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PubMed1980

The role and limitations of frozen section and needle aspiration biopsy in breast cancer diagnosis.

Frozen section of breast biopsy specimens, and cytologic smears of breast mass aspirates, are both acceptable methods in the initial evaluation of palpable breast masses. The latter method is an outpatient procedure without significant morbidity. Interpretation may be made immediately; however, the diagnostic information obtained is limited to "malignant" or "negative." Frozen section may be applied to open biopsy or needle core biopsy specimens. In either case, the false-negative rate is less than that experienced with needle aspiration, and additional information is obtained regarding the histologic characteristic of the neoplasm. Although open biopsy is an operating room procedure, needle core biopsy may be performed in the office; however, local anesthetic is required and the patients do experience more pain than with fine-needle aspiration. The selection of the proper procedure must be individualized, depending on the clinical situation and the amount of diagnostic information required. It is essential to remember that although a positive result may be considered diagnostic, a negative report is always tenuous and should not lead to definitive therapy.

Biopsy↗
PubMed2001

Antenatal genetic screening for congenital nephrosis.

This study was undertaken to study the applicability of genetic antenatal screening for the Finnish type of congenital nephrosis (CNF), which is a recessive disorder leading to nephrotic syndrome from birth. At Kuopio University Hospital, a total of 1303 pregnant women were offered carrier screening for CNF at the time of first trimester nuchal fold translucency measurement when fetally derived alpha-fetoprotein is still produced by the yolk sac. Two mutations of the nephrin (NPHS 1) gene, accounting for approximately 95% of affected alleles, were tested by two PCR tests. Uptake of the gene test was 91.0% (n=1183). Altogether 38 female carriers were found; a population carrier frequency of 1 in 31. Their partners were tested and two of them were also found to be carriers. In these two pregnancies invasive prenatal diagnosis was offered and accepted, and the results indicated one carrier and one affected fetus. Carrier screening is an effective and well-accepted method for antenatal screening for fetal CNF. Direct mutation analysis involves markedly less invasive procedures compared with serum alpha-fetoprotein (AFP) screening, and the diagnosis was clear-cut. The results indicate that in single-gene disorders genetic testing is suitable for antenatal screening.

Alleles↗
PubMed2001

The etiology of urinary retention after surgery for genuine stress incontinence.

Transient postoperative urinary retention after stress incontinence surgery is common, and there is no widely accepted method of hastening the return to normal voiding. The etiology of this retention is poorly understood. Failure of the relaxation of the striated external urethral sphincter has been proposed as an etiologic agent, but has not been documented. Ten patients about to undergo a Burch colposuspension or sub-urethral sling, who demonstrated normal preoperative voiding, were recruited to a study of postoperative retention. Hook-wire electromyographic (EMG)probes were placed into the external urethral sphincter while the patients were under anesthesia, and a suprapubic catheter was placed. We performed instrumented voiding trials 1 or 2 days after surgery while continuously recording urethral EMG and intravesical pressure. Two patients demonstrated normal voiding. Two patients were able to void but demonstrated no EMG silencing. Six patients were unable to void and demonstrated persistent EMG activity. Four of these demonstrated no detrusor contraction, whereas two demonstrated detrusor contractions. All patients resumed normal voiding by clinical parameters within 14 days of surgery. Our study supports other research that suggests that failure of relaxation of the striated urethral sphincter contributes to postoperative urinary retention.

Aged↗
PubMed2001

Effect of aronia berry honey syrup used for sweetening jams on their quality.

The effects of sweetening agents on the quality of low sweetened jams were compared with respect to blackcurrant, raspberry, sour cherry, strawberry, and bilberry jams. The sweetening agents were sucrose, aronia berry honey syrup, and sucrose + honey syrup at a ratio of 1:1. The level of physicochemical indices, especially the content of vitamin C and anthocyanins determined directly after production and after 3- and 6-month storage, was used as the quality criterion for the evaluation of jams. Moreover, after 6-month storage the products were subjected to sensorial analysis. According to the accepted method of the investigation the produced jams were characterized by a 32-33% content of extract. During the production and 6-month storage the content of acids slightly and that of pectin considerably (from 26 to 46%) decreased, although the consistency of the jams was not affected thereby. In the case of vitamin C, its pronounced losses concerned raspberry (62-67% of the initial value), strawberry (57-61%), and sour cherry (57-58%), being distinctly smaller in blackcurrant (13-16%) and bilberry (15-35%) jams. With respect to anthocyanins a similar regularity was observed, the losses reaching 49-63% in strawberry jam, 40-56% in raspberry, 33-39% in sour cherry, 30-36% in blackcurrant, and 28-36% in bilberries. In almost all the products the losses of vitamin C and anthocyanins were higher when sweetening agent was aronia berry honey syrup. The organoleptic evaluation showed that the addition of aronia berry honey syrup to raspberry and strawberry jams slightly spoiled their colour but improved the aroma and taste. In the final score the significant differentiation in favour of the addition of aronia berry honey syrup concerned only blackcurrant, sour cherry, and bilberry jams.

Color↗
PubMed1990

Synthesis of antifeedants for insects: novel behaviour-modifying chemicals from plants.

The need to protect our food supply from predatory insect attack using more ecologically acceptable methods has led to a rapidly growing interest in behavior-modifying chemicals from natural sources. Compounds which deter insects from feeding (antifeedants) are attracting special attention owing to their potential use in integrated pest control management systems. We have been studying the synthesis of plant-derived compounds that display antifeedant properties. The aim of the work is to understand more precisely the feeding mechanisms of insects at a molecular level so as ultimately to be able to design simpler compounds capable of mimicking the activity of the natural products. Our synthetic studies on the sesquiterpenoid antifeedants, polygodial and warburganal, and on the diterpenoid clerodane, ajurgarin I, have shown the promise of this approach. Current effort is directed towards structure-activity studies and synthesis of the extraordinarily potent antifeedant and growth-disrupting agent azadirachtin, isolated from the Neem tree, Azadirachta indica (A. Juss). This work has led to the correct structure assignment for azadirachtin and afforded many compounds for biological evaluation. It is of special significance that incorporation of the hydroxydihydrofuran portion of azadirachtin in a simple model system formed a compound with antifeedant activity comparable to that of the natural product.

Animals↗
PubMed2003

Birth prevalence and pattern of osteochondrodysplasias in an inbred high risk population.

BACKGROUND: Define the pattern and birth prevalence of the different types of osteochondrodysplasias in newborn infants in the United Arab Emirates (UAE) population, which is highly inbred and where termination of pregnancy is not accepted. METHODS: All infants with a birth weight of 500 gm and above in the three hospitals in Al Ain Medical District of the UAE were studied prospectively over a period of 5 years. For each live birth or stillbirth with suspected skeletal dysplasia, a detailed clinical and radiological examination was carried out. Pregnancy history and information regarding parental age, ethnic origin, family history, and level of consanguinity were obtained and a pedigree was constructed. RESULTS: Among the 38,048 births during the study period, 36 (9.46/10,000 births) had some type of skeletal dysplasia. Eighteen cases were attributed to autosomal recessive genes (4.7/10,000 births), 10 were due to apparent new dominant mutations (2.62/10,000), five were autosomal dominant type (1.3/10,000) and one was X-linked dominant type (0.26/10,000). In three cases, inheritance was unknown. The most common recessive type of skeletal dysplasia in our series was fibrochondrogenesis (1.05/10,000), followed by chondrodysplasia punctata (0.78/10,000). The birth prevalence rate of skeletal dysplasia doubled in the last 2 years of the 5-year observation period (6.74/10,000 in 1996 vs. 12.86/10,000 in 1999, and 13.45/10,000 in 2000). This increase involved cases caused by new dominant mutations, and occurred mainly in the first half of 1999. CONCLUSION: This prospective study has identified a high birth prevalence of skeletal dysplasia, and risk factors are postulated. These findings represent an accurate birthprevalence figure and a useful baseline for this group of birth defects in the UAE.

Adult↗
PubMed1994

Radiological quality of coronary guiding catheters: a quantitative analysis.

Quantitative coronary angiography (QCA) is a validated and widely accepted method to investigate changes in arterial dimension over time. Calibration of measurements is enabled by the use of the coronary catheter as a scaling device. The dimensions and laminar composition of coronary catheters, however, have changed significantly over recent years and the suitability of the current generation of coronary catheters for calibration purposes has not been validated. We therefore recorded 57 coronary guiding catheters on cinefilm, and compared their automated quantitative measurements (Cardiovascular Angiography Analysis System, CAAS) with their true values (precision micrometer). We found an overall underestimation of quantitatively derived dimensions, ranging from -8.9 to +4% for water-filled catheters and from -15.5 to -3.9% for contrast-filled catheters. In conclusion, while the current generation of coronary guiding catheters shows a wide variety in radiological quality, it can be clearly detected by the CAAS system, and is suitable for calibration of QCA measurements (with the exception of the DVI atherectomy catheter), provided that calibration is done on contrast-empty catheters.

Biocompatible Materials↗
PubMed1989

Peripheral percutaneous transluminal laser angioplasty in humans: in vitro investigations and clinical results with a novel laser catheter system.

Percutaneous transluminal laser angioplasty has become an accepted method of treatment of peripheral arterial occlusive disease. To minimize the risk of arterial wall perforation during laser angioplasty, a novel laser catheter system was developed. In 113 obliterated postmortem human arteries the perforation rate was 0.9%. The mean degree of stenosis was reduced from 89 +/- 9% before, to 53 +/- 11% after laser irradiation. Clinical Nd:YAG laser angioplasty was performed in 19 patients suffering from peripheral arterial occlusive disease. The Fontaine stage improved in 16 patients; in no case did it deteriorate. The mean degree of stenosis was reduced by laser angioplasty from 91 +/- 12% to 31 +/- 19%. A further reduction down to 13 +/- 18% was achieved by subsequent percutaneous transluminal balloon angioplasty. The systolic Doppler ankle-arm pressure gradient was improved from 0.58 +/- 0.26 to 0.89 +/- 0.25. In 7 patients microembolisms were detectable on the final angiogram. There was no acute reocclusion and no perforation. Within a follow-up period of 12 months, four restenoses were diagnosed by digital subtraction angiography. On average, the Doppler index was 0.75 +/- 0.32.

Angioplasty, Balloon↗
PubMed2002

Increase of sensitivity of sputum cytology using high-resolution image cytometry: field study results.

Lung cancer remains the leading cause of cancer deaths in the developed world. There is no widely accepted method to screen for this cancer. The most commonly used method remains conventional sputum cytology, but this method is hampered by low sensitivity. We tested the hypothesis that sensitivity of sputum cytology for early lung cancer can be greatly improved by using image analysis of sputum cells, at a modest reduction of specificity. The study was double-blinded and used sputum samples from subjects with well-characterized clinical diagnoses. There were 177 cancers, 98 dysplasias, and 558 normals. The study samples were separated into two independent sets: training set and test set. Sputum samples were collected prospectively from subjects with a high probability of having lung cancer. Seven institutions from five countries participated in the study. All subjects had complete clinical diagnoses which included, as a minimum, negative chest x-rays for all negative cancers, while all cancers had confirmed tissue pathology. Samples were prepared according to the Saccomanno method. For conventional cytology, slides were stained using Papanicolaou stain. For image analysis, slides were stained using a DNA-specific (Feulgen-Thionin) stain. An automated, high-resolution image cytometer was used for measurements. At 90% specificity, sensitivity of 60% can be achieved for adenocarcinoma, compared to only 14% sensitivity of conventional cytology (at 99% specificity). Similarly, 45% sensitivity at 90% specificity can be reached for stages 0 and I lung cancer, compared to only 14% (at 99% specificity) using conventional cytology.Cytometry combined with conventional cytology shows an increase in sensitivity to early-stage cancer and to adenocarcinomas compared to conventional cytology alone. While the results are encouraging, the sensitivity to detect early lung cancer should be further improved to 70-80% at 90-95% specificity before this test can be considered for screening of high-risk individuals for lung cancer. Cytometry (Clin. Cytometry) 50:168-176, 2002.

Double-Blind Method↗
PubMed2004

Interferences in clinical capillary zone electrophoresis of serum proteins.

Capillary zone electrophoresis (CZE) of serum proteins has become a well-accepted method for the separation of serum proteins and for the detection of monoclonal proteins in clinical laboratories. As CZE uses ultraviolet detection for direct protein quantification, exogenous ultraviolet-absorbing substances are a novel challenge, not present in conventional gel-based methods in which protein is quantified by dye binding. This minireview gives a survey of interfering substances, including iodinated contrast agents and antibiotics.

Absorption↗
PubMed2007

Evaluation of recurrent nodal disease after definitive radiation therapy for nasopharyngeal carcinoma: diagnostic value of fine-needle aspiration cytology and CT scan.

BACKGROUND: Recurrent nodal disease in patients with nasopharyngeal carcinoma (NPC) after definitive radiotherapy presents a difficult clinical problem. This cohort of patients poses a diagnostic challenge to the head and neck surgeon because evaluation of the post-irradiated neck, both clinically and radiologically, is known to be difficult, and it is not uncommon for neck dissection specimen in suspected recurrent nodal disease to contain no viable tumor cells. Currently, there is no well-accepted method for the preoperative determination of the presence of malignancy in these nodal diseases. METHODS: Over a 7-year period in a tertiary hospital, we systematically reviewed the clinical charts of 42 patients with NPC who were diagnosed with suspected recurrent nodal disease, after radical definitive radiotherapy. Fine-needle aspiration cytology (FNAC) was performed on clinically palpable nodes and results were correlated with final histopathologic results. Findings on CT scan were also correlated with final histopathologic specimens. RESULTS: The specificity and sensitivity of FNAC was 75.0% and 75.0%, respectively. The positive and negative predictive value of FNAC was 93.8% and 37.5%, respectively. CT scan had a positive predictive value of 78.6%. The negative predictive value for multilevel involvement on CT scan was 20%. CONCLUSION: Radiological imaging and FNAC are useful diagnostic modalities in assessing recurrent nodal disease in the post-irradiated neck in patients with NPC. Although routine CT scan criteria for pathologic lymphadenopathy cannot be accurately applied in the post-irradiated neck, it is a useful surveillance tool in the routine follow-up of patients with post-irradiated neck with NPC. Clinicians, however, must understand their limitations when assessing these patients. The possibility of negative neck dissection must be conveyed to the patients.

Adult↗
PubMedDate not supplied

Embolization of the ophthalmic artery for control of epistaxis: report of two cases.

Embolization of the internal maxillary artery, an accepted method for control of severe or recurrent posterior epistaxis, usually involves the ipsilateral artery, but occasionally the contralateral vessel and the facial arteries as well. Such endovascular treatment may fail if the vascular supply to the bleeding vessels originates in derivative branches of the ophthalmic artery. We report two unusual cases in which embolization of the ophthalmic artery was performed to control epistaxis. The first patient had a prosthetic eye. In the second, sight in one eye was sacrificed after careful consideration in order to prolong life.

Adult↗
PubMedDate not supplied

Preparation of dry powder dispersions for non-viral gene delivery by freeze-drying and spray-drying.

BACKGROUND: Dry powder dispersion devices offer potential for delivering therapeutic macromolecules to the pulmonary epithelia. Previously, freeze-drying (lyophilisation) has been the accepted method for preparing dried formulations of proteins and non-viral gene vectors despite the respirability of such powders being inadequate without further processing. In this study we compare the utility of freeze-drying and spray-drying, a one-step process for producing dry and respirable powders, as methods for preparing non-viral respiratory gene delivery systems. METHODS: Lipid:polycation:pDNA (LPD) vectors comprising 1,2-dioleoyl-3-trimethylammoniumpropane (DOTAP), protamine sulphate and pEGFP-N1 in 3% lactose solution were either snap-frozen and lyophilised or spray-dried. Lyophilised powder was used as recovered or following coarse grinding. Structural integrity of dehydrated pDNA was assessed by agarose gel electrophoresis and powder particle size determined by laser diffraction. The apparent structure of the systems was visualised by scanning and transmission electron microscopy with the biological functionality quantified in vitro (A549 human lung epithelial cell line) by Green Fluorescent Protein (GFP) associated fluorescence. RESULTS: Lyophilisation produced large, irregularly shaped particles prior to (mean diameter approximately 21 microm) and following (mean diameter approximately 18 microm) coarse grinding. Spray-drying produced uniformly shaped spherical particles (mean diameter approximately 4 microm). All dehydrated formulations mediated reporter gene expression in A549 cells with the spray-dried formulation generally proving superior even when compared with freshly prepared LPD complexes. Biological functionality of the LPD dry powders was not adversely affected following 3 months storage. CONCLUSIONS: Spray-drying has utility for producing stable, efficient and potentially respirable non-viral dry powder systems for respiratory gene delivery.

Cell Line↗
PubMed1985

Comparison of specific red-cell adherence and immunoperoxidase staining techniques for ABO(H) blood-group cell-surface antigens on superficial transitional cell carcinoma of the bladder.

The presence or absence of blood-group antigens have been used to predict the clinical course of patients with superficial transitional cell carcinoma of the bladder. Antigen loss has been associated with neoplastic change. The red-cell adherence test has been the most widely accepted method of antigen determination, but this technique has inherent weaknesses. Recently, the immunoperoxidase assay has been used to detect antigens on tumor cells. We compared 30 patients using the red-cell adherence and immunoperoxidase methods on adjacent microtome cut sections. The red-cell adherence and immunoperoxidase methods performed similarly (86%) when assessing antigen presence or absence. However, the immunoperoxidase method was clearly superior in: 1) specificity for antigens on tumor cells and normal internal controls; 2) localization of antigen; 3) demonstration of cellular morphology; 4) increased objectivity of analysis; 5) ease of reproducibility; and 6) cost effectiveness.

ABO Blood-Group System↗
PubMed1984

Adhesion of composite materials to enamel: comparison between the use of acid and lasing as pretreatment.

Acid-etch is presently the accepted method for adhesion of composite materials to enamel. In this investigation, we used the laser for pretreatment of the enamel instead of acid. The adhesive (tensile) strength was measured by the Instron unit and statistically analyzed. Results demonstrated that bonding strength following laser pretreatment is comparable to that of acid-etch.

Acid Etching, Dental↗
PubMed2004

Pringle's maneuver and selective inflow occlusion in living donor liver hepatectomy.

While inflow occlusion techniques such as Pringle's maneuver are accepted methods of reducing bleeding without inducing liver injury during liver surgery, donor hepatectomy for living donor liver transplantation is currently performed without inflow occlusion for fear that injury to the graft may result. We have performed donor hepatectomy for 12 years using selective intermittent inflow occlusion, a technique in which the portion used to form the graft is perfused during hepatectomy. Starting in November 2000, we applied intermittent Pringle's maneuver to donor hepatectomy in 81 cases of living donor liver transplantation. We reviewed our experience with Pringle's maneuver and selective inflow occlusion techniques in donor hepatectomy in living donor liver transplantation. The quality of the grafts was assessed and compared by determining maximum postoperative aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values. Neither primary nonfunction nor dysfunction occurred. Maximum AST values in the recipients were the same whether the liver segments that formed the grafts were totally ischemic during dissection (total ischemia), partially ischemic (partial ischemia), perfused only with arterial blood flow (portal ischemia), or not ischemic at all (no ischemia). Maximum ALT values in the recipients of the total ischemia group was lower, albeit not significantly, than in other groups. Total inflow occlusion can be applied to living donor hepatectomy without causing graft injury. In conclusion, because the transection surface is blood-free, there is decreased risk to the donor during living donor liver transplantation surgery, and surgeons should not hesitate to apply this technique because it contributes to donor safety.

Adult↗
PubMed1990

Collection and quality of rhesus monkey semen.

Electroejaculation is an accepted method of semen collection from nonhuman primates. Although both penile and rectal probe stimulation techniques have been used, there has been a general lack of consistency and detail regarding their application. This report describes the collection, processing, and evaluation of rhesus monkey semen contrasting two methods of penile electroejaculation: 1) a constant-voltage method where stimulus current is a variable and 2) a constant-current method where stimulus current is operator-controlled. The constant-current method was the more efficient procedure, requiring a lower stimulus current for successful electroejaculation. The influence on semen quality of potentially toxic agents used in the procedure, surgical glove powder and electrolyte cream, was tested; both were detrimental as measured by motility loss. No correlation was found between coagula volume and sperm numbers. The intra- and interanimal variability in semen samples from six monkeys was also evaluated. Penile electroejaculation, combined with control of stimulus current, provides a consistent, successful, and humane method for the collection of semen in the rhesus monkey.

Animals↗
PubMed2006

Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease.

INTRODUCTION: Hydroxyurea (HU) improves hematologic parameters and decreases adverse events in patients with sickle cell disease (SCD). HU has been proposed as an alternative to chronic transfusions for secondary stroke prevention. Transcranial doppler (TCD) is an accepted method of stroke risk stratification in patients with SCD. We sought to determine if HU affects TCD velocities in children with SCD. METHODS: A cohort of 24 children with HbSS with a baseline TCDi prior to HU and a follow-up after at least 6 months of therapy was analyzed. Twenty-four age-matched children with HbSS formed the control group. Differences in hematologic parameters before and after HU therapy were evaluated. RESULTS: TCDi velocities decreased in the HU-treated patients. The adjusted mean change in TCDi velocities was -13.0 cm/sec (95% CI -20.19, -5.92) in the HU-treated group and +4.72 cm/sec (95% CI -3.24, 12.69) in the controls. Changes in TCDi between the two groups were statistically significant (P < 0.001). Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated patients. Four out of five patients with TCDi velocities >170 cm/sec had normalization of TCDi velocities on HU. Mean change was -34.75 cm/sec in this subgroup. No patients experienced cerebrovascular accidents (CVA) while on HU. CONCLUSIONS: HU-treated patients experienced statistically significant decreases in TCDi velocities compared to age-matched controls. Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated group. The decrease in TCDi velocities is not a consequence of changes in hematologic values in patients treated with HU.

Adolescent↗