16-gauge) core needle. Materials and Methods A preliminary study was performed using one pig to determine optimal ablation parameters. For the main experiment, four pigs were assigned to different groups according to heparinization use and biopsy needle caliber. In each pig, 14 control (without tract ablation) and 14 experimental (tract ablation) ultrasound-guided core biopsies were performed using either an 18- or 16-gauge needle. Post-biopsy bleeding amounts were measured by soaking up the blood for five minutes. The results were compared using the Mann-Whitney U test. Results The optimal parameters for biopsy tract ablation were determined as a 2-cm active tip electrode set at 40-watt with a tip temperature of 70–80℃. The bleeding amounts in all experimental groups were smaller than those in the controls; however they were significant in the non-heparinized pig biopsied with an 18-gauge needle and in two heparinized pigs (p < 0.001). In the heparinized pigs, the mean blood loss in the experimental group was 3.5% and 13.5% of the controls biopsied with an 18- and 16-gauge needle, respectively. Conclusion Radiofrequency ablation of hepatic core biopsy tract ablation may reduce post-biopsy bleeding even under bleeding tendency and using a larger core needle, according to the result from in vivo porcine model experiments. PMID:28096727

  10. Contemporary update on pathology-related issues on routine workup of prostate biopsy: sectioning, tumor extent measurement, specimen orientation, and immunohistochemistry.

    PubMed

    Montironi, Rodolfo; Lopez-Beltran, Antonio; Mazzucchelli, Roberta; Scarpelli, Marina; Galosi, Andrea B; Cheng, Liang

    2014-04-01

    While the prime goal of the needle biopsy is to diagnose prostatic adenocarcinoma (PCa), once PCa is detected further descriptive information regarding the type of cancer, amount of tumor, and grade in prostate needle cores forms the cornerstone for contemporary management of the patient and to assess the potential for local cure and the risk for distant metastasis. This review gives an update on selected pathology-related issues on routine workup of prostate biopsy with special references to adequate histologic sectioning necessary to maximize cancer yield, tumor extent measurements and methodologies, specimen orientation, and the role of immunohistochemistry in the evaluation of the prostate. Multiple factors influence the diagnostic yield of prostate biopsies. Many of these factors are fixed and uncontrollable. Other factors are controlled by the urologist, including number of cores obtained, method and location of biopsy, and amount of tissue obtained. The yield of cancer is also controlled by the pathologist and histotechnologist. It is necessary to report the number of cores submitted and the number of positive cores, thereby giving the fraction of positive cores. The percentage involvement by carcinoma with or without the linear extent of carcinoma of the single core with the greatest amount of tumor should also be provided. Using the marking technique, we can add a new pathological parameter: pathological orientation. Cancer or atypical lesions can be accurately located within the biopsy specimen and integrated to biopsy approach. Probably the most common use of immunohistochemistry in the evaluation of the prostate is for the identification of basal cells, which are absent with rare exception in adenocarcinoma of the prostate and in general positive in mimickers of prostate cancer. If a case is still considered atypical by a uropathology expert after negative basal cell staining, positive staining for alpha-methylacyl-CoA-racemase can help establish in 50

  11. Obese diet-induced mouse models of nonalcoholic steatohepatitis-tracking disease by liver biopsy

    PubMed Central

    Kristiansen, Maria Nicoline Baandrup; Veidal, Sanne Skovgård; Rigbolt, Kristoffer Tobias Gustav; Tølbøl, Kirstine Sloth; Roth, Jonathan David; Jelsing, Jacob; Vrang, Niels; Feigh, Michael

    2016-01-01

    AIM: To characterize development of diet-induced nonalcoholic steatohepatitis (NASH) by performing liver biopsy in wild-type and genetically obese mice. METHODS: Male wild-type C57BL/6J (C57) mice (DIO-NASH) and male Lepob/Lepob (ob/ob) mice (ob/ob-NASH) were maintained on a diet high in trans-fat (40%), fructose (22%) and cholesterol (2%) for 26 and 12 wk, respectively. A normal chow diet served as control in C57 mice (lean chow) and ob/ob mice (ob/ob chow). After the diet-induction period, mice were liver biopsied and a blinded histological assessment of steatosis and fibrosis was conducted. Mice were then stratified into groups counterbalanced for steatosis score and fibrosis stage and continued on diet and to receive daily PO dosing of vehicle for 8 wk. Global gene expression in liver tissue was assessed by RNA sequencing and bioinformatics. Metabolic parameters, plasma liver enzymes and lipids (total cholesterol, triglycerides) as well as hepatic lipids and collagen content were measured by biochemical analysis. Non-alcoholic fatty liver disease activity score (NAS) (steatosis/inflammation/ballooning degeneration) and fibrosis were scored. Steatosis and fibrosis were also quantified using percent fractional area. RESULTS: Diet-induction for 26 and 12 wk in DIO-NASH and ob/ob-NASH mice, respectively, elicited progressive metabolic perturbations characterized by increased adiposity, total cholesterol and elevated plasma liver enzymes. The diet also induced clear histological features of NASH including hepatosteatosis and fibrosis. Overall, the metabolic NASH phenotype was more pronounced in ob/ob-NASH vs DIO-NASH mice. During the eight week repeated vehicle dosing period, the metabolic phenotype was sustained in DIO-NASH and ob/ob-NASH mice in conjunction with hepatomegaly and increased hepatic lipids and collagen accumulation. Histopathological scoring demonstrated significantly increased NAS of DIO-NASH mice (0 vs 4.7 ± 0.4, P < 0.001 compared to lean chow

  12. Analysis of histopathological pattern of kidney biopsy specimens in Kuwait: A single-center, five-year prospective study.

    PubMed

    Abdallah, Emad; Al-Helal, Bassam; Asad, Reem; Kannan, Shreeram; Draz, Wael; Abdelgawad, Zeyad

    2015-11-01

    Glomerulonephritis (GN) varies in incidence in different geographical areas due to different socioeconomic conditions and ethnicity, genetic variability and environmental factors. Our study is aimed to determine the histopathological pattern of kidney biopsies in Kuwait over the preceding five years. In a prospective study, we analyzed the clinical and pathological data of 214 kidney biopsies that were performed during the period from November 2009 to November 2014 at the Al-Khezam Dialysis Center, Al-Adan Hospital, Kuwait. Kidney biopsies were performed percutaneously using an automated gun guided by ultrasound. The biopsy samples were processed for light microscopy and immunofluorescence. Electron microscopy was performed only in selected cases. Age, gender, serum creatinine, 24-h urinary protein, virology, immunology profiles, indication for renal biopsy and histopathological findings were recorded for analysis. Primary GN was reported in 46.7%, secondary GN was reported in 42.9% and tubulointerstitial disease was reported in 10.3% of the 214 kidney biopsies studied. Among primary GN, membranous GN (MGN) was the most common lesion (12.1%), followed by immunoglobulin A nephropathy (IgAN, 11.7%), minimal change disease (9.8%), focal and segmental glomerulosclerosis (9.3%), membranoproliferative GN (1.9%), Alport's syndrome (1.4%) and fibrillary GN (0.46%). Among biopsies that showed secondary GN, lupus nephritis was the most common (11.7%), followed by hypertensive glomerulosclerosis (10.3%), crescentic GN (7.1%), diabetic nephropathy (3.3%), thrombotic microangiopathy (2.3%), amyloidosis (2.3%), post-infectious GN (1.4%) and myeloma kidney (0.9%). Among biopsies that showed tubulointerstitial disease, acute interstitial nephritis was the most common lesion (6.1%), followed by chronic interstitial nephritis (2.8%) and acute tubular necrosis (1.4%). Our study indicates that MGN was the most common primary GN, followed by IgAN, while lupus nephritis was the most

  13. A systematic pipeline for the objective comparison of whole-brain spectroscopic MRI with histology in biopsy specimens from grade III glioma

    PubMed Central

    Cordova, J. Scott; Gurbani, Saumya S.; Olson, Jeffrey J.; Liang, Zhongxing; Cooper, Lee A. D.; Shu, Hui-Kuo G.; Schreibmann, Eduard; Neill, Stewart G.; Hadjipanayis, Constantinos G.; Holder, Chad A.; Shim, Hyunsuk

    2016-01-01

    The diagnosis, prognosis, and management of patients with gliomas are largely dictated by the pathological analysis of tissue biopsied from a selected region within the lesion. However, due to the heterogeneous and infiltrative nature of gliomas, identifying the optimal region for biopsy with conventional magnetic resonance imaging (MRI) can be quite difficult. This is especially true for low grade gliomas, which often are non-enhancing tumors. To improve the management of patients with these tumors, the field of neuro-oncology requires an imaging modality that can specifically identify a tumor’s most anaplastic/aggressive region(s) for biopsy targeting. The addition of metabolic mapping using spectroscopic MRI (sMRI) to supplement conventional MRI could improve biopsy targeting and, ultimately, diagnostic accuracy. Here, we describe a pipeline for the integration of state-of-the-art, high-resolution whole-brain 3D sMRI maps into a stereotactic neuronavigation system for guiding biopsies in gliomas with nonenhancing components. We also outline a machine-learning method for automated histology analysis that generates normalized, quantitative metrics describing tumor infiltration in immunohistochemically-stained tissue specimens. As a proof of concept, we describe the combination of these two techniques in a small cohort of grade III glioma patients. In this work, we aim to set forth a systematic pipeline to stimulate histopathology-image validation of advanced MRI techniques, such as sMRI. PMID:27489883

  14. Specimen Identification Errors in Breast Biopsies: Age Matters. Report of Two Near-Miss Events and Review of the Literature.

    PubMed

    Tozbikian, Gary; Gemignani, Mary L; Brogi, Edi

    2017-03-16

    The consequences of patient identification errors due to specimen mislabeling can be deleterious. We describe two near-miss events involving mislabeled breast specimens from two patients who sought treatment at our institution. In both cases, microscopic review of the slides identified inconsistencies between the histologic findings and patient age, unveiling specimen identification errors. By correlating the clinical information with the microscopic findings, we identified mistakes that had occurred at the time of specimen accessioning at the original laboratories. In both cases, thanks to a timely reassignment of the specimens, the patients suffered no harm. These cases highlight the importance of routine clinical and pathologic correlation as a critical component of quality assurance and patient safety. A review of possible specimen identification errors in the anatomic pathology setting is presented.

  15. Peripheral neuropathy in chronic liver disease: clinical, electrodiagnostic, and nerve biopsy findings

    PubMed Central

    Knill-Jones, R. P.; Goodwill, C. J.; Dayan, A. D.; Williams, Roger

    1972-01-01

    In a prospective study of 70 unselected patients with chronic liver disease, clinical signs of a peripheral neuropathy were observed in 13 patients. Abnormal nerve conduction was demonstrated in nine of these and in one further patient who had no abnormal neurological signs. The occurrence of a neuropathy (in patients with cryptogenic cirrhosis, haemochromatosis, active chronic hepatitis as well as in alcoholic cirrhosis) could not be related to liver function, although it was associated with higher IgA and IgM values. Clinical diabetes was present in six of the 14 patients with neuropathy but there was no relation in the non-diabetic patients between neuropathy and minor impairment of carbohydrate tolerance. Those with neuropathy had a significantly higher incidence of oesophageal varices and there was also a relationship to a history of previous encephalopathy. Sural nerve biopsy was carried out on 14 patients, eight of whom had clinical or electrodiagnostic evidence of neuropathy. Single nerve fibres were examined by teasing and in all nerves histological evidence was found of an indolent process which had damaged whole Schwann cells and which resulted in demyelination and remyelination. Diabetic angiopathy was not seen and axonal degeneration, which was never severe, was found in all disease groups equally. Images PMID:4337271

  16. Fibrosis Progression in Paired Liver Biopsies from HIV/HCV-Coinfected Patients without Prior Treatment of Hepatitis C.

    PubMed

    Leite, Andréa G B; Duarte, Maria Irma S; Mendes-Correa, Maria Cássia

    2015-01-01

    Several studies have demonstrated that HIV/hepatitis C virus (HCV)-coinfected patients experience more rapid fibrosis progression. In this study, to estimate the annual rate of direct liver fibrosis progression, we used analyses of paired biopsy samples from HIV/HCV-coinfected patients without prior treatment of hepatitis and assessed the possible association of fibrosis progression with certain clinical variables. We evaluated 30 HIV/HCV-coinfected patients, with no history of prior treatment of hepatitis C, who underwent paired liver biopsies. All patients were under antiretroviral therapy at first and second biopsies. The average annual progression rate was 0.13 fibrosis unit/year, with 36.7% of patients defined as progressors. Liver fibrosis progression was associated with alanine aminotransferase (ALT; P < .001) and aspartate aminotransferase (AST; P < .0340) levels over 3 times the upper limit of normal present at first biopsy. Elevated ALT and AST levels appear to be associated with more accelerated liver fibrosis progression among HIV/HCV-coinfected patients.

  17. Ultrasound: a new tool for precisely locating posterior iliac crests to obtain adequate bone marrow trephine biopsy specimen.

    PubMed

    Islam, Anwarul

    2013-08-01

    Ultrasound imaging has evolved as a very useful tool in medical science. However, the technique of ultrasound-guided bone marrow trephine biopsy (BMTB) has not been routinely used by haematologists and oncologists to help locate the posterior iliac crest during the BMTB procedure. We have used the technique of ultrasound-guided BMTB in 20 patients diagnosed with various haematological and non-haematological malignant conditions. We found the technique simple and useful in precisely locating the posterior iliac crest. As a result, it facilitates the extraction of a satisfactory core sample or aspiration biopsy and is more surgically precise than when access to the target bone is based only on external landmarks and blind biopsy.

  18. Quantitative assessment of fibrosis and steatosis in liver biopsies from patients with chronic hepatitis C

    PubMed Central

    Zaitoun, A; Al, M; Awad, S; Ukabam, S; Makadisi, S; Record, C

    2001-01-01

    Backgrounds—Hepatic fibrosis is one of the main consequences of liver disease. Both fibrosis and steatosis may be seen in some patients with chronic hepatitis C and alcoholic liver disease (ALD). Aims—To quantitate fibrosis and steatosis by stereological and morphometric techniques in patients with chronic hepatitis C and compare the results with a control group of patients with ALD. In addition, to correlate the quantitative features of fibrosis with the Ishak modified histological score. Materials and methods—Needle liver biopsies from 86 patients with chronic hepatitis C and from 32 patients with alcoholic liver disease (disease controls) were analysed by stereological and morphometric analyses using the Prodit 5.2 system. Haematoxylin and eosin and Picro-Mallory stained sections were used. The area fractions (AA) of fibrosis, steatosis, parenchyma, and other structures (bile duct and central vein areas) were assessed by stereological method. The mean diameters of fat globules were determined by morphometric analysis. Results—Significant differences were found in the AA of fibrosis, including fibrosis within portal tract areas, between chronic hepatitis C patients and those with ALD (mean (SD): 19.14 (10.59) v 15.97 (12.51)). Portal and periportal (zone 1) fibrosis was significantly higher (p = 0.00004) in patients with chronic hepatitis C compared with the control group (mean (SD): 9.04 (6.37) v 3.59 (3.16)). Pericentral fibrosis (zone 3) occurred in both groups but was significantly more pronounced in patients with ALD. These results correlate well with the modified Ishak scoring system. However, in patients with cirrhosis (stage 6) with chronic hepatitis C the AA of fibrosis varied between 20% and 74%. The diameter of fat globules was significantly lower in patients with hepatitis C (p = 0.00002) than the ALD group (mean (SD): 14.44 (3.45) v 18.4 (3.32)). Microglobules were more frequent in patients with chronic hepatitis C than in patients with ALD

  19. Pathological findings of condemned bovine liver specimens and associated economic loss at Nyabugogo abattoir, Kigali, Rwanda.

    PubMed

    Habarugira, Gervais; Mbasinga, Gloria; Mushonga, Borden; Chitura, Teedzai; Kandiwa, Erick; Ojok, Lonzy

    2016-12-01

    There are no published abattoir bovine hepatic lesion prevalence studies in cattle in Rwanda. This study estimated that 12.3% of the livers (n=4751) examined at Nyabugogo slaughterhouse in Kigali were condemned. Condemnation prejudiced the nation of 3492.00kg of meat with attendant economic losses of US$8932.40 during the study period. Risk factors for these lesions were also assessed. Male and female animals from 11 districts were used in this study. Hepatic lesions were higher in females (14.6%; n=1494) than in males (11.1%; n=3257). About 78.7% of the condemnations were due to fascioliasis, followed by abscesses (5.7%), hepatitis (5.3%), cirrhosis (4%) and other lesions (6.3%). Female animal livers showed more fascioliasis and abscesses (82.2% and 9.5%) than male animal livers (73.3% and 3.3%). The highest rate of condemnation was observed from Kayonza (40.2%; n=413) and the least was from Gakenke district (0.9%; n=1031). Cattle from the Eastern Province showed significantly (P<0.05) higher prevalence of condemnations (26.8%) than the rest of the provinces. Liver specimens of animals below 3 years and above 6 years of age had a significantly higher (P<0.05) condemnation rate (14.4%) (n=3000 and n=769) than the 3-6year age-group at 4.1% (n=982). We conclude that fascioliasis was responsible for a significant proportion of the liver condemnations at Nyabugogo slaughterhouse. Being a zoonosis, we recommend an epidemio-surveillance, implementation of control measures and anthelmintic resistance investigation for fascioliasis in Rwanda.

  20. Assessment of HER2 Status Using Immunohistochemistry (IHC) and Fluorescence In Situ Hybridization (FISH) Techniques in Mucinous Epithelial Ovarian Cancer: A Comprehensive Comparison between ToGA Biopsy Method and ToGA Surgical Specimen Method.

    PubMed

    Chao, Wan-Ru; Lee, Ming-Yung; Ruan, Alexandra; Sheng, Huang Pin; Hsu, Jeng-Dong; Han, Chih-Ping; Koo, Chiew-Loon

    2015-01-01

    We aimed to compare the assay performance characteristics of HER2 status in mucinous epithelial ovarian cancer (EOC) by ToGA (Trastuzumab for Gastric Cancer) biopsy versus ToGA surgical specimen methods. Forty-nine tissue microarray (TMA) samples of mucinous EOC from Asian women were analyzed by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) tests using ToGA trial HER2 scoring methods. The overall concordance between IHC and FISH by the ToGA surgical specimen method is 97.56% and by the ToGA biopsy specimen method is 97.14%. The agreements of HER2 IHC results under both biopsy and surgical specimen methods were nearly perfect (weighted kappa = 0.845). Additionally, the percentage of Her2 FISH amplification showed increasing trend with increasing HER2 IHC ordinals (negative, equivocal, positive) by both TOGA biopsy (P<0.001) and surgical specimen method (P<0.001). After excluding equivocal cases, the sensitivity (100%), PPV (88.89%) and NPV (100%) of HER2 IHC were unchanged under either surgical specimen method or biopsy method. However, the specificity (96.97%) and accuracy (97.56%) of HER2 IHC was slightly higher under the surgical specimen method than those (specificity 96.30%, accuracy 97.14%) under the biopsy method. Of the total 49 cases, the number (n = 14) of HER2 IHC equivocal results under the ToGA biopsy method was 1.75-fold higher than those (n = 8) under the ToGA surgical specimen method (28.57% vs. 16.32%). Therefore, compared to ToGA surgery specimen method, the ToGA biopsy method caused more equivocal IHC cases to be referred to FISH testing and did not increase the detection rates of Her2 FISH amplification.

  1. Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis.

    PubMed

    Sumida, Yoshio; Nakajima, Atsushi; Itoh, Yoshito

    2014-01-14

    It is estimated that 30% of the adult population in Japan is affected by nonalcoholic fatty liver disease (NAFLD). Fatty changes of the liver are generally diagnosed using imaging methods such as abdominal ultrasonography (US) and computed tomography (CT), but the sensitivity of these imaging techniques is low in cases of mild steatosis. Alanine aminotransferase levels may be normal in some of these patients, warranting the necessity to establish a set of parameters useful for detecting NAFLD, and the more severe form of the disease, nonalcoholic steatohepatitis (NASH). Although liver biopsy is currently the gold standard for diagnosing progressive NASH, it has many drawbacks, such as sampling error, cost, and risk of complications. Furthermore, it is not realistic to perform liver biopsies on all NAFLD patients. Diagnosis of NASH using various biomarkers, scoring systems and imaging methods, such as elastography, has recently been attempted. The NAFIC score, calculated from the levels of ferritin, fasting insulin, and type IV collagen 7S, is useful for the diagnosis of NASH, while the NAFLD fibrosis score and the FIB-4 index are useful for excluding NASH in cases of advanced fibrosis. This article reviews the limitations and merits of liver biopsy and noninvasive diagnostic tests in the diagnosis of NAFLD/NASH.

  2. Determination of trace elements in human liver biopsy samples by ICP-MS and TXRF: hepatic steatosis and nickel accumulation.

    PubMed

    Varga, Imre; Szebeni, Agnes; Szoboszlai, Norbert; Kovács, Béla

    2005-10-01

    Human liver biopsy samples, collected from 52 individuals, were analysed by inductively coupled plasma-mass spectrometry (ICP-MS) and total reflection X-ray fluorescence (TXRF) spectrometry in a retrospective study (i.e. patient selection and liver biopsy were not for the purpose of element analysis). The freeze-dried samples (typically 0.5-2 mg dry weight) were digested in a laboratory microwave digestion system and solutions with a final volume of 1 mL were prepared. The concentrations of Cr, Mn, Fe, Ni, Cu, Zn, Rb, and Pb were determined by use of a Thermo Elemental X7 ICP-MS spectrometer. TXRF measurements were performed with an Atomika Extra IIA spectrometer. Yttrium was employed as an internal standard, prepared by dissolution of 5N-purity yttria (Y(2)O(3)) in our laboratory. The accuracy was tested by analysis of NIST 1577a Bovine Liver certified reference material. The concentrations of Fe, Cu, Zn, and Rb determined in human liver biopsy samples were in good agreement with data published by other authors. The distribution of nickel in the samples was surprisingly uneven-nickel concentrations ranged from 0.7 to 12 microg g(-1) (dry weight) in 38 samples and in several samples were extremely high, 36-693 microg g(-1). Analysis of replicate procedural blanks and control measurements were performed to prevent misinterpretation of the data. For patients with steatosis (n=14) Ni concentrations were consistently high except for two who had levels close to those measured for the normal group. As far as we are aware no previous literature data are available on the association of steatosis with high concentration of nickel in human liver biopsies taken from living patients.

  3. Identification of Mycobacterium avium subsp. paratuberculosis in Biopsy Specimens from Patients with Crohn's Disease Identified by In Situ Hybridization

    PubMed Central

    Sechi, Leonardo A.; Manuela, Mura; Francesco, Tanda; Amelia, Lissia; Antonello, Solinas; Giovanni, Fadda; Stefania, Zanetti

    2001-01-01

    Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract of unknown etiology. We report on the presence of cell wall-deficient Mycobacterium avium subsp. paratuberculosis in 35 of 48 paraffin-embedded tissue specimens from 33 patients with Crohn's disease by in situ hybridization with IS900 as a probe. PMID:11724871

  4. Stereological Analysis of Liver Biopsy Histology Sections as a Reference Standard for Validating Non-Invasive Liver Fat Fraction Measurements by MRI

    PubMed Central

    St. Pierre, Tim G.; House, Michael J.; Bangma, Sander J.; Pang, Wenjie; Bathgate, Andrew; Gan, Eng K.; Ayonrinde, Oyekoya T.; Bhathal, Prithi S.; Clouston, Andrew; Olynyk, John K.; Adams, Leon A.

    2016-01-01

    Background and Aims Validation of non-invasive methods of liver fat quantification requires a reference standard. However, using standard histopathology assessment of liver biopsies is problematical because of poor repeatability. We aimed to assess a stereological method of measuring volumetric liver fat fraction (VLFF) in liver biopsies and to use the method to validate a magnetic resonance imaging method for measurement of VLFF. Methods VLFFs were measured in 59 subjects (1) by three independent analysts using a stereological point counting technique combined with the Delesse principle on liver biopsy histological sections and (2) by three independent analysts using the HepaFat-Scan® technique on magnetic resonance images of the liver. Bland Altman statistics and intraclass correlation (IC) were used to assess the repeatability of each method and the bias between the methods of liver fat fraction measurement. Results Inter-analyst repeatability coefficients for the stereology and HepaFat-Scan® methods were 8.2 (95% CI 7.7–8.8)% and 2.4 (95% CI 2.2–2.5)% VLFF respectively. IC coefficients were 0.86 (95% CI 0.69–0.93) and 0.990 (95% CI 0.985–0.994) respectively. Small biases (≤3.4%) were observable between two pairs of analysts using stereology while no significant biases were observable between any of the three pairs of analysts using HepaFat-Scan®. A bias of 1.4±0.5% VLFF was observed between the HepaFat-Scan® method and the stereological method. Conclusions Repeatability of the stereological method is superior to the previously reported performance of assessment of hepatic steatosis by histopathologists and is a suitable reference standard for validating non-invasive methods of measurement of VLFF. PMID:27501242

  5. Extended pathology reporting of resection specimens of colorectal liver metastases: the significance of a tumour pseudocapsule

    PubMed Central

    Wiggans, Matthew G; Shahtahmassebi, Golnaz; Malcolm, Paul; McCormick, Frances; Aroori, Somaiah; Bowles, Matthew J; Stell, David A

    2013-01-01

    Introduction: The aim of this study was to analyse the influence of factors reported in the minimum histopathology dataset for colorectal liver metastases (CRLM) and other pre-operative factors compared with additional data relating to the presence of tumour pseudocapsules and necrosis on recurrence 1 year after a resection. Methods: For a period of 14 months, extended histological reporting of CRLM specimens was performed, including the presence of pseudocapsules and necrosis in each tumour. The details of recurrence were obtained from surveillance imaging. Results: In 66 patients there were 27 recurrences within 1 year. The rates were lower for patients with tumour pseudocapsules (8/27) than for patients without (19/36) (P = 0.030). Pseudocapsules were associated with a younger age (P = 0.005), nodal stage of the primary colorectal tumour (P = 0.025) and metachronous tumours (P = 0.004). In patients with synchronous disease and pseudocapsules, the recurrence rate was 2/12 compared with 13/23 patients without pseudocapsules (P = 0.026). Discussion: These findings demonstrate that histological examination of resection specimens can provide significant additional prognostic information for patients after resection of CRLM, compared with clinical and radiological data. The present finding that the absence of a pseudocapsule in patients with synchronous CRLM is associated with a dramatically worse outcome may help direct patient-specific adjuvant treatment and care. PMID:23458032

  6. Analysis of parasitic diseases diagnosed by tissue biopsy specimens at KyungHee Medical Center (1984-2005) in Seoul, Korea.

    PubMed

    Choi, Won-Hyung; Chu, Jong-Phil; Jiang, Meihua; Lee, Yun-Sik; Kim, Bum-Shik; Kim, Deog-Gon; Park, Yong-Koo

    2010-03-01

    We analyzed parasitic diseases diagnosed by tissue biopsy specimens at KyungHee Medical Center (KMC) from 1984 to 2005. The total number of parasite infection cases was 150 (0.07%) out of the total 211,859 biopsy specimens submitted for histopathological examinations. They consisted of 62 cysticercosis, 23 sparganosis, 16 paragonimiasis, 15 amebiasis, 11 anisakiasis, 11 clonorchiasis, 3 ascariasis, 2 scabies, 2 enterobiasis, 2 trichuriasis, 1 leishmaniasis, 1 taeniasis, and 1 thelaziasis. Out of 62 cysticercosis cases, 55 were detected in subcutaneous tissues or the central nerve system. Eighteen out of 23 sparganosis cases were involved in muscular and subcutaneous tissues. In most anisakiasis cases, the involved organ was the stomach. The lung and the pleura were the most common site of paragonimiasis. The incidence of parasitic diseases during the first 5 years (1984-1988) was the highest of all observed periods. After 1989, similar incidences were shown throughout the period. Whereas cysticercosis was diagnosed in 34 cases during 1984-1988, no case has been diagnosed since 2000. In the case of sparganosis, the chronological incidence was almost uniform throughout the period 1984-2005. Paragonimiasis showed a similar tendency to cysticercosis. In gender and age distribution of parasitic diseases, men showed higher incidence rates than females, and the age groups of the 40s or older indicated higher infection frequencies than other age groups. Therefore, these results are a significant report to appear the tendency of human parasitic disease diagnosed by tissue biopsy in association with parasitosis at KMC in Seoul.

  7. Hematoxylin and eosin stain shows a high sensitivity but sub-optimal specificity in demonstrating iron pigment in liver biopsies

    PubMed Central

    Alwahaibi, Nasar Yousuf; Alkhatri, Azza Sarhan; Kumar, Johanes Selva

    2015-01-01

    Background: Perls’ stain is routinely used to demonstrate iron in liver biopsies. We tested the hypothesis that it may be unnecessary in cases, where no iron or another similar pigment was seen on the routine hematoxylin and eosin (H and E) stained section. Aim: The aim of this study was to evaluate the efficiency of H and E stain in demonstrating iron in liver biopsies as well as to determine the possibility of replacing Perls’ stain with H and E stain. Materials and Methods: Two hundred pairs of slides of liver biopsies were taken from the archival files of the Department of Pathology from 2006 to 2011. Perls’ and H and E slides were independently reviewed for the presence of iron. Results: Hundred and one cases showed the presence of iron using H and E stain. 84 of 86 cases showed positive iron using both Perls’ and H and E stains. Seventeen cases were positive using H and E stain but negative with Perls’. Only two cases did not show the presence of iron using H and E stain. Ninety-seven cases were negative using both Perls’ and H and E stains. H and E stain showed a sensitivity, specificity, accuracy, positive predictive valve, and negative predictive value of 97.67%, 85.08%, 90.5%, 83.16%, and 97.98%, respectively. Conclusion: We demonstrate that the H and E stain is a sensitive method to detect iron pigment in liver biopsies, particularly when present in large quantities. A negative H and E stain might obviate the need for extra Perls’ staining, thus saving costs and shortening report turn-around times. PMID:26539364

  8. Prevalence of apoptotic epidermal keratinocytes in eosinophilic dermatoses of the cat: a retrospective light-microscopic study of 145 skin-biopsy specimens.

    PubMed

    Griffin, Joya S; Scott, Danny W; Erb, Hollis N

    2010-02-01

    A retrospective light-microscopic study was performed on skin-biopsy specimens from 145 cats with eosinophilic inflammatory dermatoses in order to determine the prevalence of apoptotic epidermal keratinocytes (AKs), the prevalence of eosinophils in close proximity to AKs, and whether there was a difference in the prevalence of AKs or the prevalence of eosinophils in close proximity to AKs based on histopathological reaction pattern. Overall, 62/145 (43%) specimens had AKs. Of the cases in which AKs were seen, 18% had eosinophils in close proximity to the AKs. The specimens were divided into three groups based on histopathological reaction pattern: perivascular-to-interstitial, diffuse, and nodular. No difference in the prevalence of AKs was found among the three histological groups. Because the sample size containing eosinophils in close proximity to AKs was too small to compare the three histological patterns individually, nodular and non-nodular patterns were compared. No difference in the presence of eosinophils in close proximity to AKs was found in these two subsets. More AKs were present if eosinophils were in close proximity to the AKs (range 1-9 with eosinophils near compared to 0-7 without).

  9. Response-Guided Therapy for Hepatitis C Virus Recurrence Based on Early Protocol Biopsy after Liver Transplantation

    PubMed Central

    Kim, Hyeyoung; Yi, Nam-Joon; Lee, Hae Won; Choi, YoungRok; Suh, Suk-Won; Jeong, Jaehong; Suh, Kyung-Suk

    2015-01-01

    Hepatitis C virus (HCV) recurrence after liver transplantation (LT) is universal and progressive. Here, we report recent results of response-guided therapy for HCV recurrence based on early protocol biopsy after LT. We reviewed patients who underwent LT for HCV related liver disease between 2010 and 2012. Protocol biopsies were performed at 3, 6, and 12 months after LT in HCV recurrence (positive HCV-RNA). For any degree of fibrosis, ≥ moderate inflammation on histology or HCV hepatitis accompanying with abnormal liver function, we treated with pegylated interferon and ribavirin. We adjusted treatment period according to individual response to treatment. Among 41 HCV related recipients, 25 (61.0%) who underwent protocol biopsies more than once were enrolled in this study. The mean follow-up time was 43.1 (range, 23-55) months after LT. Genotype 1 and 2 showed in 56.0% and 36.0% patients, respectively. Of the 25 patients, 20 (80.0%) started HCV treatment after LT. Rapid or early virological response was observed in 20 (100%) patients. Fifteen (75.0%) patients finished the treatment with end-of-treatment response. Sustained virological response (SVR) was in 11 (55.0%) patients, including 5 (41.7%) of 12 genotype 1 and 6 (75.0%) of 8 non-genotype 1 (P = 0.197). Only rapid or complete early virological response was a significant predictor for HCV treatment response after LT (100% in SVR group vs. 55.6% in non-SVR group, P = 0.026). Overall 3-yr survival rate was 100%. In conclusion, response-guided therapy for HCV recurrence based on early protocol biopsy after LT shows encouraging results. PMID:26539000

  10. Antemortem Detection of Chronic Wasting Disease Prions in Nasal Brush Collections and Rectal Biopsy Specimens from White-Tailed Deer by Real-Time Quaking-Induced Conversion.

    PubMed

    Haley, Nicholas J; Siepker, Chris; Walter, W David; Thomsen, Bruce V; Greenlee, Justin J; Lehmkuhl, Aaron D; Richt, Jürgen A

    2016-04-01

    Chronic wasting disease (CWD), a transmissible spongiform encephalopathy of cervids, was first documented nearly 50 years ago in Colorado and Wyoming and has since spread to cervids in 23 states, two Canadian provinces, and the Republic of Korea. The expansion of this disease makes the development of sensitive diagnostic assays and antemortem sampling techniques crucial for the mitigation of its spread; this is especially true in cases of relocation/reintroduction of farmed or free-ranging deer and elk or surveillance studies of private or protected herds, where depopulation is contraindicated. This study sought to evaluate the sensitivity of the real-time quaking-induced conversion (RT-QuIC) assay by using recto-anal mucosa-associated lymphoid tissue (RAMALT) biopsy specimens and nasal brush samples collected antemortem from farmed white-tailed deer (n= 409). Antemortem findings were then compared to results from ante- and postmortem samples (RAMALT, brainstem, and medial retropharyngeal lymph nodes) evaluated by using the current gold standardin vitroassay, immunohistochemistry (IHC) analysis. We hypothesized that the sensitivity of RT-QuIC would be comparable to IHC analysis in antemortem tissues and would correlate with both the genotype and the stage of clinical disease. Our results showed that RAMALT testing by RT-QuIC assay had the highest sensitivity (69.8%) compared to that of postmortem testing, with a specificity of >93.9%. These data suggest that RT-QuIC, like IHC analysis, is an effective assay for detection of PrP(CWD)in rectal biopsy specimens and other antemortem samples and, with further research to identify more sensitive tissues, bodily fluids, or experimental conditions, has potential for large-scale and rapid automated testing for CWD diagnosis.

  11. Lung beta-adrenoceptors in pulmonary hypertension. A study of biopsy specimens in children with congenital heart disease

    SciTech Connect

    Lopes, A.A.; Liberato, M.H.; Brentani, M.M.; Aiello, V.D.; Riso, A.A.; Ebaid, M. )

    1991-03-01

    Characteristics of beta-adrenoceptors were analyzed using radioligand-binding techniques with 3H-dihydroalprenolol in lung specimens from 11 children with pulmonary hypertension (median age, three years) undergoing surgical repair of congenital heart defects and four pediatric control subjects (median age, five years) undergoing thoracotomy for removal of neoplasms or cysts. Scatchard analysis of 3H-DHA binding to lung membranes showed similar values of the dissociation constant in both groups (Kd = 0.72 +/- 0.22 nM in patients vs 1.22 +/- 0.22 nM in controls; p = NS). The receptor density was significantly increased in patients in comparison with controls, with respective values of 164 +/- 19 and 95 +/- 13 fmol/mg of protein (p less than 0.025), and correlated directly with mean pulmonary arterial pressure (r = 0.82; p less than 0.0005). No significant relationship was observed between receptor number and pulmonary arterial medial thickness. Thus, the increase in receptor density in these patients may be related to adaptative changes in cells other than vascular smooth muscle.

  12. Increased T-cell sinusoidal lymphocytosis in liver biopsies in patients with chronic hepatitis C and mixed cryoglobulinemia.

    PubMed

    Carmack, Susanne; Taddei, Tamar; Robert, Marie E; Mistry, Pramod; Jain, Dhanpat

    2008-03-01

    Mixed cryoglobulinemia (MC) has a strong association with hepatitis C virus (HCV) infection and is associated with a higher degree of fibrosis and poor response to therapy. Currently, there are no known histological findings on liver biopsy that correlate with the presence of MC in HCV-infected patients, although we have occasionally noted prominent sinusoidal lymphocytosis in MC patients. The goal of this study is to determine whether sinusoidal lymphocytosis is a histological marker of MC in liver biopsies from patients with chronic hepatitis C. The liver clinic database at our institution was searched for chronic hepatitis C patients with MC who underwent liver biopsy during 1999-2005. Ten such cases were identified and were included in the study. Ten chronic hepatitis C MC-negative cases were matched for age and stage of fibrosis to serve as controls. Histological features (sinusoidal lymphocytes, inflammatory activity, acidophil bodies, and fibrosis stage) were evaluated in each biopsy. Clinical and laboratory data (serum protein electrophoresis, liver enzymes, hepatitis C viral load, treatment status, comorbidities, etc.) were also recorded. Formalin-fixed, paraffin-embedded sections were submitted for immunohistochemical analysis using antibodies against CD3, CD20, CD4, CD8, and CD68. Sinusoidal lymphocytes were counted in 5 hpf (40x) on hematoxylin and eosin (H&E) stain, and on CD3 and CD20 immunostains. The number of CD68+ Kupffer cells was also counted in a similar fashion. In the MC-positive versus MC-negative cases, mean fibrosis stage (2.4 vs. 2.4), inflammatory grade (1.7 vs. 2.1), lymphocyte count (359 vs. 128/5 hpf), and Kupffer cell count (239 vs. 220/5 HPF) were assessed. There was a significant increase in sinusoidal T-cell lymphocytes (P < 0.05) in MC-positive cases as compared to MC-negative cases. Nearly all sinusoidal lymphocytes were CD8-positive cells in both groups. Other histological parameters did not differ in the two groups. MC

  13. Serotonin Syndrome in a Patient on Trazodone and Duloxetine Who Received Fentanyl following a Percutaneous Liver Biopsy.

    PubMed

    Gaffney, Ryan R; Schreibman, Ian R

    2015-01-01

    Serotonin syndrome is a rare but potentially life-threatening adverse drug reaction resulting from the use or overuse of serotonergic medications alone or in combination. Mild symptoms, overlapping features with similar conditions and clinician lack of awareness are the major reasons for an often missed diagnosis. Not surprisingly, this condition is significantly underreported as a potential complication of endoscopy if serotonergic medications are used periprocedurally for sedation and analgesia. Here we report the case of a patient with relapsed chronic hepatitis C on antidepressant medications who developed signs and symptoms of serotonin syndrome after a percutaneous liver biopsy. Review of the patient's medication list suggested a possible interaction between her home antidepressants and the post-procedure use of fentanyl for abdominal pain. The patient required monitoring in the medical intensive care unit and stabilized after the administration of benzodiazepines and temporary discontinuation of her home medications. We propose that clinicians need to be aware of the increased risk of serotonin syndrome in the outpatient endoscopy setting, particularly with the wider use of serotonergic antidepressants now available and the repeated number of liver biopsies being performed for management of patients with chronic liver disease.

  14. Serotonin Syndrome in a Patient on Trazodone and Duloxetine Who Received Fentanyl following a Percutaneous Liver Biopsy

    PubMed Central

    Gaffney, Ryan R.; Schreibman, Ian R.

    2015-01-01

    Serotonin syndrome is a rare but potentially life-threatening adverse drug reaction resulting from the use or overuse of serotonergic medications alone or in combination. Mild symptoms, overlapping features with similar conditions and clinician lack of awareness are the major reasons for an often missed diagnosis. Not surprisingly, this condition is significantly underreported as a potential complication of endoscopy if serotonergic medications are used periprocedurally for sedation and analgesia. Here we report the case of a patient with relapsed chronic hepatitis C on antidepressant medications who developed signs and symptoms of serotonin syndrome after a percutaneous liver biopsy. Review of the patient's medication list suggested a possible interaction between her home antidepressants and the post-procedure use of fentanyl for abdominal pain. The patient required monitoring in the medical intensive care unit and stabilized after the administration of benzodiazepines and temporary discontinuation of her home medications. We propose that clinicians need to be aware of the increased risk of serotonin syndrome in the outpatient endoscopy setting, particularly with the wider use of serotonergic antidepressants now available and the repeated number of liver biopsies being performed for management of patients with chronic liver disease. PMID:26078731

  15. Mutant-specific BRAF and CD117 immunocytochemistry potentially facilitate risk stratification for papillary thyroid carcinoma in fine-needle aspiration biopsy specimens.

    PubMed

    Meng, Zhilan; Lu, Junliang; Wu, Huanwen; Zhao, Yu; Luo, Yufeng; Gao, Jie; Zhu, Qingli; Jiang, Yuxin; Li, Wenbo; Liang, Zhiyong

    2016-01-01

    The study aims to test whether combination of mutant-specific BRAF and CD117 immunocytochemical (ICC) staining stratifies probability for papillary thyroid carcinoma (PTC) in thyroid fine-needle aspiration biopsy (FNAB) specimens. A consecutive cohort of cases diagnosed as atypia of undetermined significance (AUS) or suspicious for malignancy-suspicious for papillary thyroid carcinoma (SM-SPTC) from 30 December, 2011 to 23 October, 2014 in a single institute was enrolled. Forty cytologically benign and 50 cytologically diagnosed PTC within the same time span were also included. CD117 and mutant-specific BRAF (BRAF VE1) ICC staining was performed. Association of BRAF VE1 and CD117 expression with final diagnosis was analyzed. Both BRAF VE1 and CD117 showed good performance in distinguishing PTC from benign nodules. Combination of BRAF VE1 and CD117 stratified 180 cases into three categories: BRAF VE1 positive regardless of CD117 expression (ICC-malignant), BRAF VE1 negative plus low level of CD117 expression (ICC-intermediate), and BRAF VE1 negative plus high level of CD117 expression (ICC-benign), which was associated with 100, 75.6, and 0 % of malignancy. Combination of mutant-specific BRAF and CD117 ICC may potentially facilitate the PTC risk stratification in FNAB thyroid nodule specimens.

  16. Real-Time PCR Assay Using Fine-Needle Aspirates and Tissue Biopsy Specimens for Rapid Diagnosis of Mycobacterial Lymphadenitis in Children

    PubMed Central

    van Coppenraet, E. S. Bruijnesteijn; Lindeboom, J. A.; Prins, J. M.; Peeters, M. F.; Claas, E. C. J.; Kuijper, E. J.

    2004-01-01

    A real-time PCR assay was developed to diagnose and identify the causative agents of suspected mycobacterial lymphadenitis. Primers and probes for the real-time PCR were designed on the basis of the internal transcribed spacer sequence, enabling the recognition of the genus Mycobacterium and the species Mycobacterium avium and M. tuberculosis. The detection limit for the assay was established at 1,100 CFU/ml of pus, and the specificity tests showed no false-positive reaction with other mycobacterial species and other pathogens causing lymphadenitis. From 67 children with suspected mycobacterial lymphadenitis based on a positive mycobacterial skin test, 102 samples (58 fine-needle aspirates [FNA] and 44 tissue specimens) were obtained. The real-time PCR assay detected a mycobacterial infection in 48 patients (71.6%), whereas auramine staining and culturing were positive for 31 (46.3%) and 28 (41.8%) of the patients. The addition of the real-time PCR assay to conventional diagnostic tests resulted in the recognition of 13 more patients with mycobacterial disease. These results indicate that the real-time PCR is more sensitive than conventional staining and culturing techniques (P = 0.006). The M. avium-specific real-time PCR was positive for 38 patients, and the M. tuberculosis-specific real-time PCR was positive for 1 patient. Analysis of 27 patients from whom FNA and tissue biopsy specimens were collected revealed significantly more positive real-time PCR results for FNA than for tissue biopsy specimens (P = 0.003). Samples from an age-matched control group of 50 patients with PCR-proven cat scratch disease were all found to be negative by the real-time PCR. We conclude that this real-time PCR assay with a sensitivity of 72% for patients with lymphadenitis and a specificity of 100% for the detection of atypical mycobacteria can provide excellent support for clinical decision making in children with lymphadenitis. PMID:15184446

  17. Elevated miR-33a and miR-224 in steatotic chronic hepatitis C liver biopsies

    PubMed Central

    Lendvai, Gabor; Jármay, Katalin; Karácsony, Gizella; Halász, Tünde; Kovalszky, Ilona; Baghy, Kornélia; Wittmann, Tibor; Schaff, Zsuzsa; Kiss, András

    2014-01-01

    AIM: To assess the expression of selected microRNAs (miRNA) in hepatitis C, steatotic hepatitis C, noninfected steatotic and normal liver tissues. METHODS: The relative expression levels of miR-21, miR-33a, miR-96, miR-122, miR-125b, miR-221 and miR-224 were determined in 76 RNA samples isolated from 18 non-steatotic and 28 steatotic chronic hepatitis C (CHC and CHC-Steatosis, respectively) cases, 18 non-infected, steatotic liver biopsies of metabolic origin (Steatosis) and 12 normal formalin-fixed paraffin-embedded liver tissues using TaqMan MicroRNA Assays. All CHC biopsy samples were obtained prior to initiating therapy. Patients’ serum biochemical values, which included glucose, triglyceride, cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl-transferase (GGT), alkaline phosphatase (AP), were obtained and correlated with relative miRNA expression. RESULTS: When compared with control non-infected liver samples, miR-122 and miR-221 levels were reduced in CHC-Steatosis (P < 0.03) and in CHC, CHC-Steatosis and Steatosis (P < 0.01). Alternatively, the expression of miR-33a and miR-224 were elevated in CHC-Steatosis and Steatosis in comparison to control tissue (P < 0.01). The levels of miR-33a and miR-224 in CHC-Steatosis (P < 0.02) and miR-224 in Steatosis (P < 0.001) were increased in comparison to CHC samples. By contrast, the expression of miR-21 did not differ statistically between diseased and normal liver samples. Levels of miR-33a correlated negatively with serum AST and AP levels in Steatosis as well as with necroinflammatory grade in CHC, whereas miR-21 correlated positively with AST in Steatosis and displayed negative correlation with triglyceride level in CHC-Steatosis. In contrast, miRNA levels were not correlated with ALT, GGT, cholesterol levels or fibrosis stage. CONCLUSION: Differences in miRNA expression were observed between CHC and steatotic CHC, CHC and steatotic liver, but not between steatotic CHC

  18. Ventricular expression of atrial natriuretic polypeptide and its relations with hemodynamics and histology in dilated human hearts. Immunohistochemical study of the endomyocardial biopsy specimens.

    PubMed

    Takemura, G; Fujiwara, H; Horike, K; Mukoyama, M; Saito, Y; Nakao, K; Matsuda, M; Kawamura, A; Ishida, M; Kida, M

    1989-11-01

    To investigate the mechanism of expression of atrial natriuretic polypeptide (ANP) in human ventricles, we conducted an immunohistochemical study of ANP in biventricular endomyocardial biopsy specimens obtained from a total of 49 patients with cardiac dilatation due to dilated cardiomyopathy (21 patients), postmyocarditis (18 patients), or volume overload (five patients) and subjects with no dilatation as controls (five patients). Four-micron thick sections were stained by an indirect immunoperoxidase method using monoclonal antibody to alpha-human ANP as the primary antibody. The frequency of ANP-present myocytes was calculated in each specimen and compared with clinical, echocardiographic, hemodynamic, angiographic, and histologic parameters. ANP-present myocytes were noted in all of the 21 patients with dilated cardiomyopathy, in 11 of the 18 patients with postmyocarditis, in four of the five patients with volume overload, and in zero of the five controls. The mean percentage of ANP-present myocytes was significantly greater in the left-side specimens (35 +/- 37%) than in the right-side ones (2 +/- 4%). The percentage of ANP-present myocytes in the left-side specimens significantly correlated with peak systolic or end-diastolic wall stress (r = 0.67 and 0.58), left ventricular end-systolic or end-diastolic volume index (r = 0.75 and 0.69), or left ventricular end-diastolic pressure (r = 0.42) and inversely correlated with ejection fraction (r = -0.73), systolic left ventricular wall thickness (r = -0.58), or cardiac index (r = -0.30). Expression of ANP was rarely seen in the cases with normal wall stresses, normal ejection fraction, normal volume, or normal myocyte size. However, it was seen frequently even in hearts with normal levels of left ventricular end-diastolic pressure and cardiac index (compensated hearts). The percent of ANP-present myocytes in both sides significantly correlated with size of myocytes (r = 0.48 at right and r = 0.57 at left side) or

  19. Liver biopsy as diagnostic method for poisoning by swainsonine-containing plants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    With the aim to investigate the use of hepatic biopsies for the diagnosis of poisoning by swainsonine-containing plants, dry leaves of Ipomoea marcellia containing 0.02% of swainsonine were administered to goats. Group I, with six goats, ingested 4g/kg of dry plant (0.8mg of swainsonina/kg) until th...

  20. Comparison of liver biopsy and noninvasive techniques for liver fibrosis assessment in patients infected with HCV-genotype 4 in Egypt.

    PubMed

    Bonnard, P; Elsharkawy, A; Zalata, K; Delarocque-Astagneau, E; Biard, L; Le Fouler, L; Hassan, A B; Abdel-Hamid, M; El-Daly, M; Gamal, M E; El Kassas, M; Bedossa, P; Carrat, F; Fontanet, A; Esmat, G

    2015-03-01

    In Egypt, as elsewhere, liver biopsy (LB) remains the gold standard to assess liver fibrosis in chronic hepatitis C (CHC) and is required to decide whether a treatment should be proposed. Many of its disadvantages have led to develop noninvasive methods to replace LB. These new methods should be evaluated in Egypt, where circulating virus genotype 4 (G4), increased body mass index and co-infection with schistosomiasis may interfere with liver fibrosis assessment. Egyptian CHC-infected patients with G4 underwent a LB, an elastometry measurement (Fibroscan(©)), and serum markers (APRI, Fib4 and Fibrotest(©)). Patients had to have a LB ≥15 mm length or ≥10 portal tracts with two pathologists blinded readings to be included in the analysis. Patients with hepatitis B virus co-infection were excluded. Three hundred and twelve patients are reported. The performance of each technique for distinguishing F0F1 vs F2F3F4 was compared. The area under receiver operating characteristic curves was 0.70, 0.76, 0.71 and 0.75 for APRI, Fib-4, Fibrotest© and Fibroscan©, respectively (no influence of schistosomiasis was noticed). An algorithm using the Fib4 for identifying patients with F2 stage or more reduced by nearly 90% the number of liver biopsies. Our results demonstrated that noninvasive techniques were feasible in Egypt, for CHC G4-infected patients. Because of its validity and its easiness to perform, we believe that Fib4 may be used to assess the F2 threshold, which decides whether treatment should be proposed or delayed.

  1. Anesthesia and liver biopsy techniques for pigeon guillemots (Cepphus columba) suspected of exposure to crude oil in marine environments

    USGS Publications Warehouse

    Degernes, Laurel A.; Harms, Craig A.; Golet, Gregory H.; Mulcahy, Daniel M.

    2002-01-01

    This paper reports on the anesthesia and liver biopsy techniques used in adult and nestling pigeon guillemots (Cepphus columba) to test for continued exposure to residual crude oil in the marine environment. Populations of pigeon guillemots have declined significantly in Prince William Sound, Alaska, USA, possibly because of residual effects of crude oil in the environment after the Exxon Valdez oil spill in March 1989. Measurement of hepatic cytochrome P450 1A (CYP1A) is currently the best way to assess crude oil exposure from food sources; however, lethal sampling to obtain adequate liver tissue was not desirable in this declining population of birds. As part of a larger study to identify factors limiting the recovery of pigeon guillemots and other seabird populations, we surgically collected liver samples from adult and nestling guillemots to provide samples for measurement of hepatic CYP1A concentrations. Results from the larger study were reported elsewhere. Liver samples were taken from 26 nestling (1998) and 24 adult (1999) guillemots from a previously oiled site (Naked Island; 12 chicks, 13 adults) and from a nonoiled site (Jackpot Island/Icy Bay; 14 chicks, 11 adults). The birds were anesthetized with isoflurane. No surgical complications occurred with any of the birds and all adult and nestling birds survived after surgery to the point of release or return to the nest. Thirteen out of 14 chicks from the Jackpot Island/Icy Bay and 8 out of 12 chicks from Naked Island fledged. Four chicks at Naked Island were depredated before fledging. All adults abandoned their nests after surgery, so the study sites were revisited the following summer (2000) in an attempt to assess overwinter survival of the adults. All but 1 adult biopsied bird at the nonoiled site (Icy Bay) was found renesting, whereas only 2 birds at the previously oiled site (Naked Island) were similarly observed. The percent of 1999 breeders at Naked Island that returned to their nest sites to breed

  2. [Double-blind study on the analgesic efficacy of tilidine (valoron) and pethidine (dolantin) in gastro-intestinal endoscopies and liver biopsies (author's transl)].

    PubMed

    Tomatis, H P

    1977-02-01

    In a double-blind trial involving 99 patients, equi-analgesic doses of tilidine and pethidine (100 mg of each i.m.) were compared as to their effectiveness in laparoscopies, gastroscopies, esophagoscopies and liver needle biopsies. The two substances produced equally analgesic effects both during and after the various procedures, with the exception of the liver biopsies, in which tilidine was shown to be significantly more effective than pethidine. Whereas no sedation was noted in connection with tilidine medication, pethidine produced a marked, undesirable sleepiness in 12% of the cases observed. Due to the high analgesic efficacy and tolerance of tilidine found in both this and numerous other clinical trials and to its particular advantages over pethidine and other opiates (no respiratory depression, no effect on intestinal motility) tilidine can be recommended for premedication in gastrointestinal endoscopies and liver needle biopsies. Tilidine (Valoron) is not subject to the restrictions imposed by the West German narcotics laws.

  3. Low Helicobacter pylori primary resistance to clarithromycin in gastric biopsy specimens from dyspeptic patients of a city in the interior of São Paulo, Brazil

    PubMed Central

    2013-01-01

    Background Clarithromycin, amoxicillin, and a pump proton inhibitor are the most common drugs recommended as first-line triple therapy for H.pylori treatment, which results in eradication rates close to 80%, varying regionally, principally due to emergency cases and increases of clarithromycin resistant strains. Nucleotide substitutions at the H. pylori domain V of the 23S rRNA fraction are involved in the macrolide resistance and the A2142G and A2143G mutations are predominant in clinical isolates worldwide including in Brazil. As H. pylori culture is fastidious, we investigated the primary occurrence of H. pylori A2142G and A2143G rDNA 23S mutations using a molecular approach directly on gastric biopsies of dyspeptic patients consecutively attended at Hospital das Clinicas of Marilia, São Paulo, Brazil. Methods Biopsy specimens obtained from 1137 dyspeptic patients, were subjected to histopathology and H. pylori diagnosis by histology and PCR. PCR/RFLP assay was used to detect A2142G and A2143G point mutations at domain V of the H. pylori 23S rDNA associated with clarithromycin resistance. Through the developed assay, a 768 bp PCR amplicon corresponding to1728 to 2495 bp of the 23S H. pylori rDNA is restricted with MboII for A2142G mutation detection and with BsaI for A2143G mutation detection. Occurrence of 23S rDNA A2142G results in two DNA fragments (418 and 350 bp) and of 23S rDNA A2143G results in three DNA fragments (108, 310 and 350pb), due to a conserved BsaI restriction site. Results The PCR method used to diagnose H. pylori presented sensitivity, specificity and accuracy of 77,6%, 79,3% and 78,6%, respectively, compared to histology, the gold standard method for H. pylori diagnosis used in our routine. Prevalence of H.pylori with clarithromycin resistant genotypes was 2,46%, with predominance of A2143G 23S rDNA point mutation. Conclusions The PCR/RFLP assay was a rapid and accurate H.pylori diagnostic and clarithromycin resistance determination

  4. Concordance between core needle biopsy and surgical specimen for oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status in breast cancer

    PubMed Central

    Asogan, Aravind Barathi; Hong, Ga Sze; Prabhakaran, Subash Kumar Arni

    2017-01-01

    INTRODUCTION This study aimed to analyse the concordance rate, sensitivity, specificity, positive predictive value (PPV) and negative predictive value of core needle biopsy (CNB) and subsequent surgical specimen (SS) in assessing levels of oestrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2/neu). It also evaluated the revised American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines for ER/PgR positivity. METHODS We analysed the breast cancer database of KK Women’s and Children’s Hospital, Singapore, from 1 June 2005 to 30 December 2012. Invasive breast cancer patients who had CNB and subsequent SS were included. RESULTS A total of 560 patients were included. The concordance of ER, PgR and HER2/neu positivity between CNB and SS was 96.1%, 89.1% and 96.8%, respectively. When the ‘ER ≥ 10% positive’ group was compared with the ‘ER ≥ 1% positive’ group, specificity increased from 79.7% to 92.5% and PPV increased from 93.9% to 97.5%. When the ‘PgR ≥ 10% positive’ group was compared with the ‘PgR ≥ 1% positive’ group, specificity increased from 84.2% to 89.3% and PPV improved from 89.7% to 92.9%. The revised ASCO/CAP guidelines decreased discordant results by > 50% for ER and by 18.2% for PgR. CONCLUSION CNB has high concordance with SS in the evaluation of the molecular profile of invasive breast cancer. Thus, molecular evaluation does not need to be repeated with SS except for ER-, PgR- and HER2/neu-negative CNB results. The revised ASCO/CAP guidelines resulted in more precise ER and PgR status on CNB. PMID:27029805

  5. Association of recently described adipokines with liver histology in biopsy-proven non-alcoholic fatty liver disease: a systematic review.

    PubMed

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

    2016-01-01

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

  6. Cellular and humoral immune reactions in chronic active liver disease. II. Lymphocyte subsets and viral antigens in liver biopsies of patients with acute and chronic hepatitis B.

    PubMed Central

    Eggink, H F; Houthoff, H J; Huitema, S; Wolters, G; Poppema, S; Gips, C H

    1984-01-01

    The characteristics and distribution of the inflammatory infiltrate in liver biopsies of 25 patients with hepatitis B viral (HBV) infection were studied in relation to the distribution and expression of HBV antigens. Mononuclear subsets were characterized with monoclonal (OKT, OKM, Leu) antibodies to surface antigens. For the demonstration of viral antigens directly conjugated antibodies to surface (HBsAg), core (HBcAg) and 'e' (HBeAg) antigen were used. For the study of mutual relations all methods were performed on serial cut tissue sections. In chronic active hepatitis B (CAH-B, n = 12) OKT8+ lymphocytes of T cell origin were the only cell type present in areas with liver cell degeneration and T cell cytotoxicity appears to be the only immune mechanism. In chronic persistent hepatitis B (CPH-B, n = 7) the only conspicuous feature was the presence of many Leu 3+ lymphocytes of the helper/inducer population in the portal tracts. In acute hepatitis B (AHB, n = 6) OKT8+ cells of non-T origin (OKT1-,3-) and Leu 7+ cells of presumed natural killer (NK) potential predominated in the areas with liver cell necrosis, and non-T cell cytotoxicity appears to be the predominant immune mechanism. In none of these disease entities a positive spatial relation could be established between the cytotoxic cells and the demonstrable expression of HBV antigens in hepatocytes. It is concluded that differences in immunological reaction pattern may explain the different course in the three forms of HBV infection studied. Images Fig. 1 Fig. 2 PMID:6713726

  7. Risk Assessment of Hepatocellular Carcinoma Using Transient Elastography Vs. Liver Biopsy in Chronic Hepatitis B Patients Receiving Antiviral Therapy

    PubMed Central

    Seo, Yeon Seok; Kim, Mi Na; Kim, Seung Up; Kim, Sang Gyune; Um, Soon Ho; Han, Kwang-Hyub; Kim, Young Seok

    2016-01-01

    Abstract Liver stiffness (LS) assessed using transient elastography (TE) can assess the risk of developing hepatocellular carcinoma (HCC). We evaluated whether TE, when compared with histological data as a reference standard, can predict the risk of HCC development in chronic hepatitis B (CHB) patients starting antiviral therapy. Observational cohort database of 381 patients with CHB who underwent liver biopsy (LB) and TE were reviewed. All patients underwent surveillance for HCC development using ultrasonography and alpha-fetoprotein. During the median follow-up period of 48.1 (interquartile range 30.3–69.3) months, HCC developed in 34 (8.9%) patients. In patients with HCC development, age, proportion of diabetes mellitus, histological fibrosis stage, and LS value were significantly higher than those in patients without (all P <0.05). The cumulative incidence rates of HCC increased significantly in association with elevated LS value in 3 stratified groups (LS value <8, 8–13, and >13 kPa; log-rank test, P <0.001), and with higher histological fibrosis stage in 3 stratified groups (F0–2, F3, and F4; log-rank test, P <0.001). On multivariate analysis, along with age, LS value was an independent predictor of HCC development (hazard ratio 1.041, P <0.001), whereas histological staging was not (P >0.05). TE predicted HCC development independently in patients with CHB starting antiviral therapy. However, further investigation is needed to determine whether the current surveillance strategy can be optimized based on the LS value at the time of starting antiviral therapy. PMID:27015173

  8. Progression of Liver Fibrosis in HIV/HCV Co-Infection: A Comparison between Non-Invasive Assessment Methods and Liver Biopsy

    PubMed Central

    Schmid, Patrick; Bregenzer, Andrea; Huber, Milo; Rauch, Andri; Jochum, Wolfram; Müllhaupt, Beat; Vernazza, Pietro; Opravil, Milos; Weber, Rainer

    2015-01-01

    Objectives To evaluate the diagnostic performance of seven non-invasive tests (NITs) of liver fibrosis and to assess fibrosis progression over time in HIV/HCV co-infected patients. Methods Transient elastography (TE) and six blood tests were compared to histopathological fibrosis stage (METAVIR). Participants were followed over three years with NITs at yearly intervals. Results Area under the receiver operating characteristic curve (AUROC) for significant fibrosis (> = F2) in 105 participants was highest for TE (0.85), followed by FIB-4 (0.77), ELF-Test (0.77), APRI (0.76), Fibrotest (0.75), hyaluronic acid (0.70), and Hepascore (0.68). AUROC for cirrhosis (F4) was 0.97 for TE followed by FIB-4 (0.91), APRI (0.89), Fibrotest (0.84), Hepascore (0.82), ELF-Test (0.82), and hyaluronic acid (0.79). A three year follow-up was completed by 87 participants, all on antiretroviral therapy and in 20 patients who completed HCV treatment (9 with sustained virologic response). TE, APRI and Fibrotest did not significantly change during follow-up. There was weak evidence for an increase of FIB-4 (mean increase: 0.22, p = 0.07). 42 participants had a second liver biopsy: Among 38 participants with F0-F3 at baseline, 10 were progessors (1-stage increase in fibrosis, 8 participants; 2-stage, 1; 3-stage, 1). Among progressors, mean increase in TE was 3.35 kPa, in APRI 0.36, and in FIB-4 0.75. Fibrotest results did not change over 3 years. Conclusion TE was the best NIT for liver fibrosis staging in HIV/HCV co-infected patients. APRI-Score, FIB-4 Index, Fibrotest, and ELF-Test were less reliable. Routinely available APRI and FIB-4 performed as good as more expensive tests. NITs did not change significantly during a follow-up of three years, suggesting slow liver disease progression in a majority of HIV/HCV co-infected persons on antiretroviral therapy. PMID:26418061

  9. Bone Biopsy

    MedlinePlus

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

  10. Validation of AshTest as a Non-Invasive Alternative to Transjugular Liver Biopsy in Patients with Suspected Severe Acute Alcoholic Hepatitis

    PubMed Central

    Rudler, Marika; Mouri, Sarah; Charlotte, Frederic; Cluzel, Philippe; Ngo, Yen; Munteanu, Mona; Lebray, Pascal; Ratziu, Vlad; Thabut, Dominique; Poynard, Thierry

    2015-01-01

    Background/Aims According to guidelines, the histological diagnosis of severe alcoholic steatohepatitis (ASH) can require liver biopsy if a specific treatment is needed. The blood test AshTest (BioPredictive, Paris, France) has been initially validated for the non-invasive diagnosis of ASH in a large population of heavy drinkers. The aim was to validate the AshTest accuracy in the specific context of use of patients with suspected severe ASH, in order to reduce the need for transjugular biopsy before deciding treatment. Methods The reference was liver biopsy, performed using the transjugular route, classified according to its histological severity as none, minimal, moderate or severe. Biopsies were assessed by the same experienced pathologist, blinded to simultaneous AshTest results. Results A total of 123 patients with severe clinical ASH (recent jaundice and Maddrey function greater or equal to 32) were included, all had cirrhosis and 80% had EASL histological definition of ASH. 95% of patients received prednisolone; and the 2-year mortality was 63%. The high AshTest performance was confirmed both for the binary outcome [AUROC = 0.803 (95%CI 0.684–0.881)] significantly higher than the AST/ALT AUROC [0.603 (0.462–0.714); P<0.001], and for the severity of ASH-score system by the Obuchowski measures for [mean (SE) 0.902 (0.017) vs. AST/ALT 0.833 (0.023); P = 0.01], as well as for the diagnosis and severity of ballooning, PMN and Mallory bodies. According to attributability of discordances, AshTest had a 2–7% risk of 2 grades misclassification. Conclusion These results confirmed the diagnostic performance of AshTest in cirrhotic patients with severe clinical ASH, in the specific context of use of corticosteroid treatment. AshTest is an appropriate non-invasive alternative to transjugular liver biopsy. PMID:26252713

  11. Optimization of prostate biopsy

    NASA Astrophysics Data System (ADS)

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

    1999-05-01

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

  12. Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample

    PubMed Central

    Tang, Xiao‐peng; Zhang, Yong‐hong; Luo, Kai‐zhong; Jiang, Yong‐fang; Luo, Hong‐yu; Lei, Jian‐hua; Wang, Wen‐long; Li, Ming‐ming; Chen, Han‐chun; Deng, Shi‐lin; Lai, Li‐ying; Liang, Jun; Zhang, Min; Tian, Yi; Xu, Yun

    2015-01-01

    Hepatic copper determination is an important test for the diagnosis of Wilson's disease (WD). However, the method has not been standardized, the diagnostic accuracy has not been evaluated prospectively, and the optimal cut‐off value remains controversial. Accordingly, we aimed to prospectively evaluate the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample. Patients for whom a liver biopsy was indicated were consecutively enrolled. Hepatic copper content was determined with atomic absorption spectroscopy. All assays were performed using careful quality control by a single technician. WD diagnosis was based on WD score or its combination with clinical follow‐up results. A total of 3,350 consecutive patients underwent liver biopsy. Six hundred ninety‐one patients, including 178 with WD, underwent two passes of liver biopsy with hepatic copper determination. Mean hepatic content in WD patients was 770.6 ± 393.2 μg/g dry weight (wt). Sensitivity, specificity, and positive and negative predictive values of hepatic copper content for WD diagnosis in the absence of primary biliary cirrhosis (PBC) or primary sclerosing cholangitis at the cut‐off value of 250 μg/g dry wt. were 94.4%, 96.8%, 91.8%, and 97.8%, respectively. The most useful cut‐off value was 209 μg/g dry wt, with a sensitivity and specificity of 99.4% and 96.1%, respectively. A total of 23.3% of patients without WD and PBC had hepatic copper content >75 μg/g dry wt. Conclusion: A liver biopsy sample of more than 1 mg dry wt may reliably reflect hepatic copper content and should be used for hepatic copper determination. Hepatic copper determination is a very valid procedure for the diagnosis of WD, and the most useful cut‐off value is 209 μg/g dry wt.(Hepatology 2015;62:1731–1741) PMID:26095812

  13. Effects of Meloxicam on Hematologic and Plasma Biochemical Analyte Values and Results of Histologic Examination of Kidney Biopsy Specimens of African Grey Parrots (Psittacus erithacus).

    PubMed

    Montesinos, Andres; Ardiaca, Maria; Juan-Sallés, Carles; Tesouro, Miguel A

    2015-03-01

    In this study we evaluated the effects of meloxicam administered at 0.5 mg/kg IM q12h for 14 days on hematologic and plasma biochemical values and on kidney tissue in 11 healthy African grey parrots (Psittacus erithacus). Before treatment with meloxicam, blood samples were collected and renal biopsy samples were obtained from the cranial portion of the left kidney from each of the birds. On day 14 of treatment, a second blood sample and biopsy from the middle portion of the left kidney were obtained from each bird. All birds remained clinically normal throughout the study period. No significant differences were found between hematologic and plasma biochemical values before and after 14 days of treatment with meloxicam, except for a slight increase in median beta globulin and corresponding total globulin concentrations, and a slight decrease in median phosphorus concentration. Renal lesions were absent in 9 of 10 representative posttreatment biopsy samples. On the basis of these results, meloxicam administered at the dosage used in this study protocol does not appear to cause renal disease in African grey parrots.

  14. Kidney biopsy

    MedlinePlus

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

  15. A comparison of ARMS and mutation specific IHC for common activating EGFR mutations analysis in small biopsy and cytology specimens of advanced non small cell lung cancer.

    PubMed

    Wang, Xueqing; Wang, Guoqing; Hao, Yueyue; Xu, Yinhong; Zhang, Lihua

    2014-01-01

    We have compared mutation analysis by Amplification Refractory Mutation System (ARMS) and epidermal growth factor receptor (EGFR) mutant-specific antibodies for their ability to detect two common activating EGFR mutations in a cohort of 115 advanced non-small cell lung cancer (NSCLC), including cytology material, core biopsy, and bronchoscopic biopsies. Assessment of EGFR mutation status was performed by using antibodies and ARMS assay specific to the two major forms of mutant EGFR, exon 19 deletion E746-A750 (c.2235_2249del15 or c.2236_2250del15, p. Glu746_Ala750 del) and exon 21 L858R point mutation (c.2573T>G, p.Leu858Arg). In this study the optimal buffer for antigen retrieval was sodium citrate (pH 6.0). Q score was used to evaluate the specific mutant EGFR proteins expression. Validation using clinical material showed deletions in exon 19 were detected in 19.1% and L858R mutation in 20% of all cases by ARMS assay. A cutoff value of score 1 was used as positive by IHC. No wild type cases were immuno-reactive. The antibodies performed well in cytology, core biopsies and bronchoscopic biopsies. There were only one false positive case using L858R IHC (sensitivity 100%, specificity 98.5%, positive predictive value 96%, negative predictive value 100%). All 23 E746-A750 exon 19 deletions identified by mutation analysis were positive by IHC. The sensitivity of exon 19 IHC for E746-A750 was 100%, specificity 100%, positive predictive value 100% and negative predictive value 100%. The result of the IHC stains was finely correlated with mutations status determined by ARMS assay. Although inferior to molecular genetic analysis of the EGFR gene, IHC is highly specific and sensitive for the targeted EGFR mutations. The antibodies are likely to be of clinical value in cases especially where limited tumor material is available, or in situations where molecular genetic analysis is not readily available.

  16. Immunohistochemical study of Ulex europaeus agglutinin 1 (UEA-1) binding of megakaryocytes in bone marrow biopsy specimens: demonstration of heterogeneity in staining pattern reflecting the stages of differentiation.

    PubMed

    Liu, S M; Li, C Y

    1996-01-01

    During differentiation, megakaryocytes undergo nuclear endoreplication, an increase in cell size, cytoplasmic granulation, and release of platelets. The changes in highly lobulated nuclei with varying degree of polyploidy and increasing cell size are easily recognized morphologically. However, the actual cytoplasmic changes are more difficult to perceive morphologically. With the peroxidase-antiperoxidase (PAP) method using UEA-1 as the binding protein to the alpha-L-fucose of glycoprotein synthesized by megakaryocytes, we observed significant variation in cytoplasmic staining of megakaryocytes in routinely processed bone marrow biopsy sections. A total of 3344 megakaryocytes in bone marrow sections from 10 patients with nonhematologic diseases and from 10 patients with idiopathic thrombocytopenic purpura (ITP) was studied. According to the intensity and pattern of cytoplasmic staining, we divided megakaryocytes into at least six groups: (1) low granular (LG), (2) diffuse granular (DG), (3) diffuse dense granular (DDG), (4) marginal granular (MG), (5) denuded (DMK), and (6) endomitotic (EndoM). Most of the megakaryocytes were DG (mean, 42.75% +/- 19.21%) and DDG (mean, 50.25% +/- 21.23%). In correlation with nuclear morphology and cell size, it appears that substances binding to UEA-1 are located in the paranuclear region in early megakaryocytes and produce a low granular focal staining pattern (LG cells). Next, the granules spread throughout the cytoplasm (DG cells) and increase in quantity (DDG). This is followed by migration of granules to the periphery of the cytoplasm (MG cells) and is associated with the liberation of platelets and eventual formation of DMK megakaryocytes. Endomitosis, regulated by unknown factors, occurred in the MG stage. In comparing the group with nonhematologic disease (mean DG, 35.4% +/- 18.48%; DDG, 58.4% +/- 21.8%) and the group with ITP (mean DG, 50.1% +/- 17.82%; DDG, 42.1% +/- 18.12%), we found an increasing proportion of DG

  17. Biopsy - polyps

    MedlinePlus

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

  18. Alterations in the immunohistochemical expression of Das-1 and CG-3 in colonic mucosal biopsy specimens helps distinguish ulcerative colitis from Crohn disease and from other forms of colitis.

    PubMed

    Yantiss, Rhonda K; Das, Kiron M; Farraye, Francis A; Odze, Robert D

    2008-06-01

    Distinction between ulcerative colitis (UC) and Crohn disease (CD) in mucosal biopsies is often difficult. Das-1 and CG-3 are monoclonal antibodies directed against an unknown colonic epithelial protein and human tropomyosin isoform-5, respectively, both show altered expression in patients with UC. In this study, we evaluated the utility of Das-1 and CG-3 in distinguishing UC from CD and from other types of colitis. One colonic biopsy specimen from each of 85 patients with confirmed UC (n=25), CD (n=15), lymphocytic (n=15), collagenous (n=15), and ischemic (n=15) colitis, and also 10 samples from normal controls, were stained for Das-1 and CG-3 using standard techniques. Reactivity for Das-1 and CG-3 was noted to be absent or present, and the location (ie, surface+/-crypt epithelium) and degree (weak or strong) of CG-3 staining was recorded. Loss of Das-1 staining occurred more frequently in UC (96%) compared with CD (20%), lymphocytic (20%), collagenous (13%), and ischemic colitis (0%) cases, as well as controls (10%, P<0.001 for all comparisons). CG-3 positivity in crypt epithelium was significantly more common in UC (52%) compared with the other groups (P< or =0.02 for all comparisons). The combination of strong crypt CG-3 staining and loss of Das-1 staining was noted in 44% of UC cases, but not in any other type of colitis (P=0.003 for all comparisons). We conclude that the patterns of Das-1 and CG-3 staining in colonic mucosal biopsies may be clinically useful in distinguishing UC from CD and from other colitidies.

  19. Concordance between HER-2 status determined by qPCR in Fine Needle Aspiration Cytology (FNAC) samples compared with IHC and FISH in Core Needle Biopsy (CNB) or surgical specimens in breast cancer patients.

    PubMed

    Rodriguez, Claudia; Suciu, Voichita; Poterie, Audrey; Lacroix, Ludovic; Miran, Isabelle; Boichard, Amélie; Delaloge, Suzette; Deneuve, Jacqueline; Azoulay, Sandy; Mathieu, Marie-Christine; Valent, Alexander; Michiels, Stefan; Arnedos, Monica; Vielh, Philippe

    2016-11-01

    Determining the status of HER2-neu amplification and overexpression in breast cancer is crucial for prognosis but mostly for treatment purposes. Standard techniques include the determination of IHC in combination with in situ hybridization techniques to confirm a HER2-neu amplification in case of IHC2+ using either a core-needle biopsy or a surgical specimen. qPCR has been also demonstrated to be able to determine HER2 status, mostly in core biopsies or in surgical specimens. Fine-needle aspiration is a reliable, quicker and less invasive technique that is widely used for diagnosis of invasive breast cancer. In this study, we assessed the performance of qPCR in invasive breast carcinomas to determine HER2-neu status by using fine-needle aspiration samples and comparing to standard IHC and FISH. From a total of 154 samples from patients who had nodular breast lesions and attended the 1-day-stop clinic at the Gustave Roussy from March 2013 to October 2014, qPCR was able to determine the HER2 status in a mean of 3.7 days (SD 3.1). The overall concordance with standard HER2-testing was very high: 97% (95% CI 0.94 to 0.99); sensitivity was 96% (0.87-1), specificity 98% (0.95-1) and positive and negative predictive values 88% (0.75-1) and 99% (0.98-1), respectively. In conclusion, our study demonstrates that qPCR performed using fine-needle aspiration samples from a primary tumour is a reliable and fast method to determine HER2/neu status in patients with early breast cancer.

  20. Status of Red Stingray (Dasyatis akajei) Livers for Japanese Specimen Banking at National Institute for Environmental Studies, Unscathed by the 2011 Tohoku Earthquake.

    PubMed

    Takeuchi, Akinori; Shibata, Yasuyuki; Tanaka, Atsushi

    2012-04-01

    It is important to have a resource of environmental specimens in order to investigate changes in contaminant exposure and accumulation over time. At the National Institute for Environmental Studies in Japan, red stingray livers have been archived and the banking activity has expanded successfully since 2003. The developed standard operating procedure helps to maintain quality of the archived homogenized liver samples, and the risk management plan has helped to prevent thawing them from any incidents, including the catastrophic 2011 Tohoku earthquake. The cryogenically homogenized powdered livers will be stored in a cryogenic environment in liquid nitrogen vapor containers at -160 °C and will be analyzed when new pollutants are identified in the future.

  1. Impact of occult HBV infection in HIV/HCV co-infected patients: HBV-DNA detection in liver specimens and in serum samples.

    PubMed

    Fabris, Paolo; Biasin, Maria R; Giordani, Maria T; Berardo, Laura; Menini, Vania; Carlotto, Antonio; Miotti, Maria G; Manfrin, Vinicio; Baldo, Vincenzo; Nebbia, Gaia; Infantolino, Domenico

    2008-03-01

    Prevalence and impact of occult HBV infection in HIV positive patients is controversial. The aims of this study were to determine the prevalence of occult HBV infection and its impact on histological and virological parameters. 52 HIV/HCV (but HBsAg-negative) co-infected patients, 29 HBsAg and anti-HCV negative chronic hepatitis, and 20 HBsAg positive chronic hepatitis controls were studied. DNA was extracted from frozen biopsies and amplified with primers for S, C and X regions, and for (ccc) HBV-DNA. Sera were tested for HBV-DNA with two quantitative assays (Cobas Amplicor HBV Monitor, and the real-time COBAS (r) Taqman HBV Test, Roche Diagnostics, UK). Occult HBV infection was detected in 7 (13.4%) liver biopsies of the study group, and in none case of the non viral chronic hepatitis group (p=0.04). All serum samples were HBV-DNA negative with Cobas Amplicor HBV monitor assay, while 3 cases were found positive with real time PCR. Statistical analysis didn't show any impact of occult HBV infection on liver histology, CD4+ cells count, HIV and HCV load, and ALT levels. Occult B infection is relatively frequent in HIV/HCV co-infected patients, and is underestimated by common HBV-DNA serological assays. However, it doesn't seem to exert a relevant impact.

  2. Analysis of correlation between the process of thyroid fibrosis and TGFB1 gene expression level in fine-needle aspiration biopsy (FNAB) thyroid specimens collected from patients with Hashimoto's thyroiditis and non-toxic goitre.

    PubMed

    Cyniak-Magierska, A; Januszkiewicz-Caulier, J; Brzeziańska, E; Lewiński, A

    2010-07-01

    Transforming growth factor beta 1 (TGFB1) stimulates the production of various extracellular matrix components; at the same time, it inhibits matrix degradation. These actions of TGFB1 contribute to tissue repair, however, an altered expression of TGFB1 can be a causative factor of fibrosis processes, including thyroid fibrosis which follows chronic thyroiditis. The aim of our study was to examine a potential correlation between TGFB1 gene expression level in fine-needle aspiration biopsy (FNAB) thyroid specimens and fibrosis of the thyroid gland in two types of thyroid lesions. Fibrosis of the thyroid tissue was assessed, based on the expression levels of fibrosis-associated genes (COL1A1 and COL3A1) in thyroid FNAB samples, on the FNAB specimen cellularity and other features of the tissue fibrosis assessed during cytological examination, as well as on the size of thyroid gland and its function. Following routine cytological examination, 63 thyroid FNAB specimens, received from patients with Hashimoto's thyroiditis (HT, n=30) and non-toxic goitre (NTG, n=33), were quantitatively evaluated regarding TGFB1, COL1A1 and COL3A1 expression level by real-time PCR in the ABI PRISM 7500 Sequence Detection System. The obtained results showed statistically significant differences regarding the expression level (RQ) of TGFB1 and of COL1A1 genes between the groups with HT and with NTG (higher expression in HT group). No significant differences, concerning the expression level of COL3A1 gene, were observed for the studied groups (HT vs. NTG). In HT group statistically significant correlation was found between TGFB1 gene and COL3A1 gene expression levels (p<0.05). The correlation in question might suggest excessive extracellular matrix deposition and could--possibly--contribute to thyroid fibrosis mechanism in the course of chronic thyroiditis.

  3. Vitamin A concentrations in liver determined by isotope dilution assay with tetradeuterated vitamin A and by biopsy in generally healthy adult humans

    SciTech Connect

    Furr, H.C.; Amedee-Manesme, O.; Clifford, A.J.; Bergen, H.R. 3d.; Jones, A.D.; Anderson, D.P.; Olson, J.A.

    1989-04-01

    The vitamin A status in 11 generally healthy surgical patients was estimated by measuring the dilution of a 45-mg oral dose of tetradeuterated retinyl acetate (99% pure). After purification of retinol by high-performance liquid chromatography, the ratio of /sup 2/H/sub 4/-retinol:/sup 1/H-retinol in plasma was measured by gas chromatography-mass spectrometry. On the basis of the observed ratios of (/sup 2/H/sub 4/)retinol:(/sup 1/H)retinol over 19-47 d, the total body reserves and liver concentrations of vitamin A were calculated. Liver biopsy samples taken at surgery were directly analyzed for vitamin A. The correlation coefficient between calculated and measured liver vitamin A concentrations for 10 of the subjects was 0.88, and the Spearman's rank correlation coefficient was 0.95 (p less than 0.002). Thus, total body reserves of vitamin A in humans can be estimated validly in the marginal and satisfactory ranges by a benign, relatively noninvasive procedure.

  4. A Retrospective Study on the Significance of Liver Biopsy and Hepatitis B Surface Antigen in Chronic Hepatitis B Infection

    PubMed Central

    Zeng, Da-Wu; Zhang, Jie-Min; Liu, Yu-Rui; Dong, Jing; Jiang, Jia-Ji; Zhu, Yue-Yong

    2016-01-01

    Abstract To investigate changes in the HBV replication level along with the natural course of chronic HBV infection and to examine the accuracy of the immune tolerant phase defined by the serological profile. A total of 390 chronic HBV-infected patients were retrospectively recruited for this study. They were classified into immune-tolerance (IT), immune-clearance (IC), low-replicative (LR), and HBeAg-negative hepatitis (ENH) phases according to serological profiles (single-standard, SS) or dual-standard (DS) with the inclusion of liver histology. Serum HBV DNA and HBsAg were quantitatively measured, and liver histology was quantitatively analyzed. The accuracy of the SS-defined IT phase was low, and active pathological changes were detected in 56 of 112 SS-defined IT patients. DS-defined IT patients had higher HBsAg levels (P = 0.0002) than the SS-defined patients. The quantitative HBsAg level can help identify SS-defined IT patients with potential liver injury. The area under the received operating characteristic curve for predicting the DS-defined IT phase was 0.831 (HBsAg 4.398 log IU/mL; sensitivity 87.5%; specificity 73.2%). HBV DNA was reduced by 4 logs, whereas HBsAg was only decreased by 2 logs with HBeAg positive to negative phase conversion. Approximately half of IT patients defined by SS may have medium or severe liver injury. Quantitative measurement of the HBsAg level can help identify SS-defined IT patients with potential liver injury. PMID:26937895

  5. Clinical, epidemiological characteristics and indications for liver biopsy and treatment in immigrants with chronic hepatitis B at a referral hospital in Madrid.

    PubMed

    Pérez-Molina, J A; Herrero-Martínez, J M; Norman, F; Pérez-Ayala, A; Monge-Mahillo, B; Navarro-Beltrá, M; López-Vélez, R

    2011-04-01

    The increase in immigration from less developed countries to Europe has led to an increase in the incidence of hepatitis B infection. The objective of this study was to describe the clinical, epidemiological characteristics and indications for treatment of chronic hepatitis B in a cohort of immigrants, given the relative lack of current evidence. We performed a noninterventional retrospective chart review; different characteristics depending on geographical origin were compared. A case-control study was also performed to describe factors potentially associated with chronic or past hepatitis B virus (HBV) infection. We selected a random sample of 436 patients out of the 2989 immigrants attending during the study period (1989-2008). Hepatitis B serology was performed in 74% (322/436): 10.6% had chronic HBV infection (95% CI: 7.4-13.7%), and 46.9% had evidence of past infection (95% CI: 41.7-52.0%). The average age was 31 years, 60% were men, and 70% were sub-Saharan Africans. Chronic infection was related to being men (OR 2.03; 95%CI: 1.29-3.18), younger (OR 0.98; 0.96-0.99) and sub-Saharan African (OR 5.41; 2.71-10.83). Past or current infection was related to male sex (OR 2.80; 1.81-4.30), longer time elapsed until first seen at the unit (OR 0.998; 0.997-1.000), HIV infection (OR 4.99; 1.15-21.60) and being sub-Saharan African (OR 15.46; 8.97-27.18). These associations were not confirmed after adjustment for geographical origin. In 27% and 29.5% of patients, liver biopsy and treatment, respectively, would have been indicated. Prevalence of chronic HBV infection amongst immigrants is high, especially in sub-Saharan Africans. Almost a third could be considered for liver biopsy or antiviral therapy.

  6. A Comparison of Four- Versus Three-Pass Transjugular Biopsy Using a 19-G Tru-Cut Needle and a Randomized Study Using a Cassette to Prevent Biopsy Fragmentation

    SciTech Connect

    Vibhakorn, Shusang; Cholongitas, Evangelos; Kalambokis, George; Manousou, Pinelopi; Quaglia, Alberto; Marelli, Laura; Senzolo, Marco; Patch, David; Dhillon, Amar; Burroughs, Andrew K.

    2009-05-15

    Recently, it has been shown that transjugular liver biopsy (TJLB) with three passes gives comparable specimens to percutaneous liver biopsy (PLB). The aim of this study was to evaluate the adequacy of TJLB using four passes in a consecutive series of patients, and whether using a supportive cassette can prevent fragmentation. One hundred consecutive TJLBs in 92 patients (48 transplanted), always using four passes (19-G Tru-Cut), were compared to three-pass TJLBs. The four-pass TJLB specimens were randomized at a 1:1 ratio of liver cores placed in a cassette versus not. The four-pass TJLBs, compared to three-pass TJLBs, resulted in better specimens for length ({>=}25 mm: 50% vs. 35%; p = 0.026) and number of complete portal tracts (CPTs) ({>=}11: 40% vs. 26%; p = 0.027), without a higher complication rate. The four-pass TJLB with {>=}11 CPTs had a median length of 27 mm, and 57% of them longer than 28 mm contained {>=}11 CPTs. Putting the liver biopsy cores into a cassette did not improve the fragmentation rate or adequacy of the specimen (length and number of CPTs) of TJLB. We conclude that at least four passes with TJLB should be performed when liver specimens are needed for grading and staging. Using a supportive cassette did not reduce fragmentation.

  7. Kidney Biopsy

    MedlinePlus

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

  8. Examination of the liver in personnel working with liquid rocket propellant

    PubMed Central

    Petersen, Palle; Bredahl, Erik; Lauritsen, Ove; Laursen, Thomas

    1970-01-01

    Petersen, P., Bredahl, E., Lauritsen, O., and Laursen, T. (1970).Brit. J. industr. Med.,27, 141-146. Examination of the liver in personnel working with liquid rocket propellants. Personnel working with liquid rocket propellants were subjected to routine health examinations, including liver function tests, as the propellant, unsymmetrical dimethylhydrazine (UDMH) is potentially toxic to the liver. In 46 persons the concentrations of serum alanine aminotransferase (SGPT) were raised. Liver biopsy was performed in 26 of these men; 6 specimens were pathological (fatty degeneration), 5 were uncertain, and 15 were normal. All 6 pathological biopsies were from patients with a raised SGPT at the time of biopsy. Of the 15 persons with a normal liver biopsy, 14 had a normal SGPT, while one (who was an alcoholic) had a raised SGPT. The connection between SGPT and histology of the liver, as well as the possible causal relation between the pathological findings and exposure to UDMH, is discussed. Images PMID:5428632

  9. Improved polymerase chain reaction-based method to detect early-stage epitheliotropic T-cell lymphoma (mycosis fungoides) in formalin-fixed, paraffin-embedded skin biopsy specimens of the dog.

    PubMed

    Chaubert, Pascal; Baur Chaubert, Audrey S; Sattler, Ursula; Forster, Ursula; Bornand, Valérie; Suter, Maja; Welle, Monika

    2010-01-01

    In the dog, early-stage epitheliotropic T-cell lymphoma (ETCL) can clinically and histologically mimic a large range of inflammatory dermatoses and often progresses rapidly to a more aggressive tumor stage. Early diagnosis of ETCL is essential to proceed with a specific oncologic therapy that is favorable for the prognosis. In the present study, an improved method for the detection of T-cell receptor gamma (TCRgamma) rearrangement was developed by designing a new set of consensus primers to amplify the different forms of rearranged canine TCRgamma gene sequences by polymerase chain reaction. The amplicons were analyzed by conventional polyacrylamide gel electrophoresis, which requires minimal specific equipment and may be performed in almost every pathology laboratory at low costs. The method proved to be highly specific and sensitive to detect early ETCL in formalin-fixed, paraffin-embedded biopsy specimens, providing an efficient tool for veterinary pathologists to distinguish early neoplastic from reactive cutaneous T-cell infiltrates (tumor-specific marker) or to discriminate T-cell lymphoma from B-cell lymphomas or nonlymphoid neoplasms (T-cell lineage marker). By direct sequencing analysis of amplified TCRgamma gene sequences, ETCL was found to rearrange exclusively the joining (J) 4 region, which suggests specific biology for primary cutaneous T-cell lymphomas. Also, a novel (seventh) functional J region in the TCRgamma gene, localized approximately 2.3 kb upstream of J5, was identified.

  10. Increased serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels in patients with biopsy-proven nonalcoholic fatty liver disease

    PubMed Central

    Ozturk, Oguzhan; Colak, Yasar; Senates, Ebubekir; Yilmaz, Yusuf; Ulasoglu, Celal; Doganay, Levent; Ozkanli, Seyma; Oltulu, Yasemin Musteri; Coskunpinar, Ender; Tuncer, Ilyas

    2015-01-01

    AIM: To analyze the relationship between the serum lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) levels and clinical and histopathological features of biopsy-confirmed nonalcoholic fatty liver disease (NAFLD) patients. METHODS: Fifty-three consecutive, biopsy-proven NAFLD patients (31 males and 22 females, mean age 42.5 ± 9.6 years) and 26 age- and gender-matched, healthy controls (14 males and 12 females, mean age 39 ± 10.7 years) were included. The patients with NAFLD were consecutive patients who had been admitted to the hepatology outpatient clinic within the last year and had been diagnosed with NAFLD as the result of liver biopsy. The healthy controls were individuals who attended the outpatient clinic for routine health control and had no known chronic illnesses. The histological evaluation was conducted according to the NAFLD activity scoring system recommended by The National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network. The serum LOX-1 levels were measured using an ELISA kit (Life Science Inc. USCN. Wuhan, Catalog No. E1859Hu) in both patients and healthy controls. A receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff value of LOX-1 and thereby distinguish between patients with nonalcoholic steatohepatitis (NASH) and healthy controls. A P-value < 0.05 was considered statistically significant. RESULTS: NAFLD and healthy control groups were similar in terms of age and sex. NAFLD patients consisted of 8 patients with simple steatosis (15%), 27 with borderline NASH (51%) and 18 with definitive NASH (34%). Metabolic syndrome was found in 62.2% of the patients with NAFLD. The mean serum LOX-1 level in biopsy-proven NAFLD patients was 8.49 ± 6.43 ng/mL compared to 4.08 ± 4.32 ng/mL in healthy controls (P = 0.001). The LOX-1 levels were significantly different between controls, simple steatosis and NASH (borderline+definite) cases (4

  11. Cold knife cone biopsy

    MedlinePlus

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

  12. Intravoxel Incoherent Motion Diffusion Weighted MR Imaging at 3.0 T: Assessment of Steatohepatitis and Fibrosis Compared with Liver Biopsy in Type 2 Diabetic Patients

    PubMed Central

    Parente, Daniella Braz; Paiva, Fernando Fernandes; Oliveira Neto, Jaime Araújo; Machado-Silva, Lilian; Figueiredo, Fatima Aparecida Ferreira; Lanzoni, Valeria; Campos, Carlos Frederico Ferreira; do Brasil, Pedro Emmanuel Alvarenga Americano; Gomes, Marilia de Brito; Perez, Renata de Mello; Rodrigues, Rosana Souza

    2015-01-01

    Objective To evaluate the capability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) to assess steatohepatitis and fibrosis determined by histopathology in type 2 diabetic patients. Methods Fifty-nine type 2 diabetic patients (49 women, 10 men; mean age, 54 ± 9 years) were submitted to liver biopsy for the evaluation of non-alcoholic fatty liver disease (NAFLD) and underwent DWI on a 3.0T MR system using 10 b values. Institutional approval and patient consent were obtained. Pure molecular-based (D), perfusion-related (D*), and vascular fraction (f) were calculated using a double exponential model and least squares curve fitting. D, D*, and f were compared between patients with and without steatohepatitis and between patients with and without fibrosis. The variables were compared by using the Ranksum test and Student t-test. Results Steatohepatitis was observed in 22 patients and fibrosis in 16 patients. A lower D median (0.70 s/mm2 vs. 0.83 s/mm2, p<0.05) and a lower D* median (34.39 s/mm2 vs. 45.23 s/mm2, p<0.05) were observed among those with steatohepatitis. A lower D median (0.70 s/mm2 vs. 0.82 s/mm2, p<0.05) and a lower D* median (35.01 s/mm2 vs. 44.76 s/mm2, p=0.05) were also observed among those with fibrosis. Conclusion IVIM-DWI has the potential to aid in the characterization of steatohepatitis and fibrosis. PMID:25961735

  13. Noninvasive biomarkers FibroTest and ActiTest versus liver biopsy in chronic hepatitis C patients: the Middle East experience

    PubMed Central

    Yakoob, Rafie; Bozom, Issam Al; Thandassery, Ragesh Babu; Rahman, Mohamed Osman Abdel; Derbala, Moutaz F.; Mohannadi, Muneera J. Al; John, Anil K.; Sharma, Manik; Wani, Hamidulla; Kaabi, Saad Al

    2015-01-01

    Background The aim of this study was to compare noninvasive biomarkers, FibroTest and ActiTest in predicting fibrosis stage and inflammation grade in chronic hepatitis C (CHC) patients with liver biopsy (LB). Methods In 107 patients with CHC, levels of six serum biomarkers (alanine aminotransferase, γ-glutamyl transpeptidase, total bilirubin, haptoglobin, apolipoprotein, α-2 macroglobulin) were determined at the time of LB. LB was evaluated by Metavir score for fibrosis and inflammation. Voluntary blood donors (n=106) were taken as controls for the study. Results Fibrosis estimated by Fibrotest was significantly higher in patients compared to control group. The observed area under the receiver operating characteristic curve (AUROC) for advanced fibrosis (F3, F4) adjusted according to the observed difference between advanced and non-advanced fibrosis prevalence (DANA) was 0.80 (0.69-0.88) and the AUROC for cirrhosis (F4) was 0.94 (0.86-0.98). ActiTest AUROC for moderate to severe activity (A2A3) was 0.72 (0.61-0.81), and for severe activity (A3) was 0.88 (0.78-0.93). The diagnostic values in the group of good quality biopsy (n=41) showed Fibrotest AUROC (DANA-adjusted): for advanced fibrosis 0.90 (0.72-0.99); for cirrhosis 0.93 (0.76-0.98); and ctiTest AUROC: for moderate/severe activity 0.86 (0.67-0.94); and for severe activity 0.90 (0.76-0.93). There was good concordance between FibroTest and LB (with discordance for two or more stages in <20% for advanced fibrosis and <10% for cirrhosis) and between ActiTest and LB. Specificity for FibroTest and ActiTest in the control population were 95% and 100% respectively. Conclusions Fibrotest and ActiTest had high observed and standardized diagnostic values for predicting fibrosis and activity respectively. PMID:25830472

  14. Gum biopsy

    MedlinePlus

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

  15. [Optimized standards for prostate biopsy].

    PubMed

    Wullich, B; Füssel, S; Grobholz, R

    2007-06-01

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

  16. 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.

  17. Prostate biopsy

    MedlinePlus

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

  18. How to submit a nail specimen.

    PubMed

    Reinig, Erica; Rich, Phoebe; Thompson, Curtis T

    2015-04-01

    The scarcity of specific submission protocols for nail unit biopsies presents many challenges for appropriate specimen processing. Many nail biopsies are received fragmented or without orientation, often resulting in less-than-ideal tissue embedding and poor histologic sections, which are difficult to interpret. Methods are described for proper nail matrix/bed biopsy and plate submission that incorporate aspects of previous submission protocols and include inking the biopsy specimen along with submitting the tissue on a drawing of the nail. Also described is a technique for maintaining adherence of nail plate to glass slides, a chronic challenge in the laboratory.

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

    PubMed

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

    2015-11-01

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

  20. Performance of Panfungal- and Specific-PCR-Based Procedures for Etiological Diagnosis of Invasive Fungal Diseases on Tissue Biopsy Specimens with Proven Infection: a 7-Year Retrospective Analysis from a Reference Laboratory

    PubMed Central

    Bernal-Martinez, L.; Castelli, M. V.; Rodriguez-Tudela, J. L.; Cuenca-Estrella, M.

    2014-01-01

    A retrospective analysis of real-time PCR (RT-PCR) results for 151 biopsy samples obtained from 132 patients with proven invasive fungal diseases was performed. PCR-based techniques proved to be fast and sensitive and enabled definitive diagnosis in all cases studied, with detection of a total of 28 fungal species. PMID:24574295

  1. Clinicopathological evaluation of downer dairy cows with fatty liver

    PubMed Central

    Kalaitzakis, Emmanouil; Panousis, Nikolaos; Roubies, Nikolaos; Giadinis, Nektarios; Kaldrymidou, Eleni; Georgiadis, Marios; Karatzias, Harilaos

    2010-01-01

    This study evaluated the relationship between severity of fatty liver and macromineral status in downer dairy cows and determined the usefulness of selected biochemical analytes for assessing prognosis. Blood and liver biopsy specimens were obtained from 36 Holstein downer cows shortly after the cows became recumbent and before they were treated. Liver tissue was examined histologically and serum activity of liver-derived enzymes and concentration of total lipids, triglycerides, bile acids, glucose, β-hydroxybutyrate, acetoacetic acid, total bilirubin, non-esterified fatty acids (NEFA), cholesterol and macrominerals (Ca, Mg, K, Na, P) were determined. Fatty liver infiltration was severe in 44% of the cows and moderate in 44%. Serum activities of ornithine carbamoyltransferase and glutamate dehydrogenase, and NEFA/cholesterol ratio were good indicators of fatty liver. Cows with severe fatty liver had the lowest mean K values. The prognosis is guarded for downer cows with moderate and severe fatty liver and when total bilirubin concentration is high. PMID:20808573

  2. Ultrasound-Guided Percutaneous Core Needle Biopsy of Abdominal Viscera: Tips to Ensure Safe and Effective Biopsy

    PubMed Central

    Kim, Jin Woong

    2017-01-01

    Ultrasound-guided percutaneous core needle biopsy (USPCB) is used extensively in daily clinical practice for the pathologic confirmation of both focal and diffuse diseases of the abdominal viscera. As a guidance tool, US has a number of clear advantages over computerized tomography or magnetic resonance imaging: fewer false-negative biopsies, lack of ionizing radiation, portability, relatively short procedure time, real-time intra-procedural visualization of the biopsy needle, ability to guide the procedure in almost any anatomic plane, and relatively lower cost. Notably, USPCB is widely used to retrieve tissue specimens in cases of hepatic lesions. However, general radiologists, particularly beginners, find USPCB difficult to perform in abdominal organs other than the liver; indeed, a full understanding of the entire USPCB process and specific considerations for specific abdominal organs is necessary to safely obtain adequate specimens. In this review, we discuss some points and techniques that need to be borne in mind to increase the chances of successful USPCB. We believe that the tips and considerations presented in this review will help radiologists perform USPCB to successfully retrieve target tissue from different organs with minimal complications. PMID:28246511

  3. Virtual Specimens

    NASA Astrophysics Data System (ADS)

    de Paor, D. G.

    2009-12-01

    Virtual Field Trips have been around almost as long as the Worldwide Web itself yet virtual explorers do not generally return to their desktops with folders full of virtual hand specimens. Collection of real specimens on fields trips for later analysis in the lab (or at least in the pub) has been an important part of classical field geoscience education and research for generations but concern for the landscape and for preservation of key outcrops from wanton destruction has lead to many restrictions. One of the author’s favorite outcrops was recently vandalized presumably by a geologist who felt the need to bash some of the world’s most spectacular buckle folds with a rock sledge. It is not surprising, therefore, that geologists sometimes leave fragile localities out of field trip itineraries. Once analyzed, most specimens repose in drawers or bins, never to be seen again. Some end up in teaching collections but recent pedagogical research shows that undergraduate students have difficulty relating specimens both to their collection location and ultimate provenance in the lithosphere. Virtual specimens can be created using 3D modeling software and imported into virtual globes such as Google Earth (GE) where, they may be linked to virtual field trip stops or restored to their source localities on the paleo-globe. Sensitive localities may be protected by placemark approximation. The GE application program interface (API) has a distinct advantage over the stand-alone GE application when it comes to viewing and manipulating virtual specimens. When instances of the virtual globe are embedded in web pages using the GE plug-in, Collada models of specimens can be manipulated with javascript controls residing in the enclosing HTML, permitting specimens to be magnified, rotated in 3D, and sliced. Associated analytical data may be linked into javascript and localities for comparison at various points on the globe referenced by ‘fetching’ KML. Virtual specimens open up

  4. Transjugular Renal Biopsy: Our Experience and Technical Considerations

    SciTech Connect

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

    2008-09-15

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

  5. Quantification of intrahepatic total HBV DNA in liver biopsies of HBV-infected patients by a modified version of COBAS(®) Ampliprep/COBAS(®)TaqMan HBV test v2.0.

    PubMed

    Salpini, Romina; Piermatteo, Lorenzo; Gill, Upkar; Battisti, Arianna; Stazi, Francesca; Guenci, Tania; Giannella, Sara; Serafini, Valentina; Kennedy, Patrick T F; Perno, Carlo Federico; Svicher, Valentina; Ciotti, Marco

    2017-04-11

    Intrahepatic total HBV DNA (it-HBV DNA) level might reflect the size of virus reservoir and correlate with the histological status of the liver. To quantitate it-HBV DNA in a series of 70 liver biopsies obtained from hepatitis B chronic patients, a modified version of the COBAS(®)Ampliprep/COBAS(®)TaqMan HBV test v2.0 was used for this purpose. The linearity and reproducibility of the modified protocol was tested by quantifying serial dilutions of a full-length HBV containing plasmid and it-HBV DNA from a reference patient. A good linear trend between the expected values and those generated by the assay was observed at different concentrations of both plasmid and reference patient (R (2) = 0.994 and 0.962, respectively). Differences between the values obtained in two independent runs were ≤0.3 log IU for the plasmid and ≤0.6 log IU/mg for the reference patient, showing a high inter-run reproducibility. In the 70 liver biopsies, it-HBV DNA level ranged from 1.4 to 5.4 log IU/mg, with a good linearity and reproducibility between the values obtained in two runs [R (2) = 0.981; median (IQR) difference of it-HBV DNA 0.05 (0.02-0.09) IU/mg]. The modified COBAS(®)Ampliprep/COBAS(®)TaqMan HBV test v2.0 allows an accurate quantitation of it-HBV DNA. Its determination may have prognostic value and may be a useful tool for the new therapeutic strategies aimed at eradicating the HBV infection.

  6. Biopsy-driven diagnosis in infants with cholestatic jaundice in Iran

    PubMed Central

    Talachian, Elham; Bidari, Ali; Mehrazma, Mitra; Nick-khah, Nahid

    2014-01-01

    AIM: To determine the frequencies of diagnoses confirmed by liver biopsy in infants with cholestasis in an Iranian pediatric hospital. METHODS: This was a retrospective study conducted in a tertiary referral children’s hospital in Iran. We retrieved all pathology reports of liver biopsies from children less than two years of age who had presented for evaluation of cholestatic jaundice from March 2001 to March 2011. Additional specimen samples obtained from archived pathology blocks were reviewed by a pathologist blinded to the final diagnosis. These results were compared with the pathology reports from chart records to ensure consensus and eliminate any inconsistencies in final diagnoses. A structured checklist was used to gather information on multiple variables including age, sex, gestational age at birth, birth weight, age at which hyperbilirubinemia manifested, presence and identification of associated anomalies, clinical manifestations, and histological findings from liver biopsies. The baseline data are reported using descriptive statistics, and differences between groups were assessed by Fisher’s exact test and Student’s t test when indicated. RESULTS: Fifty-five cases (28 females; 27 males) of infantile cholestasis (IC) were included in this study. The mean serum total bilirubin and direct bilirubin at presentation were 13.6 ± 5.9 and 7.3 ± 3.4, respectively. Forty cases (72.7%) were the product of term pregnancies. Common associated clinical findings were acholic stool in 33 cases (60.0%), hepatomegaly in 30 cases (54.5%), and dark-colored urine in 21 cases (38.2%). Biliary atresia (BA) was the most frequent diagnosis, found in 32 cases (58.2%), followed by intrahepatic bile duct paucity found in 6 cases (10.9%), metabolic disease in 6 cases (10.9%), idiopathic neonatal hepatitis in 5 cases (9.1%), choledochal cyst in 2 cases (3.6%), liver cirrhosis in 2 cases (3.6%), and progressive familial intrahepatic cholestasis and portal fibrosis each in 1

  7. 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 ...

  8. Muscle biopsy (image)

    MedlinePlus

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

  9. Bone biopsy (image)

    MedlinePlus

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

  10. Limitations and opportunities of non-invasive liver stiffness measurement in children

    PubMed Central

    Engelmann, Guido; Quader, Jasmin; Teufel, Ulrike; Schenk, Jens Peter

    2017-01-01

    Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20th century, these changes could only be determined by histological analyses of a liver specimen obtained via biopsy. The well-known limitations of this technique (i.e., pain, bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases. However, the introduction of non-invasive technologies, such as ultrasound and magnetic resonance imaging, for measurement of liver stiffness as an indirect marker of fibroses has changed this situation. Today, several non-invasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness. This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children, and discusses their features in comparison to the “historical” tools. PMID:28357028

  11. Novel and recurrent germline and somatic mutations in a cohort of 67 patients from 48 families with Brooke-Spiegler syndrome including the phenotypic variant of multiple familial trichoepitheliomas and correlation with the histopathologic findings in 379 biopsy specimens.

    PubMed

    Grossmann, Petr; Vanecek, Tomas; Steiner, Petr; Kacerovska, Denisa; Spagnolo, Dominic V; Cribier, Bernard; Rose, Christian; Vazmitel, Marina; Carlson, J Andrew; Emberger, Michael; Martinek, Petr; Pearce, Robert L; Pearn, John; Michal, Michal; Kazakov, Dmitry V

    2013-02-01

    Brooke-Spiegler syndrome (BSS) is a rare, inherited, autosomal dominant disorder characterized by development of multiple adnexal cutaneous neoplasms including spiradenoma, cylindroma, spiradenocylindroma, and trichoepithelioma. The syndrome of multiple familial trichoepitheliomas (MFT) is considered a phenotypic variant of BSS in which patients present with trichoepitheliomas only. We studied germline and somatic mutations of the CYLD gene by direct sequencing in patients with BSS (n = 49) and MFT (n = 18) using peripheral blood and 90 samples of frozen or formalin-fixed paraffin-embedded tumor tissue selected from 379 available histology specimens. Germline CYLD mutations were found in 51 patients (76%) from 36 families (75%). Germline CYLD mutations were found in 43 of the 49 patients with BSS (88%) but in only 8 of 18 MFT cohort (44%). Twenty-one frameshift, 15 nonsense, 3 missense, and 4 splice site mutations were found in patients with BSS, whereas 1 frameshift, 5 nonsense, and 2 splice site mutations were identified in the MFT cohort. Five novel mutations were identified including 4 frameshift mutations (c.1027dupA/p.T343NfsX7, c.2155dupA/p.M719NfsX5, c.2288_2289delTT/p.F763X, and c.2641delG/p.D881TfsX32) and 1 nonsense mutation (c.2713C>T/p. Q905X). Of the 76 tumors from 32 patients with a germline CYLD mutation, 12 were spiradenomas, 15 spiradenocylindromas, 26 cylindromas, 15 trichoepitheliomas, and 7 were other tumor types. Somatic mutations were detected in 67 specimens of these 76 tumors (88%). Of the 67 somatic mutations, 21 (31%) represented a sequence alteration and 46 (69%) showed loss of heterozygosity. In the remaining 9 cases (12%), the somatic changes remained unknown. A germline CYLD mutation was not detected in 14 tumor samples from 8 patients. In these 14 tumors, somatic mutations were identified in 6 samples (43%), all consisting of sequence alterations (1 sample showed 2 different sequence alterations). In the remaining 8 samples (53

  12. Direct measurement of catalase activity in living cells and tissue biopsies.

    PubMed

    Scaglione, Christine N; Xu, Qijin; Ramanujan, V Krishnan

    2016-01-29

    Spatiotemporal regulation of enzyme-substrate interactions governs the decision-making steps in biological systems. Enzymes, being functional units of every living cell, contribute to the macromolecular stability of cell survival, proliferation and hence are vital windows to unraveling the biological complexity. Experimental measurements capturing this dynamics of enzyme-substrate interactions in real time add value to this understanding. Furthermore these measurements, upon validation in realistic biological specimens such as clinical biopsies - can further improve our capability in disease diagnostics and treatment monitoring. Towards this direction, we describe here a novel, high-sensitive measurement system for measuring diffusion-limited enzyme-substrate kinetics in real time. Using catalase (enzyme) and hydrogen peroxide (substrate) as the example pair, we demonstrate that this system is capable of direct measurement of catalase activity in vitro and the measured kinetics follows the classical Michaelis-Menten reaction kinetics. We further demonstrate the system performance by measuring catalase activity in living cells and in very small amounts of liver biopsies (down to 1 μg total protein). Catalase-specific enzyme activity is demonstrated by genetic and pharmacological tools. Finally we show the clinically-relevant diagnostic capability of our system by comparing the catalase activities in liver biopsies from young and old mouse (liver and serum) samples. We discuss the potential applicability of this system in clinical diagnostics as well as in intraoperative surgical settings.

  13. Direct Measurement of Catalase Activity in Living Cells and Tissue Biopsies

    PubMed Central

    Scaglione, Christine N; Xu, Qijin; Ramanujan, V. Krishnan

    2016-01-01

    Spatiotemporal regulation of enzyme-substrate interactions governs the decision-making steps in biological systems. Enzymes, being functional units of every living cell, contribute to the macromolecular stability of cell survival, proliferation and hence are vital windows to unraveling the biological complexity. Experimental measurements capturing this dynamics of enzyme-substrate interactions in real time add value to this understanding. Furthermore these measurements, upon validation in realistic biological specimens such as clinical biopsies – can further improve our capability in disease diagnostics and treatment monitoring. Towards this direction, we describe here a novel, high-sensitive measurement system for measuring diffusion-limited enzyme-substrate kinetics in real time. Using catalase (enzyme) and hydrogen peroxide (substrate) as the example pair, we demonstrate that this system is capable of direct measurement of catalase activity in vitro and the measured kinetics follows the classical Michaelis-Menten reaction kinetics. We further demonstrate the system performance by measuring catalase activity in living cells and in very small amounts of liver biopsies (down to 1μg total protein). Catalase-specific enzyme activity is demonstrated by genetic and pharamacological tools. Finally we show the clinically-relevant diagnostic capability of our system by comparing the catalase activities in liver biopsies from young and old mouse (liver and serum) samples. We discuss the potential applicability of this system in clinical diagnostics as well as in intraoperative surgical settings. PMID:26772884

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

    NASA Astrophysics Data System (ADS)

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

    2000-04-01

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

  15. Biopsy techniques for intraocular tumors

    PubMed Central

    Rishi, Pukhraj; Dhami, Abhinav; Biswas, Jyotirmay

    2016-01-01

    Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB) to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88–95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous), suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies. PMID:27488148

  16. 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.

  17. Histology-driven data mining of lipid signatures from multiple imaging mass spectrometry analyses: application to human colorectal cancer liver metastasis biopsies.

    PubMed

    Thomas, Aurélien; Patterson, Nathan Heath; Marcinkiewicz, Martin M; Lazaris, Anthoula; Metrakos, Peter; Chaurand, Pierre

    2013-03-05

    Imaging mass spectrometry (IMS) represents an innovative tool in the cancer research pipeline, which is increasingly being used in clinical and pharmaceutical applications. The unique properties of the technique, especially the amount of data generated, make the handling of data from multiple IMS acquisitions challenging. This work presents a histology-driven IMS approach aiming to identify discriminant lipid signatures from the simultaneous mining of IMS data sets from multiple samples. The feasibility of the developed workflow is evaluated on a set of three human colorectal cancer liver metastasis (CRCLM) tissue sections. Lipid IMS on tissue sections was performed using MALDI-TOF/TOF MS in both negative and positive ionization modes after 1,5-diaminonaphthalene matrix deposition by sublimation. The combination of both positive and negative acquisition results was performed during data mining to simplify the process and interrogate a larger lipidome into a single analysis. To reduce the complexity of the IMS data sets, a sub data set was generated by randomly selecting a fixed number of spectra from a histologically defined region of interest, resulting in a 10-fold data reduction. Principal component analysis confirmed that the molecular selectivity of the regions of interest is maintained after data reduction. Partial least-squares and heat map analyses demonstrated a selective signature of the CRCLM, revealing lipids that are significantly up- and down-regulated in the tumor region. This comprehensive approach is thus of interest for defining disease signatures directly from IMS data sets by the use of combinatory data mining, opening novel routes of investigation for addressing the demands of the clinical setting.

  18. Nerve biopsy (image)

    MedlinePlus

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

  19. Sentinel node biopsy (image)

    MedlinePlus

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

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

    PubMed

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

    2000-07-01

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

  1. Acute liver failure following intravenous methamphetamine.

    PubMed

    Kamijo, Yoshito; Soma, Kazui; Nishida, Manami; Namera, Akira; Ohwada, Takashi

    2002-08-01

    A 41-y-o Pakistani man presented with psychosis, hyperthermia, rhabdomyolysis, and liver dysfunction approximately 6 h after i.v. injection of methamphetamine. Serum concentrations of methamphetamine and amphetamine on admission were 0.30 microg/mL and 0.04 microg/mL, respectively. Total serum bilirubin and alanine aminotransferase concentrations peaked on the 3rd hospital day at 8.6 mg/dL and 4155 IU/L, respectively, and gradually returned to normal with supportive care. The patient had no evidence of infectious hepatitis or intake of other drugs. Histologic examination of a liver biopsy specimen obtained on the 11th d showed confluent necrosis and ballooning degeneration in centrilobular zones. No inflammatory changes were seen in portal tracts. Liver damage can be a complication of illicit methamphetamine use, even in patients without viral infection or intake of other drugs.

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

    PubMed

    Johl, Alice; Lengfelder, Eva; Hiddemann, Wolfgang; Klapper, Wolfram

    2016-08-01

    Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation.

  3. Preclinical study of using multiphoton microscopy to diagnose liver cancer and differentiate benign and malignant liver lesions

    NASA Astrophysics Data System (ADS)

    Yan, Jun; Zhuo, Shuangmu; Chen, Gang; Wu, Xiufeng; Zhou, Dong; Xie, Shusen; Jiang, Jiahao; Ying, Mingang; Jia, Fan; Chen, Jianxin; Zhou, Jian

    2012-02-01

    Recently, the miniaturized multiphoton microscopy (MPM) and multiphoton probe allow the clinical use of multiphoton endoscopy for diagnosing cancer via ``optical biopsy''. The purpose of this study was to establish MPM optical diagnostic features for liver cancer and evaluate the sensitivity, specificity, and accuracy of MPM optical diagnosis. Firstly, we performed a pilot study to establish the MPM diagnostic features by investigating 60 surgical specimens, and found that high-resolution MPM images clearly demonstrated apparent differences between benign and malignant liver lesions in terms of their tissue architecture and cell morphology. Cancer cells, characterized by irregular size and shape, enlarged nuclei, and increased nuclear-cytoplasmic ratio, were identified by MPM images, which were comparable to hematoxylin-eosin staining images. Secondly, we performed a blinded study to evaluate the sensitivity, specificity, and accuracy of MPM optical diagnosis by investigating another 164 specimens, and found that the sensitivity, specificity, and accuracy of MPM diagnosis was 96.32%, 96.43%, and 96.34%, respectively. In conclusion, it is feasible to use MPM to diagnose liver cancer and differentiate benign and malignant liver lesions. This preclinical study provides the groundwork for further using multiphoton endoscopy to perform real-time noninvasive ``optical biopsy'' for liver lesions in the near future.

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

    PubMed

    Schiavo, Dante; Batzlaff, Cassandra; Maldonado, Fabien

    2016-04-01

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

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

    PubMed Central

    Yuan, Chun-Hui; Qu, Zhen; Guan, Qing; Chen, Hao

    2016-01-01

    Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide due to latent liver disease, late diagnosis, and nonresponse to systemic treatments. Till now, surgical and/or biopsy specimens are still generally used as a gold standard by the clinicians for clinical decision-making. However, apart from their invasive characteristics, tumor biopsy only mirrors a single spot of the tumor, failing to reflect current cancer dynamics and progression. Therefore, it is imperative to develop new diagnostic strategies with significant effectiveness and reliability to monitor high-risk populations and detect HCC at an early stage. In the past decade, the potent utilities of “liquid biopsy” have attracted intense concern and were developed to evaluate cancer progression in several clinical trials. “Liquid biopsies” represent a series of noninvasive tests that detect cancer byproducts easily accessible in peripheral blood, mainly including circulating tumor cells (CTCs) and cell-free nucleic acids (cfNAs) that are shed into the blood from the tumor sites. In this review, we focus on the recent developments in the field of “liquid biopsy” as well as the diagnostic and prognostic significance of CTCs and cfNAs in HCC patients. PMID:27403030

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

    SciTech Connect

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

    2002-03-15

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

  7. Immunogenicity of decellularized porcine liver for bioengineered hepatic tissue.

    PubMed

    Mirmalek-Sani, Sayed-Hadi; Sullivan, David C; Zimmerman, Cynthia; Shupe, Thomas D; Petersen, Bryon E

    2013-08-01

    Liver disease affects millions of patients each year. The field of regenerative medicine promises alternative therapeutic approaches, including the potential to bioengineer replacement hepatic tissue. One approach combines cells with acellular scaffolds derived from animal tissue. The goal of this study was to scale up our rodent liver decellularization method to livers of a clinically relevant size. Porcine livers were cannulated via the hepatic artery, then perfused with PBS, followed by successive Triton X-100 and SDS solutions in saline buffer. After several days of rinsing, decellularized liver samples were histologically analyzed. In addition, biopsy specimens of decellularized scaffolds were seeded with hepatoblastoma cells for cytotoxicity testing or implanted s.c. into rodents to investigate scaffold immunogenicity. Histological staining confirmed cellular clearance from pig livers, with removal of nuclei and cytoskeletal components and widespread preservation of structural extracellular molecules. Scanning electron microscopy confirmed preservation of an intact liver capsule, a porous acellular lattice structure with intact vessels and striated basement membrane. Liver scaffolds supported cells over 21 days, and no increased immune response was seen with either allogeneic (rat-into-rat) or xenogeneic (pig-into-rat) transplants over 28 days, compared with sham-operated on controls. These studies demonstrate that successful decellularization of the porcine liver could be achieved with protocols developed for rat livers, yielding nonimmunogenic scaffolds for future hepatic bioengineering studies.

  8. High-yield biopsy technique for subepidermal blisters.

    PubMed

    Braswell, Mark A; McCowan, Nancye K; Schulmeier, Jennifer S; Brodell, Robert T

    2015-04-01

    Dermatologists often perform 2 biopsies in patients with widespread tense blisters: one for light microscopy and another for direct immunofluorescence (DIF). Biopsy techniques recommended for blistering diseases with tense blisters are discussed, and illustrations demonstrate an alternative approach utilizing a single punch biopsy. A single punch biopsy is more cost effective and provides the same diagnostic information as the standard 2-biopsy approach for subepidermal blisters plus additional salt-split skin-like diagnostic information. A limitation for bisecting the single punch biopsy specimen is a potential complete separation of the epidermis from the dermis. The single punch biopsy technique is a simple cost-effective method for obtaining necessary diagnostic information when sampling tense blisters in patients with blistering diseases.

  9. Cardiac angiosarcoma diagnosed by transvenous endomyocardial biopsy with the aid of transesophageal echocardiography and intra-procedural consultation.

    PubMed

    Hosokawa, Yusuke; Kodani, Eitaro; Kusama, Yoshiki; Kamiya, Masataka; Yoshikawa, Masatomo; Hirasawa, Yasuhiro; Nakagomi, Akihiro; Atarashi, Hirotsugu; Maeda, Shotaro; Mizuno, Kyoichi

    2010-01-01

    We report a case who had confirmed tumor cells in the biopsy specimens by transvenous endomyocardial biopsy with intra-procedural consultation and fast smear cytology. A 57-year-old female was admitted to our hospital because of shortness of breath and left back pain. Transthoracic echocardiography (TTE) and contrast-enhanced computed tomography (CT) scans demonstrated a large mass in the right atrium and multiple liver tumors thought to be due to spread of the disease. Coronary angiography showed the right coronary artery was involved in the mass. In order to confirm the histological diagnosis, we attempted transvenous endomyocardial tumor biopsy under fluoroscopic guidance. However, we failed to obtain adequate tissue material. Due to several risks associated with a surgical procedure such as an open surgical biopsy, transvenous endomyocardial tumor biopsy was again attempted with the aid of transesophageal echocardiography (TEE). Intra-procedural consultation and fast smear cytology enabled us to finish the procedure. Hematoxylin-eosin stained sections demonstrated spindle-shaped cells. Immunohistochemical stains of these cells were positive for anti-factor VIII antigen, CD31, and CD34. These findings indicated a definite diagnosis of angiosarcoma. Since there was no surgical indication for this tumor, the patient underwent chemotherapy with docetaxel and radiotherapy. Three months later, CT scans showed a reduction in the size of the cardiac tumor.

  10. Complications of prostate biopsy.

    PubMed

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

    2013-07-01

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

  11. Analysis of bone biopsies.

    PubMed

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

    1983-11-01

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

  12. Trephine biopsy of the lung and pleura

    PubMed Central

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

    1969-01-01

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

  13. Biopsies in oncology.

    PubMed

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

    2014-01-01

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

  14. Utility of synovial biopsy

    PubMed Central

    2009-01-01

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

  15. Cinemicrographic specimen housing

    NASA Technical Reports Server (NTRS)

    Wilkins, J. R.

    1979-01-01

    Housing used to observe gravitation effects on specimens embedded in support media, such as agar, supports microbial specimens vertically for time-lapsed cinemicrographic studies. Procedure cannot be performed with conventional microscopes which see specimens in horizontal plane only.

  16. Colposcopy - directed biopsy

    MedlinePlus

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

  17. Urine culture - catheterized specimen

    MedlinePlus

    Culture - urine - catheterized specimen; Urine culture - catheterization; Catheterized urine specimen culture ... urinary tract infections may be found in the culture. This is called a contaminant. You may not ...

  18. Interleukin-34 as a fibroblast-derived marker of liver fibrosis in patients with non-alcoholic fatty liver disease.

    PubMed

    Shoji, Hirotaka; Yoshio, Sachiyo; Mano, Yohei; Kumagai, Erina; Sugiyama, Masaya; Korenaga, Masaaki; Arai, Taeang; Itokawa, Norio; Atsukawa, Masanori; Aikata, Hiroshi; Hyogo, Hideyuki; Chayama, Kazuaki; Ohashi, Tomohiko; Ito, Kiyoaki; Yoneda, Masashi; Nozaki, Yuichi; Kawaguchi, Takumi; Torimura, Takuji; Abe, Masanori; Hiasa, Yoichi; Fukai, Moto; Kamiyama, Toshiya; Taketomi, Akinobu; Mizokami, Masashi; Kanto, Tatsuya

    2016-07-01

    Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic non-viral liver disease. Activation of macrophages and hepatic stellate cells is a critical step that promotes liver fibrosis. We aimed to explore the feasibility of interleukin-34 (IL-34), a key regulator of macrophages, as a fibrosis marker in patients with NAFLD. We enrolled 197 liver biopsy-proven NAFLD patients. We evaluated the serum levels of IL-34, macrophage-colony stimulating factor (M-CSF), soluble CD163 (sCD163), 40 cytokines/chemokines, hyaluronic acid, type IV collagen 7s, and clinically-approved fibrosis scores. IL-34 increased with the progression of fibrosis and was an independent marker for liver fibrosis. Immunostaining experiments, using resected liver specimens from NAFLD patients, revealed that IL-34 was mainly expressed on liver fibroblasts. IL-34 based fibrosis score (0.0387*IL-34 (pg/ml) + 0.3623*type IV collagen 7s (ng/ml) + 0.0184*age (year)-1.1850) was a practical predictive model of liver fibrosis. Using receiver-operating characteristic analyses, the area under the curve, sensitivity, and specificity of IL-34 based fibrosis score were superior or comparable to the other fibrosis biomarkers and scores. In conclusion, the IL-34 based fibrosis score, including serum IL-34, type IV collagen 7s and age, is a feasible diagnostic marker of liver fibrosis in NAFLD patients.

  19. [Evaluation of testicular biopsy as an aspect of Chlamydia trachomatis infection (introductory report)].

    PubMed

    Maciejewski, Z; Swierczyński, W; Dziecielski, H; Semmler, G

    1989-01-01

    The purpose of the study was demonstration of the presence of Chlamydia trachomatis in biopsy testicular specimens. The indication to testicular biopsy was azoospermia or cryptozoospermia. The studied group comprised 12 patients in whose semen C. trachomatis was found. For the identification of the organism culture in chick embryo was used. In 2 preparations C. trachomatis was demonstrated in testicular biopsy.

  20. Giardia lamblia trophozoites in gastric biopsies.

    PubMed

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

    2006-10-01

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

  1. Liver fibrosis in a patient with familial homozygous hypobetalipoproteinaemia: possible role of vitamin supplementation.

    PubMed Central

    Scoazec, J Y; Bouma, M E; Roche, J F; Blache, D; Verthier, N; Feldmann, G; Gay, G

    1992-01-01

    A case of apolipoprotein B-related disorder is reported in which liver fibrosis developed without long term administration of medium chain triglycerides, previously incriminated in the pathogenesis of this lesion. The patient was a young woman in whom the diagnosis of familial homozygous hypobetalipoproteinaemia was made at the age of 21. A first liver specimen taken at diagnosis revealed steatosis, hypertrophic Golgi apparatus and proliferating smooth endoplasmic reticulum. The patient was treated with vitamin A and E supplementation only. Two years later, a second liver biopsy, carried out because of increased serum alanine aminotransferase concentrations, showed fibrosis, mild cytolysis and marked mitochondrial alterations. Hepatic level of vitamin A was increased. This finding supports the hypothesis that liver disease observed in our patient might be an adverse effect of vitamin supplementation. Our observation underlines the importance of including liver function tests in the follow up of patients with apolipoprotein B-related disorders. Images Figure 1 Figure 2 Figure 3 PMID:1568667

  2. Patterns of alcohol consumption after liver transplantation

    PubMed Central

    Tang, H; Boulton, R; Gunson, B; Hubscher, S; Neuberger, J

    1998-01-01

    Background—Uncertainty exists about the extent and consequences of a return to alcohol consumption after liver transplantation for alcoholic liver disease (ALD). 
Aims—To determine the prevalence and consequences of alcohol consumption in patients transplanted for ALD. 
Methods—A retrospective case controlled study of all patients transplanted for ALD at the Queen Elizabeth Hospital, Birmingham, between 1987 and 1996. 
Results—Seventy patients with ALD were transplanted, of which 59 survived more than three months; 56 were interviewed. Twenty eight had consumed some alcohol after transplantation; for the nine "heavy drinkers" (HD), the median time to resumption of alcohol intake was six months and for the 19 "moderate drinkers" (MD) it was eight months. There was no significant difference in episodes of acute rejection or compliance with medication between those who were abstinent, MD, or HD. Histological evidence of liver injury was common in ALD patients who had returned to drink. Mild fatty change was found in 1/11 biopsy specimens from abstinent patients but moderate to severe fatty change and ballooned hepatocytes were seen in 3/5 MD and 2/5 HD specimens. Two HD patients had early fibrosis. One HD patient has died of alcohol related complications. 
Conclusions—Moderate to heavy alcohol consumption occurs in patients transplanted for ALD. Patient recall of abstinence advice is unreliable, and patients return to alcohol mainly within the first year after liver transplantation. Return to alcohol consumption after liver transplantation is associated with rapid development of histological liver injury including fibrosis. 

 Keywords: alcohol consumption; liver transplantation PMID:9771419

  3. Characterization of prostate cancer missed by sextant biopsy.

    PubMed

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

    2003-09-01

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

  4. Membranous Nephropathy Associated With Immunological Disorder-Related Liver Disease

    PubMed Central

    Dauvergne, Maxime; Moktefi, Anissa; Rabant, Marion; Vigneau, Cécile; Kofman, Tomek; Burtey, Stephane; Corpechot, Christophe; Stehlé, Thomas; Desvaux, Dominique; Rioux-Leclercq, Nathalie; Rouvier, Philippe; Knebelmann, Bertrand; Boffa, Jean-Jacques; Frouget, Thierry; Daugas, Eric; Jablonski, Mathieu; Dahan, Karine; Brocheriou, Isabelle; Remy, Philippe; Grimbert, Philippe; Lang, Philippe; Chazouilleres, Oliver; Sahali, Dil; Audard, Vincent

    2015-01-01

    Abstract The association between membranous nephropathy (MN) and immunological disorder-related liver disease has not been extensively investigated, and the specific features of this uncommon association, if any, remain to be determined. We retrospectively identified 10 patients with this association. We aimed to describe the clinical, biological, and pathological characteristics of these patients and their therapeutic management. The possible involvement of the phospholipase A2 receptor (PLA2R) in these apparent secondary forms of MN was assessed by immunohistochemistry with renal and liver biopsy specimens. The mean delay between MN and liver disease diagnoses was 3.9 years and the interval between the diagnosis of the glomerular and liver diseases was <1.5 years in 5 patients. MN was associated with a broad spectrum of liver diseases including primary biliary cirrhosis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). AIH whether isolated (n = 3) or associated with PBC (n = 2) or PSC (n = 2) was the most frequent autoimmune liver disease. Circulating PLA2R antibodies were detected in 4 out of 9 patients but the test was performed under specific immunosuppressive treatment in 3 out of 9 patients. Seven of the 9 patients with available renal tissue specimens displayed enhanced expression of PLA2R in glomeruli whereas PLA2R was not expressed in liver parenchyma from these patients or in normal liver tissue. The study of immunoglobulin (Ig) subclasses of deposits in glomeruli revealed that the most frequent pattern was the coexistence of IgG1 and IgG4 immune deposits with IgG4 predominating. Detection of PLA2R antibodies in glomeruli but not in liver parenchyma is a common finding in patients with MN associated with autoimmune liver disease, suggesting that these autoantibodies are not exclusively detected in idiopathic MN. PMID:26222864

  5. Biopsy - biliary tract

    MedlinePlus

    ... ducts ( cholangiocarcinoma ) Cysts in the liver Liver cancer Pancreatic cancer Swelling and scarring of the bile ducts ( primary ... More Bile Cholangiocarcinoma Cyst Duodenum Hepatic Malignancy MRI Pancreatic cancer Ultrasound X-ray Review Date 2/11/2015 ...

  6. 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.

  7. Salivary gland biopsy

    MedlinePlus

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

  8. 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 ...

  9. Open lung biopsy

    MedlinePlus

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

  10. Pleural needle biopsy

    MedlinePlus

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

  11. Open pleural biopsy

    MedlinePlus

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

  12. Mediastinoscopy with biopsy

    MedlinePlus

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

  13. Intrahepatic synthese of immunoglobulin G in chronic liver disease.

    PubMed

    Kronborg, I J; Knopf, P M

    1980-04-01

    A method has been developed to measure the in vitro production of immunoglobulin (Ig) by liver biopsy specimens. Five to 30 mg of liver tissue was cultured for 24 h in Dulbecco's modified Eagle's medium/10% foetal calf serum (FCS) containing radiolabelled leucine (L-[4,5-3H] leucine). The culture medium was collected, centrifuged and the supernatant dialysed to remove labelled leucine. The residual radioactivity was a measure of newly synthesized 3H-labelled proteins released into the medium. The quantity of IgG was determined by immunoprecipitation with monospecific antisera to IgG heavy chains. The presence of IgG in the supernatant was confirmed by chromatography on protein-A Sepharose column. In 6 biopsies without evidence of active inflammation (4 normal and 2 fatty liver by histological criteria) less than 1% of the protein synthesized was IgG. In contrast in the presence of active inflammation in 4 cases of alcoholic hepatitis the IgG percentage ranged from 2 to 6%. Maximal levels of IgG production were detected in 3 cases of chronic active hepatitis (CAH) and ranged from 5 to 30%. The increased Ig synthesis by the liver in alcoholic hepatitis and CAH is presumed to be an index of the intrahepatic host response and may have important implications for mechanisms of liver damage in these diseases.

  14. 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.

  15. Granulomatous cryptococcal prostatitis diagnosed by transrectal biopsy.

    PubMed

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

    2006-05-01

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

  16. Confusion—specimen mix-up in dermatopathology and measures to prevent and detect it

    PubMed Central

    Weyers, Wolfgang

    2014-01-01

    Maintaining patient identity throughout the biopsy pathway is critical for the practice of dermatology and dermatopathology. From the biopsy procedure to the acquisition of the pathology report, a specimen may pass through the hands of more than twenty individuals in several workplaces. The risk of a mix-up is considerable and may account for more serious mistakes than diagnostic errors. To prevent specimen mix-up, work processes should be standardized and automated wherever possible, e.g., by strict order in the operating room and in the laboratory and by adoption of a bar code system to identify specimens and corresponding request forms. Mutual control of clinicians, technicians, histopathologists, and secretaries, both simultaneously and downstream, is essential to detect errors. The most vulnerable steps of the biopsy pathway, namely, labeling of specimens and request forms and accessioning of biopsy specimens in the laboratory, should be carried out by two persons simultaneously. In preceding work steps, clues must be provided that allow a mix-up to be detected later on, such as information about clinical diagnosis, biopsy technique, and biopsy site by the clinician, and a sketch of the specimen by the technician grossing it. Awareness of the danger of specimen mix-up is essential for preventing and detecting it. The awareness can be heightened by documentation of any error in the biopsy pathway. In case of suspicion, a mix-up of specimens from different patients can be confirmed by DNA analysis. PMID:24520511

  17. Microtubule turnover in ooplasm biopsy reflects ageing phenomena in the parent oocyte.

    PubMed

    Goud, A P; Goud, P T; Diamond, M P; Van Oostveldt, P; Hughes, M R

    2005-07-01

    Oviductal oocytes retrieved from superovulated B6D2F1 mice at 13.5, 16 and 19 h after human chorionic gonadotrophin (HCG) (groups A, B and C respectively, n = 382) were micromanipulated to obtain 12-20 mum sized ooplasm biopsy fragments. Experiments were divided into three sets. Ooplasmic microtubule dynamics were studied in ooplasm biopsy specimens and parent oocytes (set 1) and ooplasm biopsy specimens (set 2), whilst zona pellucida dissolution time, cortical granule loss and spindle/chromatin morphology using confocal microscopy were also studied in parent oocytes (set 2). Oocytes withstood oocyte biopsy with a high survival rate (98.2%) and the biopsied oocytes underwent successful fertilization and development (set 3). An absolute one-to-one correlation was seen between the oocyte biopsy specimens and the parent oocytes in terms of ooplasmic microtubule dynamics (set 1), and increased ooplasmic microtubule dynamics in oocyte biopsy specimens paralleled ageing phenomena in the parent oocytes (set 2). Zona pellucida dissolution time was significantly lower in parent oocytes from group A versus groups B (P = 0.032), and C (P < 0.001). (Groups A, B, C include minimal, moderate, increased ooplasmic microtubule dynamics in oocyte biopsy specimens respectively.) Oocyte cortical granule loss and spindle/chromatin abnormalities were mainly seen in group C (P < 0.001). Oocyte biopsy can thus be applied to judge age-related changes in the parent oocytes.

  18. Toward surface quantification of liver fibrosis progression

    NASA Astrophysics Data System (ADS)

    He, Yuting; Kang, Chiang Huen; Xu, Shuoyu; Tuo, Xiaoye; Trasti, Scott; Tai, Dean C. S.; Raja, Anju Mythreyi; Peng, Qiwen; So, Peter T. C.; Rajapakse, Jagath C.; Welsch, Roy; Yu, Hanry

    2010-09-01

    Monitoring liver fibrosis progression by liver biopsy is important for certain treatment decisions, but repeated biopsy is invasive. We envision redefinition or elimination of liver biopsy with surface scanning of the liver with minimally invasive optical methods. This would be possible only if the information contained on or near liver surfaces accurately reflects the liver fibrosis progression in the liver interior. In our study, we acquired the second-harmonic generation and two-photon excitation fluorescence microscopy images of liver tissues from bile duct-ligated rat model of liver fibrosis. We extracted morphology-based features, such as total collagen, collagen in bile duct areas, bile duct proliferation, and areas occupied by remnant hepatocytes, and defined the capsule and subcapsular regions on the liver surface based on image analysis of features. We discovered a strong correlation between the liver fibrosis progression on the anterior surface and interior in both liver lobes, where biopsy is typically obtained. The posterior surface exhibits less correlation with the rest of the liver. Therefore, scanning the anterior liver surface would obtain similar information to that obtained from biopsy for monitoring liver fibrosis progression.

  19. [Non-invasive assessment of liver fibrosis].

    PubMed

    Cohen-Ezra, Oranit; Ben-Ari, Ziv

    2015-03-01

    Chronic liver diseases represent a major public health problem, accounting for significant morbidity and mortality worldwide. Prognosis and management of chronic liver diseases depend on the amount of liver fibrosis. Liver biopsy has long remained the gold standard for assessment of liver fibrosis. Liver biopsy is an invasive procedure with associated morbidity, it is rarely the cause for mortality, and has a few limitations. During the past two decades, in an attempt to overcome the limitations of liver biopsy, non-invasive methods for the evaluation of liver fibrosis have been developed, mainly in the field of viral hepatitis. This review will focus on different methods available for non-invasive evaluation of liver fibrosis including a biological approach which quantifies serum levels of biomarkers of fibrosis and physical techniques which measure liver stiffness by transient elastography, ultrasound or magnetic resonance based elastography, their accuracy, advantages and disadvantages.

  20. 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.

  1. 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.

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

    PubMed

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

    2006-08-01

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

  3. 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.

  4. Rapid diagnosis of cytomegalovirus infection by in-situ hybridisation in liver grafts.

    PubMed

    Naoumov, N V; Alexander, G J; O'Grady, J G; Sutherland, S; Aldis, P; Portmann, B C; Williams, R

    1988-06-18

    Cytomegalovirus (CMV) is a major cause of hepatic dysfunction after liver transplantation, but proof of infection and distinguishing CMV hepatitis from other causes of impaired liver function can be difficult. In-situ hybridisation for CMV-DNA in liver biopsy specimens was assessed in 25 liver graft recipients in whom CMV was suspected on clinical grounds. CMV-DNA was detected in all 10 patients with primary CMV infection, in whom a close correlation was found between the number of CMV-DNA-positive cells and both the number of cells containing viral inclusions identified by light microscopy and the clinical severity of disease. In contrast, CMV-DNA was not detected in patients with secondary CMV infection, or in those without evidence of CMV infection. In-situ hybridisation for CMV-DNA provides an accurate and rapid diagnosis of CMV infection, and allows specific antiviral therapy to be used earlier.

  5. [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.

  6. In situ hybridization for the detection of hepatitis C virus RNA in human liver tissue.

    PubMed

    Li, G; Li, K; Lea, A S; Li, N L; Abdulla, N E; Eltorky, M A; Ferguson, M R

    2013-03-01

    In situ hybridization (ISH) enables visualization of specific nucleic acid in morphologically preserved cells and tissue sections. Detection of the HCV genomes in clinical specimens is useful for differential diagnosis, particularly between recurrent HCV infection and acute cellular rejection in transplant specimens. We optimized an ISH protocol that demonstrated sensitivity and specificity for detecting genomic and replicative form of HCV RNA in tissue biopsies. Digoxigenin (Dig)-labelled sense and anti-sense riboprobes were synthesized using a plasmid containing a fragment of the highly conserved HCV noncoding region as a template. The efficiency of the Dig-labelled riboprobes in detecting genomic and replicative-intermediate HCV RNA was analysed in 30 liver biopsies from patients infected or uninfected with HCV in a blinded study. A Huh7 cell line that stably replicates genome-length HCV RNA was developed to be used as a positive control. Negative control riboprobes were used in parallel to evaluate and control for background staining. The anti-sense probe detected HCV RNA in 20/21 specimens from HCV-infected liver tissues obtained from patients and in 0/9 samples from patients with non-HCV-related liver diseases, resulting in a sensitivity and specificity of 95% and 100%, respectively. HCV genomic RNA was variably distributed in tissue sections and was located primarily in the perinuclear regions in hepatocytes. Detection of HCV RNA by our optimized ISH protocol appears to be a sensitive and specific method when processing clinical specimens. It may also be revealing when exploring the pathophysiology of HCV infection by verifying the presence of viral genetic material within heptocytes and other cellular elements of diseased liver tissue. This methodology might also evaluate the response to antiviral therapies by demonstrating the absence or alteration of genetic material in clinical specimens from successfully treated patients.

  7. Thyroid gland biopsy (image)

    MedlinePlus

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

  8. Shear-Wave Elastography for the Estimation of Liver Fibrosis in Chronic Liver Disease: Determining Accuracy and Ideal Site for Measurement

    PubMed Central

    Dhyani, Manish; Vij, Abhinav; Bhan, Atul K.; Halpern, Elkan F.; Méndez-Navarro, Jorge; Corey, Kathleen E.; Chung, Raymond T.

    2015-01-01

    Purpose To evaluate the accuracy of shear-wave elastography (SWE) for staging liver fibrosis in patients with diffuse liver disease (including patients with hepatitis C virus [HCV]) and to determine the relative accuracy of SWE measurements obtained from different hepatic acquisition sites for staging liver fibrosis. Materials and Methods The institutional review board approved this single-institution prospective study, which was performed between January 2010 and March 2013 in 136 consecutive patients who underwent SWE before their scheduled liver biopsy (age range, 18–76 years; mean age, 49 years; 70 men, 66 women). Informed consent was obtained from all patients. SWE measurements were obtained at four sites in the liver. Biopsy specimens were reviewed in a blinded manner by a pathologist using METAVIR criteria. SWE measurements and biopsy results were compared by using the Spearman correlation and receiver operating characteristic (ROC) curve analysis. Results SWE values obtained at the upper right lobe showed the highest correlation with estimation of fibrosis (r = 0.41, P < .001). Inflammation and steatosis did not show any correlation with SWE values except for values from the left lobe, which showed correlation with steatosis (r = 0.24, P = .004). The area under the ROC curve (AUC) in the differentiation of stage F2 fibrosis or greater, stage F3 fibrosis or greater, and stage F4 fibrosis was 0.77 (95% confidence interval [CI]: 0.68, 0.86), 0.82 (95% CI: 0.75, 0.91), and 0.82 (95% CI: 0.70, 0.95), respectively, for all subjects who underwent liver biopsy. The corresponding AUCs for the subset of patients with HCV were 0.80 (95% CI: 0.67, 0.92), 0.82 (95% CI: 0.70, 0.95), and 0.89 (95% CI: 0.73, 1.00). The adjusted AUCs for differentiating stage F2 or greater fibrosis in patients with chronic liver disease and those with HCV were 0.84 and 0.87, respectively. Conclusion SWE estimates of liver stiffness obtained from the right upper lobe showed the best

  9. Liver cell adenoma and liver cell adenomatosis

    PubMed Central

    Barthelmes, Ludger

    2005-01-01

    During the last three decades liver cell adenoma and liver cell adenomatosis have emerged as new clinical entities in hepato-logical practice due to the widespread use of oral contraceptives and increased imaging of the liver. On review of published series there is evidence that 10% of liver cell adenomas progress to hepatocellular carcinoma, diagnosis is best made by open or laparoscopic excision biopsy, and the preferred treatment modality is resection of the liver cell adenoma to prevent bleeding and malignant transformation. In liver cell adenomatosis, the association with oral contraceptive use is not as high as in solitary liver cell adenomas. The risk of malignant transformation is not increased compared with solitary liver cell adenomas. Treatment consists of close monitoring and imaging, resection of superficially located, large (>4 cm) or growing liver cell adenomas. Liver transplantation is the last resort in case of substantive concern about malignant transformation or for large, painful adenomas in liver cell adenomatosis after treatment attempts by liver resection. PMID:18333188

  10. Fluorescence characteristics of human Barrett tissue specimens grafted on chick chorioallantoic membrane.

    PubMed

    Holz, Jasmin A; Boerwinkel, David F; Meijer, Sybren L; Visser, Mike; van Leeuwen, Ton G; Bergman, Jacques J G H M; Aalders, Maurice C G

    2016-01-01

    To improve (pre)malignant lesion identification in Barrett's esophagus (BE), recent research focuses on new developments in fluorescence imaging and spectroscopy to enhance tissue contrast. Our aim was to validate the chorioallantoic membrane (CAM) model as a preclinical tool to study the fluorescence characteristics such as autofluorescence and exogenously induced fluorescence of human Barrett's tissue. Therefore, esophageal biopsy specimens from Barrett's patients were freshly grafted onto the CAM of fertilized hen's eggs to simulate the in vivo situation. The BE biopsy specimens stayed between 1 and 9 days on the CAM to study the persistence of vitality. Fluorescence spectroscopy was performed using six excitation wavelengths (369, 395, 400, 405, 410, 416 nm). Obtained autofluorescence spectra were compared with in vivo spectra of an earlier study. Exogenous administration of 5-aminolevulinic-acid to the biopsy specimens was followed by fluorescence spectroscopy at several time points. Afterwards, the biopsy specimens were harvested and histologically evaluated. In total, 128 biopsy specimens obtained from 34 patients were grafted on the CAM. Biopsy specimens which stayed on average 1.7 days on the CAM were still vital. Autofluorescence spectra of the specimens correlated well with in vivo spectra. Administered 5-aminolevulinic-acid to the biopsy specimens showed conversion into protoporphyrin-IX. In conclusion, we showed that grafting freshly collected human BE biopsy specimens on the CAM is feasible. Our results suggest that the CAM model might be used to study the fluorescence behavior of human tissue specimens. Therefore, the CAM model might be a preclinical research tool for new photosensitizers.

  11. 37 CFR 2.59 - Filing substitute specimen(s).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Filing substitute specimen(s..., DEPARTMENT OF COMMERCE RULES OF PRACTICE IN TRADEMARK CASES Drawing § 2.59 Filing substitute specimen(s). (a... specimen(s), the applicant must: (1) For an amendment to allege use under § 2.76, verify by affidavit...

  12. Considerations in the design of an environmental specimen bank: experiences of the National Biomonitoring Specimen Bank Program.

    PubMed Central

    Wise, S A; Koster, B J

    1995-01-01

    Since 1979 the National Institute of Standards and Technology (NIST) has been involved in environmental specimen banking activities as part of the National Biomonitoring Specimen Bank (NBSB). These activities have focused on the development of procedures for the collection, processing, analysis, and long-term storage of a variety of environmental specimens including: human liver, mussels and oysters, fish tissue (liver and muscle), marine mammal tissues (blubber, liver, and kidney), and marine sediments. The experiences of the NBSB can provide valuable information to assist in the design of new specimen bank efforts. Based on the experiences of the NBSB, the issues that should be addressed in the design and operation of a valid specimen bank program are presented. PMID:7635114

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

    SciTech Connect

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

    2013-10-15

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

  14. Ultrasound-Guided Breast Biopsy

    MedlinePlus

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

  15. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

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

  16. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

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

  17. Liver metastases

    MedlinePlus

    Metastases to the liver; Metastatic liver cancer; Liver cancer - metastatic; Colorectal cancer - liver metastases; Colon cancer - liver metastases; Esophageal cancer - liver metastases; Lung cancer - liver metastases; Melanoma - liver metastases

  18. Diagnosis of primary squamous cell carcinoma of the pancreas using endoscopic ultrasound-guided core needle biopsy.

    PubMed

    Kashani, Amir; Kahn, Melissa; Jamil, Laith H

    2015-05-16

    Primary squamous cell carcinoma (SCC) of the pancreas is a particularly rare entity. Diagnosis of this tumor is tentatively made after ruling out metastatic SCC from another primary site and adenosquamous carcinoma (ASC) of the pancreas. Here we discuss the case of a 76-year-old woman who was found to have a solitary pancreatic lesion and multiple hepatic lesions. Results of computed tomography-guided biopsy of the liver lesions were consistent with a metastatic carcinoma displaying squamous differentiation; therefore, an endoscopic ultrasound (EUS)-guided core-needle biopsy (CNB) of the pancreatic mass was performed. Meticulous histopathological examination of the pancreatic specimen at multiple levels revealed moderately well-differentiated SCC with no glandular component. An extensive metastatic work-up did not reveal an extra-pancreatic origin for this SCC; hence, a diagnosis of primary SCC of the pancreas was established. To our knowledge, this is the first report of the diagnosis of a primary SCC of the pancreas using EUS-guided CNB. We believe that CNB has a diagnostic yield equivalent to that of fine-needle aspiration for recognizing pancreatic adenocarcinoma; however, when cytological examinations reveal atypical squamous epithelial cells suggestive of malignancy, CNB may provide a better tissue specimen, from which to determine the presence of a glandular component. Such an assessment will differentiate pancreatic SCC from ASC.

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

    PubMed

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

    2014-03-01

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

  20. A Case Study of Hemochromatosis and Conflicting Point Shear Wave Measurements in the Assessment of Liver Fibrosis.

    PubMed

    Cohen, Tal; Barr, Richard G

    2017-01-09

    There are multiple factors that affect the shear wave speed in the assessment of liver stiffness. In this case report, we present a case of hemochromatosis that has elevated liver stiffness suggestive of significant fibrosis or cirrhosis; however on liver biopsy, no fibrosis was identified. This article will discuss the possibility that liver iron deposition may affect SWE measurements of the liver, leading to inaccurate assessment of liver fibrosis. In these cases, a liver biopsy may be required for accurate liver assessment.

  1. Real-time magnetic resonance imaging guidance improves the diagnostic yield of endomyocardial biopsy

    PubMed Central

    Rogers, Toby; Ratnayaka, Kanishka; Karmarkar, Parag; Campbell-Washburn, Adrienne E.; Schenke, William H.; Mazal, Jonathan R.; Kocaturk, Ozgur; Faranesh, Anthony Z.; Lederman, Robert J.

    2016-01-01

    Background Diagnostic yield of endomyocardial biopsy is low, particularly in disease that affects the myocardium in a non-uniform distribution. We hypothesized that real-time MRI guidance could improve the yield through targeted biopsy of focal myocardial pathology. Methods An animal model of focal myocardial pathology was created by infusing 3mL of fluorescent microspheres (NuFlow Hydrocoat, 15μm diameter, 5 million spheres/mL) followed by 2mL of 100% ethanol to a branch coronary artery. Animals were survived for minimum 14days, before undergoing MRI guided endomyocardial biopsy using a custom 6.5Fr active visualization MRI-conditional bioptome and X-ray guided biopsy using a commercial bioptome. Specimens were analyzed using a dissecting microscope under ultraviolet light to determine the proportion of ‘on-target’ specimens containing fluorescent microspheres. Results A total of 77 specimens were obtained using real-time MRI guidance and 87 using X-ray guidance, in five animals. Specimens obtained with the MRI-conditional bioptome were smaller compared with the commercial X-ray bioptome. Real-time MRI guidance significantly increased the diagnostic yield of endomyocardial biopsy (82% vs. 56% on-target biopsy specimens with real-time MRI vs. X-ray guidance, p<0.01). Conclusions Endomyocardial biopsy performed using real-time MRI guidance is feasible and significantly improves the diagnostic yield compared with X-ray fluoroscopy guidance. PMID:27631028

  2. How to Interpret Thyroid Biopsy Results: A Three-Year Retrospective Interventional Radiology Experience

    SciTech Connect

    Oppenheimer, Jason D. Kasuganti, Deepa; Nayar, Ritu; Chrisman, Howard B.; Lewandowski, Robert J.; Nemcek, Albert A.; Ryu, Robert K.

    2010-08-15

    Results of thyroid biopsy determine whether thyroid nodule resection is appropriate and the extent of thyroid surgery. At our institution we use 20/22-gauge core biopsy (CBx) in conjunction with fine-needle aspiration (FNA) to decrease the number of passes and improve adequacy. Occasionally, both ultrasound (US)-guided FNA and CBx yield unsatisfactory specimens. To justify clinical recommendations for these unsatisfactory thyroid biopsies, we compare rates of malignancy at surgical resection for unsatisfactory biopsy results against definitive biopsy results. We retrospectively reviewed a database of 1979 patients who had a total of 2677 FNA and 663 CBx performed by experienced interventional radiologists under US guidance from 2003 to 2006 at a tertiary-care academic center. In 451 patients who had surgery following biopsy, Fisher's exact test was used to compare surgical malignancy rates between unsatisfactory and malignant biopsy cohorts as well as between unsatisfactory and benign biopsy cohorts. We defined statistical significance at P = 0.05. We reported an overall unsatisfactory thyroid biopsy rate of 3.7% (100/2677). A statistically significant higher rate of surgically proven malignancies was found in malignant biopsy patients compared to unsatisfactory biopsy patients (P = 0.0001). The incidence of surgically proven malignancy in unsatisfactory biopsy patients was not significantly different from that in benign biopsy patients (P = 0.8625). In conclusion, an extremely low incidence of malignancy was associated with both benign and unsatisfactory thyroid biopsy results. The difference in incidence between these two groups was not statistically significant. Therefore, patients with unsatisfactory biopsy specimens can be reassured and counseled accordingly.

  3. 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

  4. Membranous Nephropathy Associated With Immunological Disorder-Related Liver Disease: A Retrospective Study of 10 Cases.

    PubMed

    Dauvergne, Maxime; Moktefi, Anissa; Rabant, Marion; Vigneau, Cécile; Kofman, Tomek; Burtey, Stephane; Corpechot, Christophe; Stehlé, Thomas; Desvaux, Dominique; Rioux-Leclercq, Nathalie; Rouvier, Philippe; Knebelmann, Bertrand; Boffa, Jean-Jacques; Frouget, Thierry; Daugas, Eric; Jablonski, Mathieu; Dahan, Karine; Brocheriou, Isabelle; Remy, Philippe; Grimbert, Philippe; Lang, Philippe; Chazouilleres, Oliver; Sahali, Dil; Audard, Vincent

    2015-07-01

    The association between membranous nephropathy (MN) and immunological disorder-related liver disease has not been extensively investigated, and the specific features of this uncommon association, if any, remain to be determined.We retrospectively identified 10 patients with this association. We aimed to describe the clinical, biological, and pathological characteristics of these patients and their therapeutic management. The possible involvement of the phospholipase A2 receptor (PLA2R) in these apparent secondary forms of MN was assessed by immunohistochemistry with renal and liver biopsy specimens.The mean delay between MN and liver disease diagnoses was 3.9 years and the interval between the diagnosis of the glomerular and liver diseases was <1.5 years in 5 patients. MN was associated with a broad spectrum of liver diseases including primary biliary cirrhosis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). AIH whether isolated (n = 3) or associated with PBC (n = 2) or PSC (n = 2) was the most frequent autoimmune liver disease. Circulating PLA2R antibodies were detected in 4 out of 9 patients but the test was performed under specific immunosuppressive treatment in 3 out of 9 patients. Seven of the 9 patients with available renal tissue specimens displayed enhanced expression of PLA2R in glomeruli whereas PLA2R was not expressed in liver parenchyma from these patients or in normal liver tissue. The study of immunoglobulin (Ig) subclasses of deposits in glomeruli revealed that the most frequent pattern was the coexistence of IgG1 and IgG4 immune deposits with IgG4 predominating.Detection of PLA2R antibodies in glomeruli but not in liver parenchyma is a common finding in patients with MN associated with autoimmune liver disease, suggesting that these autoantibodies are not exclusively detected in idiopathic MN.

  5. [Neuromuscular biopsy and diagnosis of vasculitis].

    PubMed

    Vital, Anne; Vital, Claude

    2006-09-01

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

  6. Liver precancerous lesions and hepatocellular carcinoma: the histology report.

    PubMed

    Roncalli, Massimo; Terracciano, Luigi; Di Tommaso, Luca; David, Ezio; Colombo, Massimo

    2011-03-01

    The current ability to increase the survival of patients with hepatocellular carcinoma (HCC) relies upon the surveillance of cirrhotic patients. Surveillance allows HCC precursors (dysplastic nodules) and malignant tumors to be recognized at an earlier stage making cure possible. Radiology plays a major role in HCC diagnosis because HCC is characterized by neoarterial vascularisation with a typical imaging pattern. Current international guidelines have restricted the use of the liver biopsy to the characterization of hepatocellular nodules which remain diagnostically equivocal after imaging. Thus pathologists are today facing very challenging and often well differentiated lesions, leading to difficulties in distinguishing high grade dysplasia and well differentiated HCC. In this scenario novel concepts obtained through international consensus have been proposed with emphasis on HCC of small size (up to 2 cm) which includes 2 distinct types, the early and progressed HCC. In this paper we will report the main histopathological criteria of a biopsy which allow the differentiation of HCC precursors (dysplastic nodules) from well differentiated HCC with attention to the role and weight of both classical histopathological criteria and novel immunocytochemical markers. The second part of the paper is devoted to the histopathology report of HCC on surgical specimens including explanted livers and on the differential diagnosis between HCC and liver metastasis.

  7. Histopathologic features of the liver in pediatric acquired immune deficiency syndrome.

    PubMed

    Jonas, M M; Roldan, E O; Lyons, H J; Fojaco, R M; Reddy, R K

    1989-07-01

    Autopsy and liver biopsy specimens from 30 pediatric patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC) were retrospectively reviewed. Of 28 cases with histologic abnormalities, the following findings were noted singly or in combination: giant-cell transformation, cytomegalovirus inclusions, Kaposi's sarcoma, diffuse lymphoplasmocytic infiltrate, granulomatous hepatitis, mild portal inflammation, necrosis around central veins, steatosis, and cholestasis. For the most part, abnormalities in the liver were not predictive of those in other organs, but the two children with the diffuse parenchymal lymphoplasmocytic infiltrate also had lymphoid interstitial pneumonitis (LIP). Liver histopathology in pediatric patients with AIDS shares some features with that in adults, but appreciable differences are noted. In particular, these differences include the higher frequency of giant-cell transformation and the lower frequency of granulomas in children and the observation of diffuse lymphoplasmocytic infiltrate associated with LIP.

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

    PubMed Central

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

    1983-01-01

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

  9. Liver transplant

    MedlinePlus

    Hepatic transplant; Transplant - liver; Orthotopic liver transplant; Liver failure - liver transplant; Cirrhosis - liver transplant ... The donated liver may be from: A donor who has recently died and has not had liver injury. This type of ...

  10. Understanding the diagnostic yield of current endoscopic biopsy for gastric neoplasm: A prospective single-center analysis based on tumor characteristics stratified by biopsy number and site.

    PubMed

    Kwack, Won G; Ho, Won J; Kim, Jae H; Lee, Jin H; Kim, Eo J; Kang, Hyoun W; Lee, Jun K

    2016-07-01

    Although there are general guidelines on endoscopic biopsy for diagnosing gastric neoplasms, they are predominantly based on outdated literature obtained with fiberscopes without analyses specific to tumor characteristics.This study aims to comprehensively characterize the contemporary endoscopic biopsy by determining the diagnostic yield across different lesion morphologies and histological stages, especially exploring how the number and site of biopsy may influence the overall yield.Biopsy samples from suspected gastric neoplasms were collected prospectively from May 2011 to August 2014 in a tertiary care medical center. A standardized methodology was used to obtain a total of 6 specimens from 2 defined sites per lesion. Rate of positive diagnosis based on the biopsy number and site was assessed for specific gastric lesion morphologies and histological stages.A total of 1080 biopsies from 180 pathologically diagnosed neoplastic lesions in 176 patients were obtained during the study. For depressed/ulcerative and polypoid lesions, the yield was already >99% by the fourth biopsy without further gain from additional biopsies. Lower overall yield was observed for infiltrative lesions (57.1% from 4 biopsies). The site of biopsy did not influence the diagnostic yield except for with infiltrative lesions in which biopsies from thickened mucosal folds were of higher yield than erosive regions.Obtaining 4 specimens may be sufficient for accurate diagnosis of a depressed/ulcerative or polypoid gastric lesion regardless of its histological stage. For infiltrative lesions, at least 5 to 6 biopsies per lesion with more representative sampling from thickened mucosal folds may be preferable.

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

    SciTech Connect

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

    2008-01-15

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

  12. Steerable real-time sonographically guided needle biopsy.

    PubMed

    Buonocore, E; Skipper, G J

    1981-02-01

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

  13. Needle biopsy for hepatic vitamin A levels in lions (Panthera leo).

    PubMed

    Shamir, Merav H; Rubin, Gal; Aizenberg, Zachi; Berkovich, Zipi; Reifen, Ram; Horowitz, Igal; Bdolah-Abram, Tali; Aroch, Itamar

    2012-06-01

    Hypovitaminosis A (HA)-related skull malformations resulting in neurologic abnormalities and death have been, and still are, reported in captive lions (Panthera leo) worldwide. Liver vitamin A (VA) concentration is the most reliable indicator of animals' VA status, and its assessment is essential in prevention and treatment of HA in lions. A percutaneous needle liver biopsy using high-performance liquid chromatography ultraviolet retinoid analysis for VA concentration measurement was validated. It was first assessed in vitro using chicken liver. Later, the safety and feasibility of ultrasound-guided percutaneous needle liver biopsy was assessed in living lions. Hepatic VA concentrations in lion liver were measured using the above laboratory method. Mean chicken hepatic VA concentration in needle biopsy (NB) and wedge biopsy (WB) of the same liver lobes were 108.66 and 60.89 microg/g wet tissue, respectively, and were significantly (P = 0.03) correlated (r = 0.74). The calculated linear regression for predicting VA concentration in WB using NB VA for chicken liver was 25.194 + 0.3234x NB (microg/g). Four ultrasound-guided percutaneous needle liver biopsies were obtained from each of the four lions under general anesthesia. Mean hepatic VA concentration was 8.25 microg/g wet tissue (range 1.43-25.29 microg/g). Mean serum VA concentration, measured in these four lions was 1,011.1 nmol/L with a standard deviation of 337.91 nmol/L (range 590.26-1,077.2 nmol/L). The lions recovered uneventfully, and no complications were observed during a 4-yr follow-up period. In conclusion, the percutaneous needle liver biopsy technique is a reliable, practical, safe tool for obtaining liver tissue samples antemortem for assessment of the VA status in lions and can be used in future studies.

  14. Brucella infection with pancytopenia after pediatric liver transplantation.

    PubMed

    Polat, K Y; Tosun, M S; Ertekin, V; Aydinli, B; Emre, S

    2012-06-01

    Brucellosis is considered the most widespread zoonosis in the world. It has been reported that the prevalence of seropositivity among the Turkish population varies from 3% to 14%. We present a case of brucellosis after pediatric liver transplantation. A 15-year-old boy with the diagnosis of neuro Wilson's disease underwent deceased-donor liver transplantation. The postoperative immunosuppressive protocol consisted of steroids and tacrolimus. Two months after the operation the patient experienced fever to 40°C. The patient complained of poor appetite, headache, and diarrhea. He had had pancytopenia. Despite administration of appropriate antibiotics, antiviral and antifungal agents, fever persisted for > 1 month. Multiple blood, urine, stool, and sputum cultures were negative. Bone marrow aspirate revealed hypocellularity. Liver biopsy was performed, but rejection was not observed on biopsy specimen. Brucella serology was positive and Brucella agglutination titer was 1:320. Bone marrow culture was positive for Brucella but blood culture was negative. The patient was then treated with oral doxycycline and rifampin for 8 weeks. No previous case report about Brucella infection after liver transplantation has appeared in the literature, to our knowledge; our case is presented as the first. Bone marrow hypoplasia is a rare feature of Brucella infection. Our patient with brucellosis and pancytopenia had had hypocellular bone marrow. The clinical and hematologic findings resolved with treatment of the infection. Brucella infection should be suspected in liver transplanted recipients with fever of unknown origin, especially in a recipient who has lived in an endemic area. Brucella also should be considered as a possible diagnosis in patients with pancytopenia.

  15. Biaxial Creep Specimen Fabrication

    SciTech Connect

    JL Bump; RF Luther

    2006-02-09

    This report documents the results of the weld development and abbreviated weld qualification efforts performed by Pacific Northwest National Laboratory (PNNL) for refractory metal and superalloy biaxial creep specimens. Biaxial creep specimens were to be assembled, electron beam welded, laser-seal welded, and pressurized at PNNL for both in-pile (JOYO reactor, O-arai, Japan) and out-of-pile creep testing. The objective of this test campaign was to evaluate the creep behavior of primary cladding and structural alloys under consideration for the Prometheus space reactor. PNNL successfully developed electron beam weld parameters for six of these materials prior to the termination of the Naval Reactors program effort to deliver a space reactor for Project Prometheus. These materials were FS-85, ASTAR-811C, T-111, Alloy 617, Haynes 230, and Nirnonic PE16. Early termination of the NR space program precluded the development of laser welding parameters for post-pressurization seal weldments.

  16. 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

  17. Oral biopsy in dental practice.

    PubMed

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

    2007-11-01

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

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

    SciTech Connect

    Wallace, Adam N. Pacheco, Rafael A. Tomasian, Anderanik; Hsi, Andy C.; Long, Jeremiah; Chang, Randy O.; Jennings, Jack W.

    2016-02-15

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

  19. Immunohistochemical evidence of disease recurrence after liver transplantation for primary biliary cirrhosis.

    PubMed

    Van de Water, J; Gerson, L B; Ferrell, L D; Lake, J R; Coppel, R L; Batts, K P; Wiesner, R H; Gershwin, M E

    1996-11-01

    Whether primary biliary cirrhosis (PBC) recurs after liver transplantation has remained an interesting and controversial issue; rejection, viral hepatitis, and drug effects all may mimic recurrent PBC histologically and biochemically. Furthermore, reliable clinical criteria for PBC recurrence are lacking. In this study, the issue of disease recurrence using a well-characterized monoclonal antibody (MAb), C355.1, that reacts with the immunodominant mitochondrial autoantigen of PBC (pyruvate dehydrogenase complex [PDC-E2]) was addressed. When used in an immunohistochemical assay, C355.1 produces intense apical staining of bile duct epithelium specifically in liver sections of patients with PBC and may be the earliest known marker of PBC. Immunohistochemical and histological analysis of serial liver biopsy specimens of 67 patients pre- and post-orthotopic liver transplantation (OLT), including 38 patients with PBC and 29 non-PBC liver disease controls, was performed. Sections were stained with MAb C355.1 or the control MAb C315 and analyzed to determine whether there was a recurrence of apical reactivity in the bile ducts of the posttransplantation biopsy specimens. The immunohistochemical staining was correlated with the histological findings and serum biochemistries at the time of the biopsy. Our data indicate that a significant number of patients who underwent transplantation for PBC (28 of 38) but not controls (0 of 29) develop a staining pattern of liver bile duct epithelium with MAb C355.1 that is indistinguishable from the pretransplantation pattern. Of the 28 patients with this apical staining pattern, 8 were characterized histologically as possible recurrent PBC, 2 as chronic rejection, 2 as acute rejection, 9 as nonspecific changes, 4 as normal or near normal, and 3 had other histological changes. Only 50% of the patients with apical C355.1 staining had liver enzyme levels suggestive of cholestasis. Thus, there appears to be immunohistochemical evidence that

  20. Liver Transplant

    MedlinePlus

    ... Home > Your Liver > Liver Disease Information > Liver Transplant Liver Transplant Explore this section to learn more about ... resource. www.paulcox.com.au Why is the liver important? The liver is the second largest organ ...

  1. Surgical follow-up results for apocrine adenosis and atypical apocrine adenosis diagnosed on breast core biopsy.

    PubMed

    Hou, Yanjun; Chaudhary, Shweta; Gao, Faye F; Li, Zaibo

    2016-10-01

    Apocrine adenosis (AA) and atypical apocrine adenosis (AAA) are uncommon findings in breast biopsies that may be misinterpreted as carcinoma. The clinical significance and risk implications of AAA diagnosed on core biopsy are not well established. This study aimed to determine the frequency of carcinoma on follow-up excision in patients with a diagnosis of AA or AAA on core biopsy. Forty-one breast core biopsies of AA (n=29) and AAA (n=12) were identified during a study period of 12 years. Of the 41 core biopsies with AA or AAA, 10 biopsies showed coexisting/concurrent atypical hyperplasia or carcinoma. In the absence of coexisting/concurrent atypical hyperplasia or carcinoma in core biopsy, none of the follow-up excision specimens after a diagnosis of AA or AAA showed ductal carcinoma in situ or invasive carcinoma. In conclusion, AA or AAA by itself is an uncommon core biopsy diagnosis that may not require surgical excision.

  2. US-guided biopsy of neck masses in postoperative management of patients with thyroid cancer.

    PubMed

    Sutton, R T; Reading, C C; Charboneau, J W; James, E M; Grant, C S; Hay, I D

    1988-09-01

    High-frequency (10-MHz) sonography demonstrated a cervical mass or lymphadenopathy, or both, during postoperative follow-up of 52 patients who had undergone surgery for thyroid cancer. Percutaneous biopsy with ultrasonographic (US) guidance was performed in all 52 masses, 44 of which were nonpalpable. Malignant cells were obtained in 29 biopsies, and the results of 20 biopsies were negative, yielding benign lymphocytes only. Results in three biopsies were nondiagnostic due to hypocellular specimens. Therefore, 94% of biopsy results (49) of 52) were confidently assigned as either positive (56%) or negative (38%) for malignancy. There were no complications. High-frequency sonography can demonstrate clinically occult thyroid bed tumor recurrence and lymph node metastases. US-guided biopsy is an accurate and safe technique to confirm or exclude malignancy in patients at high risk of recurrence of thyroid cancer.

  3. Confocal reflectance imaging of excised malignant human bladder biopsies

    NASA Astrophysics Data System (ADS)

    Daniltchenko, Dmitri I.; Kastein, Albrecht; Koenig, Frank; Sachs, Markus; Schnorr, Dietmar; Al-Shukri, Salman; Loening, Stefan A.

    2004-08-01

    To evaluate the potential of reflectance confocal scanning laser microscopy (CM) for rapid imaging of non-processed freshly excised human bladder biopsies and cystectomy specimens. Freshly excised bladder tumors from three cystectomy specimens and random biopsies from twenty patients with a history of superficial bladder tumors were imaged with CM. Additional acetic acid washing prior to CM imaging was performed in some of the samples. Confocal images were compared to corresponding routine histologic sections. CM allows imaging of unprocessed bladder tissue at a subcellular resolution. Urothelial cell layers, collagen, vessels and muscle fibers can be rapidly visualized, in native state. In this regard, umbrella cells, basement membrane elucidated. Besides obvious limitations partly due to non-use of exogenous dyes, CM imaging offers several advantages: rapid imaging of the tissue in its native state like the basement membrane, normally seen only by using immunohistopathology. Reflectance CM opens a new avenue for imaging bladder cancer.

  4. NASA Biological Specimen Repository

    NASA Technical Reports Server (NTRS)

    McMonigal, K. A.; Pietrzyk, R. A.; Sams, C. F.; Johnson, M. A.

    2010-01-01

    The NASA Biological Specimen Repository (NBSR) was established in 2006 to collect, process, preserve and distribute spaceflight-related biological specimens from long duration ISS astronauts. This repository provides unique opportunities to study longitudinal changes in human physiology spanning may missions. The NBSR collects blood and urine samples from all participating ISS crewmembers who have provided informed consent. These biological samples are collected once before flight, during flight scheduled on flight days 15, 30, 60, 120 and within 2 weeks of landing. Postflight sessions are conducted 3 and 30 days after landing. The number of in-flight sessions is dependent on the duration of the mission. Specimens are maintained under optimal storage conditions in a manner that will maximize their integrity and viability for future research The repository operates under the authority of the NASA/JSC Committee for the Protection of Human Subjects to support scientific discovery that contributes to our fundamental knowledge in the area of human physiological changes and adaptation to a microgravity environment. The NBSR will institute guidelines for the solicitation, review and sample distribution process through establishment of the NBSR Advisory Board. The Advisory Board will be composed of representatives of all participating space agencies to evaluate each request from investigators for use of the samples. This process will be consistent with ethical principles, protection of crewmember confidentiality, prevailing laws and regulations, intellectual property policies, and consent form language. Operations supporting the NBSR are scheduled to continue until the end of U.S. presence on the ISS. Sample distribution is proposed to begin with selections on investigations beginning in 2017. The availability of the NBSR will contribute to the body of knowledge about the diverse factors of spaceflight on human physiology.

  5. Method for thinning specimen

    SciTech Connect

    Follstaedt, David M.; Moran, Michael P.

    2005-03-15

    A method for thinning (such as in grinding and polishing) a material surface using an instrument means for moving an article with a discontinuous surface with an abrasive material dispersed between the material surface and the discontinuous surface where the discontinuous surface of the moving article provides an efficient means for maintaining contact of the abrasive with the material surface. When used to dimple specimens for microscopy analysis, a wheel with a surface that has been modified to produce a uniform or random discontinuous surface significantly improves the speed of the dimpling process without loss of quality of finish.

  6. Biochemical surrogate markers of liver fibrosis and activity in a randomized trial of peginterferon alfa-2b and ribavirin.

    PubMed

    Poynard, Thierry; McHutchison, John; Manns, Michael; Myers, Rob P; Albrecht, Janice

    2003-08-01

    Liver fibrosis and activity indexes were validated in patients infected by hepatitis C virus (HCV) nontreated and treated by interferon. The aim was to validate their usefulness as surrogate markers of histologic features using the data of a randomized trial of combination peginterferon alfa-2b and ribavirin. Three hundred fifty-two patients who had had 2 interpretable liver biopsies and stored serum sample before and after treatment were selected. Two hundred eight patients received peginterferon alfa-2b 1.5 mcg per kg and ribavirin and 144 patients interferon alfa-2b 3 MU three times a week and ribavirin for 48 weeks. A fibrosis and an activity index combining 5 and 6 biochemical markers were assessed at baseline and at end of follow-up (24 weeks after treatment). The biochemical markers have significant predictive values both for the diagnosis of fibrosis and for activity. For the diagnosis of bridging fibrosis and/or moderate necroinflammatory activity, the area under the receiver operating characteristics curve of the activity index was 0.76 +/- 0.03 at baseline and 0.82 +/- 0.02 at end of follow-up. A cutoff of activity index at 0.30 (range, 0.00-1.00) had 90% sensitivity and 88% positive predictive value for the diagnosis of bridging fibrosis or moderate necroinflammatory activity. Sensitivity analyses with biopsy specimens of size greater than 15 mm suggest that a part of discordances between biochemical markers and histology were due to biopsy specimen sampling error. In conclusion, these biochemical markers of fibrosis and activity could be used as surrogate markers for liver biopsy in patients with chronic hepatitis C, both for the initial evaluation and for follow-up.

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

    MedlinePlus

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

  8. [Pulmonary needle biopsy in children].

    PubMed

    Gerbeaux, J

    1975-01-01

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

  9. For Women Facing a Breast Biopsy

    MedlinePlus

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

  10. Multicentre study of prevalence of HBV-associated delta infection and liver disease in drug-addicts.

    PubMed

    Raimondo, G; Smedile, A; Gallo, L; Balbo, A; Ponzetto, A; Rizzetto, M

    1982-01-30

    To assess the epidemiological and pathogenic effects of infection with the hepatitis-B-virus (HBV)-associated delta agent in addicts who take drugs parenterally, 225 symptomless addicts from Italy and 261 addicts with HBsAg-positive hepatitis from Italy, Denmark, Switzerland, and Ireland were tested for delta antigen (delta-Ag) and its antibody (anti-delta) by radioimmunoassay. 79 liver biopsy specimens from HBsAg-positive addicts were also tested for intrahepatic delta-Ag by immunofluorescence. Anti-delta was found in 9 (27%) of 33 of the symptomless HBsAg-positive addicts, in 13 (8%) of 156 of those without HBsAg but with anti-HBs, and in none of those negative for HBV markers. The prevalence of serum delta-Ag or anti-delta among addicts with HBsAg-positive hepatitis was 64% (104/161) in Italy, 44% (8/18) in Denmark, 33% (11/33) in Switzerland, and 31% (15/49) in Ireland. 32 of the 79 (40%)liver biopsy specimens from HBsAg-positive addicts showed positive delta-Ag immunofluorescence. Delta infection occurring simultaneously with HBV infection is common and possibly a major cause of liver disease in drug addicts who receive drug parenterally. The spread of delta infection in drug-using communities is not confined to one country, and the drug habit may represent the major means by which delta agent spreads in areas of the Western world where this infection is not endemic.

  11. Gram stain of tissue biopsy

    MedlinePlus

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

  12. Gastric tissue biopsy and culture

    MedlinePlus

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

  13. NASA Biological Specimen Repository

    NASA Technical Reports Server (NTRS)

    Pietrzyk, Robert; McMonigal, K. A.; Sams, C. F.; Johnson, M. A.

    2009-01-01

    The NASA Biological Specimen Repository (NBSR) has been established to collect, process, annotate, store, and distribute specimens under the authority of the NASA/JSC Committee for the Protection of Human Subjects. The International Space Station (ISS) provides a platform to investigate the effects of microgravity on human physiology prior to lunar and exploration class missions. The NBSR is a secure controlled storage facility that is used to maintain biological specimens over extended periods of time, under well-controlled conditions, for future use in approved human spaceflight-related research protocols. The repository supports the Human Research Program, which is charged with identifying and investigating physiological changes that occur during human spaceflight, and developing and implementing effective countermeasures when necessary. The storage of crewmember samples from many different ISS flights in a single repository will be a valuable resource with which researchers can validate clinical hypotheses, study space-flight related changes, and investigate physiological markers All samples collected require written informed consent from each long duration crewmember. The NBSR collects blood and urine samples from all participating long duration ISS crewmembers. These biological samples are collected pre-flight at approximately 45 days prior to launch, during flight on flight days 15, 30, 60 120 and within 2 weeks of landing. Postflight sessions are conducted 3 and 30 days following landing. The number of inflight sessions is dependent on the duration of the mission. Operations began in 2007 and as of October 2009, 23 USOS crewmembers have completed or agreed to participate in this project. As currently planned, these human biological samples will be collected from crewmembers covering multiple ISS missions until the end of U.S. presence on the ISS or 2017. The NBSR will establish guidelines for sample distribution that are consistent with ethical principles

  14. Modification of the Gouda frame to allow stereotactic biopsy of the brain using the GE 8800 computed tomographic scanner.

    PubMed

    Gouda, K I; Freidberg, S R; Larsen, C R; Baker, R A; Silverman, M L

    1983-08-01

    The Gouda stereotactic frame has been modified to interface with the GE 8800 scanner. The patient, attached to the frame, is scanned and then moved to the operating room for a stereotactic biopsy. This is a safe, accurate method of obtaining biopsy specimens of otherwise inaccessible tumors of the brain.

  15. Expression pattern of thymosin beta 4 in the adult human liver

    PubMed Central

    Nemolato, S.; Van Eyken, P.; Cabras, T.; Cau, F.; Fanari, M.U.; Locci, A.; Fanni, D.; Gerosa, C.; Messana, I.; Castagnola, M.; Faa, G.

    2011-01-01

    Thymosin beta-4 (Tβ4) is a member of beta-thymosins, a family of small peptides involved in polymerization of G-actin, and in many critical biological processes including apoptosis, cell migration, angiogenesis, and fibrosis. Previous studies in the newborn liver did not reveal any significant reactivity for Tβ4 during the intrauterine life. The aim of the present study was to investigate by immunohistochemistry Tβ4 expression in the adult normal liver. Thirty-five human liver samples, including 11 needle liver biopsies and 24 liver specimens obtained at autopsy, in which no pathological change was detected at the histological examination, were immunostained utilizing an anti-Tβ4 commercial antibody. Tβ4 was detected in the hepatocytes of all adult normal livers examined. A zonation of Tβ4 expression was evident in the vast majority of cases. Immunostaining was preferentially detected in zone 3, while a minor degree of reactivity was detected in periportal hepatocytes (zone 1). At higher power, Tβ4-reactive granules appeared mainly localized at the biliary pole of hepatocytes. In cases with a strong immunostaining, even perinuclear areas and the sinusoidal pole of hepatocytes appeared interested by immunoreactivity for Tβ4. The current work first evidences a strong diffuse expression of Tβ4 in the adult human liver, and adds hepatocytes to the list of human cells able to synthesize large amounts of Tβ4 in adulthood. Moreover, Tβ4 should be added to the liver proteins characterized by a zonate expression pattern, in a descending gradient from the terminal vein to the periportal areas of the liver acinus. Identifying the intimate role played by this peptide intracellularly and extracellularly, in physiology and in different liver diseases, is a major challenge for future research focusing on Tβ4. PMID:22073372

  16. Mitotic figure counts are significantly overestimated in resection specimens of invasive breast carcinomas.

    PubMed

    Lehr, Hans-Anton; Rochat, Candice; Schaper, Cornelia; Nobile, Antoine; Shanouda, Sherien; Vijgen, Sandrine; Gauthier, Arnaud; Obermann, Ellen; Leuba, Susana; Schmidt, Marcus; C, Curzio Ruegg; Delaloye, Jean-Francois; Simiantonaki, Nectaria; Schaefer, Stephan C

    2013-03-01

    Several authors have demonstrated an increased number of mitotic figures in breast cancer resection specimen when compared with biopsy material. This has been ascribed to a sampling artifact where biopsies are (i) either too small to allow formal mitotic figure counting or (ii) not necessarily taken form the proliferating tumor periphery. Herein, we propose a different explanation for this phenomenon. Biopsy and resection material of 52 invasive ductal carcinomas was studied. We counted mitotic figures in 10 representative high power fields and quantified MIB-1 immunohistochemistry by visual estimation, counting and image analysis. We found that mitotic figures were elevated by more than three-fold on average in resection specimen over biopsy material from the same tumors (20±6 vs 6±2 mitoses per 10 high power fields, P=0.008), and that this resulted in a relative diminution of post-metaphase figures (anaphase/telophase), which made up 7% of all mitotic figures in biopsies but only 3% in resection specimen (P<0.005). At the same time, the percentages of MIB-1 immunostained tumor cells among total tumor cells were comparable in biopsy and resection material, irrespective of the mode of MIB-1 quantification. Finally, we found no association between the size of the biopsy material and the relative increase of mitotic figures in resection specimen. We propose that the increase in mitotic figures in resection specimen and the significant shift towards metaphase figures is not due to a sampling artifact, but reflects ongoing cell cycle activity in the resected tumor tissue due to fixation delay. The dwindling energy supply will eventually arrest tumor cells in metaphase, where they are readily identified by the diagnostic pathologist. Taken together, we suggest that the rapidly fixed biopsy material better represents true tumor biology and should be privileged as predictive marker of putative response to cytotoxic chemotherapy.

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

    PubMed

    Fishbein, Michael C

    2005-11-01

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

  18. Liver Disease in the Alcoholic

    PubMed Central

    Szilagyi, Andrew

    1986-01-01

    The problem of liver damage in alcoholic patients is widespread. This review discusses hepatic damage on the basis of a histologic classification of increasing severity. In the early stages, or with compensated cirrhosis, clinical and laboratory findings may not accurately reflect hepatic involvement. Furthermore, there exists a group of alcoholic patients in whom liver disease may be caused by factors other than alcohol. Nevertheless, in most patients with liver disease, certain biochemical features help to establish an alcoholic etiology. These features and the use of liver biopsy are discussed, and a practical guideline for diagnosis and follow-up is offered. PMID:21267299

  19. [Electron miscroscopic liver changes in acute carbon tetrachloride poisoning in man)].

    PubMed

    Kendrey, G; László, B

    1975-01-01

    Lesions of the liver revealed by light and electron microscopy at two young men, workers of the chemical industry are described. At one of the patients biopsy was performed twice at the other three times. Patient having jaundice were admitted to hospital because of the suspected acute viral hepatitis. Laboratory findings have shown an acute parenchymal lesion. By light microscopy at one of them mid-zonal, at the other centro-lobular necrosis of hepatic cells further lipoid droplets of the cytoplasma of hepatocytes were revealed. Electronmicroscopically in the first biopsy specimens, and at one of the ptients at the second biopsy as well mostly damage to the mitochondria (enormous osmiophilia of the matrix, presence of osmiophil granules) and enlargement of the tubules of the endoplasmic reticulum could be seen. The controll clinical and morphological findings evidenced the reversible character of the process. Authors stress the differences existing between hepatic lesions caused by CCl4 at different persons on one side, and at rat and human liver on the other.

  20. Pathology of chronic hepatitis C in children. Child Liver Study Group of Japan.

    PubMed

    Kage, M; Fujisawa, T; Shiraki, K; Tanaka, T; Fujisawa, T; Kimura, A; Shimamatsu, K; Nakashima, E; Kojiro, M; Koike, M; Tazawa, Y; Abukawa, D; Okaniwa, M; Takita, H; Matsui, A; Hayashi, T; Etou, T; Terasawa, S; Sugiyama, K; Tajiri, H; Yoden, A; Kajiwara, Y; Sata, M; Uchimura, Y

    1997-09-01

    Limited information is available regarding the histology of hepatitis C virus infection in children. The aim of this study was to determine the histological pattern of chronic hepatitis C (CHC) in children, and liver biopsy specimens from 109 pediatric patients with CHC were examined. Each biopsy specimen was evaluated based on a numerical scoring system for the stage of fibrosis (1-4), the grade of portal/periportal necroinflammation (0-4), the grade of lobular necroinflammation (0-4), and their sum (final grade). The histological lesions considered to be characteristic of chronic hepatitis were also evaluated. None of the children had liver cirrhosis, and 105 cases (97%) were stage 1 or 2. Only 4 children were stage 3. Two of these 4 cases showed hemosiderosis. A significant correlation was observed between the staging score and the final grade in the pediatric patients (r = .59; P < .0001). The histological characteristics of adult CHC, such as lymphoid aggregate, bile duct injury, and fatty changes, were also observed in the children. In conclusion, the majority of children with CHC presented with mild fibrosis, but a few showed CHC with lobular distortion and hemosiderosis. Frequent blood transfusion may aggravate hepatic lesions in pediatric CHC.

  1. Pathologic response and microdosimetry of {sup 90}Y microspheres in man: Review of four explanted whole livers

    SciTech Connect

    Kennedy, Andrew S. . E-mail: akennedy@wakerad.com; Nutting, Charles; Coldwell, Douglas; Gaiser, James; Drachenberg, Cinthia

    2004-12-01

    Introduction: Radioactive microsphere {sup 90}Y therapy is increasingly used for primary and metastatic solid tumors in the liver. We present an analysis of 4 explanted livers previously treated with {sup 90}Y microsphere agents (glass or resin). One tumor nodule was analyzed with submillimeter three-dimensional microdosimetry. Methods and materials: Four patients received hepatic artery delivery of {sup 90}Y microspheres for unresectable hepatocellular and colon cancers. Whole livers were explanted as part of lifesaving cadaveric transplant in 2 patients with hepatoma. These patients had received glass microspheres as a procedural bridge to transplant. Autopsy was performed on 2 patients with colon cancer who died of progressive metastatic disease and who had been treated with resin microspheres. Complete pathologic review was performed on each whole liver, including estimation of the response of the tumor to therapy, distribution of microspheres in the tumor and normal liver tissues, and normal-tissue radiation response. A biopsy taken from the edge of a tumor nodule was sectioned serially for three-dimensional radiation dosimetry analyses. Three-dimensional microsphere coordinates within the biopsy specimen were used to calculate dosage using a three-dimensional dose kernel. Isodose coverage of tumor and normal liver areas and total dose delivered were determined. Results: Preferential and heterogeneous deposition of microspheres was noted at the edge of tumor nodules compared with the center portion of the tumor or normal liver parenchyma. Both glass and resin microspheres delivered high cumulative doses to the tumor, which varied from 100 Gy to more than 3000 Gy. No veno-occlusive disease or widespread radiation hepatitis was seen. Conclusion: Microsphere ({sup 90}Y) therapy delivers high numbers of spheres with resulting high total doses of radiation, preferentially in the periphery of tumors. Normal liver parenchyma showed little radiation effect away from

  2. Collision tumor of hepatocellular carcinoma and neuroendocrine carcinoma involving the liver: Case report and review of the literature.

    PubMed

    Choi, Gyu Ho; Ann, Sun Young; Lee, Soon Il; Kim, Suk Bae; Song, Il Han

    2016-11-07

    Primary hepatic neuroendocrine carcinoma (NEC) with concurrent occurrence of hepatocellular carcinoma (HCC) of the liver is very rare. Only 8 cases have been reported in the literature. Concurrent occurrence of HCC and NEC in the liver is classified as combined type or collision type by histological distributional patterns; only 2 cases have been reported. Herein, we report a case of collision type concurrent occurrence of HCC and NEC, in which primary hepatic NEC was in only a small portion of the nodule, which is different from the 2 previously reported cases. A 72-year-old male with chronic hepatitis C was admitted to our hospital for a hepatic mass detected by liver computed tomography (CT) at another clinic. Because the nodule was in hepatic segment 3 and had proper radiologic findings for diagnosis of HCC, including enhancement in the arterial phase and wash-out in the portal and delay phases, the patient was treated with laparoscopic left lateral sectionectomy. The pathology demonstrated that the nodule was 2.5 cm and was moderately differentiated HCC. However, a 3 mm-sized focal neuroendocrine carcinoma was also detected on the capsule of the nodule. The tumor was concluded to be a collision type with HCC and primary hepatic NEC. After the surgery, for follow-up, the patient underwent a liver CT every 3 mo. Five multiple nodules were found in the right hepatic lobe on the follow-up liver CT 6 mo post-operatively. As the features of the nodules in the liver CT and MRI were different from that of HCC, a liver biopsy was performed. Intrahepatic recurrent NEC was proven after the liver biopsy, which showed the same pathologic features with the specimen obtained 6 mo ago. Palliative chemotherapy with a combination of etoposide and cisplatin has been administered for 4 months, showing partial response.

  3. [Liquid Biopsy and Laboratory Medicine].

    PubMed

    Furuta, Koh

    2015-09-01

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

  4. Optimizing prostate needle biopsy through 3D simulation

    NASA Astrophysics Data System (ADS)

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

    1998-06-01

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

  5. Reverse Transcription-PCR Detection of Mycobacterium leprae in Clinical Specimens

    PubMed Central

    Kurabachew, Mekonnen; Wondimu, Assefa; Ryon, Judith J.

    1998-01-01

    A reverse transcription (RT)-PCR assay targeting the 16S rRNA of Mycobacterium leprae was developed to detect the organism in clinical specimens. A 171-bp fragment was amplified when M. leprae RNA was used as a template but not when a panel of RNAs from 28 potentially cross-reacting mycobacterial species, seven genera related to Mycobacterium, and three organisms normally found among skin or nose flora were tested. As few as 10 organisms isolated from infected tissue could be detected, confirming the sensitivity of the assay. When the test was applied to clinical specimens, M. leprae was detected in 82% of skin biopsy specimens obtained from untreated leprosy patients, while skin biopsy specimens from healthy volunteers and patients with other dermatological disorders were negative. The sensitivity of the RT-PCR was higher than that of slit skin smear staining for acid-fast bacilli or acid-fast staining of fixed biopsy specimens since 53% of acid-fast bacillus-negative biopsy specimens were RT-PCR positive. Because 16S rRNA is rapidly degraded upon cell death, the assay may detect only viable organisms and may prove to be useful in assessing the efficacy of chemotherapy. PMID:9574704

  6. Liver disease associated with occupational exposure to the solvent dimethylformamide

    SciTech Connect

    Redlich, C.A.; Beckett, W.S.; Sparer, J.; Barwick, K.W.; Riely, C.A.; Miller, H.; Sigal, S.L.; Shalat, S.L.; Cullen, M.R.

    1988-05-01

    An attempt is made to characterize an outbreak of liver disease among workers in a fabric coating factory; and to determine the outbreak's cause and natural history and strategies for clinical recognition, treatment, and prevention. Fifty-eight of sixty-six workers participated in the study. All had standard liver function tests at least once. Forty-six workers completed a questionnaire; 27 had more extensive clinical evaluation for recognized liver abnormalities. A plant-wide outbreak of liver disease was recognized after a new employee presented with signs and symptoms of hepatitis. Evaluation of the worksite showed that dimethylformamide, a widely used industrial solvent and known hepatotoxin, was being used to coat fabric in poorly ventilated areas without appropriate skin protection. No other major hepatotoxic exposure was identified. Overall, 36 of 58 (62%) workers tested had elevations of either aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels. Enzyme abnormalities occurred almost exclusively in production workers (35 of 46 were abnormal), whereas only 1 of 12 nonproduction workers showed any elevations in enzyme levels (P less than 0.0001). Serologic tests excluded known infectious causes of hepatitis in all but 2 workers and changes characteristic of toxic liver injury were confirmed by histologic examinations of biopsy specimens from 4 workers. The ratio of AST to ALT levels was one or less in all but 1 worker. After modification of work practices and removal of workers most severely affected from exposure, improvement in liver enzyme abnormalities and symptoms in most patients were seen, although some patients showed persistent elevations of enzyme levels.

  7. Correlation between endometrial biopsy and serum progesterone level in prediction of corpus luteum function.

    PubMed

    El-hefnawi, N; Abou-gabal, A; El-etriby, A; Maged, M; Wafa, G; Ragab, I

    1987-01-01

    This study aimed to determine the correlation between endometrial biopsy and serum progesterone level in prediction of corpus luteum function in regularly menstruating women. Endometrial biopsy specimens were obtained from 40 women 20-25 years old with unproven fertility 2-3 days before the anticipated onset of menses. A simultaneous blood sample was obtained for measurement of serum progesterone levels using a radioimmunoassay technique. 27 biopsies were considered to be in-phase (IP) by histologic criteria, and the remaining 13 were out-of-phase (OOP). The mean serum progesterone level obtained from women with OOP biopsies 3-4 days before onset of menses was significantly lower than that obtained 1-2 days before the onset of menses. Menstruation occurred in women with OOP biopsies at a time when serum progesterone level was apparently rising. On the other hand, values were too small to identify any significant difference between groups of women with IP and OOP biopsies when these biopsies were performed very late in the cycle. The author states the importance of evaluating both serum progesterone and endometrial biopsy dating in the late luteal phase of the menstrual cycle. Serum progesterone was easy to perform, while endometrial biopsy showed the end result.

  8. [Utility of Fibroscan in the evaluation of liver fibrosis].

    PubMed

    Carrión, José A

    2009-01-01

    Chronic liver diseases produce a progressive accumulation of collagenous fiber in the liver parenchyma. For years, liver biopsy has been the gold standard to quantify liver fibrosis. Currently, non-invasive alternatives are available to quantify fibrosis. Transient elastography (TE) or Fibroscan quantifies liver rigidity, which is proportional to the grade of liver fibrosis. Studies are available that have evaluated the reliability and limitations of TE in healthy individuals, in patients with acute hepatitis, in distinct chronic liver diseases and in liver transplant recipients. TE is reliable for the diagnosis of liver cirrhosis (F4) and significant fibrosis (F2) but its values may vary according to the patient's characteristics and the etiology of the disease. TE can avoid liver biopsy in 90% of patients with cirrhosis and in up to 70% of those with significant fibrosis when combined with other non-invasive methods.

  9. Phosphatase and tensin homolog is a differential diagnostic marker between nonalcoholic and alcoholic fatty liver disease

    PubMed Central

    Sanchez-Pareja, Andrea; Clément, Sophie; Peyrou, Marion; Spahr, Laurent; Negro, Francesco; Rubbia-Brandt, Laura; Foti, Michelangelo

    2016-01-01

    AIM: To investigate the protein expression of phosphatase and tensin homolog (PTEN) in human liver biopsies of patients with alcoholic and non-alcoholic liver disease. METHODS: PTEN protein expression was assessed by immunohistochemistry in formalin-fixed, paraffin-embedded liver sections of patients with non-alcoholic fatty liver disease (NAFLD) (n = 44) or alcoholic liver disease (ALD) (n = 25). Liver resections obtained from 3 healthy subjects candidate for partial liver donation served as controls. Histological evaluations were performed by two experienced pathologists, and diagnoses established based on international criteria. The intensity of the PTEN staining in nuclei was compared between steatotic and non-steatotic areas of each liver fragment analyzed. For each liver specimen, the antibody-stained sections were examined and scored blindly by three independent observers, who were unaware of the patients’ clinical history. RESULTS: In healthy individuals, PTEN immunostaining was intense in both the cytoplasm and nuclei of all hepatocytes. However, PTEN was strongly downregulated in both the nucleus and the cytoplasm of hepatocytes from steatotic areas in patients with NAFLD, independently of the disease stage. In contrast, no changes in PTEN protein expression were observed in patients with ALD, regardless of the presence of steatosis or the stage of the disease. The degree of PTEN downregulation in hepatocytes of patients with NAFLD correlated with the percentage of steatosis (r = 0.3061, P = 0.0459) and the BMI (r = 0.4268, P = 0.0043). Hovewer, in patients with ALD, PTEN expression was not correlated with the percentage of steatosis with or without obesity as a confounding factor (P = 0.5574). Finally, PTEN expression level in steatotic areas of ALD patients was significantly different from that seen in steatotic areas of NAFLD patients (P < 0.0001). CONCLUSION: PTEN protein expression is downregulated early in NAFLD, but not in ALD. PTEN

  10. Update on Renal Mass Biopsy.

    PubMed

    Haifler, Miki; Kutikov, Alexander

    2017-04-01

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

  11. Does length of prostate biopsy cores have an impact on diagnosis of prostate cancer?

    PubMed Central

    Ergün, Müslüm; İslamoğlu, Ekrem; Yalçınkaya, Soner; Tokgöz, Hüsnü; Savaş, Murat

    2016-01-01

    Objective To investigate whether core length is a significant biopsy parameter in the detection of prostate cancer. Material and methods We retrospectively analyzed pathology reports of the specimens of 188 patients diagnosed with prostate cancer who had undergone initial transrectal ultrasound (TRUS) guided prostate biopsy, and compared biopsy core lengths of the patients with, and without prostate cancer. The biopsy specimens of prostate cancer patients were divided into 3 groups according to core length, and the data obtained were compared (Group 1; total core length <10 mm, Group 2; total core length 10 mm–19 mm, and Group 3; total core length >20 mm). Biopsy core lengths of the patients diagnosed as prostate cancer, and benign prostatic hyperplasia were compared, and a certain cut-off value for core length with optimal diagnostic sensitivity and specificity for prostate cancer was calculated. Results Mean age, PSA and total length of cores were 65.08±7.41 years, 9.82±6.34 ng/mL and 11.2±0.2 mm, respectively. Assessment of biopsy core lengths showed that cores with cancer (n=993, median length 12.5 mm) were significantly longer than benign cores (n=1185, median length=11.3 mm) (p<0.001). Core length analysis yielded 12 mm cores have an optimal sensitivity (41.9%) and specificity (62%) for detection of cancer (odds ratio: 1.08). Conclusion Biopsy core length is one of the most important parameter that determines the quality of biopsy and detection of prostate cancer. A median sample length of 12 mm is ideal lower limit for cancer detection, and biopsy procedures which yield shorter biopsy cores should be repeated. PMID:27635285

  12. Phenotypes and Pathology of Drug-Induced Liver Disease.

    PubMed

    Goodman, Zachary D

    2017-02-01

    Drug hepatotoxicity can simulate nearly any clinical syndrome or pathologic lesion that may occur in the liver, so clinical and histopathologic diagnosis of drug-induced liver injury may be difficult. Nevertheless, most drugs that are known to idiosyncratic liver injury tend to cause patterns of injury that produce characteristic phenotypes. Recognition of these patterns or phenotypes in liver biopsy material is helpful in evaluation of clinical cases of suspected drug-induced liver injury.

  13. Assessment of histopathological features of needle biopsy in recurrent prostate cancer following salvage high-intensity focused ultrasound

    PubMed Central

    Billia, Michele; Siddiqui, Khurram M.; Chan, Susanne; Li, Fan; Al-Zahrani, Ali; Gomez, Jose A.; Chin, Joseph L.

    2016-01-01

    Introduction Local recurrence of prostate cancer (PCa) following radiotherapy may be treated with curative intent using salvage high-intensity focused ultrasound (s-HIFU). The interpretation of needle core biopsy specimens following s-HIFU is a daunting task, even for experienced pathologists. We describe various histopathological features encountered in biopsy specimens following whole-gland s-HIFU in one of the largest descriptive studies to date. Methods Fifty-five patients with biopsy-proven localized radio-recurrent PCa underwent s-HIFU and transrectal ultrasound (TRUS)-guided prostatic needle biopsies at 180 days post-treatment. All biopsies were reviewed by two genitourinary pathologists. Results PCa was detected in 11 (24%) biopsies. Radiation therapy-associated changes were identified in all cases. Additional findings included extensive coagulative stromal necrosis (100%), smudgy chromatin of cancer nuclei (82%), and markedly enlarged bizarre nuclei in the residual cancer (55%). Gleason grade assignment was possible in 10 (91%) of these biopsies and concordance of Gleason grading between pre- and post-therapy specimens was observed in six (60%) cases. Conclusions The histological interpretation of needle biopsies following salvage HIFU is challenging and requires an understanding of the histopathological changes associated with this procedure in both tumoural and non-tumoural prostatic tissue. Accurate interpretation of the morphological changes following s-HIFU is instrumental for optimization of clinical decision-making and treatment planning in recurrent PCa. PMID:28096917

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

    PubMed Central

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

    2014-01-01

    INTRODUCTION The needle biopsy technique for the soleus muscle is of particular interest because of its unique fiber type distribution, contractile properties, and sensitivity to unloading. Unlike other commonly biopsied muscles, the soleus is not fully superficial and is in close proximity to neurovascular structures resulting in a more challenging biopsy. Because of this, a standardized protocol for performing needle biopsies on the human soleus muscle that is safe, reliable, and repeatable is presented. METHODS Ultrasonography was used on an initial set of 12 subjects to determine the optimal biopsy zone thereby guiding the location of the incision site. Forty-five subjects were recruited and attended two separate biopsy sessions. Each biopsy session incorporated 3 passes of the biopsy needle proximal, posterior, and distal using suction from a portable vacuum source producing 3 separate muscle specimens. RESULTS Eighty-four soleus muscle biopsy procedures were successfully conducted yielding 252 total samples without complication. Ultrasonography was used to confirm biopsy needle infiltration of the soleus muscle. Average sample weight obtained per pass was 61.5 ± 15.7 mg. Histochemistry and molecular analyses demonstrated a considerably higher amount of slow type I MHC in comparison to the vastus lateralis providing verification for the successful sampling of the soleus muscle. DISCUSSION The procedure presented consists of a detailed protocol to accurately and consistently obtain muscle biopsy samples from the human soleus muscle. We have demonstrated that the human soleus biopsy is a safe, reliable and repeatable procedure providing ample tissue for multiple types of analyses. PMID:24261060

  15. 37 CFR 2.59 - Filing substitute specimen(s).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Filing substitute specimen(s). 2.59 Section 2.59 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE... mark as used on or in connection with the goods, or in the sale or advertising of the services....

  16. Nonalcoholic fatty liver disease: diagnosis and management.

    PubMed

    Wilkins, Thad; Tadkod, Altaf; Hepburn, Iryna; Schade, Robert R

    2013-07-01

    Nonalcoholic fatty liver disease is characterized by excessive fat accumulation in the liver (hepatic steatosis). Nonalcoholic steatohepatitis is characterized by steatosis, liver cell injury, and inflammation. The mechanism of nonalcoholic fatty liver disease is unknown but involves the development of insulin resistance, steatosis, inflammatory cytokines, and oxidative stress. Nonalcoholic fatty liver disease is associated with physical inactivity, obesity, and metabolic syndrome. Screening is not recommended in the general population. The diagnosis is usually made after an incidental discovery of unexplained elevation of liver enzyme levels or when steatosis is noted on imaging (e.g., ultrasonography). Patients are often asymptomatic and the physical examination is often unremarkable. No single laboratory test is diagnostic, but tests of liver function, tests for metabolic syndrome, and tests to exclude other causes of abnormal liver enzyme levels are routinely performed. Imaging studies, such as ultrasonography, computed tomography, and magnetic resonance imaging, can assess hepatic fat, measure liver and spleen size, and exclude other diseases. Liver biopsy remains the criterion standard for the diagnosis of nonalcoholic steatohepatitis. Noninvasive tests are available and may reduce the need for liver biopsy. A healthy diet, weight loss, and exercise are first-line therapeutic measures to reduce insulin resistance. There is insufficient evidence to support bariatric surgery, metformin, thiazolidinediones, bile acids, or antioxidant supplements for the treatment of nonalcoholic fatty liver disease. The long-term prognosis is not associated with an increased risk of all-cause mortality, cardiovascular disease, cancer, or liver disease.

  17. Vacuum Enhanced Cutaneous Biopsy Instrument

    SciTech Connect

    Collins, Joseph

    1999-06-25

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

  18. 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.

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

    PubMed

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

    2014-08-14

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

  20. Electromagnetic-Tracked Biopsy under Ultrasound Guidance: Preliminary Results

    SciTech Connect

    Hakime, Antoine Deschamps, Frederic; Marques De Carvalho, Enio Garcia; Barah, Ali; Auperin, Anne; Baere, Thierry De

    2012-08-15

    Purpose: This study was designed to evaluate the accuracy and safety of electromagnetic needle tracking for sonographically guided percutaneous liver biopsies. Methods: We performed 23 consecutive ultrasound-guided liver biopsies for liver nodules with an electromagnetic tracking of the needle. A sensor placed at the tip of a sterile stylet (18G) inserted in a coaxial guiding trocar (16G) used for biopsy was localized in real time relative to the ultrasound imaging plane, thanks to an electromagnetic transmitter and two sensors on the ultrasound probe. This allows for electronic display of the needle tip location and the future needle path overlaid on the real-time ultrasound image. Distance between needle tip position and its electronic display, number of needle punctures, number of needle pull backs for redirection, technical success (needle positioned in the target), diagnostic success (correct histopathology result), procedure time, and complication were evaluated according to lesion sizes, depth and location, operator experience, and 'in-plane' or 'out-of-plane' needle approach. Results: Electronic display was always within 2 mm from the real position of the needle tip. The technical success rate was 100%. A single needle puncture without repuncture was used in all patients. Pull backs were necessary in six patients (26%) to obtain correct needle placement. The overall diagnostic success rate was 91%. The overall true-positive, true-negative, false-negative, and failure rates of the biopsy were 100% (19/19) 100% (2/2), 0% (0/23), and 9% (2/23). The median total procedure time from the skin puncture to the needle in the target was 30 sec (from 5-60 s). Lesion depth and localizations, operator experience, in-plane or out-of-plane approach did not affect significantly the technical, diagnostic success, or procedure time. Even when the tumor size decreased, the procedure time did not increase. Conclusions: Electromagnetic-tracked biopsy is accurate to determine

  1. Histopathology of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

    PubMed Central

    Takahashi, Yoshihisa; Fukusato, Toshio

    2014-01-01

    Nonalcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, is the most common chronic liver disease, and the prevalence is rapidly increasing worldwide. Nonalcoholic steatohepatitis (NASH), the severe form of NAFLD, can progress to liver cirrhosis and hepatocellular carcinoma (HCC). Although noninvasive clinical scores and image-based diagnosis for NAFLD have improved, histopathological evaluation of biopsy specimens remains the gold standard for diagnosing NAFLD/NASH. Steatosis, lobular inflammation, and hepatocellular ballooning are all necessary components for the diagnosis of NASH; fibrosis is also typically observed. Other histopathological abnormalities commonly observed in NASH include hepatocellular glycogenated nuclei, lipogranulomas, and acidophil bodies. The characteristics of pediatric NAFLD/NASH differ from adult NAFLD/NASH. Specifically, steatosis and portal inflammation are more severe in pediatric NAFLD, while intralobular inflammation and perisinusoidal fibrosis are milder. Although interobserver agreement for evaluating the extent of steatosis and fibrosis is high, agreement is low for intralobular and portal inflammation. A recently reported histological variant of HCC, steatohepatitic HCC (SH-HCC), shows features that resemble non-neoplastic steatohepatitis, and is thought to be strongly associated with underlying NASH. In this report, we review the histopathological features of NAFLD/NASH. PMID:25400438

  2. Histopathology of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis.

    PubMed

    Takahashi, Yoshihisa; Fukusato, Toshio

    2014-11-14

    Nonalcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, is the most common chronic liver disease, and the prevalence is rapidly increasing worldwide. Nonalcoholic steatohepatitis (NASH), the severe form of NAFLD, can progress to liver cirrhosis and hepatocellular carcinoma (HCC). Although noninvasive clinical scores and image-based diagnosis for NAFLD have improved, histopathological evaluation of biopsy specimens remains the gold standard for diagnosing NAFLD/NASH. Steatosis, lobular inflammation, and hepatocellular ballooning are all necessary components for the diagnosis of NASH; fibrosis is also typically observed. Other histopathological abnormalities commonly observed in NASH include hepatocellular glycogenated nuclei, lipogranulomas, and acidophil bodies. The characteristics of pediatric NAFLD/NASH differ from adult NAFLD/NASH. Specifically, steatosis and portal inflammation are more severe in pediatric NAFLD, while intralobular inflammation and perisinusoidal fibrosis are milder. Although interobserver agreement for evaluating the extent of steatosis and fibrosis is high, agreement is low for intralobular and portal inflammation. A recently reported histological variant of HCC, steatohepatitic HCC (SH-HCC), shows features that resemble non-neoplastic steatohepatitis, and is thought to be strongly associated with underlying NASH. In this report, we review the histopathological features of NAFLD/NASH.

  3. [Disparity between cytohistopathological results of diagnostic specimens and the resected tumor piece in bronchopulmonary carcinoma].

    PubMed

    Sánchez Varilla, J M; Benítez Moya, J M; Baena Luna, M; Loscertales Abril, J; García Díaz, F; Vázquez Valiente, M; Villa Arellano, F; Márquez Varela, F; Martínez Puentes, V

    1996-04-01

    In 88 patients diagnosed and intervened of lung carcinoma, we evaluate the security of the Diagnostic method--cytology: sputum, brushed bronchial, bronchial aspiration, puncture pulmonary aspiration and histology of the bronchial biopsy--when we correlate them with the histology of the dried up tumour. From the 88 patient, in 11 (12.5%) there was a disparity between some specimen and the piece tumour. If we analyze the specimen: the bronchial biopsy, was different in 3 cases, (4.8%); the brushed and the bronchial biopsy, aspiration in 2, (2.7% and 2.3% respectively); the puncture pulmonary aspiration in 6, (26%) and the cytology of sputum in 2 cases, (2.4%). In 8 patients (9%), the outputs of some specimen were not conclusive, if we remove these we find that: the bronchial biopsy was not conclusive in 2 cases, (3.2%), the brushed bronchial in 5, (6.8%); the bronchial aspiration in 9 (10.2%) and the cytology of sputum in 2 cases, (2.4%). With this data we could infer that sometimes the positive outputs of the specimen have no correlation with the histology of the tumour dried up. This disparity has not been observed in the oat-cells. Therefore when we send the specimens to the pathologist, it would always be advisable for him to inform us if there are any different cells belonging to the principal group of the tumor.

  4. The impact of obesity on liver histology.

    PubMed

    Goodman, Zachary D

    2014-02-01

    Obesity and insulin resistance produce alterations in the liver's normal role in lipid metabolism resulting in a sequence of changes recognizable on liver biopsy. Hepatocellular fat vacuoles increase with BMI, producing steatosis. Steatohepatitis occurs when there is also cytoskeletal damage with loss of keratin filaments, ballooning of affected liver cells and formation of Mallory-Denk bodies. Activation of hepatic stellate cells produces fibrosis in the perisinusoidal spaces. With continuing fibrogenesis there is progression to bridging fibrosis and cirrhosis. Hepatocellular carcinoma may develop in the cirrhotic liver, but both hepatocellular adenoma and hepatocellular carcinoma may occur in pre-cirrhotic fatty liver disease.

  5. Noninvasive Measures of Liver Fibrosis and Severity of Liver Disease

    PubMed Central

    Lucero, Catherine; Brown, Robert S.

    2016-01-01

    Determining the degree of fibrosis is an important step in the assessment of disease severity in patients with chronic liver disease. Liver biopsy has been the gold standard for estimating the extent of inflammation and fibrosis, although the procedure has limitations such as sampling error and variability. Noninvasive testing has been shown to be equally predictive in ruling out fibrosis or ruling in advanced fibrosis. Serum biomarkers and imaging-based tests have more limited predictive ability when classifying intermediate stages, but these tools can help identify which patients should receive antiviral treatment sooner and require ongoing cancer surveillance without the need for biopsy. Using a combination of serum markers and imaging tests may also be helpful in providing functional assessment of portal hypertension in patients with chronic liver disease. PMID:27330502

  6. 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 ...

  7. Biopsy

    MedlinePlus

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

  8. Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis

    SciTech Connect

    O'Connell, J.B.; Henkin, R.E.; Robinson, J.A.; Subramanian, R.; Scanlon, P.J.; Gunnar, R.M.

    1984-07-01

    Current standards for detection of myocarditis in a clinical setting rely on endomyocardial biopsy for accurate diagnosis. With this technique a subset of patients with dilated cardiomyopathy show unsuspected myocarditis histologically. Endomyocardial biopsy, despite its specificity, may lack sensitivity due to sampling error if the inflammation is patchy or focal. Therefore, inflammation-sensitive radioisotopic imaging may be a useful adjunct in the diagnosis of myocarditis. This study was designed to evaluate the applicability of gallium-67 (67Ga) myocardial imaging as an adjunct to endomyocardial biopsy in the diagnosis of myocarditis. Sixty-eight consecutive patients referred for evaluation of dilated cardiomyopathy underwent 71 parallel studies with 67Ga imaging and biopsies that served as the basis of comparison for this study. Histologic myocarditis was identified in 8% of biopsy specimens. Clinical and hemodynamic parameters could not be used to predict the presence of myocarditis. Five of six biopsy samples (87%) with myocarditis showed dense 67Ga uptake, whereas only nine of 65 negative biopsy samples (14%) were paired with equivocally positive 67Ga scans. The single patient with myocarditis and no myocardial 67Ga uptake had dense mediastinal lymph node uptake that may have obscured cardiac uptake. The incidence of myocarditis on biopsy with a positive 67Ga scan was 36% (5/14); however, the incidence of myocarditis with a negative 67Ga scan was only 1.8% (1/57). Follow-up scans for three patients showed close correlation of 67Ga uptake with myocarditis on biopsy. In conclusion 67Ga may be a useful screening test for identifying patients with a high yield of myocarditis on biopsy, and serial scans may eliminate the need for frequent biopsies in patients with proven myocarditis.

  9. Phenotypes of apolipoprotein B and apolipoprotein E after liver transplantation.

    PubMed Central

    Linton, M F; Gish, R; Hubl, S T; Bütler, E; Esquivel, C; Bry, W I; Boyles, J K; Wardell, M R; Young, S G

    1991-01-01

    Apolipoprotein (apo) E and the two B apolipoproteins, apoB48 and apoB100, are important proteins in human lipoprotein metabolism. Commonly occurring polymorphisms in the genes for apoE and apoB result in amino acid substitutions that produce readily detectable phenotypic differences in these proteins. We studied changes in apoE and apoB phenotypes before and after liver transplantation to gain new insights into apolipoprotein physiology. In all 29 patients that we studied, the postoperative serum apoE phenotype of the recipient, as assessed by isoelectric focusing, converted virtually completely to that of the donor, providing evidence that greater than 90% of the apoE in the plasma is synthesized by the liver. In contrast, the cerebrospinal fluid apoE phenotype did not change to the donor's phenotype after liver transplantation, indicating that most of the apoE in CSF cannot be derived from the plasma pool and therefore must be synthesized locally. The apoB100 phenotype (assessed with immunoassays using monoclonal antibody MB19, an antibody that detects a two-allele polymorphism in apoB) invariably converted to the phenotype of the donor. In four normolipidemic patients, we determined the MB19 phenotype of both the apoB100 and apoB48 in the "chylomicron fraction" isolated from plasma 3 h after a fat-rich meal. Interestingly, the apoB100 in the chylomicron fraction invariably had the phenotype of the donor, indicating that the vast majority of the large, triglyceride-rich apoB100-containing lipoproteins that appear in the plasma after a fat-rich meal are actually VLDL of hepatic origin. The MB19 phenotype of the apoB48 in the plasma chylomicron fraction did not change after liver transplantation, indicating that almost all of the apoB48 in plasma chylomicrons is derived from the intestine. These results were consistent with our immunocytochemical studies on intestinal biopsy specimens of organ donors; using apoB-specific monoclonal antibodies, we found evidence for

  10. Pediatric nonalcoholic fatty liver disease.

    PubMed

    Bozic, Molly A; Subbarao, Girish; Molleston, Jean P

    2013-08-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the pediatric population. Increased recognition of this form of liver disease parallels the dramatic rise in childhood and adolescent obesity over the past 2 decades. Like adults, most children with NAFLD are obese, and comorbidities include insulin resistance, hypertension, and dyslipidemia. Unfortunately, pediatric NAFLD is not always a benign condition, with some children progressing to hepatic fibrosis and even cirrhosis in severe cases. The etiology of nonalcoholic steatohepatitis is not yet fully understood; however, hepatic steatosis in the context of insulin resistance and increased oxidative stress may lead to progressive disease. Although physical examination, laboratory evaluation, and radiographic findings provide clues to the potential presence of fatty liver disease, liver biopsy remains the gold standard for diagnosis. Lifestyle modification, including slow and steady weight loss, improved dietary habits, and increased daily, aerobic physical activity, remains the first-line approach in treating pediatric fatty liver disease. Antioxidant pharmacologic therapy such as use of vitamin E has shown some benefit in patients with biopsy-proven steatohepatitis. Nutrition plays an essential role not only in the development of fatty liver disease but also potentially in the treatment and prevention of progression to more severe disease.

  11. Fortuitously discovered liver lesions

    PubMed Central

    Dietrich, Christoph F; Sharma, Malay; Gibson, Robert N; Schreiber-Dietrich, Dagmar; Jenssen, Christian

    2013-01-01

    The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrast-enhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as image-guided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g., in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible. PMID:23745019

  12. Evaluation of HistoGel™-embedded specimens for use in veterinary diagnostic pathology.

    PubMed

    Joiner, Kellye S; Spangler, Elizabeth A

    2012-07-01

    HistoGel™ is an aqueous specimen-processing gel that encapsulates and suspends histologic and cytologic specimens in a solidified medium. HistoGel-embedded specimens can then be processed and evaluated by routine histologic and immunohistochemical methods. This methodology has been used in human diagnostic pathology and is especially useful for small, friable, or viscous tissue samples that are difficult to process. In addition, special histochemical stains or immunohistochemistry can be performed on HistoGel-embedded cytologic specimens using standardized methods developed for histopathology. The current report describes several applications for HistoGel, including use with cytologic specimens, bone marrow aspirates, retention of tissue orientation for endoscopic biopsy specimens, and evaluation of friable tissues. Samples were encapsulated in HistoGel, fixed in 10% neutral buffered formalin, routinely processed, paraffin embedded, and sectioned for histochemical and immunohistochemical evaluation. The results of this study support the use of HistoGel in veterinary diagnostic pathology.

  13. Drill-Assisted Biopsy of the Axial and Appendicular Skeleton: Safety, Technical Success, and Diagnostic Efficacy.

    PubMed

    Wallace, Adam N; McWilliams, Sebastian R; Wallace, Andrew; Chang, Randy O; Vaswani, Devin; Stone, Robert E; Berlin, Ari N; Liu, Kevin X; Gilcrease-Garcia, Brian; Madaelil, Thomas P; Shoela, Ramy A; Hillen, Travis J; Long, Jeremiah; Jennings, Jack W

    2016-10-01

    The purpose of this study was to evaluate the safety, technical success rate, and diagnostic efficacy of drill-assisted axial and appendicular bone biopsies. During a 3-y period, 703 drill-assisted biopsies were performed. The cohort included 54.2% men, with a mean age of 57.6 y ± 17.1. Median lesion volume was 10.9 mL (interquartile range, 3.4-30.2 mL). Lesions were lytic (31.7%), sclerotic (21.2%), mixed lytic and sclerotic (27.7%), or normal radiographic bone quality (19.3%). No complications were reported. The technical biopsy success rate was 99.9%. Crush artifact was present in 5.8% of specimens submitted for surgical pathologic examination, and 2.1% of specimens were inadequate for histologic evaluation.

  14. Grips for Lightweight Tensile Specimens

    NASA Technical Reports Server (NTRS)

    Witte, William G., Jr.; Gibson, Walter D.

    1987-01-01

    Set of grips developed for tensile testing of lightweight composite materials. Double-wedge design substantially increases gripping force and reduces slippage. Specimen held by grips made of hardened wedges. Assembly screwed into load cell in tensile-testing machine.

  15. Rapid Detection of Trichodysplasia Spinulosa-Associated Polyomavirus in Skin Biopsy Specimen

    PubMed Central

    Urbano, Paulo Roberto P.; Pannuti, Cláudio Sérgio; Pierrotti, Ligia C.; David-Neto, Elias

    2014-01-01

    Trichodysplasia spinulosa-associated polyomavirus (TSV) is responsible for a rare skin cancer. Using metagenomic approaches, we determined the complete genome sequence of a TSV first detected in Brazil in spicules of an immunocompromised patient suspected to have trichodysplasia spinulosa. PMID:25059864

  16. Multimodal nonlinear microscopy of biopsy specimen: towards intraoperative diagnostics (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Schmitt, Michael; Heuke, Sandro; Meyer, Tobias; Chernavskaia, Olga; Bocklitz, Thomas W.; Popp, Juergen

    2016-03-01

    The realization of label-free molecule specific imaging of morphology and chemical composition of tissue at subcellular spatial resolution in real time is crucial for many envisioned applications in medicine, e.g., precise surgical guidance and non-invasive histopathologic examination of tissue. Thus, new approaches for a fast and reliable in vivo and near in vivo (ex corpore in vivo) tissue characterization to supplement routine pathological diagnostics is needed. Spectroscopic imaging approaches are particularly important since they have the potential to provide a pathologist with adequate support in the form of clinically-relevant information under both ex vivo and in vivo conditions. In this contribution it is demonstrated, that multimodal nonlinear microscopy combining coherent anti-Stokes Raman scattering (CARS), two photon excited fluorescence (TPEF) and second harmonic generation (SHG) enables the detection of characteristic structures and the accompanying molecular changes of widespread diseases, particularly of cancer and atherosclerosis. The detailed images enable an objective evaluation of the tissue samples for an early diagnosis of the disease status. Increasing the spectral resolution and analyzing CARS images at multiple Raman resonances improves the chemical specificity. To facilitate handling and interpretation of the image data characteristic properties can be automatically extracted by advanced image processing algorithms, e.g., for tissue classification. Overall, the presented examples show the great potential of multimodal imaging to augment standard intraoperative clinical assessment with functional multimodal CARS/SHG/TPEF images to highlight functional activity and tumor boundaries. It ensures fast, label-free and non-invasive intraoperative tissue classification paving the way towards in vivo optical pathology.

  17. Rapid detection of trichodysplasia spinulosa-associated polyomavirus in skin biopsy specimen.

    PubMed

    Urbano, Paulo Roberto P; Pannuti, Cláudio Sérgio; Pierrotti, Ligia C; David-Neto, Elias; Romano, Camila Malta

    2014-07-24

    Trichodysplasia spinulosa-associated polyomavirus (TSV) is responsible for a rare skin cancer. Using metagenomic approaches, we determined the complete genome sequence of a TSV first detected in Brazil in spicules of an immunocompromised patient suspected to have trichodysplasia spinulosa.

  18. Concurrent fine needle aspirations and core needle biopsies: a comparative study of substrates for next-generation sequencing in solid organ malignancies.

    PubMed

    Roy-Chowdhuri, Sinchita; Chen, Hui; Singh, Rajesh R; Krishnamurthy, Savitri; Patel, Keyur P; Routbort, Mark J; Manekia, Jawad; Barkoh, Bedia A; Yao, Hui; Sabir, Sharjeel; Broaddus, Russell R; Medeiros, L Jeffrey; Staerkel, Gregg; Stewart, John; Luthra, Rajyalakshmi

    2017-01-13

    Minimally invasive procedures, such as fine needle aspiration and core needle biopsy, are commonly used for the diagnosis in solid organ malignancies. In the era of targeted therapy, it is crucial for molecular testing to be performed on these limited volume specimens. Although several recent studies have demonstrated the utility of small biopsy specimens for molecular testing, there remains debate as to whether core needle biopsy specimens are more reliable than fine needle aspiration for molecular studies. In this study, we reviewed concurrently acquired fine needle aspiration and core needle biopsy samples (n=24), and compared overall cellularity, tumor fraction, and the results of next-generation sequencing. All somatic mutations detected in core needle biopsy samples were also detected in fine needle aspiration samples. The estimated tumor fraction was significantly higher in fine needle aspiration smears than core needle biopsy samples (P=0.003), whereas the overall DNA yield from smears was significantly lower than that obtained from the core needle biopsy specimens (P=0.01). The normalized average amplicon coverage for the genes analyzed was significantly higher in cytology smears than paired core needle biopsy samples, with lower numbers of failed amplicons and higher overall mutation allelic frequencies seen in the former. We further evaluated 100 malignant fine needle aspiration and core needle biopsy samples, acquired concurrently, for overall cellularity and tumor fraction. Overall cellularity and tumor fraction of fine needle aspiration samples was significantly higher than concurrently acquired core needle biopsy samples (P<0.001). In conclusion, we show that fine needle aspiration samples frequently provide better cellularity, higher tumor fraction, and superior sequencing metrics than concurrently acquired core needle biopsy samples. Cytologic specimens, therefore, should be better integrated into routine molecular diagnostics workflow to maximize

  19. Manufacturing of Plutonium Tensile Specimens

    SciTech Connect

    Knapp, Cameron M

    2012-08-01

    Details workflow conducted to manufacture high density alpha Plutonium tensile specimens to support Los Alamos National Laboratory's science campaigns. Introduces topics including the metallurgical challenge of Plutonium and the use of high performance super-computing to drive design. Addresses the utilization of Abaqus finite element analysis, programmable computer numerical controlled (CNC) machining, as well as glove box ergonomics and safety in order to design a process that will yield high quality Plutonium tensile specimens.

  20. DNA extraction from herbarium specimens.

    PubMed

    Drábková, Lenka Záveská

    2014-01-01

    With the expansion of molecular techniques, the historical collections have become widely used. Studying plant DNA using modern molecular techniques such as DNA sequencing plays an important role in understanding evolutionary relationships, identification through DNA barcoding, conservation status, and many other aspects of plant biology. Enormous herbarium collections are an important source of material especially for specimens from areas difficult to access or from taxa that are now extinct. The ability to utilize these specimens greatly enhances the research. However, the process of extracting DNA from herbarium specimens is often fraught with difficulty related to such variables as plant chemistry, drying method of the specimen, and chemical treatment of the specimen. Although many methods have been developed for extraction of DNA from herbarium specimens, the most frequently used are modified CTAB and DNeasy Plant Mini Kit protocols. Nine selected protocols in this chapter have been successfully used for high-quality DNA extraction from different kinds of plant herbarium tissues. These methods differ primarily with respect to their requirements for input material (from algae to vascular plants), type of the plant tissue (leaves with incrustations, sclerenchyma strands, mucilaginous tissues, needles, seeds), and further possible applications (PCR-based methods or microsatellites, AFLP).

  1. Real-time three-dimensional optical coherence tomography image-guided core-needle biopsy system

    PubMed Central

    Kuo, Wei-Cheng; Kim, Jongsik; Shemonski, Nathan D.; Chaney, Eric J.; Spillman, Darold R.; Boppart, Stephen A.

    2012-01-01

    Advances in optical imaging modalities, such as optical coherence tomography (OCT), enable us to observe tissue microstructure at high resolution and in real time. Currently, core-needle biopsies are guided by external imaging modalities such as ultrasound imaging and x-ray computed tomography (CT) for breast and lung masses, respectively. These image-guided procedures are frequently limited by spatial resolution when using ultrasound imaging, or by temporal resolution (rapid real-time feedback capabilities) when using x-ray CT. One feasible approach is to perform OCT within small gauge needles to optically image tissue microstructure. However, to date, no system or core-needle device has been developed that incorporates both three-dimensional OCT imaging and tissue biopsy within the same needle for true OCT-guided core-needle biopsy. We have developed and demonstrate an integrated core-needle biopsy system that utilizes catheter-based 3-D OCT for real-time image-guidance for target tissue localization, imaging of tissue immediately prior to physical biopsy, and subsequent OCT imaging of the biopsied specimen for immediate assessment at the point-of-care. OCT images of biopsied ex vivo tumor specimens acquired during core-needle placement are correlated with corresponding histology, and computational visualization of arbitrary planes within the 3-D OCT volumes enables feedback on specimen tissue type and biopsy quality. These results demonstrate the potential for using real-time 3-D OCT for needle biopsy guidance by imaging within the needle and tissue during biopsy procedures. PMID:22741064

  2. Application of microsatellite PCR techniques in the identification of mixed up tissue specimens in surgical pathology.

    PubMed

    Gras, E; Matias-Guiu, X; Catasus, L; Arguelles, R; Cardona, D; Prat, J

    2000-03-01

    A fragment of tumour was erroneously mixed up with an endometrial biopsy. Micro-satellite polymerase chain reaction (PCR) clearly demonstrated the extraneous nature of the fragment. Micro-satellite PCR may be useful for the identification of mis-labelled or mismatched tissue fragments in surgical pathology specimens.

  3. 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

  4. Screening Rectal Culture to Identify Fluoroquinolone-resistant Organisms Before Transrectal Prostate Biopsy: Do the Culture Results Between Office Visit and Biopsy Correlate?

    PubMed Central

    Liss, Michael A.; Nakamura, Kristen K.; Meuleners, Rachel; Kolla, Surendra B.; Dash, Atreya; Peterson, Ellena M.

    2014-01-01

    OBJECTIVE To investigate the performance of screening rectal cultures obtained 2 weeks before transrectal prostate biopsy to detect fluoroquinolone-resistant organisms and again at transrectal prostate biopsy. MATERIALS AND METHODS After institutional review board approval for observational study, we obtained a rectal culture on patients identified for a prostate biopsy but before antibiotic prophylaxis from September 12, 2011 to April 23, 2012. The specimen was cultured onto MacConkey agar with and without 1 µg/mL ciprofloxacin. We then obtained a second rectal culture immediately before prostate biopsy after 24 hours of ciprofloxacin prophylaxis. All cultures were blinded to the practitioner until the end of the study. RESULTS Of 108 patients enrolled, 58 patients had both rectal cultures for comparison. The median time duration between cultures was 14 (6–119) days. There were 54 of 58 concordant pairs (93%), which included 47 negative cultures and 7 positive cultures; 2 patients (3%) who were culture negative from the first screening culture became positive at biopsy. Sensitivity, specificity, negative, positive predictive values, and area under the operator curve were 95.9%, 77.8%, 95.9%, 77.8%, and 0.868, respectively. When Pseudomonas spp. are removed from the analysis, the area under the curve is increased to 0.927. CONCLUSION Screening rectal cultures 2 weeks before prostate biopsy has favorable test performance, suggesting screening cultures give an accurate estimate of fluoroquinolone-resistant colonization. PMID:23806391

  5. Fifteen years of kidney biopsies in children: a single center in Egypt.

    PubMed

    Bakr, Ashraf; Eid, Riham; Sarhan, Amr; Hammad, Ayman; El-Refaey, Ahmed Mahmoud; El-Mougy, Atef; Zedan, Mohammed Magdy; ElHusseini, Fatma; El-Rahman, Ashraf Abd

    2014-11-01

    This study retrospectively investigates the indications and results of renal biopsy in children to determine the patterns of childhood kidney disease in a single tertiary children's hospital in Egypt. We included all the patients who underwent ultrasound-guided renal biopsy from 1998 to 2012. All the kidney biopsies were studied under light microscopy, while immunofluorescence and electron microscopy were performed when indicated. A total of 1246 renal biopsies were performed over 15 years, on 1096 patients. The mean age of the patients at the time of biopsy was 9.2±3.7 years. The main indication for a biopsy was the steroid-resistant nephrotic syndrome (n=354, 28.4%), followed by the atypical nephrotic syndrome (n=250, 20.1%), and renal abnormalities in the systemic diseases (n=228, 18.3 %). In the 1226 pathologically diagnosed specimens, primary glomerulonephritis was the most common finding (n=826, 67.4%), followed by secondary glomerulonephritis (n=238, 19.4%). The most common causes of primary glomerulonephritis were Minimal Change Disease (MCD) (n=267, 21.8%), diffuse proliferative glomerulonephritis (n=188, 15. 3%), and focal proliferative glomerulonephritis (n=164, 13.3%). Lupus nephritis (n=209, 17%) was the most common cause of secondary glomerulonephritis. We conclude that the steroid-resistant nephrotic syndrome was the most frequent indication for biopsy and minimal change disease was the most common histopathological finding in our population.

  6. Differences in microbial signatures between rectal mucosal biopsies and rectal swabs.

    PubMed

    Araújo-Pérez, Félix; McCoy, Amber N; Okechukwu, Charles; Carroll, Ian M; Smith, Kevin M; Jeremiah, Kim; Sandler, Robert S; Asher, Gary N; Keku, Temitope O

    2012-01-01

    There is growing evidence the microbiota of the large bowel may influence the risk of developing colorectal cancer as well as other diseases including type-1 diabetes, inflammatory bowel diseases and irritable bowel syndrome. Current sampling methods to obtain microbial specimens, such as feces and mucosal biopsies, are inconvenient and unappealing to patients. Obtaining samples through rectal swabs could prove to be a quicker and relatively easier method, but it is unclear if swabs are an adequate substitute. We compared bacterial diversity and composition from rectal swabs and rectal mucosal biopsies in order to examine the viability of rectal swabs as an alternative to biopsies. Paired rectal swabs and mucosal biopsy samples were collected in un-prepped participants (n = 11) and microbial diversity was characterized by Terminal Restriction Fragment Length polymorphism (T-RFLP) analysis and quantitative polymerase chain reaction (qPCR) of the 16S rRNA gene. Microbial community composition from swab samples was different from rectal mucosal biopsies (p = 0.001). Overall the bacterial diversity was higher in swab samples than in biopsies as assessed by diversity indexes such as: richness (p = 0.01), evenness (p = 0.06) and Shannon's diversity (p = 0.04). Analysis of specific bacterial groups by qPCR showed higher copy number of Lactobacillus (p < 0.0001) and Eubacteria (p = 0.0003) in swab samples compared with biopsies. Our findings suggest that rectal swabs and rectal mucosal samples provide different views of the microbiota in the large intestine.

  7. Liver Panel

    MedlinePlus

    ... AACC products and services. Advertising & Sponsorship: Policy | Opportunities Liver Panel Share this page: Was this page helpful? Also known as: Liver Profile; Liver Function Tests; LFTs Formal name: Hepatic ...

  8. Cardiac Sarcoidosis Diagnosed by Incidental Lymph Node Biopsy.

    PubMed

    Matsuda, Jun; Fujiu, Katsuhito; Roh, Solji; Tajima, Miyu; Maki, Hisataka; Kojima, Toshiya; Ushiku, Tetsuo; Nawata, Kan; Takeda, Norihiko; Watanabe, Masafumi; Akazawa, Hiroshi; Komuro, Issei

    2017-02-07

    Cardiac involvement in systemic sarcoidosis sometimes provokes life-threatening ventricular tachyarrhythmia. Steroid administration is one of the fundamental anti-arrhythmia therapies. For an indication of steroid therapy, a definitive diagnosis of sarcoidosis is required.(1)) However, cases that are clearly suspected of cardiac sarcoidosis based on their clinical courses sometimes do not meet the current diagnostic criteria and result in the loss of an appropriate opportunity to perform steroid therapy.Here we report a case that was diagnosed as sarcoidosis by incidental biopsy of an inguinal lymph node during cardiac resuscitation for cardiac tamponade.(2)) While the inguinal lymph node was not swollen on computed tomography, a specimen obtained from an incidental biopsy during the exposure of a femoral vessel for the establishment of extracorporeal cardio-pulmonary resuscitation showed a non-caseating granuloma.This findings suggest a non-swelling lymph node biopsy might be an alternative strategy for the diagnosis for sarcoidosis if other standard strategies do not result in a diagnosis of sarcoidosis.

  9. [A Case of Advanced Gastric Cancer with Multiple Liver Metastases Successfully Treated with Capecitabine, Cisplatin, and Trastuzumab].

    PubMed

    Oneda, Yasuo; Tamura, Shigeyuki; Murakami, Kouhei; Takeno, Atsushi; Kuwahara, Ryuichi; Akiyama, Yasuki; Sakamoto, Takuya; Inatome, Junichi; Naito, Atushi; Katsura, Yoshiteru; Ohmura, Yoshiaki; Kagawa, Yoshinori; Egawa, Chiyomi; Takeda, Yutaka; Kato, Takeshi

    2016-11-01

    A 70-year-old-man, whose chief complaint was epigastric pain, was referred to our hospital and diagnosed with advanced gastric cancer with multiple liver metastases. Gastrointestinal endoscopy showed a tumor on the anterior wall of the gastric lower body. Histologically, biopsy specimens indicated adenocarcinoma, and immunohistochemistry showed positive expression of HER2(3+). Chest and abdominal computed tomography showed multiple liver metastases and lymph node metastases. We started chemotherapy with capecitabine, cisplatin, and trastuzumab. Abdominal CT showed the primary tumor and metastases to be reduced after 3 courses, but a ringed enhanced space occupying lesion in the liver had appeared, which was diagnosed as a liver abscess. After administering antibiotics and performing percutaneous transhepatic abscess drainage (PTAD), we continued XPT chemotherapy. The patient received 6 courses of XPT, 15 courses of capecitabine and trastuzumab, and 6 courses of trastuzumab alone, and has remained progression free in the 1 year and 5 months after diagnosis. We experienced a case of advanced gastric cancer with multiple liver metastases successfully treated with capecitabine, cisplatin, and trastuzumab.

  10. [SWE elastography in assessment of liver fibrosis].

    PubMed

    Zaleska-Dorobisz, Urszula; Pawluś, Aleksander; Kucharska, Marta; Inglot, Marcin

    2015-02-15

    Liver fibrosis is a relatively common consequence of chronic liver diseases, especially chronic viral hepatitis B and C. Biopsy still remains the gold standard in the assessment of liver fibrosis. However, due to its invasiveness and possible complications, less or even non-invasive methods are being developed, e.g. using biochemical parameters (Fibrotest) or elastography. Elastography is a new diagnostic tool that aims to evaluate stiffness of the tissues. Elastography techniques that are used in the assessment of liver fibrosis are transient elastography (TE), acoustic radiation force impulse (ARFI) and shear-wave elastography (SWE). SWE is a novel real-time two-dimensional elastography technique, which allows one to estimate stiffness quantitatively in kilopascals (kPa). Moreover, lapping elastography over regular B-mode allows precise choice of the region of interest. Therefore SWE creates the opportunity for accurate assessment of liver fibrosis. In this paper we describe processes leading to liver fibrosis as well as methods of liver fibrosis assessment, e.g. liver biopsy, biochemical tests or elastography. The main goal of this paper is to present the SWE technique, its role in liver fibrosis assessment and a short review of the most important clinical studies on SWE. We also present several examples of SWE examinations performed on patients with different stages of liver fibrosis - F0 to F4 on the METAVIR scale.

  11. 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

  12. Dual specimens increase the diagnostic accuracy and reduce the reaction duration of rapid urease test

    PubMed Central

    Hsu, Wen-Hung; Wang, Sophie SW; Kuo, Chao-Hung; Chen, Chiao-Yun; Chang, Ching-Wen; Hu, Huang-Ming; Wang, Jaw-Yuan; Yang, Yuan-Chieh; Lin, Yu-Chun; Wang, Wen-Ming; Wu, Deng-Chyang; Wu, Ming-Tsang; Kuo, Fu-Chen

    2010-01-01

    AIM: To evaluate the influence of multiple samplings during esophagogastroduodenoscopy (EGD) on the accuracy of the rapid urease test, and the validity of newly developed rapid urease tests, HelicotecUT plus test and HelicotecUT test, CLO test and ProntoDry test. METHODS: A total of 355 patients undergoing EGD for dyspepsia were included. Their Helicobacter pylori (H. pylori) treatment status was either naïve or eradicated. Six biopsy specimens from antrum and gastric body, respectively, were obtained during EGD. Single antral specimens and dual (antrum + body) specimens were compared. Infection status of H. pylori was evaluated by three different tests: culture, histology, and four different commercially available rapid urease tests (RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test, and established CLO test and ProntoDry test. H. pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology, CLO test and ProntoDry test. RESULTS: When dual specimens were applied, sensitivity was enhanced and RUT reaction time was significantly reduced, regardless of their treatment status. Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs. Both newly developed RUTs showed comparable sensitivity, specificity and accuracy to the established RUTs, regardless of patient treatment status, RUT reaction duration, and EGD biopsy sites. CONCLUSION: Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min. PMID:20556840

  13. Radiographically occult intrasinusoidal liver metastases leading to hepatic failure in a case of breast cancer.

    PubMed

    Gulia, Seema; Khurana, Sachin; Shet, Tanuja; Gupta, Sudeep

    2016-02-15

    The liver is one of the commonest sites of metastatic involvement in breast cancer, usually evident as focal lesions on imaging tests. Rarely, the pattern of metastatic spread is so diffuse that it remains radiologically occult. Such patients usually present with signs of hepatic insufficiency without any focal lesions on liver imaging. In such cases, liver biopsy is required to make a definitive diagnosis. We report a case of a 56-year-old postmenopausal woman with metastatic breast cancer who presented with subacute progressive liver failure. Repeated imaging of the liver was normal or non-descript. Liver biopsy finally established the diagnosis of intrasinusoidal metastases from breast cancer.

  14. A liver lesion in primary sclerosing cholangitis

    PubMed Central

    Biswas, Sujata; Rajoriya, Neil; Wang, Lai Mun; Collier, Jane

    2015-01-01

    Primary sclerosing cholangitis is associated with an increased risk of cholangiocarcinoma; appropriate surveillance should be undertaken for this. Our case illustrates an unexpected liver lesion in such a patient, which would not have been detected with imaging alone. In suspected cancer, if a patient is not a candidate for liver resection, liver biopsy should be considered in case there is a treatment option for an alternative cause of the liver lesion. This is a careful decision to be made due to the risk of tumour seeding compromising cure and needs to be discussed via the hepatobiliary multidisciplinary team. PMID:25827915

  15. An interlaminar tension strength specimen

    NASA Technical Reports Server (NTRS)

    Jackson, Wade C.; Martin, Roderick H.

    1992-01-01

    This paper describes a technique to determine interlaminar tension strength, sigma(sub 3c) of a fiber reinforced composite material using a curved beam. The specimen was a unidirectional curved beam, bent 90 degrees, with straight arms. Attached to each arm was a hinged loading mechanism which was held by the grips of a tensile testing machine. Geometry effects of the specimen, including the effects of loading arm length, inner radius, thickness, and width, were studied. The data sets fell into two categories: low strength corresponding to a macroscopic flaw related failure and high strength corresponding to a microscopic flaw related failure. From the data available, the loading arm length had no effect on sigma(sub 3c). The inner radius was not expected to have a significant effect on sigma(sub 3c), but this conclusion could not be confirmed because of differences in laminate quality for each curve geometry. The thicker specimens had the lowest value of sigma(sub 3c) because of poor laminate quality. Width was found to affect the value of sigma(sub 3c) only slightly. The wider specimens generally had a slightly lower strength since more material was under high stress, and hence, had a larger probability of containing a significant flaw.

  16. Image-Guided Adrenal and Renal Biopsy

    PubMed Central

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

    2010-01-01

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

  17. A Comparison of Brunt Criteria, the Non Alcoholic Fatty Liver Disease Activity Score (NAS) & a Proposed NAS-including fibrosis as Valid Diagnostic Scores for NASH

    PubMed Central

    Santiago-Rolón, Amarilys; Purcell, Dagmary; Rosado, Kathia; Toro, Doris H.

    2016-01-01

    Objective Non-alcoholic steatohepatitis (NASH) can result in cirrhosis and end stage liver disease. It is of utmost importance to differentiate NASH from simple steatosis. The aim of this study is to determine the prevalence of NASH in Latino veterans with metabolic syndrome and compare histologic grading using Brunt Criteria, the NAFLD activity score (NAS), and a proposed NAS score including fibrosis. Methods Veterans with metabolic syndrome, hepatic steatosis and elevation of ALT/AST who underwent a liver biopsy from 2004-2010 were included in this study. Biopsies were evaluated by a single blinded Hepatopathologist. Steatosis, lobular inflammation, ballooning and fibrosis were graded per specimen. Each biopsy was evaluated using Brunt criteria, NAS and NAS plus fibrosis. Results Sixty patients were included in this study, 88.3% men with a mean age of 50.4 (± 12.8). 50.0% met criteria for NASH according to the Brunt system. When classifying biopsies using NAS, only 30.0% (18/60) had a score ≥5, while when adding fibrosis, the number of patients with a score ≥5 increased to 33 (55.0%). When evaluating the predictive ability of the two scoring systems, we found that NAS including fibrosis had a higher sensitivity than NAS (86.7% vs. 40.0%) and a lower specificity (76.7% vs. 80.0%). Conclusion In our population with metabolic syndrome and altered liver function tests, about 50-55% had steatohepatitis. There were significant differences between the scoring systems. When using NAS-plus-fibrosis more patients were recognized and the sensitivity increased. Further validation studies are required to evaluate this proposed NAS scoring System. PMID:26602577

  18. Percutaneous computed tomography-guided aspiration and biopsy of intrathoracic lesions: Results of 265 procedures

    PubMed Central

    Neyaz, Zafar; Lal, Hira; Thakral, Anuj; Nath, Alok; Rao, Ram Naval; Verma, Ritu

    2016-01-01

    Context: Percutaneous computed tomography (CT)-guided needle aspiration and biopsy technique have developed over time as a method for obtaining tissue specimen. Although this is a minimally invasive procedure, complications do occasionally occur. Aims: The aim of the study was to evaluate the diagnostic yield and complications of 265 percutaneous CT-guided aspiration and biopsy procedures performed on various intrathoracic lesions. Settings and Design: Data of percutaneous CT-guided aspiration and biopsy procedures of intrathoracic lesions performed over a 4 year period were retrospectively analyzed. Subjects and Methods: Procedure details, radiological images, and pathological and microbiological reports were retrieved from radiology records and hospital information system. Technical success, diagnostic yield, and complication rates were calculated. Results: Total 265 procedures were performed for lung (n = 179), mediastinum (n = 73), and pleural lesions (n = 13). Diagnostic yield for lung, mediastinal, and pleural lesions was 80.7%, 74.2, and 75%, respectively, for core biopsy specimens. Major complication was noted in only one procedure (0.4%). Minor complications were noted in 13.6% procedures which could be managed conservatively. Conclusions: Percutaneous CT-guided aspiration and biopsy procedures for intrathoracic lesions are reasonably safe with good diagnostic yield. Complications are infrequent and conservatively managed in most of the cases. PMID:27890990

  19. Budesonide combined with UDCA to improve liver histology in primary biliary cirrhosis: a three-year randomized trial.

    PubMed

    Rautiainen, Henna; Kärkkäinen, Päivi; Karvonen, A-L; Nurmi, Heimo; Pikkarainen, Pekka; Nuutinen, Hannu; Färkkilä, Martti

    2005-04-01

    Ursodeoxycholic acid (UDCA) is a safe medical therapy for primary biliary cirrhosis (PBC), but its effect on liver histology remains uncertain. Budesonide is a glucocorticoid with high receptor activity and high first-pass metabolism in liver. We evaluated the combination of budesonide and UDCA on liver histology and compared this with UDCA alone in a 3-year prospective, randomized, open multicenter study. Patients with PBC (n = 77), at stages I to III, were randomized into 2 treatment arms, A (n = 41): budesonide 6 mg/d and UDCA 15 mg/kg/d and B (n = 36): UDCA 15 mg/kg/d. Liver histology was assessed at the beginning and at the end of the study. Liver function tests and glucose and cortisol values were determined every 4 months. Paired liver biopsy specimens were available from 69 patients (A = 37 and B = 32). Stage improved 22% in group A but deteriorated 20% in group B (P = .009). Fibrosis decreased 25% in group A but increased 70% in group B (P = .0009). S-PIIINP decreased significantly in group A. Inflammation decreased in both groups, 34% in group A (P = .02), but only 10% in group B (P = NS). Serum liver enzymes decreased significantly in both treatment arms. Bilirubin values rose in group B but stayed stable in group A (A/B P = .002). A mild systemic glucocorticoid effect from budesonide was evident after 2 years. In conclusion, budesonide combined with UDCA improved liver histology, whereas the effect of UDCA alone was mainly on laboratory values. Studies with longer follow-up using a combination of budesonide and UDCA are warranted to confirm safety and effects.

  20. Human immunodeficiency virus infection and the liver.

    PubMed

    Crane, Megan; Iser, David; Lewin, Sharon R

    2012-03-27

    Liver disease in human immunodeficiency virus (HIV)-infected individuals encompasses the spectrum from abnormal liver function tests, liver decompensation, with and without evidence of cirrhosis on biopsy, to non-alcoholic liver disease and its more severe form, non-alcoholic steatohepatitis and hepatocellular cancer. HIV can infect multiple cells in the liver, leading to enhanced intrahepatic apoptosis, activation and fibrosis. HIV can also alter gastro-intestinal tract permeability, leading to increased levels of circulating lipopolysaccharide that may have an impact on liver function. This review focuses on recent changes in the epidemiology, pathogenesis and clinical presentation of liver disease in HIV-infected patients, in the absence of co-infection with hepatitis B virus or hepatitis C virus, with a specific focus on issues relevant to low and middle income countries.

  1. Hepatitis B antigen in hepatocytes of chronic active liver disease.

    PubMed

    Kawanishi, H

    1979-04-01

    To study the morphologic interrelation of hepatocytes with the replication of hepatitis B vius (HBV) and immunocompetent cells in chronic active liver disease(CALD), organ cultures were prepared from liver biopsy specimens. Replication of hepatitis B core antigen (HBcAg) appears to occur in the nucleus of the hepatocyte in close association with intranuclear electron-dense strands and sometimes intranucleolar matrixes (likely HBcAg genomes), and cytoplasmic maturation of the HBcAg takes place in the preautolytic condition of host hepatocytes. Immunocompetent cells became progressively autolyzed in the early period of cultures. No difference in progression of hepatocyte injury in tissues from normal subjects and from hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative patients with CALD may suggest that intracellular synthesis of HBV alone is not cytopathic to host hepatocytes. This model is promising for the study of HBV replication and development, and also for testing the efficacy of new antiviral agents against the virus.

  2. Intraductal papillomas on core biopsy can be upgraded to malignancy on subsequent excisional biopsy regardless of the presence of atypical features.

    PubMed

    Shiino, Sho; Tsuda, Hitoshi; Yoshida, Masayuki; Jimbo, Kenjiro; Asaga, Sota; Hojo, Takashi; Kinoshita, Takayuki

    2015-06-01

    Intraductal papillary lesions of the breast constitute a heterogeneous entity, including benign intraductal papilloma (IDP) with or without atypia and malignant papillary carcinoma. Differentiating between these diagnoses can be challenging. We re-evaluated core biopsy specimens that were diagnosed as IDP and the corresponding surgical excision specimens, and assessed the potential risk for the diagnosis to be modified to malignancy based on excision. By sorting the pathology database of the National Cancer Center Hospital, Tokyo, we identified 146 core biopsy cases that were histologically diagnosed as IDP between 1997 and 2013. The re-evaluated diagnosis was IDP without atypia in 79 (54%) patients, IDP with atypia in 66 (45%), and ductal carcinoma in situ (DCIS) in 1 (1%). Among the 34 patients (23%) who underwent surgical excision subsequent to core biopsy, histological diagnosis was upgraded to carcinoma, excluding lobular carcinoma in situ (LCIS), in 14 (41%) cases, including 4 (33%) of 12 IDPs without atypia and 10 (45%) of 22 IDPs with atypia. Complete surgical excision should be kept in mind for all IDPs diagnosed on core biopsy, not only IDPs with atypia but IDPs without atypia, especially when clinical or imaging diagnosis findings cannot rule out the possibility of malignancy, because papillary lesions comprise a variety of morphological appearances.

  3. Evaluation of the cone biopsy excisor compared with the large loop for electrosurgical excision of cervical lesions.

    PubMed

    Fischer; Alexandarian; Gagliardi; Oglesby; Scribner; Asuncion; Mesologitis

    1998-07-01

    Data incorporated from August 1994 to July 30, 1997.Objective: To compare a newly designed triangular electrode, the Cone Biopsy Excisor to the loop electrode with respect to the margin evaluation, fragmentation, and thermal damage of the conization specimen.Methods: After approval by the Institutional Review Boards of Hartford Hospital, St. Francis Hospital, and New Britain General Hospital/University of Connecticut, patients were randomly assigned to undergo conization with the Cone Biopsy Excisor or with the large loop. Inclusion criteria included biopsy proven CIN II, CIN III, inadequate colposcopy, positive endocervical curettage, or cytohistological discrepancy. Exclusion criteria included pregnancy, undiagnosed uterine bleeding, and invasive carcinoma. The procedures were performed by senior residents on clinic patients at the respective institutions. In addition, after FDA approval November 18, 1996, private OB/GYN practitioners performed cases and added those results to the study. Seventy-eight patients were randomized to the Cone Biopsy Excisor, while 77 patients were randomized to the loop electrosurgical excision procedure (LEEP). To obtain the surgical specimen, Force 2 Valley Lab generators were used with wattage ranging from 35 to 50 according to the size of the instrument chosen, 40/60 blend of coagulation, and cutting current.Pathology reports were reviewed to determine the amount of fragmentation that occurred during the procedure and for tissue diagnosis. Specimens were then evaluated by two gynecologic pathologists blinded to the instrument used. The specimens were analyzed for the ability to evaluate the margins and for degree of thermal damage. A thermal damage score was assigned to each specimen. The scoring system results in 4 levels of thermal damage, from one (minimal thermal damage) to four (heavy thermal damage). Follow-up data was obtained from the patients' medical and pathology records.Results: Seventy-two of 78 (92%) Cone Biopsy

  4. Polycystic Liver Disease

    SciTech Connect

    Linda, Nguyen

    2016-03-25

    A 77-year-old African American male presented with intermittent abdominal pain for one week. He denied nausea, vomiting, diarrhea, constipation, fevers, anorexia, or weight loss. He denied a family history of liver disease, recent travel, or history of intravenous drug abuse. His vital signs were normal. Labs revealed total bilirubin of 1.5 mg/dl, hypoalbuminaemia 3.0 gm/dl and prolonged prothrombin time of 14.8 sec. Computed Tomography of the abdomen and pelvis with contrast showed multiple hepatic cysts with the largest cyst occupying the right abdomen, measuring 20.6 cm (Panel A and). This cyst had predominantly fluid attenuation, but also contained several septations. The patient underwent laparoscopic fenestration of the large hepatic cyst with hepatic cyst wall biopsy. Pathology revealed blood without malignant cells. The patient tolerated the procedure well with improvement of his abdominal pain and normalization of his liver function tests and coagulation profile.

  5. Hyperplasia and prolapse of hepatocytes into hepatic veins during longterm methyltestosterone therapy: possible relationships of these changes to the developement of peliosis hepatis and liver tumours.

    PubMed

    Paradinas, F J; Bull, T B; Westaby, D; Murray-Lyon, I M

    1977-07-01

    We report the pathological changes in liver biopsies from 10 patients (four female transexuals and six impotent males) after treatment with 150 mg methyltestosterone daily for periods of up to 3 years, and in a hemihepatectomy specimen from a female transexual who developed a liver adenoma after 37 months of this treatment. Hepatocyte hyperplasia and mild focal sinusoidal dilatation was found in most cases. In some cases there were microcysts and dissociation of hepatocytes. In nine patients there was accumulation of hepatocytes between the endothelium and the supporting collagen of hepatic veins which often resulted in either partial occlusion of their lumina or disruption of their walls. These vascular changes do not appear to have been reported before. It is postulated that a single pathological process-hyperplasia, perhaps related to the anabolic effect of methyltestosterone--could be partly responsible both for the formation of cysts through mechanical obstruction of hepatic veins and for the formation of nodules and tumours.

  6. The Histopathologic Spectrum of Kidney Biopsies in Patients with Inflammatory Bowel Disease

    PubMed Central

    Walker, Patrick D.; Larsen, Christopher P.

    2014-01-01

    Summary Background and objectives Kidney disease as a complication of inflammatory bowel disease (IBD), including Crohn disease (CD) and ulcerative colitis (UC), has been the subject of case reports. However, no cases series examining IBD and kidney disease has been published to date. This study aimed to evaluate a large series of kidney biopsy specimens from patients with IBD to better define the spectrum and relative frequencies of IBD-associated kidney pathology. Design, setting, participants, & measurements A retrospective review of native kidney biopsy specimens obtained from March 2001 to June 2012 identified 83 patients with IBD. Standard processing of all biopsy specimens included light microscopy, immunofluorescence, and electron microscopy. Results There were 45 cases of CD and 38 cases of UC represented. The most common indication for kidney biopsy was acute or chronic kidney failure (63% [52 of 83]) and nephrotic-range proteinuria (16% [13 of 83]). IgA nephropathy was the most common diagnosis (24% [20 of 83]), followed by interstitial nephritis (19% [16 of 83]), arterionephrosclerosis (12% [10 of 83]), acute tubular injury (8% [7 of 83]), proliferative GN (7% [6 of 83]), and minimal-change disease (5% [4 of 83]). When compared, the frequency of IgA nephropathy in IBD was significantly higher than in all other native renal biopsy specimens from the same time period (24% [20 of 83] versus 8% [2734 of 33,630]; P<0.001). Of the 16 cases of interstitial nephritis, 9 (56%) had current or recent past exposure to aminosalicylates, including all cases of granulomatous interstitial nephritis. Conclusions IBD is associated with a spectrum of kidney diseases most commonly affecting the glomerular and tubulointerstitial compartments. IgA nephropathy is the most frequent kidney biopsy diagnosis in IBD and has a significantly higher diagnostic prevalence compared with all non-IBD kidney biopsy specimens. This may reflect a common pathogenic mechanism. Although many

  7. Baseline Test Specimen Machining Report

    SciTech Connect

    mark Carroll

    2009-08-01

    The Next Generation Nuclear Plant (NGNP) Project is tasked with selecting a high temperature gas reactor technology that will be capable of generating electricity and supplying large amounts of process heat. The NGNP is presently being designed as a helium-cooled high temperature gas reactor (HTGR) with a large graphite core. The graphite baseline characterization project is conducting the research and development (R&D) activities deemed necessary to fully qualify nuclear-grade graphite for use in the NGNP reactor. Establishing nonirradiated thermomechanical and thermophysical properties by characterizing lot-to-lot and billet-to-billet variations (for probabilistic baseline data needs) through extensive data collection and statistical analysis is one of the major fundamental objectives of the project. The reactor core will be made up of stacks of graphite moderator blocks. In order to gain a more comprehensive understanding of the varying characteristics in a wide range of suitable graphites, any of which can be classified as “nuclear grade,” an experimental program has been initiated to develop an extensive database of the baseline characteristics of numerous candidate graphites. Various factors known to affect the properties of graphite will be investigated, including specimen size, spatial location within a graphite billet, specimen orientation within a billet (either parallel to [P] or transverse to [T] the long axis of the as-produced billet), and billet-to-billet variations within a lot or across different production lots. Because each data point is based on a certain position within a given billet of graphite, particular attention must be paid to the traceability of each specimen and its spatial location and orientation within each billet. The evaluation of these properties is discussed in the Graphite Technology Development Plan (Windes et. al, 2007). One of the key components in the evaluation of these graphite types will be mechanical testing on

  8. Enhanced Liver Fibrosis (ELF) test accurately identifies liver fibrosis in patients with chronic hepatitis C.

    PubMed

    Parkes, J; Guha, I N; Roderick, P; Harris, S; Cross, R; Manos, M M; Irving, W; Zaitoun, A; Wheatley, M; Ryder, S; Rosenberg, W

    2011-01-01

    Assessment of liver fibrosis is important in determining prognosis and evaluating interventions. Due to limitations of accuracy and patient hazard of liver biopsy, non-invasive methods have been sought to provide information on liver fibrosis, including the European liver fibrosis (ELF) test, shown to have good diagnostic accuracy for the detection of moderate and severe fibrosis. Access to independent cohorts of patients has provided an opportunity to explore if this test could be simplified. This paper reports the simplification of the ELF test and its ability to identity severity of liver fibrosis in external validation studies in patients with chronic hepatitis C (CHC). Paired biopsy and serum samples from 347 naïve patients with CHC in three independent cohorts were analysed. Diagnostic performance characteristics were derived (AUROC, sensitivity and specificity, predictive values), and clinical utility modelling performed to determine the proportion of biopsies that could have been avoided if ELF test was used in this patient group. It was possible to simplify the original ELF test without loss of performance and the new algorithm is reported. The simplified ELF test was able to predict severe fibrosis [pooled AUROC of 0.85 (95% CI 0.81-0.89)] and using clinical utility modelling to predict severe fibrosis (Ishak stages 4-6; METAVIR stages 3 and 4) 81% of biopsies could have been avoided (65% correctly). Issues of spectrum effect in diagnostic test evaluations are discussed. In chronic hepatitis C a simplified ELF test can detect severe liver fibrosis with good accuracy.

  9. Skin biopsy as a nondestructive tool for the toxicological assessment of endangered populations of pinnipeds: preliminary results on mixed function oxidase in Otaria flavescens.

    PubMed

    Fossi, M C; Savelli, C; Marsili, L; Casini, S; Jimenez, B; Junin, M; Castello, H; Lorenzani, J A

    1997-10-01

    The aim of this study was to develop and validate a method for assessing the toxicological risk of endangered populations of pinnipeds based on a nondestructive biological tool, the skin biopsy specimen. Skin biopsies can be obtained from pinnipeds by anaesthetising the animals and taking a small amount of skin in the anterior flipper area, or by shooting a biopsy dart with a crossbow. Skin biopsy material is suitable for a wide range of chemical and biomarker analysis. Organochlorines and polycyclic aromatic hydrocarbons can be analysed in subcutaneous fat and MFO activity (BPMO), Cyt.P450 isoforms, and DNA damage can be detected in epidermis.

  10. 77 FR 6971 - Establishment of User Fees for Filovirus Testing of Nonhuman Primate Liver Samples

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... Primate Liver Samples AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and... current special-permit notice requires filovirus antigen-detection testing on liver specimens from any NHP... testing for filovirus required on liver specimens from monkeys that die during the...

  11. Nonalcoholic Fatty Liver Disease in Pediatrics.

    PubMed

    Duncan, Martin; Zong, Wenjing; Biank, Vincent F; Hageman, Joseph R

    2016-02-01

    A 16-year-old Hispanic girl with an elevated body mass index in an otherwise normal state of health presented for her well-child examination. She had signs of metabolic syndrome and insulin resistance including increased waist circumference and acanthosis nigricans. Laboratory results revealed elevated transaminases with otherwise normal hepatic function. Based on the physical examination and laboratory results, she was diagnosed with nonalcoholic fatty liver disease (NAFLD). After further evaluation, she eventually underwent a liver biopsy. The biopsy revealed nonalcoholic steatohepatitis (NASH) with stage 2 fibrosis. This article reviews the definition of NAFLD and NASH, an increasingly prevalent cause of pediatric chronic liver disease associated with obesity and metabolic syndrome. The article also outlines the epidemiology, risk factors, and natural history of NAFLD, which may help identify and prevent high-risk pediatric patients from progressing to irreversible liver disease. Understanding the diagnostic and treatment options offers the best chance at preventing and reversing the early stages of this disease.

  12. Appendix A: Specimen 72275 documentation

    NASA Technical Reports Server (NTRS)

    Marvin, U. B.

    1974-01-01

    The friability of the matrix of specimen 72275 caused numerous fragments and an abundance of fines to break away from the main mass during transport from the moon and handling in the lunar receiving laboratory. Samples 72275,1 to 72275,14 were labeled during PET examination. Samples 72275,1, 4, 6, 7, 8, and 9 were placed in storage, and the remainder were distributed.

  13. Concepts of marine specimen banking.

    PubMed

    Rossbach, M; Kniewald, G

    1997-05-01

    For more than a decade environmental specimen banking (ESB) has been an established approach for monitoring and retrospective environmental survey purposes in a number of developed countries. Specimen banking is carried out on regional or national scales for various environmental materials. The ecological or problem-oriented approach, as pursued e.g. in Germany or USA has the advantages of a restricted survey and a clear political mandate. Environmental problems, however, are by no means national or regional issues, since the diversity and dispersion of hazardous substances make environmental monitoring clearly a global affair. The structuring of our environment suggests that banking should not be limited by national boundaries, but rather be based on eco-systematic principles. Such distinct banking efforts should be devoted to the monitoring of physico-chemical aspects of climatic change and air pollution, soil quality, and aquatic monitoring on a world-wide scale. As some experience already exists with specialized banking programs for marine samples, such as the National Marine Mammal Tissue Bank or the Mussel Watch Program in the United States, an international marine specimen bank, based on principles of national ESB's, is advocated to be established in due time. Following the recommendations of the 1992 Rio 'Earth Summit' to pursue sustainable development strategies, such an establishment could strongly facilitate efforts concerning pollution control and mitigation, overexploitation and mining of ocean resources on a regional or global scale.

  14. Severe veno-occlusive disease/sinusoidal obstruction syndrome after deceased-donor and living-donor liver transplantation.

    PubMed

    Takamura, H; Nakanuma, S; Hayashi, H; Tajima, H; Kakinoki, K; Kitahara, M; Sakai, S; Makino, I; Nakagawara, H; Miyashita, T; Okamoto, K; Nakamura, K; Oyama, K; Inokuchi, M; Ninomiya, I; Kitagawa, H; Fushida, S; Fujimura, T; Onishi, I; Kayahara, M; Tani, T; Arai, K; Yamashita, Taro; Yamashita, Tatsuya; Kitamura, H; Ikeda, H; Kaneko, S; Nakanuma, Y; Matsui, O; Ohta, T

    2014-12-01

    Veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) occurring after liver transplantation is a relatively rare complication but it often takes a life-threatening course. However, the detailed etiology and mechanism of VOD/SOS after liver transplantation (LT) remains unclear. We report two cases with rapidly progressive VOD/SOS after ABO-identical LT resistant to various therapies. In case 1, in which the patient underwent deceased-donor LT, the first episode of acute allograft rejection was triggered VOD/SOS, and the presence of donor non-specific anti-HLA antibodies was confirmed. The recipient died with graft failure on day 46 after transplantation. Case 2, in which the patient underwent living-donor LT from the mother, had neither rejection nor mechanical venous obstruction, but condition of the patient rapidly worsened and he died on day 13 after transplantation. This recipient's direct cross-match test for the donor's B lymphocyte was strongly positive, but that for T lymphocyte was negative. In both cases, neither stenosis of hepatic vein outflow tract nor C4d deposition in post-transplantation liver biopsy specimens and autopsy specimen was found. On the other hand, in both cases, the patient was transfusion unresponsive thrombocytopenia and hyperbilirubinemia persisted postoperatively, and glycoprotein Ⅰ bα was strongly stained in the neighboring centrilobular area (zone 3), especially in the space of Disse, and platelet phagocytosis was observed in Kupffer cells and hepatocytes around zone 3 such as clinical xenotransplantation of the liver in post-transplantation liver biopsy specimens. From the viewpoint of graft injury, VOD/SOS was considered that sustained sinusoidal endothelial cells injury resulted in bleeding in the space of Disse and led to around centrilobular hemorrhagic necrosis, and the fundamental cause was damage around centrilobular area including sinusoid by acute cellular rejection, antibody-mediated rejection or ischemic

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

    PubMed

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

    2013-02-01

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

  16. Tolerance of the liver to the effects of Yttrium-90 radiation

    SciTech Connect

    Gray, B.N.; Burton, M.A.; Kelleher, D.; Klemp, P.; Matz, L. )

    1990-03-01

    There are no reliable data documenting the tolerance of the human liver to ionizing radiation from a continuous Yttrium-90 source. As Yttrium-90 incorporated into microspheres is being used to treat patients with liver cancer, it is imperative that the tolerance of the human liver to this form of radiation damage be determined. Four patients with metastatic liver cancer were treated with Yttrium-90 to deliver radiation doses above that considered tolerable when given by conventional external sources. Patients were monitored with serial estimations of liver function tests and between 7 and 9 months after treatment liver biopsies were performed. Histological examination of the liver biopsies confirmed only minimal changes in the normal liver parenchyma. These data indicate that the human liver may tolerate relatively large radiation doses when delivered by Yttrium-90 microspheres embedded in the liver parenchyma as a number of discrete point sources.

  17. Rectourethral fistula after repeat transrectal prostate biopsy.

    PubMed

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

    2013-09-01

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

  18. 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.

  19. The liquid biopsy in lung cancer

    PubMed Central

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

    2016-01-01

    The incidence of lung cancer has significantly increased over the last century, largely due to smoking, and remains the most common cause of cancer deaths worldwide. This is often due to lung cancer first presenting at late stages and a lack of curative therapeutic options at these later stages. Delayed diagnoses, inadequate tumor sampling, and lung cancer misdiagnoses are also not uncommon due to the limitations of the tissue biopsy. Our better understanding of the tumor microenvironment and the systemic actions of tumors, combined with the recent advent of the liquid biopsy, may allow molecular diagnostics to be done on circulating tumor markers, particularly circulating tumor DNA. Multiple liquid biopsy molecular methods are presently being examined to determine their efficacy as surrogates to the tumor tissue biopsy. This review will focus on new liquid biopsy technologies and how they may assist in lung cancer detection, diagnosis, and treatment. PMID:28191282

  20. [Experimental quality control of biopsy cannulas].

    PubMed

    Schild, H H; Michel, S G

    1993-09-01

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

  1. Using multiphoton fluorescence lifetime imaging to characterize liver damage and fluorescein disposition in liver in vivo

    NASA Astrophysics Data System (ADS)

    Thorling, Camilla A.; Studier, Hauke; Crawford, Darrell; Roberts, Michael S.

    2016-03-01

    Liver disease is the fifth most common cause of death and unlike many other major causes of mortality, liver disease rates are increasing rather than decreasing. There is no ideal measurement of liver disease and although biopsies are the gold standard, this only allows for a spot examination and cannot follow dynamic processes of the liver. Intravital imaging has the potential to extract detailed information over a larger sampling area continuously. The aim of this project was to investigate whether multiphoton and fluorescence lifetime imaging microscopy could detect early liver damage and to assess whether it could detect changes in metabolism of fluorescein in normal and diseased livers. Four experimental groups were used in this study: 1) control; 2) ischemia reperfusion injury; 3) steatosis and 4) steatosis with ischemia reperfusion injury. Results showed that multiphoton microscopy could visualize morphological changes such as decreased fluorescence of endogenous fluorophores and the presence of lipid droplets, characteristic of steatosis. Fluorescence lifetime imaging microscopy showed increase in NADPH in steatosis with and without ischemia reperfusion injury and could detect changes in metabolism of fluorescein to fluorescein monoglurcuronide, which was impaired in steatosis with ischemia reperfusion injury. These results concluded that the combination of multiphoton microscopy and fluorescence lifetime imaging is a promising method of assessing early stage liver damage and that it can be used to study changes in drug metabolism in the liver as an indication of liver disease and has the potential to replace the traditional static liver biopsy currently used.

  2. Transplant biopsy beyond light microscopy.

    PubMed

    Adam, Benjamin; Mengel, Michael

    2015-08-07

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

  3. Primary Liver Sinusoidal Non-Hodgkin's Lymphoma Presenting as Acute Liver Failure

    PubMed Central

    Nagral, Aabha; Jhaveri, Ajay; Kalthoonical, Vilesh; Bhat, Ganapathi; Mahajan, Pravin; Borges, Anita

    2015-01-01

    We describe a case of a middle-aged woman, who presented to us with fever, anorexia, abdominal distension from a massive hepatomegaly, low hemoglobin, and acute liver failure. A liver biopsy revealed B cell non-Hodgkin's lymphoma predominantly in the sinusoids with CD10, CD20, and Bcl-2 positive on immunohistochemistry. She initially responded well to chemotherapy but succumbed 6 months later to the recurrence of disease. Sinusoidal non-Hodgkin's lymphoma of the liver should be considered in the differential diagnosis of a patient with large hepatomegaly presenting with acute liver failure. PMID:26900276

  4. Open Lung Biopsy Among Critically Ill, Mechanically Ventilated Patients. A Metaanalysis

    PubMed Central

    Walkey, Allan J.

    2015-01-01

    Rationale: Open lung biopsy may be performed to guide therapy in mechanically ventilated patients with diagnostic uncertainty regarding etiology of pulmonary infiltrates. Current evidence for open lung biopsy in mechanically ventilated patients comes from single-center case series. Objectives: We performed a metaanalysis of case series to determine diagnoses, complications, and changes in therapy after lung biopsy in critically ill patients requiring mechanical ventilation. Methods: We searched Medline for case series of lung biopsies in critically ill patients requiring mechanical ventilation. We pooled results of individual case series using random effects metaanalysis models to obtain summary proportions. Measurements and Main Results: We identified 14 case series including a total of 512 mechanically ventilated patients with 530 histopathological diagnoses. The most common diagnoses were “fibrosis/pneumonitis” (n = 155, 25%; 95% confidence interval [CI], 14–37%) and infection (n = 113, 20%; 95% CI, 15–27%). Viruses were the most commonly identified infectious etiology identified on open lung biopsy, representing 50% of potential pathogens. Diffuse alveolar damage was present in a minority of specimens (n = 100, 16%; 95% CI, 8–25%). Therapeutic changes after lung biopsy occurred in 399 patients (78%; 95% CI, 64–81%). Procedure-related complications occurred in 29% of patients (95% CI, 25–33%), most commonly persistent air leak. Mortality among mechanically ventilated patients after diagnostic open lung biopsy was 54%. Conclusions: Among mechanically ventilated patients with respiratory failure of unclear etiology, lung biopsy yielded a wide range of diagnoses and was associated with a change in therapy in most patients. PMID:26065712

  5. Liver Immunology

    PubMed Central

    Bogdanos, Dimitrios P.; Gao, Bin; Gershwin, M. Eric

    2014-01-01

    The liver is the largest organ in the body and is generally regarded by non-immunologists as not having lymphoid function. However, such is far from accurate. This review highlights the importance of the liver as a lymphoid organ. Firstly, we discuss experimental data surrounding the role of liver as a lymphoid organ. The liver facilitates a tolerance rather than immunoreactivity, which protects the host from antigenic overload of dietary components and drugs derived from the gut and is also instrumental to fetal immune tolerance. Loss of liver tolerance leads to autoaggressive phenomena which if are not controlled by regulatory lymphoid populations may lead to the induction of autoimmune liver diseases. Liver-related lymphoid subpopulations also act as critical antigen-presenting cells. The study of the immunological properties of liver and delineation of the microenvironment of the intrahepatic milieu in normal and diseased livers provides a platform to understand the hierarchy of a series of detrimental events which lead to immune-mediated destruction of the liver and the rejection of liver allografts. The majority of emphasis within this review will be on the normal mononuclear cell composition of the liver. However, within this context, we will discus select, but not all, immune mediated liver disease and attempt to place these data in the context of human autoimmunity. PMID:23720323

  6. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  7. Comparison of Pipelle sampler with conventional dilatation and curettage (D&C) for Chinese endometrial biopsy.

    PubMed

    Liu, H; Wang, F-L; Zhao, Y-M; Yao, Y-Q; Li, Y-L

    2015-01-01

    The aim of this study is to investigate the accuracy and adequacy of the Pipelle endometrial sampler for endometrial biopsy as compared with those of conventional dilatation and curettage (D&C). A total of 245 patients subject to endometrial biopsy were included in this study. We have shown that the failure rates with D&C and Pipelle were 7.75% and 8.98%, respectively, without statistical difference. Additionally, the obtained specimen quality and accurate diagnosis of various diseases using the two methods had no significant statistical differences. Furthermore, patients experienced less pain when Pipelle sampler was used than D&C. Therefore, Pipelle sampler is effective in obtaining adequate endometrial tissue for histodiagnosis, and is applicable in most of the cases for Chinese endometrial biopsy.

  8. Optical Coherence Tomography: An Emerging Technology for Biomedical Imaging and Optical Biopsy1

    PubMed Central

    Fujimoto, James G; Pitris, Costas; Boppart, Stephen A; Brezinski, Mark E

    2000-01-01

    Abstract Optical coherence tomography (OCT) is an emerging technology for performing high-resolution cross-sectional imaging. OCT is analogous to ultrasound imaging, except that it uses light instead of sound. OCT can provide cross-sectional images of tissue structure on the micron scale in situ and in real time. Using OCT in combination with catheters and endoscopes enables high-resolution intraluminal imaging of organ systems. OCT can function as a type of optical biopsy and is a powerful imaging technology for medical diagnostics because unlike conventional histopathology which requires removal of a tissue specimen and processing for microscopic examination, OCT can provide images of tissue in situ and in real time. OCT can be used where standard excisional biopsy is hazardous or impossible, to reduce sampling errors associated with excisional biopsy, and to guide interventional procedures. In this paper, we review OCT technology and describe its potential biomedical and clinical applications. PMID:10933065

  9. Enlarged Liver

    MedlinePlus

    ... Approach to the patient with liver disease. In: Harrison’s Principles of Internal Medicine. 19th ed. New York, ... DL, et al., eds. Alcoholic liver disease. In: Harrison’s Principles of Internal Medicine. 19th ed. New York, ...

  10. Liver scan

    MedlinePlus

    ... Nuclear scan - technetium; Nuclear scan - liver or spleen Images Liver scan References Lidofsky S. Jaundice. In: Feldman M, ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  11. Liver Diseases

    MedlinePlus

    Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. There are many kinds of liver diseases. Viruses cause some of them, like hepatitis ...

  12. Liver disease

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000205.htm Liver disease To use the sharing features on this page, please enable JavaScript. The term "liver disease" applies to many conditions that stop the ...

  13. Prevention of sepsis prior to prostate biopsy

    PubMed Central

    Toner, Liam; Bolton, Damien M

    2016-01-01

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

  14. Automated Tracking of Drosophila Specimens

    PubMed Central

    Chao, Rubén; Macía-Vázquez, Germán; Zalama, Eduardo; Gómez-García-Bermejo, Jaime; Perán, José-Ramón

    2015-01-01

    The fruit fly Drosophila Melanogaster has become a model organism in the study of neurobiology and behavior patterns. The analysis of the way the fly moves and its behavior is of great scientific interest for research on aspects such as drug tolerance, aggression or ageing in humans. In this article, a procedure for detecting, identifying and tracking numerous specimens of Drosophila by means of computer vision-based sensing systems is presented. This procedure allows dynamic information about each specimen to be collected at each moment, and then for its behavior to be quantitatively characterized. The proposed algorithm operates in three main steps: a pre-processing step, a detection and segmentation step, and tracking shape. The pre-processing and segmentation steps allow some limits of the image acquisition system and some visual artifacts (such as shadows and reflections) to be dealt with. The improvements introduced in the tracking step allow the problems corresponding to identity loss and swaps, caused by the interaction between individual flies, to be solved efficiently. Thus, a robust method that compares favorably to other existing methods is obtained. PMID:26258779

  15. Use of power Doppler ultrasound-guided biopsies to locate regions of tumour hypoxia.

    PubMed Central

    Evans, S. M.; Laughlin, K. M.; Pugh, C. R.; Sehgal, C. M.; Saunders, H. M.

    1997-01-01

    The purpose of this study was to determine whether power Doppler ultrasound techniques could be used to direct biopsies into tumour regions with relatively low red blood cell flux, and therefore preferentially sample regions that were relatively hypoxic. Subcutaneous 9L glioma rat tumours were biopsied using power Doppler ultrasound guidance. Immunohistochemical detection of the 2-nitroimidazole EF5 was performed to determine the presence and level of hypoxia in the biopsy samples. Comparisons between the power Doppler-determined red blood cell flux and EF5 binding were made. In seven out of eight tumours studied, power Doppler ultrasound allowed differentiation of a relatively hypoxic region from a relatively oxic region by localizing relatively low vs high red blood cell flux areas respectively. In one of these seven tumours, RBC flux was high in both biopsied sites and hypoxia was not present in either. In two of these seven tumours, hypoxia was present in each biopsy and both of the red blood cell flux measurements were low. In the eighth tumour, both the EF5 binding and the red blood cell flux measurements were low. In this tumour, low EF5 binding was due to the dominance of necrotic cells, which will not reduce or bind EF5 in the biopsy specimen. Using EF5-binding techniques, we have confirmed that regions of relatively low red blood cell flux are more hypoxic than those with relatively high red blood cell flux. Counterstaining specimens with haematoxylin and eosin allows differentiation of low EF5-binding regions due to oxia vs necrosis. These methods have clinical implications for the expanded use of power Doppler ultrasound as a means to direct tissue sampling when it is important to identify the presence of hypoxia. Images Figure 1 Figure 2 Figure 4 Figure 5 PMID:9374376

  16. Can EGFR mutation status be reliably determined in pre-operative needle biopsies from adenocarcinomas of the lung?

    PubMed

    Lindahl, Kim Hein; Sørensen, Flemming Brandt; Jonstrup, Søren Peter; Olsen, Karen Ege; Loeschke, Siegfried

    2015-04-01

    The identification of EGFR mutations in non-small-cell lung cancer is important for selecting patients, who may benefit from treatment with EGFR tyrosine kinase inhibitors. The analysis is usually performed on cytological aspirates and/or histological needle biopsies, representing a small fraction of the tumour volume. The aim of the present investigation was to evaluate the diagnostic performance of this molecular test. We retrospectively included 201 patients with primary adenocarcinoma of the lung. EGFR mutation status (exon 19 deletions and exon 21 L858R point mutation) was evaluated on both pre-operative biopsies (131 histological and 70 cytological) and on the surgical specimens, using PCR. Samples with low tumour cell fraction were assigned to laser micro-dissection (LMD). We found nine (4.5%) patients with EGFR mutation in the lung tumour resections, but failed to identify mutation in one of the corresponding pre-operative, cytological specimens. Several (18.4%) analyses of the pre-operative biopsies were inconclusive, especially in case of biopsies undergoing LMD and regarding exon 21 analysis. Discrepancy of mutation status in one patient may reflect intra-tumoural heterogeneity or technical issues. Moreover, several inconclusive results in the diagnostic biopsies reveal that attention must be paid on the suitability of pre-operative biopsies for EGFR mutation analysis.

  17. Offset-sparsity decomposition for automated enhancement of color microscopic image of stained specimen in histopathology

    NASA Astrophysics Data System (ADS)

    Kopriva, Ivica; Hadžija, Marijana Popović; Hadžija, Mirko; Aralica, Gorana

    2015-07-01

    We propose an offset-sparsity decomposition method for the enhancement of a color microscopic image of a stained specimen. The method decomposes vectorized spectral images into offset terms and sparse terms. A sparse term represents an enhanced image, and an offset term represents a "shadow." The related optimization problem is solved by computational improvement of the accelerated proximal gradient method used initially to solve the related rank-sparsity decomposition problem. Removal of an image-adapted color offset yields an enhanced image with improved colorimetric differences among the histological structures. This is verified by a no-reference colorfulness measure estimated from 35 specimens of the human liver, 1 specimen of the mouse liver stained with hematoxylin and eosin, 6 specimens of the mouse liver stained with Sudan III, and 3 specimens of the human liver stained with the anti-CD34 monoclonal antibody. The colorimetric difference improves on average by 43.86% with a 99% confidence interval (CI) of [35.35%, 51.62%]. Furthermore, according to the mean opinion score, estimated on the basis of the evaluations of five pathologists, images enhanced by the proposed method exhibit an average quality improvement of 16.60% with a 99% CI of [10.46%, 22.73%].

  18. Macrophage polarisation changes within the time between diagnostic biopsy and tumour resection in oral squamous cell carcinomas—an immunohistochemical study

    PubMed Central

    Weber, M; Moebius, P; Büttner-Herold, M; Amann, K; Preidl, R; Neukam, F W; Wehrhan, F

    2015-01-01

    Background: The prognosis of solid malignancies has been shown to depend on immunological parameters, such as macrophage polarisation (M1/M2). Recently, it was reported that preoperative oral surgery leads to a worsening of oral squamous cell carcinomas (OSCC) prognosis. Diagnostic incision biopsies are oral surgery procedures that might lead to healing-associated M2 macrophage polarisation with a potential negative influence on tumour biology. No studies have compared macrophage polarisation in OSCC biopsies and tumour specimens. Methods: Preoperative diagnostic incision biopsies (n=25) and tumour resection specimens (n=34) of T1/T2 OSCC were processed for immunohistochemistry to detect CD68-, CD11c-, CD163- and MRC1-positive cells. Samples were digitised using whole-slide imaging, and the expression of macrophage markers was quantitatively analysed. Results: Carcinoma tissues obtained during OSCC tumour resections showed a significantly (P<0.05) increased CD163 cell count (M2 macrophages) compared with tissues obtained during preoperative incision biopsies. Additionally, the CD163/CD68 ratio (an indicator of M2 polarisation) was significantly (P<0.05) higher in tumour resection specimens than in biopsies. Conclusions: This study revealed for the first time an increase in M2 polarisation in samples obtained during OSCC tumour resection surgery compared with preoperative incision biopsies. The biopsy-induced tissue trauma might explain the observed shift in macrophage polarisation towards the tumour-promoting M2 type and could lead to accelerated tumour progression. PMID:26110975

  19. Predicting Low-Risk Prostate Cancer from Transperineal Saturation Biopsies

    PubMed Central

    van Leeuwen, Pim J.; Siriwardana, Amila; Roobol, Monique; Ting, Francis; Nieboer, Daan; Thompson, James; Delprado, Warick; Haynes, Anne-Marie; Brenner, Phillip; Stricker, Phillip

    2016-01-01

    Introduction. To assess the performance of five previously described clinicopathological definitions of low-risk prostate cancer (PC). Materials and Methods. Men who underwent radical prostatectomy (RP) for clinical stage ≤T2, PSA <10 ng/mL, Gleason score <8 PC, diagnosed by transperineal template-guided saturation biopsy were included. The performance of five previously described criteria (i.e., criteria 1–5, criterion 1 stringent (Gleason score 6 + ≤5 mm total max core length PC + ≤3 mm max per core length PC) up to criterion 5 less stringent (Gleason score 6-7 with ≤5% Gleason grade 4) was analysed to assess ability of each to predict insignificant disease in RP specimens (defined as Gleason score ≤6 and total tumour volume <2.5 mL, or Gleason score 7 with ≤5% grade 4 and total tumour volume <0.7 mL). Results. 994 men who underwent RP were included. Criterion 4 (Gleason score 6) performed best with area under the curve of receiver operating characteristics 0.792. At decision curve analysis, criterion 4 was deemed clinically the best performing transperineal saturation biopsy-based definition for low-risk PC. Conclusions. Gleason score 6 disease demonstrated a superior trade-off between sensitivity and specificity for clarifying low-risk PC that can guide treatment and be used as reference test in diagnostic studies. PMID:27148459

  20. Peliosis hepatis: 2 case reports of a rare liver disorder and its differential diagnosis

    PubMed Central

    Dai, Yi-Ning; Ren, Ze-Ze; Song, Wen-Yuan; Huang, Hai-Jun; Yang, Dan-Hong; Wang, Ming-Shan; Huang, Yi-Cheng; Chen, Mei-Juan; Zhang, Jia-Jie; Tong, Yong-Xi; Pan, Hong-Ying

    2017-01-01

    Abstract Rationale: Peliosis hepatis (PH) is a rare tumor-like liver lesion composed of multiple blood-filled cavities within the liver parenchyma. It is hard to differentiate PH from other liver lesions by imaging, such as carcinoma, metastases, or abscess. Patient concerns: Here, we reported 2 cases that presented with liver lesions under ultrasound and computed tomography (CT) scanning, without any history of liver diseases or drug usage traced back. Diagnoses: Liver biopsy and laparoscopy were processed, and the lesions were eventually diagnosed as PH by histopathology, which microscopically presented with multiple sinusoidal dilatations with blood-filled cystic spaces. Interventions: After the liver biopsy or laparoscopy, the patients were discharged and followed up in the clinic. Outcomes: Both patients were followed up for at least 1 year with good recovery. Lessons: PH should always be recognized in the differentiation of liver lesions, particularly indistinctive lesion(s) without any history of liver-related diseases. PMID:28353584

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

    MedlinePlus

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

  2. Diagnostic algorithm to differentiate lymphoma from inflammation in feline small intestinal biopsy samples.

    PubMed

    Kiupel, M; Smedley, R C; Pfent, C; Xie, Y; Xue, Y; Wise, A G; DeVaul, J M; Maes, R K

    2011-01-01

    Differentiating between inflammatory bowel disease (IBD) and small intestinal lymphoma in cats is often difficult, especially when only endoscopic biopsy specimens are available for evaluation. However, a correct diagnosis is imperative for proper treatment and prognosis. A retrospective study was performed using surgical and endoscopic intestinal biopsy specimens from 63 cats with a history of chronic diarrhea or vomiting or weight loss. A diagnosis of lymphoma or inflammation was based on microscopic examination of hematoxylin and eosin (HE)-stained sections alone, HE-stained sections plus results of immunohistochemical labeling (IHC) for CD3e and CD79a, and HE staining, immunophenotyping, and polymerase chain reaction (PCR) results for B and/or T cell clonality. In addition, various histomorphologic parameters were evaluated for significant differences between lymphoma and IBD using Fisher's exact test. The sensitivity and specificity of each parameter in the diagnosis of lymphoma were also determined. Results of Bayesian statistical analysis demonstrated that combining histologic evaluation of small intestinal biopsy specimens with immunophenotyping and analysis of clonality of lymphoid infiltrates results in more accurate differentiation of neoplastic versus inflammatory lymphocytes. Important histologic features that differentiated intestinal lymphoma from IBD included lymphoid infiltration of the intestinal wall beyond the mucosa, epitheliotropism (especially intraepithelial nests and plaques), heterogeneity, and nuclear size of lymphocytes. Based on the results of this study, a stepwise diagnostic algorithm that first uses histologic assessment, followed by immunophenotyping and then PCR to determine clonality of the lymphocytes, was developed to more accurately differentiate between intestinal lymphoma and IBD.

  3. Atypical cells in a voided urine cytology specimen in a renal transplant recipient.

    PubMed

    Lu, Miao; Ho, Julie; Azordegan, Nazila; Perry, Anamarija M; Gibson, Ian W; Baker, Patricia

    2017-01-01

    Voided urine is routinely collected from renal transplant patients to screen for polyomavirus. In rare cases, atypical lymphoid cells can be detected in voided urine and raise the suspicion of post-transplant lymphoproliferative disorder (PTLD). However, further immunohistochemistry of the cell block and flow cytometry is frequently limited by the low cellularity and poor preservation of voided urine. Therefore, PTLD of the renal allograft is usually diagnosed from tissue biopsy or nephrectomy specimens. Herein, we report a rare case of atypical cells in a voided urine cytology specimen from a kidney transplant recipient. Needle core biopsy of the renal allograft showed monomorphic PTLD. Diagn. Cytopathol. 2017;45:69-72. © 2016 Wiley Periodicals, Inc.

  4. Brain biopsy in benign neurological disease.

    PubMed

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

    2012-05-01

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

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

    PubMed

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

    2013-06-01

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

  6. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  7. Magnetic Resonance (MR)-Guided Breast Biopsy

    MedlinePlus

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

  8. Laparoscopic grasper for intramedullary biopsy: a technique to improve tissue sampling.

    PubMed

    Xia, Zhan; Takano, Angela Maria; Sittampalam, Kesavan; Howe, Tet Sen

    2014-08-01

    Fluorodeoxyglucose (FDG) hepatic superscan refers to the diffuse intense uptake of 18F-FDG in the liver on positron emission tomography (PET), with reduced physiological activity in the brain and heart. The common causes include lymphoma and metastasis. In this case report, we describe the imaging features of tuberculosis as a rare cause of FDG hepatic superscan. PET imaging may be the only clue to a diagnosis of hepatic tuberculosis, as other imaging modalities may demonstrate only nonspecific hepatomegaly. It is important to consider this entity in the differential diagnosis of patients presenting with FDG hepatic superscan and proceed with liver biopsy for a definitive diagnosis.

  9. Liver transplantation☆

    PubMed Central

    Rossi, M.; Mennini, G.; Lai, Q.; Ginanni Corradini, S.; Drudi, F.M.; Pugliese, F.; Berloco, P.B.

    2007-01-01

    Orthotopic liver transplantation (OLT) involves the substitution of a diseased native liver with a normal liver (or part of one) taken from a deceased or living donor. Considered an experimental procedure through the 1980s, OLT is now regarded as the treatment of choice for a number of otherwise irreversible forms of acute and chronic liver disease. The first human liver transplantation was performed in the United States in 1963 by Prof. T.E. Starzl of the University of Colorado. The first OLT to be performed in Italy was done in 1982 by Prof. R. Cortesini. The procedure was successfully performed at the Policlinico Umberto I of the University of Rome (La Sapienza). The paper reports the indications for liver transplantation, donor selection and organ allocation in our experience, surgical technique, immunosuppression, complications and results of liver transplantation in our center. PMID:23396075

  10. 36 CFR 2.5 - Research specimens.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... superintendent approves a written research proposal and determines that the collection will benefit science or... Park Service National Catalog. (2) Specimens and data derived from consumed specimens will be...

  11. 36 CFR 2.5 - Research specimens.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... superintendent approves a written research proposal and determines that the collection will benefit science or... Park Service National Catalog. (2) Specimens and data derived from consumed specimens will be...

  12. Non invasive tools for the diagnosis of liver cirrhosis

    PubMed Central

    Soresi, Maurizio; Giannitrapani, Lydia; Cervello, Melchiorre; Licata, Anna; Montalto, Giuseppe

    2014-01-01

    Liver cirrhosis (LC), the end stage of many forms of chronic hepatitis of different etiologies is a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules surrounded by annular fibrosis. This chronic progressive clinical condition, leads to liver cell failure and portal hypertension, which can favour the onset of hepatocellular carcinoma. Defining the phase of the natural history is crucial for therapeutic choice and prognosis. Liver biopsy is currently considered the best available standard of reference but it has some limits, so alternative tools have been developed to substitute liver biopsy when assessing liver fibrosis. Serum markers offer a cost-effective alternative to liver biopsy being less invasive and theoretically without complications. They can be classified into direct and indirect markers which may be used alone or in combination to produce composite scores. Diagnostic imaging includes a number of instruments and techniques to estimate liver fibrosis and cirrhosis like ultrasound (US), US Doppler, contrast enhanced US and Elastography. US could be used for the diagnosis of advanced LC while is not able to evaluate progression of fibrosis, in this case Elastography is more reliable. This review aims to revise the most recent data from the literature about non invasive methods useful in defining liver fibrosis. PMID:25561782

  13. Non invasive tools for the diagnosis of liver cirrhosis.

    PubMed

    Soresi, Maurizio; Giannitrapani, Lydia; Cervello, Melchiorre; Licata, Anna; Montalto, Giuseppe

    2014-12-28

    Liver cirrhosis (LC), the end stage of many forms of chronic hepatitis of different etiologies is a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules surrounded by annular fibrosis. This chronic progressive clinical condition, leads to liver cell failure and portal hypertension, which can favour the onset of hepatocellular carcinoma. Defining the phase of the natural history is crucial for therapeutic choice and prognosis. Liver biopsy is currently considered the best available standard of reference but it has some limits, so alternative tools have been developed to substitute liver biopsy when assessing liver fibrosis. Serum markers offer a cost-effective alternative to liver biopsy being less invasive and theoretically without complications. They can be classified into direct and indirect markers which may be used alone or in combination to produce composite scores. Diagnostic imaging includes a number of instruments and techniques to estimate liver fibrosis and cirrhosis like ultrasound (US), US Doppler, contrast enhanced US and Elastography. US could be used for the diagnosis of advanced LC while is not able to evaluate progression of fibrosis, in this case Elastography is more reliable. This review aims to revise the most recent data from the literature about non invasive methods useful in defining liver fibrosis.

  14. De Novo Superinfection of Hepatitis B Virus in an Anti-HBs Positive Patient with Recurrent Hepatitis C Following Liver Transplantation.

    PubMed

    Ha, Sung-Hae; Park, Young-Min; Hong, Sun-Pyo; Back, So-Ya; Shin, Soo-Kyeong; Ji, Seung-Il; Kim, Soo-Ok; Yoo, Wang-Don; Kim, Bo-Hyun; Park, Sang-Jong; Hong, Zheng

    2011-06-01

    A 60-year-old woman with end stage liver cirrhosis caused by genotype 2 hepatitis C virus (HCV) infection received an orthotopic liver transplantation (OLT). The patient was negative for the hepatitis B surface antigen (HBsAg) and positive for the anti-hepatitis B surface antibody (anti-HBs) prior to and one and a half months following the OLT. Due to reactivation of hepatitis C, treatment with interferon-alpha and Ribavirin started two months following the OLT and resulted in a sustained virological response. We performed a liver biopsy because a biochemical response was not achieved. Surprisingly, liver pathology showed HBsAg-positive hepatocytes with a lobular hepatitis feature, which had been negative in the liver biopsy specimen obtained one and a half months post-OLT. High titers of both HBsAg and HBeAg were detected, while anti-HBs antibodies were not found. Tests for IgM anti-hepatitis B core antibody and anti-delta virus antibodies were negative. The serum HBV DNA titer was over 1×10(7) copies/mL. A sequencing analysis showed no mutation in the "a" determinant region, but revealed a mixture of wild and mutant strains at an overlapping region of the S and P genes (S codon 213 (Leu/Ile); P codons 221 (Phe/Tyr) and 222 (Ala/Thr)). These findings suggest that de novo hepatitis B can develop in patients with HCV infection during the post-OLT period despite the presence of protective anti-HBs.

  15. Diagnosis of Primary Cancer of the Liver

    PubMed Central

    Kew, M. C.; Dos Santos, H. A.; Sherlock, Sheila

    1971-01-01

    The diagnosis of primary cancer of the liver was reviewed in 75 patients. A definitive diagnosis was made during life in 63% and in a further 20% this condition was suspected though histological confirmation was obtained only at necropsy. The most common presenting complaints were abdominal pain and weight loss and the most frequent findings hepatomegaly and ascites. Less than one-half of the patients were jaundiced and when present it was usually mild. An arterial bruit was heard over the liver in 25% of the patients. A sudden and unexplained deterioration in a patient known to have cirrhosis or haemochromatosis should raise the possibility of a primary hepatic tumour; this occurred in 24% of our patients. Alpha-fetoprotein was found in the serum of 11 out of 18 cases. The presence of a mass in the liver was frequently confirmed by liver scan, portal venography, or hepatic arteriography, but these showed no features diagnostic of a primary tumour. Liver scan also proved useful in localizing the lesion for biopsy purposes. Definitive diagnosis is dependent on the histological demonstration of the features of the tumour. This can frequently be achieved by percutaneous needle biopsy, which was positive in 38 out of 57 patients. Wedge biopsies were positive in a further nine patients. PMID:5124443

  16. From testicular biopsy to human embryo.

    PubMed

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

    2004-01-01

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

  17. Semi-invasive and invasive procedures for the diagnosis and staging of lung cancer. I. Percutaneous transthoracic needle biopsy.

    PubMed

    Shaham, D

    2000-05-01

    PTNB is a well-established technique for the diagnosis of lung cancer. In recent years, CT guidance has become the primary imaging modality, replacing fluoroscopy guided biopsies in many institutions. CT fluoroscopy, which is currently not universally available, offers promising advantages and may permit accurate and rapid procedures. A recent innovation in biopsy needles has been the introduction of automatic core biopsy needle devices that yield large specimens and improve the diagnostic accuracy of needle biopsy, particularly in benign lesions. PTNB is one of several methods available for tissue diagnosis of suspected lung cancer. The decision as to which method to use should be tailored to each patient, and is preferably reached by a team consisting of pulmonary physicians, chest surgeons, oncologists, cytologists, and radiologists.

  18. 10 CFR 26.135 - Split specimens.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Split specimens. 26.135 Section 26.135 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.135 Split specimens. (a) If the FFD program follows split-specimen procedures, as described in § 26.113, the licensee...

  19. 10 CFR 26.135 - Split specimens.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Split specimens. 26.135 Section 26.135 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.135 Split specimens. (a) If the FFD program follows split-specimen procedures, as described in § 26.113, the licensee...

  20. 10 CFR 26.135 - Split specimens.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Split specimens. 26.135 Section 26.135 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.135 Split specimens. (a) If the FFD program follows split-specimen procedures, as described in § 26.113, the licensee...

  1. 10 CFR 26.135 - Split specimens.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Split specimens. 26.135 Section 26.135 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.135 Split specimens. (a) If the FFD program follows split-specimen procedures, as described in § 26.113, the licensee...

  2. 10 CFR 26.135 - Split specimens.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Split specimens. 26.135 Section 26.135 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.135 Split specimens. (a) If the FFD program follows split-specimen procedures, as described in § 26.113, the licensee...

  3. Lobular neoplasia diagnosed on breast Core biopsy: frequency of carcinoma on excision and implications for management.

    PubMed

    Calhoun, Benjamin C; Collie, Angela M B; Lott-Limbach, Abberly A; Udoji, Esther N; Sieck, Leah R; Booth, Christine N; Downs-Kelly, Erinn

    2016-12-01

    The appropriate follow-up and treatment for patients with a core biopsy diagnosis of lobular neoplasia (atypical lobular hyperplasia or lobular carcinoma in situ) remains controversial. Several studies have attempted to address this issue, with recommendations ranging from close clinical follow-up or surveillance to mandatory surgical excision in all cases. We report the findings at our institution, where virtually every core needle biopsy diagnosis of lobular neoplasia results in follow-up excision. The goal of the study was to identify potential predictors of upgrade to a more significant lesion. We identified 76 patients over a 15-year period with a core biopsy diagnosis of pure lobular neoplasia and no other high-risk lesions. Subsequent surgical excision identified 10 cases (13%) that were upgraded to carcinoma. Upgrade diagnoses included invasive ductal carcinoma (n=1), invasive lobular carcinoma (n=4), ductal carcinoma in situ (n=3), and pleomorphic lobular carcinoma in situ (n=2). All 10 upgraded cases had imaging findings suspicious for malignancy including irregular masses, asymmetric densities, or pleomorphic calcifications. Of the 10 upgraded cases, 7 were diagnosed as lobular carcinoma in situ on core biopsy. The data support a role for radiologic-pathologic correlation in the evaluation of suspicious breast lesions and suggest that the extent of lobular neoplasia in core biopsy specimens may be an indicator of the likelihood of upgrade to carcinoma.

  4. Phase-contrast x-ray computed tomography for observing biological specimens and organic materials

    NASA Astrophysics Data System (ADS)

    Momose, Atsushi; Takeda, Tohoru; Itai, Yuji

    1995-02-01

    A novel three-dimensional x-ray imaging method has been developed by combining a phase-contrast x-ray imaging technique with x-ray computed tomography. This phase-contrast x-ray computed tomography (PCX-CT) provides sectional images of organic specimens that would produce absorption-contrast x-ray CT images with little contrast. Comparing PCX-CT images of rat cerebellum and cancerous rabbit liver specimens with corresponding absorption-contrast CT images shows that PCX-CT is much more sensitive to the internal structure of organic specimens.

  5. Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions

    PubMed Central

    Zaric, Bojan; Stojsic, Vladimir; Carapic, Vladimir; Kovacevic, Tomi; Stojanovic, Goran; Panjkovic, Milana; Kioumis, Ioannis; Darwiche, Kaid; Zarogoulidis, Konstantinos; Stratakos, Grigoris; Tsavlis, Drosos; Hohenforst-Schmidt, Wolfgang; Pitsiou, Georgia; Zissimopoulos, Athanasios; Sachpekidis, Nikos; Karapantzos, Ilias; Karapantzou, Chrysanthi; Zarogoulidis, Paul; Perin, Branislav

    2016-01-01

    Background: EBUS guided trans-bronchial biopsy became routine in diagnosis of peripheral pulmonary lesions (PPL). Suction catheter-biopsy is a technique for obtaining a tissue sample from peripheral lung parenchyma. Aim of this study was to evaluate diagnostic efficiency, feasibility and safety of EBUS guided suction catheter-biopsy (SCB) in comparison to trans-bronchial biopsy (TBB) in diagnosis of PPL. The main intention was to demonstrate non-inferiority of the technique over trans-bronchial biopsy, especially when used under navigation of the EBUS. Methods: Radial EBUS probe (UM-3R, Olympus Co, Japan.) without guiding sheath was used to navigate suction catheter and TBB forceps to the PPL. The catheter was connected to the collection canister via vacuum pump. The SCB specimens were fixed with 10% buffered formalin. Results: There were 168 patients enrolled in this study; 69.9% males and 30.1% females. Main lesion diameter was 4.1±1.9 cm. Majority of patients, 131(77.9%) were diagnosed with lung cancer. Per-biopsy calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for EBUS-SCB were 92.4%, 100%, 100% and 67.7%, respectively. Corresponding values for EBUS-TBB were 92.3%, 100%, 100% and 69.7%. Only the size of the lesion significantly influenced (p=0.005) diagnostic performance. Complications occurred in 2 patients; one pneumothorax and one excessive bleeding. Conclusion: EBUS guided SCB is efficient, feasible and safe in diagnosis of peripheral lung cancer. The technique is complementary to trans-bronchial biopsy. PMID:26722354

  6. Spectrum of intra-thoracic lesion detected by computed tomography guided fine needle aspiration biopsy

    PubMed Central

    2013-01-01

    Background Fine needle aspiration biopsy (FNAB) is a rapid, sensitive and inexpensive procedure for diagnosing benign and malignant palpable lesions. For lesions that are not palpable or deep seated, FNAB can be performed under the guidance of radiological imaging. Our basic objective was to evaluate the spectrum of intrathoracic lesions by using Computed Tomography guided fine needle aspiration biopsy and evaluate its diagnostic yield. Methodology It was a retrospective study carried out in the Department of Histopathology, Liaquat National Hospital and Medical College, during the months of August 2011 and August 2012. All patients with pulmonary, mediastinal or paravertebral mass who underwent CT guided intrathoracic biopsy were included in this study. Fine needle aspiration biopsies were performed in the Radiology Department and specimen retrieved was sent in 10% buffered Formalin to the Histopathology Department. All the data was entered and analyzed through SPSS 19.0. Results A total of 130 cases were evaluated, out of which 108 (83.1%) were pulmonary, 16 (12.3%) were mediastinal and 6 (4.6%) were paravertebral. Conclusive biopsies were possible in 113 cases, while 17 biopsies were inconclusive. In those that showed a conclusive diagnosis, 83.1% were neoplastic and 16.9% were non neoplastic. Of the neoplastic cases, 27 (20.8%) were adenocarcinomas, followed by squamous cell carcinomas (15.4%) and large cell carcinoma, not otherwise specified, (12.3%). Conclusion CT guided fine needle aspiration biopsy is a reliable tool for examination of intrathoracic lesions, with a high rate of conclusive diagnosis. PMID:23402220

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

    PubMed Central

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

    2016-01-01

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

  8. Apoptosis in Endomyocardial Biopsies from Patients with Dilated Cardiomyopathy.

    PubMed

    Glumac, S; Pejić, S; Kostadinovic, S; Stojšić, Z; Vasiljevic, J

    2016-01-01

    Apoptosis is an active energy-consuming mechanism of cell death, which may contribute to heart failure in patients with dilated cardiomyopathy. Dilated cardiomyopathy is a common clinical outcome of many prolonged cardiac insults, and therefore is considered as the most prevalent form of cardiomyopathy. Loss of heart mass is highly correlated with the heart failure and mortality, thus the purpose of this study was to define the apoptotic index in patients with dilated cardiomyopathy. Apoptosis was detected by the TUNEL method in 30 patients. Biopsies were obtained from the left ventricle, and at least three specimens were taken. TUNEL-positive cardiomyocytes were found in 26 of 30 cases (86.7 %) and the mean apoptotic index for the entire specimen series was 5.41 ± 1.70 %. The analysis showed that patients with dilated cardiomyopathy had significantly higher apoptotic index (P < 0.001) than healthy subjects. One subject (man, 41 years old) had a markedly elevated apoptotic index of 52.2 %. In the remaining subjects, the percentage of cardiomyocyte death ranged from 0 % to 15.5 %. The high percentage of apoptosis found in our study may be in accordance with the clinically manifested cardiac failure in patients with dilated cardiomyopathy since in most patients we recorded the left ventricular ejection fraction values below 30 %.

  9. Liver Function Tests

    MedlinePlus

    ... Your Liver > Liver Disease Information > Liver Function Tests Liver Function Tests Explore this section to learn more ... including a description and diagnosis. Why is the liver important? The liver is the second largest organ ...

  10. What Is Liver Cancer?

    MedlinePlus

    ... Treatment? Liver Cancer About Liver Cancer What Is Liver Cancer? Cancer starts when cells in the body ... structure and function of the liver. About the liver The liver is the largest internal organ. It ...

  11. Renal biopsy research in the former soviet union: prevention of a negligent custom.

    PubMed

    Jargin, Sergei V

    2013-01-01

    Insufficient international coordination of medical research and partial isolation from the international scientific community can result in repetition of research already performed in other countries. Renal biopsy was broadly used for research in the former Soviet Union. It was performed, sometimes without sufficient clinical indications, in patients with amyloidosis, renovascular hypertension (from both kidneys: on the side of the renal artery stenosis and the contralateral one), chronic alcoholism, and acute and chronic pyelonephritis (intraoperative wedge and core biopsies). In chronic alcoholism, biopsies were taken from kidneys, pancreas, salivary glands, stomach, lung, skin, and liver, sometimes repeatedly. The classification of glomerulonephritis was different from those used internationally, for example, it did not include IgA nephropathy as a separate entity. Several examples of studies based on renal biopsies are discussed in this paper. A conclusion is however optimistic: the upturn in economy enables today to modernize equipment and introduce new methods, while broadening international cooperation facilitates the flow of foreign experience into the country. The purpose of this paper was to prevent inadequate use of renal biopsy in future.

  12. Confocal Microscopy of Unfixed Breast Needle Core Biopsies: A Comparison to Fixed and Stained Sections

    PubMed Central

    2009-01-01

    Background Needle core biopsy, often in conjunction with ultrasonic or stereotactic guided techniques, is frequently used to diagnose breast carcinoma in women. Confocal scanning laser microscopy (CSLM) is a technology that provides real-time digital images of tissues with cellular resolution. This paper reports the progress in developing techniques to rapidly screen needle core breast biopsy and surgical specimens at the point of care. CSLM requires minimal tissue processing and has the potential to reduce the time from excision to diagnosis. Following imaging, specimens can still be submitted for standard histopathological preparation. Methods Needle core breast specimens from 49 patients were imaged at the time of biopsy. These lesions had been characterized under the Breast Imaging Reporting And Data System (BI-RADS) as category 3, 4 or 5. The core biopsies were imaged with the CSLM before fixation. Samples were treated with 5% citric acid and glycerin USP to enhance nuclear visibility in the reflectance confocal images. Immediately following imaging, the specimens were fixed in buffered formalin and submitted for histological processing and pathological diagnosis. CSLM images were then compared to the standard histology. Results The pathologic diagnoses by standard histology were 7 invasive ductal carcinomas, 2 invasive lobular carcinomas, 3 ductal carcinomas in-situ (CIS), 21 fibrocystic changes/proliferative conditions, 9 fibroadenomas, and 5 other/benign; two were excluded due to imaging difficulties. Morphologic and cellular features of benign and cancerous lesions were identified in the confocal images and were comparable to standard histologic sections of the same tissue. Conclusion CSLM is a technique with the potential to screen needle core biopsy specimens in real-time. The confocal images contained sufficient information to identify stromal reactions such as fibrosis and cellular proliferations such as intra-ductal and infiltrating carcinoma, and

  13. Cirrhosis and autoimmune liver disease: Current understanding

    PubMed Central

    Liberal, Rodrigo; Grant, Charlotte R

    2016-01-01

    Primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) constitute the classic autoimmune liver diseases (AILDs). While AIH target the hepatocytes, in PBC and PSC the targets of the autoimmune attack are the biliary epithelial cells. Persistent liver injury, associated with chronic AILD, leads to un-resolving inflammation, cell proliferation and the deposition of extracellular matrix proteins by hepatic stellate cells and portal myofibroblasts. Liver cirrhosis, and the resultant loss of normal liver function, inevitably ensues. Patients with cirrhosis have higher risks or morbidity and mortality, and that in the decompensated phase, complications of portal hypertension and/or liver dysfunction lead to rapid deterioration. Accurate diagnosis and monitoring of cirrhosis is, therefore of upmost importance. Liver biopsy is currently the gold standard technique, but highly promising non-invasive methodology is under development. Liver transplantation (LT) is an effective therapeutic option for the management of end-stage liver disease secondary to AIH, PBC and PSC. LT is indicated for AILD patients who have progressed to end-stage chronic liver disease or developed intractable symptoms or hepatic malignancy; in addition, LT may also be indicated for patients presenting with acute liver disease due to AIH who do not respond to steroids. PMID:27729952

  14. The influence of tissue procurement procedures on RNA integrity, gene expression, and morphology in porcine and human liver tissue.

    PubMed

    Kap, Marcel; Sieuwerts, Anieta M; Kubista, Mikael; Oomen, Monique; Arshad, Shazia; Riegman, Peter

    2015-06-01

    The advent of molecular characterization of tissues has brought an increasing emphasis on the quality of biospecimens, starting with the tissue procurement process. RNA levels are particularly affected by factors in the collection process, but the influence of different pre-analytical factors is not well understood. Here we present the influence of tissue specimen size, as well as the transport and freezing protocols, on RNA quality. Large, medium, and smaller porcine liver samples were stored either dry, on moist gauze, or in salt solution for various times, and then frozen in either liquid nitrogen or in pre-cooled isopentane. Large and small human liver samples were frozen in pre-cooled isopentane either immediately or after one hour at room temperature. The small samples were stored dry, on moist gauze, or in salt solution. RNA was isolated and RIN values were measured. The RNA for six standard reference genes from human liver was analyzed by RT-qPCR, and tissue morphology was assessed for artifacts of freezing. Experiments using porcine liver samples showed that RNA derived from smaller samples was more degraded after one hour of cold ischemia, and that cooled transport is preferable. Human liver samples showed significant RNA degradation after 1 h of cold ischemia, which was more pronounced in smaller samples. RNA integrity was not significantly influenced by the transport or freezing method, but changes in gene expression were observed in samples either transported on gauze or in salt solution. Based on observations in liver samples, smaller samples are more subject to gene expression variability introduced by post-excision sample handling than are larger samples. Small biopsies should be transported on ice and snap frozen as soon as possible after acquisition from the patient.

  15. Disappearance of GFP-Positive Hepatocytes Transplanted into the Liver of Syngeneic Wild-Type Rats Pretreated with Retrorsine

    PubMed Central

    Maeda, Hiromichi; Shigoka, Masatoshi; Wang, Yongchun; Fu, Yingxin; Wesson, Russell N.; Lin, Qing; Montgomery, Robert A.; Enzan, Hideaki; Sun, Zhaoli

    2014-01-01

    Background and Aim Green fluorescent protein (GFP) is a widely used molecular tag to trace transplanted cells in rodent liver injury models. The differing results from various previously reported studies using GFP could be attributed to the immunogenicity of GFP. Methods Hepatocytes were obtained from GFP-expressing transgenic (Tg) Lewis rats and were transplanted into the livers of wild-type Lewis rats after they had undergone a partial hepatectomy. The proliferation of endogenous hepatocytes in recipient rats was inhibited by pretreatment with retrorsine to enhance the proliferation of the transplanted hepatocytes. Transplantation of wild-type hepatocytes into GFP-Tg rat liver was also performed for comparison. Results All biopsy specimens taken seven days after transplantation showed engraftment of transplanted hepatocytes, with the numbers of transplanted hepatocytes increasing until day 14. GFP-positive hepatocytes in wild-type rat livers were decreased by day 28 and could not be detected on day 42, whereas the number of wild-type hepatocytes steadily increased in GFP-Tg rat liver. Histological examination showed degenerative change of GFP-positive hepatocytes and the accumulation of infiltrating cells on day 28. PCR analysis for the GFP transgene suggested that transplanted hepatocytes were eliminated rather than being retained along with the loss of GFP expression. Both modification of the immunological response using tacrolimus and bone marrow transplantation prolonged the survival of GFP-positive hepatocytes. In contrast, host immunization with GFP-positive hepatocytes led to complete loss of GFP-positive hepatocytes by day 14. Conclusion GFP-positive hepatocytes isolated from GFP-Tg Lewis rats did not survive long term in the livers of retrorsine-pretreated wild-type Lewis rats. The mechanism underlying this phenomenon most likely involves an immunological reaction against GFP. The influence of GFP immunogenicity on cell transplantation models should be

  16. Autoantibodies and liver disease: uses and abuses.

    PubMed

    Zeman, Marilyn V; Hirschfield, Gideon M

    2010-04-01

    Confirming whether a patient has autoimmune liver disease is challenging, given its varied presentation and complex definitions. In the continued absence of pathognomonic serum markers, diagnosis requires evaluation of laboratory investigations and, frequently, a liver biopsy - all of which need to be interpreted in the correct clinical context, with an emphasis on exclusion of viral infections, drug toxicity and metabolic disease. However, clear diagnosis is important for appropriate and timely therapy. Autoantibodies remain important tools for clinicians, and were the first proposed serological markers to aid in differentiating viral from chronic autoimmune hepatitis. Their presence is occasionally considered to be synonymous with autoimmune liver disease - a misinterpretation of their clinical significance. The present article summarizes the serum autoantibodies currently investigated in clinical and research practice, along with a description of their value in adult chronic liver diseases, with an emphasis on their appropriate use in the diagnosis and management of patients with autoimmune liver disease.

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

    PubMed Central

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

    2016-01-01

    Aim. The aim of this study is to evaluate whether leaving the biopsy needle used during prostate needle biopsy in 10% povidone-iodine (betadine) solution affects the infectious complications forming after biopsy. Material and Method. This study retrospectively evaluated the data of 176 patients with prostate biopsy performed between December 2012 and April 2014. Patients in Group 1 (n = 89) were given ofloxacin as a prophylactic antibiotic before biopsy. Patients in Group 2 (n = 87) had the biopsy needle left in povidone-iodine solution for 1 minute before each use, in addition to antibiotic prophylaxis. The two groups were compared in terms of infective complications developing after biopsy. Results were analyzed using the Mann–Whitney U test and Fisher's exact test. Results. The distribution of infective complications after biopsy according to group was as follows. Group 1, not using betadine, had 15.7% fever, 13.5% hospital stay, 12.4% urinary retention, 10.1% prostatitis, and 5.6% sepsis. The distribution of the same complications in Group 2 using betadine was identified as 5.7% fever, 4.6% hospital stay, 3.4% urinary retention, 2.3% prostatitis, and 0% sepsis. The use of betadine was found to significantly reduce the infectious complications after biopsy compared to the control group (p < 0.05). Conclusion. At the end of this study leaving the prostate needle in povidone-iodine solution before each use during prostate biopsy was found to reduce the infective complications and hospital stay after biopsy. PMID:28096812

  18. Liver Transplant

    MedlinePlus

    ... History Research Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  19. Usefulness of liver stiffness measurement during acute cellular rejection in liver transplantation.

    PubMed

    Crespo, Gonzalo; Castro-Narro, Graciela; García-Juárez, Ignacio; Benítez, Carlos; Ruiz, Pablo; Sastre, Lydia; Colmenero, Jordi; Miquel, Rosa; Sánchez-Fueyo, Alberto; Forns, Xavier; Navasa, Miquel

    2016-03-01

    Liver stiffness measurement (LSM) is a useful method to estimate liver fibrosis and portal hypertension. The inflammatory process that takes place in post-liver transplant acute cellular rejection (ACR) may also increase liver stiffness. We aimed to explore the association between liver stiffness and the severity of ACR, as well as to assess the relationship between liver stiffness and response to rejection treatment in a prospective study that included 27 liver recipients with biopsy-proven ACR, 30 stable recipients with normal liver tests, and 30 hepatitis C virus (HCV)-infected LT recipients with histologically diagnosed HCV recurrence. Patients with rejection were stratified into 2 groups (mild and moderate/severe) according to the severity of rejection evaluated with the Banff score. Routine biomarkers and LSM with FibroScan were performed at the time of liver biopsy (baseline) and at 7, 30, and 90 days in patients with rejection and at baseline in control patients. Median baseline liver stiffness was 5.9 kPa in the mild rejection group, 11 kPa in the moderate/severe group (P = 0.001), 4.2 kPa in stable recipients (P = 0.02 versus mild rejection), and 13.6 kPa in patients with recurrent HCV (P = 0.17 versus moderate/severe rejection). The area under the receiver operator characteristic curve of LSM to discriminate mild versus moderate/severe ACR was 0.924, and a LSM value of 8.5 kPa yielded a positive predictive value of 100% to diagnose moderate/severe rejection. Liver stiffness improved in 7%, 21%, and 64% of patients with moderate/severe rejection at 7, 30, and 90 days. In conclusion, according to the results of this exploratory study, LSM is associated with the severity of ACR in liver transplantation and thus may be of help in its assessment.

  20. Open rib biopsy guided by radionuclide technique

    SciTech Connect

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

    1984-07-01

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

  1. Non-alcoholic fatty liver disease in 2015

    PubMed Central

    Ahmed, Monjur

    2015-01-01

    There is worldwide epidemic of non-alcoholic fatty liver disease (NAFLD). NAFLD is a clinical entity related to metabolic syndrome. Majority of the patients are obese but the disease can affect non-obese individuals as well. Metabolic factors and genetics play important roles in the pathogenesis of this disorder. The spectrum of disorders included in NAFLD are benign macrovesicular hepatic steatosis, non-alcoholic steatohepatitis, hepatic fibrosis, cirrhosis of liver and hepatocellular carcinoma. Although the disease remains asymptomatic most of the time, it can slowly progress to end stage liver disease. It will be the most common indication of liver transplantation in the future. It is diagnosed by abnormal liver chemistry, imaging studies and liver biopsy. As there are risks of potential complications during liver biopsy, many patients do not opt for liver biopsy. There are some noninvasive scoring systems to find out whether patients have advanced hepatic fibrosis. At the present time, there are limited treatment options which include lifestyle modification to loose weight, vitamin E and thioglitazones. Different therapeutic agents are being investigated for optimal management of this entity. There are some studies done on incretin based therapies in patients with NAFLD. Other potential agents will be silent information regulator protein Sirtuin and antifibrotic monoclonal antibody Simtuzumab against lysyl oxidase like molecule 2. But they are still in the investigational phase. PMID:26085906

  2. Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl4-induced liver fibrosis

    PubMed Central

    Wang, Ming-Jun; Ling, Wen-Wu; Wang, Hong; Meng, Ling-Wei; Cai, He; Peng, Bing

    2016-01-01

    AIM To investigate the diagnostic performance of liver stiffness measurement (LSM) by elastography point quantification (ElastPQ) in animal models and determine the longitudinal changes in liver stiffness by ElastPQ after splenectomy at different stages of fibrosis. METHODS Liver stiffness was measured in sixty-eight rabbits with CCl4-induced liver fibrosis at different stages and eight healthy control rabbits by ElastPQ. Liver biopsies and blood samples were obtained at scheduled time points to assess liver function and degree of fibrosis. Thirty-one rabbits with complete data that underwent splenectomy at different stages of liver fibrosis were then included for dynamic monitoring of changes in liver stiffness by ElastPQ and liver function according to blood tests. RESULTS LSM by ElastPQ was significantly correlated with histologic fibrosis stage (r = 0.85, P < 0.001). The optimal cutoff values by ElastPQ were 11.27, 14.89, and 18.21 kPa for predicting minimal fibrosis, moderate fibrosis, and cirrhosis, respectively. Longitudinal monitoring of the changes in liver stiffness by ElastPQ showed that early splenectomy (especially F1) may delay liver fibrosis progression. CONCLUSION ElastPQ is an available, convenient, objective and non-invasive technique for assessing liver stiffness in rabbits with CCl4-induced liver fibrosis. In addition, liver stiffness measurements using ElastPQ can dynamically monitor the changes in liver stiffness in rabbit models, and in patients, after splenectomy. PMID:28028365

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

    SciTech Connect

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

    2009-09-15

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

  4. [The German Environmental Specimen Bank].

    PubMed

    Schröter-Kermani, Christa; Gies, Andreas; Kolossa-Gehring, Marike

    2016-03-01

    The main objective of the German Environmental Specimen Bank (ESB) is the long-term storage of environmental and human samples under stable deep-freeze conditions for future research. The ESB is unique in providing a continuous historical record of environmental and human exposure to chemicals in Germany. ESB was started parallel to the development of the first German Chemicals Legislation in the late 1970s. In 1979, the ESB test operation began. After the Chemicals Law came into force in 1982, the ESB was established as a permanent facility in 1985. With the new European Chemicals Legislation, REACH, in 2007 responsibility for the safety of commercial chemicals and risk assessment was assigned to the industry. Since then, the ESB has become even more important in verifying the self-assessment of the industry, in evaluating the effectiveness of regulations, thus ensuring the protection of humans and the environment against adverse effects caused by exposure to chemicals. These objectives are pursued by the regular monitoring of contaminations and the assessment of temporal trends. Demonstrating the necessity of deriving exposure reduction measures, ESB results serve as key information for policy-makers. Information on preventing exposure to chemicals is available to the general public and to the public health services. The ESB is thus an important monitoring instrument of the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety. The Federal Environment Agency operates the ESB based on its own concepts, heads the scientific data evaluation and transfers results into the environmental policy arena and to the general public.

  5. Uncommon liver tumors

    PubMed Central

    Wu, Chia-Hung; Chiu, Nai-Chi; Yeh, Yi-Chen; Kuo, Yu; Yu, Sz-Shian; Weng, Ching-Yao; Liu, Chien-An; Chou, Yi-Hong; Chiou, Yi-You

    2016-01-01

    Abstract Background: Beside hepatocellular carcinoma, metastasis, and cholangiocarcinoma, the imaging findings of other relatively uncommon hepatic lesions are less discussed in the literature. Imaging diagnosis of these lesions is a daily challenge. In this article, we review the imaging characteristics of these neoplasms. Methods: From January 2003 to December 2014, 4746 patients underwent liver biopsy or hepatic surgical resection in our hospital. We reviewed the pathological database retrospectively. Imaging of these lesions was reviewed. Results: Imaging findings of uncommon hepatic lesions vary. We discuss the typical imaging characteristics with literature review. Clinical and pathological correlations are also described. Primary hepatic lymphoma consists only of 1% of the extranodal non-Hodgkin lymphoma, and is defined as the one involving only the liver and perihepatic lymph nodes within 6 months after diagnosis. Combined hepatocellular and cholangiocarcinoma (cHCC-CC) shares some overlapping imaging characteristics with both HCC and cholangiocarcinoma because of being an admixture of them. Angiosarcoma is the most common hepatic mesenchymal tumor and is hypervascular in nature. Inflammatory pseudotumor is often heterogeneous on ultrasonography and with enhanced septations and rims in the portovenous phase after contrast medium. Angiomyolipoma (AML) typically presents with macroscopic fat components with low signal on fat-saturated magnetic resonance imaging (MRI) and presence of drainage vessels. Intraductal papillary neoplasm of the bile duct (IPNB) is thought of as a counterpart to the pancreatic intraductal papillary mucinous neoplasm. Most of the IPNBs secrete mucin and cause disproportional dilatation of the bile ducts. Mucinous cystic neoplasm (MCN) contains proteinaceous and colloidal components without ductal communication and characterizes with hyperintensity on T1-weighted imaging. Other extremely rare lesions, including epithelioid

  6. Clinical observation of salvianolic acid B in treatment of liver fibrosis in chronic hepatitis B

    PubMed Central

    Liu, Ping; Hu, Yi-Yang; Liu, Cheng; Zhu, Da-Yuan; Xue, Hui-Ming; Xu, Zhi-Qiang; Xu, Lie- Ming; Liu, Cheng-Hai; Gu, Hong-Tu; Zhang, Zhi-Qing

    2002-01-01

    AIM: To evaluate the clinical efficacy of salvianolic acid B (SA-B) on liver fibrosis in chronic hepatitis B. METHODS: Sixty patients with definite diagnosis of liver fibrosis with hepatitis B were included in the trial. Interferon-γ (IFN-γ) was used as control drug. The patients took orally SA-B tablets or received muscular injection of IFN-γ in the double blind randomized test. The complete course lasted 6 mo. The histological changes of liver biopsy specimen before and after the treatment were the main evidence in evaluation, in combination with the results of contents of serum HA, LN, IV-C, P-III-P, liver ultrasound imaging, and symptoms and signs. RESULTS: Reverse rate of fibrotic stage was 36.67% in SA-B group and 30.0% in IFN-γ group. Inflammatory alleviating rate was 40.0% in SA-B group and 36.67% in IFN-γ group. The average content of HA and IV-C was significantly lower than that before treatment. The abnormal rate also decreased remarkably. Overall analysis of 4 serological fibrotic markers showed significant improvement in SA-B group as compared with the IFN-γ group. Score of liver ultrasound imaging was lower in SA-B group than in IFN-γ group (HA 36.7% vs 80%, IV-C 3.3% vs 23.2%). Before the treatment, ALT AST activity and total bilirubin content of patients who had regression of fibrosis after oral administration of SA-B, were significantly lower than those of patients who had aggravation of fibrosis after oral administration of SA-B. IFN-γ showed certain side effects (fever and transient decrease of leukocytes, occurrence rates were 50% and 3.23%), but SA-B showed no side effects. CONCLUSION: SA-B could effectively reverse liver fibrosis in chronic hepatitis B. SA-B was better than IFN-γ in reduction of serum HA content, overall decrease of 4 serum fibrotic markers, and decrease of ultrasound imaging score. Liver fibrosis in chronic hepatitis B with slight liver injury was more suitable to SA-B in anti-fibrotic treatment. SA-B showed no

  7. Muscle biopsy findings in inflammatory myopathies.

    PubMed

    Dalakas, Marinos C

    2002-11-01

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

  8. Complications of the percutaneous kidney biopsy.

    PubMed

    Whittier, William L

    2012-05-01

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

  9. Surgery and sentinel lymph node biopsy.

    PubMed

    Faries, Mark B; Morton, Donald L

    2007-12-01

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

  10. Fully automated screening of immunocytochemically stained specimens for early cancer detection

    NASA Astrophysics Data System (ADS)

    Bell, André A.; Schneider, Timna E.; Müller-Frank, Dirk A. C.; Meyer-Ebrecht, Dietrich; Böcking, Alfred; Aach, Til

    2007-03-01

    Cytopathological cancer diagnoses can be obtained less invasive than histopathological investigations. Cells containing specimens can be obtained without pain or discomfort, bloody biopsies are avoided, and the diagnosis can, in some cases, even be made earlier. Since no tissue biopsies are necessary these methods can also be used in screening applications, e.g., for cervical cancer. Among the cytopathological methods a diagnosis based on the analysis of the amount of DNA in individual cells achieves high sensitivity and specificity. Yet this analysis is time consuming, which is prohibitive for a screening application. Hence, it will be advantageous to retain, by a preceding selection step, only a subset of suspicious specimens. This can be achieved using highly sensitive immunocytochemical markers like p16 ink4a for preselection of suspicious cells and specimens. We present a method to fully automatically acquire images at distinct positions at cytological specimens using a conventional computer controlled microscope and an autofocus algorithm. Based on the thus obtained images we automatically detect p16 ink4a-positive objects. This detection in turn is based on an analysis of the color distribution of the p16 ink4a marker in the Lab-colorspace. A Gaussian-mixture-model is used to describe this distribution and the method described in this paper so far achieves a sensitivity of up to 90%.

  11. Using polarization-sensitive optical coherence tomography to identify tumor stromal fibrosis and increase tumor biopsy yield (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Hariri, Lida P.; Adams, David C.; Miller, Alyssa J.; Mino-Kenudson, Mari; Suter, Melissa J.

    2016-03-01

    Tissue biopsy is the principal method used to diagnose tumors in a variety of organ systems. It is essential to maximize tumor yield in biopsy specimens for both clinical diagnostic and research purposes. This is particularly important in tumors where additional tissue is needed for molecular analysis to identify patients who would benefit from mutation-specific targeted therapy, such as in lung carcinomas. Inadvertent sampling of fibrotic stroma within tumor nodules contaminates biopsies, decreases tumor yield, and can impede diagnosis. The ability to assess tumor composition and guide biopsy site selection in real time is likely to improve diagnostic yield. Polarization sensitive OCT (PS-OCT) measures birefringence in organized tissues, such as collagen, and could be used to distinguish tumor from fibrosis. In this study, PS-OCT was obtained in 65 lung nodule samples from surgical resection specimens containing varying ratios of tumor and fibrosis. PS-OCT was obtained with either a custom-built helical scanning catheter (0.8 or 1.6mm in diameter) or a dual-axis bench top scanner. Strong birefringence was observed in nodules containing dense fibrosis, with no birefringence in adjacent regions of tumor. Tumors admixed with early, loosely-organized collagen demonstrated mild-to-moderate birefringence, and tumors with little collagen content showed little to no birefringent signal. PS-OCT provides significant insights into tumor nodule composition, and has potential to differentiate tumor from stromal fibrosis during biopsy site selection to increase diagnostic tumor yield.

  12. Pathological Assessment of Rectal Cancer after Neoadjuvant Chemoradiotherapy: Distribution of Residual Cancer Cells and Accuracy of Biopsy

    PubMed Central

    Xiao, Lin; Yu, Xin; Deng, Wenjing; Feng, Huixia; Chang, Hui; Xiao, Weiwei; Zhang, Huizhong; Xi, Shaoyan; Liu, Mengzhong; Zhu, Yujia; Gao, Yuanhong

    2016-01-01

    We investigated the distribution of residual cancer cells (RCCs) within different layers of the bowel wall in surgical specimens and the value of biopsies of primary rectal lesion after preoperative volumetric modulated arc therapy (VMAT) with concurrent chemotherapy in patients with rectal cancer. Between April 2011 and April 2013, 178 patients with rectal cancer who received preoperative VMAT, concurrent chemotherapy, and surgery were evaluated; 79 of the patients received a biopsy of the primary lesion after chemoradiotherapy and prior to surgery. The distribution of RCCs in the surgical specimens and the sensitivity and specificity of the biopsy of primary rectal lesions for pathological response were evaluated. Fifty-two patients had a complete pathological response in the bowel wall. Of the 120 patients with ypT2-4, the rate of detection of RCCs in the mucosa, submucosa, and muscularis propria was 20%, 36.7%, 69.2%, respectively. The sensitivity and specificity of biopsies of primary rectal lesions was 12.9% and 94.1%, respectively. After chemoradiotherapy, the RCCs were primarily located in the deeper layers of the bowel wall, and the biopsy results for primary rectal lesions were unreliable due to poor sensitivity. PMID:27721486

  13. Periportal CD4+ cell infiltration increases in HIV/hepatitis C virus-coinfected patients commencing ART, whereas CD8+ cells clear from the liver.

    PubMed

    Gani, Rino A; Yunihastuti, Evy; Krisnuhoni, Ening; Saraswati, Henny; Djauzi, Sjamsurizal; Lesmana, Laurentius A; Lee, Silvia; Price, Patricia

    2014-08-01

    Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is common in Asia, but the effects of antiretroviral therapy (ART) are unclear. Histopathological changes in the liver are described in a prospective study of HCV-seropositive HIV-infected patients at Cipto Mangunkusomo Hospital (Jakarta, Indonesia). Liver biopsy specimens were collected at baseline (n = 48) and 48 weeks (n = 34). Ishak scores showed mild but detectable inflammation and/or fibrosis. Levels of portal inflammation declined during ART (P = .03), whereas fibrosis remained (P = .11). Portal infiltration of CD4(+) cells increased during ART (P < .0001), whereas infiltration of CD8(+) cells subsided. Numbers of CD4(+) cells in the liver at baseline correlated with circulating CD4(+) T-cell counts (P = .03-.05). Numbers of liver-infiltrating CD4(+) and CD8(+) cells at baseline were not associates with subsequent experience of an immune restoration disease, which is defined by a rise in alanine transaminase levels during ART.

  14. Liver spots

    MedlinePlus

    Sun-induced skin changes - liver spots; Senile or solar lentigines; Skin spots - aging; Age spots ... Liver spots are changes in skin color that occur in older skin. The coloring may be due to aging, exposure to the sun or other sources of ...

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

    SciTech Connect

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

    2007-07-15

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

  16. Clinical Neuropathology practice guide 3-2014: Combined nerve and muscle biopsy in the diagnostic work-up of neuropathy – the Bordeaux experience

    PubMed Central

    Vital, Anne; Vital, Claude

    2014-01-01

    Simultaneous combined superficial peroneal nerve and peroneous brevis muscle biopsy, via the same cutaneous incision, allows examination of several tissue specimens and significantly improves the diagnosis of systemic diseases with peripheral nerve involvement. Vasculitides are certainly the most frequently diagnosed on neuro-muscular biopsies, but this procedure is also well advised to asses a diagnosis of sarcoidosis or amyloidosis. More occasionally, combined nerve and muscle biopsy may reveal an unpredicted diagnosis of cholesterol embolism, intra-vascular lymphoma, or enables complementary diagnosis investigations on mitochondrial cytopathy or storage disease. PMID:24618073

  17. Flat tensile specimen design for advanced composites

    NASA Technical Reports Server (NTRS)

    Worthem, Dennis W.

    1990-01-01

    Finite element analyses of flat, reduced gage section tensile specimens with various transition region contours were performed. Within dimensional constraints, such as maximum length, tab region width, gage width, gage length, and minimum tab length, a transition contour radius of 41.9 cm produced the lowest stress values in the specimen transition region. The stresses in the transition region were not sensitive to specimen material properties. The stresses in the tab region were sensitive to specimen composite and/or tab material properties. An evaluation of stresses with different specimen composite and tab material combinations must account for material nonlinearity of both the tab and the specimen composite. Material nonlinearity can either relieve stresses in the composite under the tab or elevate them to cause failure under the tab.

  18. Standardizing the Handling of Surgical Specimens.

    PubMed

    Shirey, Cheryl; Perrego, Kristen

    2015-11-01

    To standardize the handling of surgical specimens, the OR clinical educators in a community hospital setting devised a series of departmental changes as a quality improvement project. A newly created skill validation was reviewed in an hour-long educational meeting with all OR staff members. In addition to creating a new annual skill validation, discussions about specimens were included in the hand over, the time out, and a newly instituted debriefing tool to be used toward the end of a procedure. This interdisciplinary group devised interventions to improve the process of handling specimens such as standardizing the labeling process and changing the transparency of the specimen container. The goal was to assure standardization of specimen handling, specifically to assist novice staff members, and to harmonize inconsistencies between specialties within the practice of existing staff members. These combined methods helped to ensure accurate communication and procurement of specimens for all procedures.

  19. Advances in Pediatric Nonalcoholic Fatty Liver Disease

    PubMed Central

    Loomba, Rohit; Sirlin, Claude B.; Schwimmer, Jeffrey B.; Lavine, Joel E.

    2009-01-01

    Nonalcoholic fatty liver disease (NAFLD) has emerged as the leading cause of chronic liver disease in children and adolescents in the United States. A two- to three-fold rise in the rates of obesity and overweight in children over the last 2 decades is probably responsible for the epidemic of NAFLD. Emerging data suggest that children with NASH progress to cirrhosis which may ultimately increase liver-related mortality. More worrisome is the recognition that cardiovascular risk and morbidity in children and adolescents is associated with fatty liver. Pediatric fatty liver disease often displays a histologic pattern distinct from that found in adults. Liver biopsy remains the gold standard for diagnosis of NASH. Non-invasive biomarkers are needed to identify individuals with progressive liver injury. Targeted therapies to improve liver histology and metabolic abnormalities associated with fatty liver are needed. Currently, randomized-controlled trials are underway in the pediatric population to define pharmacologic therapy for NAFLD. Public health awareness and intervention are needed to promote healthy diet, exercise, and lifestyle modifications to prevent and reduce the burden of disease in the community. PMID:19637286

  20. The post-analytical phase of histopathology practice: Storage, retention and use of human tissue specimens.

    PubMed

    Kapila, Supriya Nikita; Boaz, Karen; Natarajan, Srikant

    2016-01-01

    There are several aspects to a histopathology practice besides the acquisition of biopsy specimens and histopathological diagnosis. Pathology Departments are home to an abundant source of knowledge in the form of stored specimens and slides. We attempt to highlight the importance of regulation of storage, retention, and appropriate use of human tissue material in research and ownership rights to the same. We also discuss requirement and waiver of informed consent for scientific work involving the use of such tissues, which in the absence of defined laws come under the purview of Institution Review Boards. Pathology Departments, under the binding of the parent institution, are conceded the responsibility of maintenance and retention of pathology specimens. This communication highlights some of the important aspects in human tissue material handling and research, underscoring the necessity for established regulations regarding the same.

  1. The post-analytical phase of histopathology practice: Storage, retention and use of human tissue specimens

    PubMed Central

    Kapila, Supriya Nikita; Boaz, Karen; Natarajan, Srikant

    2016-01-01

    There are several aspects to a histopathology practice besides the acquisition of biopsy specimens and histopathological diagnosis. Pathology Departments are home to an abundant source of knowledge in the form of stored specimens and slides. We attempt to highlight the importance of regulation of storage, retention, and appropriate use of human tissue material in research and ownership rights to the same. We also discuss requirement and waiver of informed consent for scientific work involving the use of such tissues, which in the absence of defined laws come under the purview of Institution Review Boards. Pathology Departments, under the binding of the parent institution, are conceded the responsibility of maintenance and retention of pathology specimens. This communication highlights some of the important aspects in human tissue material handling and research, underscoring the necessity for established regulations regarding the same. PMID:26958513

  2. Bone scan appearances following bone and bone marrow biopsy

    SciTech Connect

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

    1984-01-01

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

  3. Focal liver lesions found incidentally

    PubMed Central

    Algarni, Abdullah A; Alshuhri, Abdullah H; Alonazi, Majed M; Mourad, Moustafa Mabrouk; Bramhall, Simon R

    2016-01-01

    Incidentally found focal liver lesions are a common finding and a reason for referral to hepatobiliary service. They are often discovered in patients with history of liver cirrhosis, colorectal cancer, incidentally during work up for abdominal pain or in a trauma setting. Specific points should considered during history taking such as risk factors of liver cirrhosis; hepatitis, alcohol consumption, substance exposure or use of oral contraceptive pills and metabolic syndromes. Full blood count, liver function test and tumor markers can act as a guide to minimize the differential diagnosis and to categorize the degree of liver disease. Imaging should start with B-mode ultrasound. If available, contrast enhanced ultrasound is a feasible, safe, cost effective option and increases the ability to reach a diagnosis. Contrast enhanced computed tomography should be considered next. It is more accurate in diagnosis and better to study anatomy for possible operation. Contrast enhanced magnetic resonance is the gold standard with the highest sensitivity. If doubt still remains, the options are biopsy or surgical excision. PMID:27028805

  4. Hydroxycut-induced Liver Toxicity

    PubMed Central

    Kaswala, DH; Shah, S; Patel, N; Raisoni, S; Swaminathan, S

    2014-01-01

    In the recent era, use of various nutritional supplements is highly encouraged amongst the people of United States. Weight loss supplements are major part of the nutritional supplements and their usage is unregulated in the US. Obesity is a major health concern in the US and Americans spend around $30 billion a year for weight loss supplements. At times, these supplements can be responsible for documented or undocumented adverse drug effects. The health consequences related to these supplements are often overlooked by the general public, even though FDA issues advisories regarding them. One common supplement used for weight loss was Hydroxycut (Iovate Health Sciences Research, Oakville, Ontario, Canada). Hydroxycut was recalled from the market after a FDA warning in May 2009 because of 23 reports of serious health problems ranging from jaundice and elevated liver enzymes to liver damage. 1 This case report adds evidence for Hydroxycut - induced hepatotoxicity. A 27 year old man with right upper quadrant pain and jaundice was found to have elevated liver enzymes and was taking Hydroxycut along with other supplements. Liver biopsy showed drug induced hepatotoxicity. Discontinuation of Hydroxycut dramatically improved liver functions and related symptoms. PMID:24669349

  5. [Effort, accuracy and histology of MR-guided vacuum biopsy of suspicious breast lesions--retrospective evaluation after 389 interventions].

    PubMed

    Fischer, U; Schwethelm, L; Baum, F T; Luftner-Nagel, S; Teubner, J

    2009-08-01

    The aim of this study was to evaluate the effort, accuracy, histological diagnoses and value of MR-guided vacuum biopsy (10-gauge, 9-gauge) as the diagnostic procedure for suspicious breast lesions visible on MRI alone. 389 MR-guided vacuum biopsies of suspicious MRM findings were performed in 365 patients either with a Vacora system (10G, Bard Company) or an ATEC system (9G, Suros Company). The retrospective study included the number of specimens, the table time, the complication rate, and the histopathological results for open biopsy and the findings after follow-up. The study included 341 unilateral unilocular, 12 unilateral bilocular and 12 bilateral unilocular MR-guided vacuum biopsies. In 27 patients (3.9%) the planned intervention was canceled because the lesion could not be reproduced. The average number of specimens was 15.1 (range 4 - 75) with the 10G technique and 14.6 (range 4 - 38) with the 9G technique. The table time was 43.2 min (range 17 - 95 min). Histology revealed concordant benign lesions in 231 cases (59.4%), borderline lesions in 50 cases (12.8%), malignant tumors in 106 cases (DCIS 30 [7.7%], invasive carcinoma 76 [19.5%]), and discordant findings in 2 cases (0.5%). The complication rate was less than 1%. MR-guided vacuum biopsy of the breast is an effective method for the minimally invasive percutaneous evaluation of suspicious breast lesions seen on MRI alone. As a consequence, primary open biopsy can be avoided and the rate of unnecessary surgical interventions reduced. There were no major differences between 10G and 9G vacuum biopsy systems.

  6. A percutaneous needle biopsy technique for sampling the supraclavicular brown adipose tissue depot of humans

    PubMed Central

    Annamalai, Palam; Chondronikola, Maria; Chao, Tony; Porter, Craig; Saraf, Manish K.; Cesani, Fernardo; Sidossis, Labros S.

    2015-01-01

    Brown adipose tissue (BAT) has been proposed as a potential target tissue against obesity and its related metabolic complications. Although the molecular and functional characteristics of BAT have been intensively studied in rodents, only a small number of studies have used human BAT specimens due to the difficulty of sampling human BAT deposits. We established a novel positron emission tomography and computed tomography-guided Bergström needle biopsy technique to acquire human BAT specimens from the supraclavicular area in human subjects. Forty-three biopsies were performed on 23 participants. The procedure was tolerated well by the majority of participants. No major complications were noted. Numbness (9.6%) and hematoma (2.3%) were the two minor complications noted, which fully resolved. Thus, the proposed biopsy technique can be considered safe with only minimal risk of adverse events. Adoption of the proposed method is expected to increase the sampling of the supraclavicular BAT depot for research purposes so as to augment the scientific knowledge of the biology of human BAT. PMID:25920777

  7. Transthoracic needle biopsy of thoracic tumours by a colour Doppler ultrasound puncture guiding device.

    PubMed Central

    Wang, H. C.; Yu, C. J.; Chang, D. B.; Yuan, A.; Lee, Y. C.; Yang, P. C.; Kuo, S. H.; Luh, K. T.

    1995-01-01

    BACKGROUND--Ultrasound guided transthoracic needle aspiration biopsy has recently been used to obtain specimens for histological diagnosis of pulmonary and mediastinal tumours. Conventional real time, grey scale puncture guiding devices cannot differentiate vascular structures, and clear visualisation of the needle shaft or tip within a desired target is not always possible. This study describes a new built-in colour Doppler ultrasound puncture guiding device and assesses the relative safety of transthoracic needle aspiration biopsy of thoracic tumours by grey scale or colour Doppler ultrasound guidance. METHODS--Thirty patients with radiographic evidence of pulmonary (22 patients) or mediastinal tumours (eight patients) underwent ultrasonographic evaluation and transthoracic needle aspiration biopsy by using the colour Doppler ultrasound puncture guiding device (Aloka UST 5045P-3.5). These tumours were initially examined by grey scale ultrasound, and colour Doppler imaging was then used to evaluate the number of blood vessels surrounding and within the target tumour and the possibility of visualisation of the needle shaft or needle tip during the aspiration biopsy procedure. RESULTS--The colour Doppler ultrasound guiding device was far superior to the grey scale device for identification of the number of vessels surrounding or within the target tumour (83% v 20%) and for visualisation of the needle shaft or needle tip (80% v 17%). CONCLUSIONS--By using the colour Doppler ultrasound puncture device, vascular structures surrounding or within the target tumour can be verified. Visualisation of the needle shaft or tip is also better. Biopsy routes can be selected to avoid puncturing vessels. This approach should be particularly helpful for guiding biopsies of mediastinal tumours, where puncturing the heart or great vessels is a potential complication. Images PMID:8553297

  8. Frame-Based Stereotactic Biopsy of Canine Brain Masses: Technique and Clinical Results in 26 Cases

    PubMed Central

    Rossmeisl, John Henry; Andriani, Rudy T.; Cecere, Thomas E.; Lahmers, Kevin; LeRoith, Tanya; Zimmerman, Kurt L.; Gibo, Denise; Debinski, Waldemar

    2015-01-01

    This report describes the methodology, diagnostic yield, and adverse events (AE) associated with frame-based stereotactic brain biopsies (FBSB) obtained from 26 dogs with solitary forebrain lesions. Medical records were reviewed from dogs that underwent FBSB using two stereotactic headframes designed for use in small animals and compatible with computed tomographic (CT) and magnetic resonance (MR) imaging. Stereotactic plans were generated from MR and CT images using commercial software, and FBSB performed both with (14/26) and without intraoperative image guidance. Records were reviewed for diagnostic yield, defined as the proportion of biopsies producing a specific neuropathological diagnosis, AE associated with FBSB, and risk factors for the development of AE. Postprocedural AE were evaluated in 19/26 dogs that did not proceed to a therapeutic intervention immediately following biopsy. Biopsy targets included intra-axial telencephalic masses (24/26), one intra-axial diencephalic mass, and one extra-axial parasellar mass. The median target volume was 1.99 cm3. No differences in patient, lesion, or outcome variables were observed between the two headframe systems used or between FBSB performed with or without intraoperative CT guidance. The diagnostic yield of FBSB was 94.6%. Needle placement error was a significant risk factor associated with procurement of non-diagnostic biopsy specimens. Gliomas were diagnosed in 24/26 dogs, and meningioma and granulomatous meningoencephalitis in 1 dog each. AE directly related to FBSB were observed in a total of 7/26 (27%) of dogs. Biopsy-associated clinical morbidity, manifesting as seizures and transient neurological deterioration, occurred in 3/19 (16%) of dogs. The case fatality rate was 5.2% (1/19 dogs), with death attributable to intracranial hemorrhage. FBSB using the described apparatus was relatively safe and effective at providing neuropathological diagnoses in dogs with focal forebrain lesions. PMID:26664949

  9. Non-invasive assessment of liver fibrosis in patients with alcoholic liver disease

    PubMed Central

    Lombardi, Rosa; Buzzetti, Elena; Roccarina, Davide; Tsochatzis, Emmanuel A

    2015-01-01

    Alcoholic liver disease (ALD) consists of a broad spectrum of disorders, ranging from simple steatosis to alcoholic steatohepatitis and cirrhosis. Fatty liver develops in more than 90% of heavy drinkers, however only 30%-35% of them develop more advanced forms of ALD. Therefore, even if the current “gold standard” for the assessment of the stage of alcohol-related liver injury is histology, liver biopsy is not reasonable in all patients who present with ALD. Currently, although several non-invasive fibrosis markers have been suggested as alternatives to liver biopsy in patients with ALD, none has been sufficiently validated. As described in other liver disease, the diagnostic accuracy of such tests in ALD is acceptable for the diagnosis of significant fibrosis or cirrhosis but not for lesser fibrosis stages. Existing data suggest that the use of non-invasive tests could be tailored to first tier screening of patients at risk, in order to diagnose early patients with progressive liver disease and offer targeted interventions for the prevention of decompensation. We review these tests and critically appraise the existing evidence. PMID:26494961

  10. 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

  11. Immunity of fungal infections alleviated graft reject in liver transplantation compared with non-fungus recipients

    PubMed Central

    Xing, Tonghai; Zhong, Lin; Lin, Lihui; Qiu, Guoqiang; Peng, Zhihai

    2015-01-01

    Objective: To evaluate of the immune tolerance in adult LT recipients with Invasive fungal infections (IFIs). Methods: 109 consecutive LT recipients who received LT were included. Percentage of T subsets (CD4+CD25hiCD127- T cells, CD4+CD25loCD45RA+ T cells, CD4+CD25loCD45RA- and CD4+CD45RA-CD45RO+ T cells populations), levels of cytokines (IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IFN-γ, IL-12p70, IL-17, TNF-α, TNF-β and GM-CSF) were detected by FACS and Bioplex in peripheral blood. Biopsy specimens were fixed, monoclonal antibodies against CD4, Foxp3 and IL-17 were applied to the above sections and FISH was performed. Results: The risk of acute rejection was decreased in fungal infected liver transplant recipients comparing with non-fungal infected group. CD4+CD25hiCD127T cell population was increased in peripheral blood and memory CD4+CD45RA-CD45RO+ T cell population decreased. There was significant lower levels observed in naïve CD4+CD25loCD45RA+ and CD4+CD25loCD45RA- T cell populations in fungal infected liver transplant. Moreover, IL-2, IL-6, IL-10 and GM-CSF were decreased. However, no significant difference with IL-4 and IL-8 in serum in two infected LT recipients. Conclusion: The incidence of graft rejection in liver transplantation recipients with fungal infections was lower than the non-fungal group. It is important to assess the risk during pretransplant and postoperation for liver transplantation. PMID:26045766

  12. Genetic Diseases That Predispose to Early Liver Cirrhosis

    PubMed Central

    Liguori, Renato

    2014-01-01

    Inherited liver diseases are a group of metabolic and genetic defects that typically cause early chronic liver involvement. Most are due to a defect of an enzyme/transport protein that alters a metabolic pathway and exerts a pathogenic role mainly in the liver. The prevalence is variable, but most are rare pathologies. We review the pathophysiology of such diseases and the diagnostic contribution of laboratory tests, focusing on the role of molecular genetics. In fact, thanks to recent advances in genetics, molecular analysis permits early and specific diagnosis for most disorders and helps to reduce the invasive approach of liver biopsy. PMID:25132997

  13. Acute liver injury induced by weight-loss herbal supplements

    PubMed Central

    Chen, Gary C; Ramanathan, Vivek S; Law, David; Funchain, Pauline; Chen, George C; French, Samuel; Shlopov, Boris; Eysselein, Viktor; Chung, David; Reicher, Sonya; Pham, Binh V

    2010-01-01

    We report three cases of patients with acute liver injury induced by weight-loss herbal supplements. One patient took Hydroxycut while the other two took Herbalife supplements. Liver biopsies for all patients demonstrated findings consistent with drug-induced acute liver injury. To our knowledge, we are the first institute to report acute liver injury from both of these two types of weight-loss herbal supplements together as a case series. The series emphasizes the importance of taking a cautious approach when consuming herbal supplements for the purpose of weight loss. PMID:21173910

  14. Acute liver injury induced by weight-loss herbal supplements.

    PubMed

    Chen, Gary C; Ramanathan, Vivek S; Law, David; Funchain, Pauline; Chen, George C; French, Samuel; Shlopov, Boris; Eysselein, Viktor; Chung, David; Reicher, Sonya; Pham, Binh V

    2010-11-27

    We report three cases of patients with acute liver injury induced by weight-loss herbal supplements. One patient took Hydroxycut while the other two took Herbalife supplements. Liver biopsies for all patients demonstrated findings consistent with drug-induced acute liver injury. To our knowledge, we are the first institute to report acute liver injury from both of these two types of weight-loss herbal supplements together as a case series. The series emphasizes the importance of taking a cautious approach when consuming herbal supplements for the purpose of weight loss.

  15. Transcervical intrauterine levobupivacaine or lidocaine infusion for pain control during endometrial biopsy

    PubMed Central

    Kosus, Nermin; Kosus, Aydın; Demircioglu, Ruveyda I; Simavli, Serap A; Derbent, Aysel; Keskin, Esra Aktepe; Turhan, Nilgun O

    2014-01-01

    BACKGROUND: Endometrial biopsy is a common procedure for the investigation of many gynecological disorders including abnormal uterine bleeding, postmenopausal bleeding, abnormal cytology and infertility. Most women experience some degree of discomfort and pain during the procedure. Pain may occur during dilation of the cervix for insertion of the catheter and during endometrial biopsy, which further aggravates pain by inducing uterine contraction. OBJECTIVES: To determine pain levels during endometrial biopsy by comparing intrauterine instillation of levobupivacaine or lidocaine with placebo in a randomized, double-blinded trial in pre- and postmenopausal women. METHODS: Ninety patients were allocated to either control or experimental groups before endometrial biopsy. The trial medication was intra-uterine anesthesia, either 5 mL 0.9% saline (control group), or 5 mL 0.5% levobupivacaine or 2% lidocaine (experimental groups). Resident doctors used the same endometrial biopsy technique to minimize the risk of technical variation. All tissue specimens were sent for cytopathological examination. The pathologists, who were blinded to the study solution, analyzed all tissue specimens. The primary outcome measure was pain experienced during the procedure. Pain was assessed using a 10 cm visual analogue pain scale. All observed adverse effects were recorded until the patients were discharged. RESULTS: Pain scores of the intrauterine lidocaine and levobupivacaine groups were found to be significantly lower than the control group. There was no difference between the levobupivacaine and lidocaine groups with regard to pain scores. There was a moderately positive correlation between pain scores and endometrial thickness. No complications were observed due to the procedure. Most of the biopsy results were proliferative and secretory endometrium. Insufficient material causing inconclusive results was observed mostly in the control group. CONCLUSION: Transcervical intrauterine

  16. Effect of storage on tensile material properties of bovine liver.

    PubMed

    Lu, Yuan-Chiao; Kemper, Andrew R; Untaroiu, Costin D

    2014-01-01

    Cadaveric tissue models play an important role in the assessment and optimization of novel restraint systems for reducing abdominal injuries. However, the effect of tissue preservation by means of freezing on the material properties of abdominal tissues remains unknown. The goal of this study was to investigate the influence of frozen storage time on the material responses of the liver parenchyma in tensile loading. Specimens from ten bovine livers were equally divided into three groups: fresh, 30-day frozen storage, and 60-day frozen storage. All preserved specimens were stored at -12°C. Dog-bone specimens from each preservation group were randomly assigned to one of three strain rates (0.01s(-1), 0.1s(-1), and 1.0s(-1)) and tested to failure in tensile loading. The local material response recorded at the tear location and the global material response of the whole specimen of the liver parenchyma specimens were investigated based on the experimental data and optimized analytical material models. The local and global failure strains decreased significantly between fresh specimens and specimens preserved for 30 days (p<0.05), and between fresh specimens and specimens preserved for 60 days (p<0.05) for all three loading rates. Changes on the material model parameters were also observed between fresh and preserved specimens. Preservation by means of frozen storage was found to affect both the material and failure response of bovine liver parenchyma in tensile loading. The stiffness of the tissue increased with increased preservation time and increased strain rate. In summary, significant changes (p<0.05) between the failure strain of previously frozen liver parenchyma samples and fresh samples were demonstrated at both global and local levels in this study. In addition, nonlinear and viscoelastic characteristics of the liver parenchyma were observed in tension for both fresh and preserved samples.

  17. Reducing infection rates after prostate biopsy.

    PubMed

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

    2014-02-01

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

  18. Progression of Liver Disease

    MedlinePlus

    ... The Progression of Liver Disease The Progression of Liver Disease There are many different types of liver ... may put your life in danger. The Healthy Liver Your liver helps fight infections and cleans your ...

  19. Liver (Hepatocellular) Cancer Prevention

    MedlinePlus

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Liver (Hepatocellular) Cancer Prevention (PDQ®)–Patient Version What is ... to keep cancer from starting. General Information About Liver (Hepatocellular) Cancer Key Points Liver cancer is a ...

  20. Liver (Hepatocellular) Cancer Screening

    MedlinePlus

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Liver (Hepatocellular) Cancer Screening (PDQ®)–Patient Version What is ... These are called diagnostic tests . General Information About Liver (Hepatocellular) Cancer Key Points Liver cancer is a ...

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

    SciTech Connect

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

    1984-10-01

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

  2. Efficacy of Methylene Blue in Sentinel Lymph Node Biopsy for Early Breast Cancer

    PubMed Central

    Özdemir, Altan; Mayir, Burhan; Demirbakan, Kenan; Oygür, Nezihi

    2014-01-01

    Objective Sentinel lymph node biopsy is the recommended approach in the evaluation of axilla during breast cancer surgery. In this study, results of patients who underwent methylene blue sentinel lymph node biopsy were evaluated. Materials and Methods The study included 32 female patients with T1 and T2 tumors. 5 ml of 1% methylene blue was injected into the peritumoral area or around the cavity. The axillary sentinel lymph node was found and removed, and then axillary dissection was performed. The sentinel lymph node and axillary dissection specimen were histopathologically examined and the results were compared. Results The sentinel lymph node was found in 30 (94%) patients. Lymph node metastasis was not observed in 17 patients in both the sentinel lymph node and axilla. Two patients had metastasis in the axilla although this was not detected in sentinel lymph node. Eleven patients had metastasis both in the sentinel lymph node and in the axilla. The accuracy rate was 93%, and the false negativity rate was identified as 15%. Conclusion Sentinel lymph node biopsy by methylene blue is a method that can be applied with high accuracy. Methylene blue can be considered as an alternative to isosulphane blue in sentinel lymph node biopsy.

  3. Image-Directed Fine-needle Aspiration Biopsy of the Thyroid with Safety-engineered Devices

    SciTech Connect

    Sibbitt, Randy R. Palmer, Dennis J.; Sibbitt, Wilmer L. Bankhurst, Arthur D.

    2011-10-15

    Purpose: The purpose of the present study was to integrate safety-engineered devices into outpatient fine-needle aspiration (FNA) biopsy of the thyroid in an interventional radiology practice. Materials and Methods: The practice center is a tertiary referral center for image-directed FNA thyroid biopsies in difficult patients referred by the primary care physician, endocrinologist, or otolaryngologist. As a departmental quality of care and safety improvement program, we instituted integration of safety devices into our thyroid biopsy procedures and determined the effect on outcome (procedural pain, diagnostic biopsies, inadequate samples, complications, needlesticks to operator, and physician satisfaction) before institution of safety devices (54 patients) and after institution of safety device implementation (56 patients). Safety devices included a patient safety technology-the mechanical aspirating syringe (reciprocating procedure device), and a health care worker safety technology (antineedlestick safety needle). Results: FNA of thyroid could be readily performed with the safety devices. Safety-engineered devices resulted in a 49% reduction in procedural pain scores (P < 0.0001), a 56% reduction in significant pain (P < 0.002), a 21% increase in operator satisfaction (P < 0.0001), and a 5% increase in diagnostic specimens (P = 0.5). No needlesticks to health care workers or patient injuries occurred during the study. Conclusions: Safety-engineered devices to improve both patient and health care worker safety can be successfully integrated into diagnostic FNA of the thyroid while maintaining outcomes and improving safety.

  4. 36 CFR 2.5 - Research specimens.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... superintendent approves a written research proposal and determines that the collection will benefit science or... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Research specimens. 2.5... PROTECTION, PUBLIC USE AND RECREATION § 2.5 Research specimens. (a) Taking plants, fish, wildlife, rocks...

  5. 37 CFR 1.93 - Specimens.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Specimens. 1.93 Section 1.93 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE....93 Specimens. When the invention relates to a composition of matter, the applicant may be required...

  6. 36 CFR 2.5 - Research specimens.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Research specimens. 2.5... PROTECTION, PUBLIC USE AND RECREATION § 2.5 Research specimens. (a) Taking plants, fish, wildlife, rocks or... Federal agency for the purpose of research, baseline inventories, monitoring, impact analysis, group...

  7. 36 CFR 1002.5 - Research specimens.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Research specimens. 1002.5... RECREATION § 1002.5 Research specimens. (a) Taking plants, fish, wildlife, rocks or minerals except in... of research, baseline inventories, monitoring, impact analysis, group study, or museum display...

  8. Layered Plating Specimens For Mechanical Tests

    NASA Technical Reports Server (NTRS)

    Thompson, Linda B.; Flowers, Cecil E.

    1991-01-01

    Layered specimens readily made in standard sizes for tensile and other tests of mechanical properties. Standard specimen of metal ordinarily difficult to plate to standard grip thickness or diameter made by augmentation with easier-to-plate material followed by machining to standard size and shape.

  9. 37 CFR 2.56 - Specimens.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE... include one specimen per class showing the mark as used on or in connection with the goods or services... associated with the goods. (2) A service mark specimen must show the mark as actually used in the sale...

  10. 36 CFR 1002.5 - Research specimens.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Research specimens. 1002.5... RECREATION § 1002.5 Research specimens. (a) Taking plants, fish, wildlife, rocks or minerals except in... of research, baseline inventories, monitoring, impact analysis, group study, or museum display...

  11. 36 CFR 1002.5 - Research specimens.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Research specimens. 1002.5... RECREATION § 1002.5 Research specimens. (a) Taking plants, fish, wildlife, rocks or minerals except in... of research, baseline inventories, monitoring, impact analysis, group study, or museum display...

  12. 36 CFR 1002.5 - Research specimens.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Research specimens. 1002.5... RECREATION § 1002.5 Research specimens. (a) Taking plants, fish, wildlife, rocks or minerals except in... of research, baseline inventories, monitoring, impact analysis, group study, or museum display...

  13. 36 CFR 2.5 - Research specimens.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Research specimens. 2.5... PROTECTION, PUBLIC USE AND RECREATION § 2.5 Research specimens. (a) Taking plants, fish, wildlife, rocks or... Federal agency for the purpose of research, baseline inventories, monitoring, impact analysis, group...

  14. ENCODE Tiling Array Analysis Identifies Differentially Expressed Annotated and Novel 5′ Capped RNAs in Hepatitis C Infected Liver

    PubMed Central

    Maxwell, Christopher I.; Nelson, Cassie A.; Schwartz, Jason J.; Nix, David A.; Hagedorn, Curt H.

    2011-01-01

    Microarray studies of chronic hepatitis C infection have provided valuable information regarding the host response to viral infection. However, recent studies of the human transcriptome indicate pervasive transcription in previously unannotated regions of the genome and that many RNA transcripts have short or lack 3′ poly(A) ends. We hypothesized that using ENCODE tiling arrays (1% of the genome) in combination with affinity purifying Pol II RNAs by their unique 5′ m7GpppN cap would identify previously undescribed annotated and unannotated genes that are differentially expressed in liver during hepatitis C virus (HCV) infection. Both 5′-capped and poly(A)+ populations of RNA were analyzed using ENCODE tiling arrays. Sixty-four annotated genes were significantly increased in HCV cirrhotic as compared to control liver; twenty-seven (42%) of these genes were identified only by analyzing 5′ capped RNA. Thirty-one annotated genes were significantly decreased; sixteen (50%) of these were identified only by analyzing 5′ capped RNA. Bioinformatic analysis showed that capped RNA produced more consistent results, provided a more extensive expression profile of intronic regions and identified upregulated Pol II transcriptionally active regions in unannotated areas of the genome in HCV cirrhotic liver. Two of these regions were verified by PCR and RACE analysis. qPCR analysis of liver biopsy specimens demonstrated that these unannotated transcripts, as well as IRF1, TRIM22 and MET, were also upregulated in hepatitis C with mild inflammation and no fibrosis. The analysis of 5′ capped RNA in combination with ENCODE tiling arrays provides additional gene expression information and identifies novel upregulated Pol II transcripts not previously described in HCV infected liver. This approach, particularly when combined with new RNA sequencing technologies, should also be useful in further defining Pol II transcripts differentially regulated in specific disease states and

  15. Introducing a new histologic scoring system for iron deposition in liver of thalassemic patients, compared with atomic absorption spectrometry.

    PubMed

    Tavassoli, Habib; Mahjoub, Fatemeh; Jahanzad, Eesa; Farahmand, Fatemeh; Izadyar, Mina; Sani, Mehri Najafi; Rashti, Mohammad Lamei; Aramli, Mohammad Sadegh

    2015-01-01

    Iron deposition in liver is a major finding in thalassemic patients and because of direct iron toxicity to liver it is associated with several consequences for example liver fibrosis. Liver biopsies from 63 patients were evaluated, 40 (63.5%) were male and 20 (36.5%) were female. The mean age of the patients was 8.01 ± 3.7 and the age range was from 1.8 to 15 years. Histologic grading and staging was performed for each case according to modified HAI (Hepatitis Activity Index) system. Iron scoring was performed according to Sindram & Marx and MTK1-3 scoring systems. The mean (SD) dry weight (dw) of liver specimens was 1.34 (0.11) mg (range 0.20 to 3.80 mg). The mean (SD) of hepatic iron concentration was 230.9 (121.2)μmol/g dry weight. The relationship between the variables HIC, HII (hepatic iron index) and all histological gradings of iron (S&M and MTK1-3) was very strong. The relationship between the HIC and staging by HAI method was good. Significant differences were identified between the mean HIC in scores 1&2 of all histological iron scorings (S&M and MTK1-3), but no significant differences identified between mean HIC in other adjacent scores in all histological iron scorings (S&M and MTK1, 2 and 3). New scoring system introduced by us in this study which considered size and density of iron granules as well as zone of iron deposition was very much the same as simple Sindram and Marx classification.

  16. A metastatic nude-mouse model of human pancreatic cancer constructed orthotopically with histologically intact patient specimens.

    PubMed Central

    Fu, X; Guadagni, F; Hoffman, R M

    1992-01-01

    Pancreatic cancer is one of the most intractable and least understood of all human cancers. Pancreatic cancers is the fourth-leading cause of cancer-related mortality in the United States with less than 2% of the patients surviving for 5 yr. In an effort to help develop more effective treatment modalities for pancreatic cancer and improve detection, we report an animal model for individual human pancreatic-cancer patients. The model involves orthotopic transplantation of histologically intact pancreatic-cancer specimens to the nude-mouse pancreas, which can result in models that resemble the clinical picture including (i) extensive local tumor growth, (ii) extension of the locally growing human pancreatic cancer to the nude-mouse stomach and duodenum, (iii) metastases of the human pancreatic tumor to the nude-mouse liver and regional lymph nodes, and (iv) distant metastases of the human pancreatic tumor to the nude-mouse adrenal gland, diaphragm, and mediastinal lymph nodes. In a series of five patient cases, a 100% take rate has been demonstrated, and of 17 mice transplanted, 15 supported tumor growth. Immunohistochemical analysis of the antigenic phenotype of the transplanted human pancreatic tumors showed a similar pattern of expression of two different human tumor-associated antigens, such as tumor-associated glycoprotein 72 and carcinoembryonic antigen in the transplanted tumors when compared with the original surgical biopsy, suggesting similarity between the two. This model should, therefore, prove valuable for treatment evaluation of individual cancer patients, as well as for evaluation of experimental treatment modalities for this disease. Images PMID:1608975

  17. Serum Wisteria floribunda agglutinin-positive Mac-2 binding protein in non-alcoholic fatty liver disease

    PubMed Central

    Lai, Lee-Lee; Sthaneshwar, Pavai; Nik Mustapha, Nik Raihan; Goh, Khean-Lee; Mahadeva, Sanjiv

    2017-01-01

    Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+-M2BP) has been suggested to be useful for the assessment of disease severity in non-alcoholic fatty liver disease (NAFLD). Consecutive adult NAFLD patients who had a liver biopsy were included. Serum WFA+-M2BP level was measured using a lectin-antibody sandwich immunoassay using a chemiluminescence enzyme immunoassay machine (HISCL-5000, Sysmex, Kobe, Japan). The measured levels were indexed using the following equation: Cut-off index (COI) = ([WFA+-M2BP]sample−[WFA+-M2BP]NC) / ([WFA+-M2BP]PC−[WFA+-M2BP]NC), where PC = positive control and NC = negative control. Histopathological examination of liver biopsy specimen was reported according to Non-Alcoholic Steatohepatitis (NASH) Clinical Research Network Scoring System. Data for 220 cases were analyzed. The AUROC of the COI for the diagnosis of NASH was 0.65. The AUROC of the COI for the diagnosis of steatosis grade ≥2 and 3 was 0.64 and 0.53, respectively. The AUROC of the COI for the diagnosis of lobular inflammation grade ≥1, ≥2 and 3 was 0.57, 0.68 and 0.59, respectively. The AUROC of the COI for the diagnosis of hepatocyte ballooning grade ≥1 and 2 was 0.64 and 0.65, respectively. The AUROC of the COI for the diagnosis of fibrosis stage ≥1, ≥2, ≥3 and 4 was 0.61, 0.71, 0.74 and 0.84, respectively. Out of the 220 cases, 152 cases were the same 76 patients who had a repeat liver biopsy after 48 weeks of intervention. The AUROC of the change in the COI to detect improvement in steatosis, lobular inflammation, hepatocyte ballooning and fibrosis was 0.57, 0.54, 0.59 and 0.52, respectively. In conclusion, serum WFA+-M2BP was most useful for the diagnosis of significant fibrosis, advanced fibrosis and cirrhosis in NAFLD patients. However, it was less useful for differentiating NASH from non-NASH, and for diagnosis and follow-up of the individual histopathological components of NASH. PMID:28369100

  18. cDNA Microarray Analysis of Serially Sampled Cervical Cancer Specimens From Patients Treated With Thermochemoradiotherapy

    SciTech Connect

    Borkamo, Erling Dahl; Schem, Baard-Christian; Fluge, Oystein; Bruland, Ove; Dahl, Olav; Mella, Olav

    2009-12-01

    Purpose: To elucidate changes in gene expression after treatment with regional thermochemoradiotherapy in locally advanced squamous cell cervical cancer. Methods and Materials: Tru-Cut biopsy specimens were serially collected from 16 patients. Microarray gene expression levels before and 24 h after the first and second trimodality treatment sessions were compared. Pathway and network analyses were conducted by use of Ingenuity Pathways Analysis (IPA; Ingenuity Systems, Redwood City, CA). Single gene expressions were analyzed by quantitative real-time reverse transcription-polymerase chain reaction. Results: We detected 53 annotated genes that were differentially expressed after trimodality treatment. Central in the three top networks detected by IPA were interferon alfa, interferon beta, and interferon gamma receptor; nuclear factor kappaB; and tumor necrosis factor, respectively. These genes encode proteins that are important in regulation cell signaling, proliferation, gene expression, and immune stimulation. Biological processes over-represented among the 53 genes were fibrosis, tumorigenesis, and immune response. Conclusions: Microarrays showed minor changes in gene expression after thermochemoradiotherapy in locally advanced cervical cancer. We detected 53 differentially expressed genes, mainly involved in fibrosis, tumorigenesis, and immune response. A limitation with the use of serial biopsy specimens was low quality of ribonucleic acid from tumors that respond to highly effective therapy. Another 'key limitation' is timing of the post-treatment biopsy, because 24 h may be too late to adequately assess the impact of hyperthermia on gene expression.

  19. Heritability of Nonalcoholic Fatty Liver Disease

    PubMed Central

    Schwimmer, Jeffrey B.; Celedon, Manuel A.; Lavine, Joel E.; Salem, Rany; Campbell, Nzali; Schork, Nicholas J.; Shiehmorteza, Masoud; Yokoo, Takeshi; Chavez, Alyssa; Middleton, Michael S.; Sirlin, Claude B.

    2010-01-01

    Background & Aims Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States. The etiology is believed to be multi-factorial with a substantial genetic component; however, the heritability of NAFLD is undetermined. Therefore, a familial aggregation study was performed to test the hypothesis that NAFLD is highly heritable. Methods Overweight children with biopsy-proven NAFLD and overweight children without NAFLD served as probands. Family members were studied including magnetic resonance imaging to quantify liver fat fraction. Fatty liver was defined as a liver fat fraction ≥ 5%. Etiologies for fatty liver other than NAFLD were excluded. Narrow-sense heritability estimates for fatty liver (dichotomous) and fat fraction (continuous) were calculated using variance components analysis adjusted for covariate effects. Results Fatty liver was present in 17% of siblings and 37% of parents of overweight children without NAFLD. Fatty liver was significantly more common in siblings (59%) and parents (78%) of children with NAFLD. Liver fat fraction was correlated with body mass index (BMI), although the correlation was significantly stronger for families of children with NAFLD than those without NAFLD. Adjusted for age, sex, race, and BMI, heritability of fatty liver was 1.000 and of liver fat fraction 0.386. Conclusion Family members of children with NAFLD should be considered at high risk for NAFLD. These data suggest that familial factors are a major determinant of whether an individual has NAFLD. Studies examining the complex relations between genes and environment in the development and progression of NAFLD are warranted. PMID:19208353

  20. Magnetic resonance imaging of liver tumors.

    PubMed

    Weissleder, R; Stark, D D

    1989-02-01

    Careful optimization of scanning techniques, particularly motion artifact suppression, has been essential to achieve reproducible results in abdominal MRI. The investigators experience indicates that MRI can be more accurate than other imaging methods for the detection of focal liver lesions. Furthermore, MRI is able to solve the major clinical problems in differential diagnosis of benign and malignant liver lesions: cancer v cavernous hemangioma or focal fat. MRI has reduced the dependence on liver biopsy and angiography to diagnose and stage focal liver lesions. Unfortunately, both imaging techniques, especially motion artifact suppression methods, vary widely among machines operating at different field strengths. Therefore, as hardware and software evolve, it is necessary to retrace the steps of pulse sequence optimization and clinical testing. Hopefully, in the future, standardized imaging techniques will become available for body MRI.