scholarly journals Comparison of the Diagnostic Yield of EUS Needles for Liver Biopsy: Ex Vivo Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Woo Jung Lee ◽  
Lance T. Uradomo ◽  
Yang Zhang ◽  
William Twaddell ◽  
Peter Darwin
Keyword(s):  
Liver Biopsy ◽  
Ex Vivo ◽  
Diagnostic Yield ◽  
Limited Data ◽  
Specimen Length ◽  
Significant Difference ◽  
Tissue Acquisition ◽  
Liver Biopsies ◽  
Ex Vivo Study ◽  
Portal Tracts

Background and Aims. EUS-guided liver biopsy is an emerging method of liver tissue acquisition which is safe and had been shown to produce excellent histological yield. There is limited data comparing the diagnostic yield of different FNA needles. We aimed to compare the diagnostic performance of four commercially available 19-gauge FNA needles. Methods. Four FNA needles and one percutaneous needle were used to perform liver biopsies on two human cadaveric livers: Cook Echotip Procore™, Olympus EZ Shot 2™, Boston Scientific Expect Slimline™, Covidien SharkCore™, and an 18-gauge percutaneous needle (TruCore™, Argon Medical Devices). Each needle obtained biopsies by three, six, and nine complete back-and-forth motions of the needle (“throw”) with a fanning technique. The combined lengths of specimen fragments and the total number of complete portal tracts (CPT) were measured by a blinded pathologist. One-way analysis of variance (ANOVA) and Bonferroni correction were used for statistical analysis. Results. A total of 52 liver biopsies were performed. The Covidien SharkCore needle had significantly greater number of CPT compared to other FNA needles. The number of “throws” did not impact the number of CPT significantly. There was no statistically significant difference in mean total specimen length between each FNA needle type. Conclusion. The Covidien SharkCore needle produced superior histological specimen by capturing more CPT, possibly due to its unique needle design.

Mo2067 Comparison of the Diagnostic Yield of EUS Needles for Liver Biopsy: Ex-Vivo Study

2016 ◽  
Vol 83 (5) ◽  
pp. AB516
Author(s):  
Woo Jung J. Lee ◽  
Lance Uradomo ◽  
Yang Zhang ◽  
William Twaddell ◽  
Peter Darwin
Keyword(s):  
Liver Biopsy ◽  
Ex Vivo ◽  
Diagnostic Yield ◽  
Ex Vivo Study

Aerosol generation through pars plana vitrectomy

2020 ◽  
pp. bjophthalmol-2020-317214
Author(s):  
Hasan Naveed ◽  
Fong May Chew ◽  
Hanbin Lee ◽  
Edward Hughes ◽  
Mayank A Nanavaty
Keyword(s):  
Pars Plana Vitrectomy ◽  
Ex Vivo ◽  
Dynamic Changes ◽  
Aerosol Generation ◽  
Significant Difference ◽  
Optical Particle Counter ◽  
Pars Plana ◽  
23 Gauge ◽  
Set Up ◽  
Ex Vivo Study

PurposeTo assess whether pars plana vitrectomy (PPV) is an aerosol-generating procedure (AGP) in an ex vivo experimental model.MethodsIn this ex vivo study on 10 porcine eyes, optical particle counter was used to measure particles ≤10 μm using cumulative mode in the six in-built channels: 0.3 μm, 0.5 μm, 1 μm, 2.5 μm, 5 μm and 10 μm aerosols during PPV. Two parts of the study were as follows: (1) to assess the pre-experimental baseline aerosol count in the theatre environment where there are dynamic changes in temperature and humidity and (2) to measure aerosol generation with 23-gauge and 25-gauge set-up. For each porcine eye, five measurements were taken for each consecutive step in the experiment including pre-PPV, during PPV, fluid–air exchange (FAX) and venting using a flute with 23-gauge set-up and a chimney with 25-gauge set-up. Therefore, a total of 200 measurements were recorded.ResultsWith 23-gauge and 25-gauge PPV, there was no significant difference in aerosol generation in all six channels comparing pre-PPV versus PPV or pre-PPV versus FAX. Venting using flute with 23-gauge PPV showed significant reduction of aerosol ≤1 μm. Air venting using chimney with 25-gauge set-up showed no significant difference in aerosol of ≤1 μm. For cumulative aerosol counts of all particles measuring ≤5 μm, compared with pre-PPV, PPV or FAX, flute venting in 23-gauge set-up showed significant reduction unlike the same comparison for chimney venting in 25-gauge set-up.ConclusionPPV and its associate steps do not generate aerosols ≤10 μm with 23-gauge and 25-gauge set-ups.

scholarly journals EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

2020 ◽  
Vol 08 (07) ◽  
pp. E938-E943 ◽  
Author(s):  
Jose Nieto ◽  
Enad Dawod ◽  
Ameya Deshmukh ◽  
Eli Penn ◽  
Douglas Adler ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Liver Biopsy ◽  
Biliary Obstruction ◽  
Diagnostic Yield ◽  
Bile Leak ◽  
Specimen Length ◽  
Intact Specimen ◽  
Medical Centers ◽  
Post Procedure ◽  
Pancreatic Pathology

Abstract Background and study aims We compared the diagnostic yield and specimen adequacy in EUS-guided parenchymal biopsies between two types of EUS 19 G core needles. Patients and methods This is a retrospective study of 420 patients at two tertiary medical centers in Florida with unexplained abnormal liver associated tests were referred for EUS evaluation of biliary obstruction and pancreatic pathology. EUS-guided liver biopsy (EUS-LB) was performed at the same session after biliary obstruction was excluded. We compared intact specimen length (ISL), total specimen length (TSL), complete portal triads (CPT) and adverse events (AE). Welch’s T and Tukey tests were used for ISL, TSL and CPT. Results A total of 210 patients underwent EUS-LB using a Franseen needle, 210 patients using a fork-tip needle. Median patient age was 52 years (15.63) and 238 (56.7 %) were female. The fork-tip needle had a mean ISL of 2.7 (1.1 SD) cm, TSL of 6 cm (2.1 SD), and mean 19.5 CPT (8.5 SD) Abdominal pain occurred in 35 patients (17 %) post-procedure and was managed with supportive care. Two patients required intravenous (IV) narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) patients. The Franseen needle had a mean ISL of 3.1 cm (1.3 SD), TSL of 6.5 cm (2.6 SD), and mean of 24 CPT (8.8 SD). Abdominal pain occurred in four patients (2 %) post-procedure, which resolved in all patients after IV narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) and bile leak in 1(0.4 %) patients. Conclusions Use of the Franseen needle resulted in better liver core samples than that obtained with a fork-tip needle.

scholarly journals Liver Biopsies for Chronic Hepatitis C: Should Nonultrasound-Guided Biopsies Be Abandoned?

2009 ◽  
Vol 23 (6) ◽  
pp. 425-430 ◽  
Author(s):  
Jennifer A Flemming ◽  
David J Hurlbut ◽  
Ben Mussari ◽  
Lawrence C Hookey
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Hcv Infection ◽  
Significant Difference ◽  
The Us ◽  
Chronic Hcv Infection ◽  
Liver Biopsies ◽  
Chronic Hcv

BACKGROUND/OBJECTIVE: Liver biopsy has been the gold standard for grading and staging chronic hepatitis C virus (HCV)-mediated liver injury. Traditionally, this has been performed by trained practitioners using a nonimage-guided percutaneous technique at the bedside. Recent literature suggests an expanding role for radiologists in obtaining biopsies using an ultrasound (US)-guided technique. The present study was undertaken study to determine if the two techniques produced liver biopsy specimens of similar quality and hypothesized that at our institution, non-US-guided percutaneous liver biopsies for HCV would be of higher quality than US-guided specimens.METHODS: Liver biopsies from 100 patients with chronic HCV infection (50 consecutive US-guided and 50 consecutive non-US-guided), were retrospectively identified using a hospital histopathology database. All original biopsy slides were coded and prospectively reanalyzed by a single hepatopathologist who was blinded to the technique used in obtaining the biopsy. Additionally, all liver biopsies for chronic HCV infection completed at the centre from 1998 to 2007 were identified and the technique used was recorded. Biopsy quality was determined primarily by the number of complete portal tracts (CPTs) identifiable in the slides. The total length of specimen and the degree of fragmentation were secondary outcome measures.RESULTS: There was a slight difference observed between the US-guided and non-US-guided groups in mean age (46.3 years versus 42.5 years, repectively; P=0.018) but no differences in sex, presence of cirrhosis, bilirubin, creatinine, international normalized ratio, and grade or stage of disease. Biopsies obtained using the US-guided technique produced higher quality specimens than the non-US-guided technique based on our primary outcome of number of CPTs in the biopsy (11.8 versus 7.4; P<0.001). US-guided specimens also were longer (24.4 mm versus 19.7 mm; P=0.001), had less fragmentation (P=0.016), and a higher overall histopathological quality assessment (P=0.026) than the non-US-guided biopsies. However, there was no significant difference between the two groups in the ability to grade and stage the disease (96% US-guided versus 90% in non-US-guided (P=0.20). Over a 10-year period, 763 biopsies for chronic HCV infection were identified with an obvious trend toward the increased use of US-guided technique observed at 2% in 1998 to 85% in 2007.CONCLUSIONS: US-guided liver biopsies for chronic HCV are the most common method of obtaining specimens at the Kingston General Hospital, Kingston, Ontario, and are of higher quality than non-US-guided specimens. However, there is no significant difference in the two techniques in the ability to grade and stage chronic HCV.

scholarly journals Yield and Safety of Transjugular Versus Percutaneous Liver Biopsies in Suspected Cases of Diffuse Liver Disease and Correlation of Yield of Transjugular Liver Biopsy with Hepatic Venous Pressure Gradient

2020 ◽  
Author(s):  
Mousam Dey ◽  
Simi Das ◽  
Argha Chatterjee ◽  
Agnibha Dutta ◽  
Ranajoy Ghosh ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Pressure Gradient ◽  
Negative Correlation ◽  
Diagnostic Yield ◽  
Venous Pressure ◽  
Major Complication ◽  
Significant Negative Correlation ◽  
Hepatic Venous Pressure Gradient ◽  
Transjugular Liver Biopsy ◽  
Significant Difference

Abstract Background Liver biopsy is indicated in both diagnosis and prognosis of diffuse liver diseases. Conventionally, percutaneous liver biopsy (PLB) is used, as it is easily available, affordable and has a shorter procedure time, whereas transjugular liver biopsy (TJLB) is used in the setting of ascites and coagulopathy. Our aim is to evaluate the diagnostic yield of TJLB in comparison to PLB with tract embolization. Our secondary aims were to evaluate whether there is any difference in rate of major and minor complications between the two procedures and evaluate whether there is any correlation between diagnostic yield of TJLB and hepatic venous pressure gradient (HVPG). Methods In this retrospective study, we included a total of consecutive 123 patients who underwent liver biopsy through percutaneous (n = 97) and transjugular route (n = 26). We compared the yield of the specimen based on the number of complete portal tracts (CPT). Results There was no significant difference between mean CPT in TJLB and PLB specimens (mean CPT of TJLB and PLB were 10.9 ± 2.7 and 11.6 ±2.5, respectively [p = 0.566]). There was a moderate but significant negative correlation between the total number of CPT and HVPG in the TJLB group (Spearman’s rho − 0.58) (p = 0.002). There was no statistically significant difference in minor complication between the two procedures. Only one patient who underwent PLB developed major complication and none of TLJB procedure had any major complication. Conclusion Yield of tissue and complication rates are comparable in TJLB and PLB groups. Yield of tissue in TJLB have intermediate but significant negative correlation with HVPG.

scholarly journals Ex vivo and in vivo study of Kowa HA-2 applanation tonometer in the measurement of intraocular pressure in cats

2017 ◽  
Vol 38 (6) ◽  
pp. 3647
Author(s):  
Claudia Lizandra Ricci ◽  
Rogério Giuffrida ◽  
Glaucia Prada Kanashiro ◽  
Hilidia Stephania Rufino Belezzi ◽  
Carolina De Carvalho Bacarin ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Ex Vivo ◽  
Clinical Signs ◽  
In Vivo Study ◽  
Eye Drops ◽  
Significant Difference ◽  
Applanation Tonometer ◽  
Ex Vivo Study ◽  
Healthy Eyes

The objective of this study was to evaluate the use of the Kowa HA-2 applanation tonometer in measuring intraocular pressure (IOP) in cats. Ten healthy eyes were used in an ex vivo study in which the calibration curve for manometry vs. tonometry was determined by artificially raising the IOP in 5 mmHg increments up to 60 mmHg (10-60 mmHg). Both eyes of 10 anesthetized cats were studiedin vivo to compare manometry vs. tonometry. In the ambulatory study, 78 healthy eyes, 7 eyes with glaucoma and 20 eyes with uveitis were evaluated by tonometry, which was performed with topical anesthesia and 1% fluorescein eye drops for the formation of fluorescein semicircles. The correlation coefficient (r²) between the manometer and the Kowa HA-2 tonometer was 0.993 and the linear regression equation was y = 0.0915x + 0.0878 in the ex-vivo study. In the in vivo study, the IOP values (mean±SD, in mmHg) in manometry were 15.6 ± 1.1(14.0 – 17.5) and in tonometry were 15.5 ± 1.2(13.5 – 17.2), with no significant difference (P > 0.05) between manometry and tonometry. In ambulatory study, using the Kowa HA-2 tonometer, the IOP values (mean±SD, in mmHg) were 15.0 ± 1.5 (11.8 – 18.3) for the healthy eyes, 38.4 ± 8.1(29.6 – 53.7) for glaucomatous eyes and 10.4 ± 2.0(5.3 – 12.2) for eyes with uveitis. There was a strong correlation and accuracy between the IOP values with the manometry and the Kowa HA-2 tonometer. In the ambulatorystudy the IOP values obtained with the tonometer were compatible for animals with healthy eyes and with clinical signs of glaucoma and uveitis. We conclude that the Kowa HA-2 tonometer can be used in the measurement of IOP in cats, since it is a practical and accurate method in this species.

The Influence of Implant Shape on Primary Stability of Implants With a Thread Cutting and Forming Design: An Ex Vivo Study

2019 ◽  
Vol 45 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Cagatay Dayan ◽  
Onur Geckili ◽  
Canan Bural
Keyword(s):  
Ex Vivo ◽  
Primary Stability ◽  
Type I ◽  
Resonance Frequency Analysis ◽  
Implant Stability ◽  
Thread Cutting ◽  
Type Iii ◽  
Experienced Clinician ◽  
Significant Difference ◽  
Ex Vivo Study

The design of an implant has a great effect on primary stability. The purpose of this study was to determine the differences in primary stability between straight and tapered Neoss ProActive implants in type I and type III bones using resonance frequency analysis (RFA) and electronic percussive testing (EPT) methods. Fresh cow vertebrae and pelvis were used as models of type III and type i bone, respectively. Implants of 2 different designs—straight and tapered Neoss ProActive implants with a thread cutting and forming (TCF) design, both 3.5-mm wide and 11-mm long—were placed in both types of bone (n = 60). The primary stability of all implants was measured by an experienced clinician blinded to the study protocol using the EPT and RFA devices. No statistically significant difference was found between the implant stability quotients and the percussive test values of straight and tapered implants in either bone type. Within the limitations of this ex vivo study, it may be concluded that the shape of an implant with a TCF design does not affect primary stability.

scholarly journals Comparison of the amount of apically extruded debris produced by four retreatment techniques: an ex vivo study

2017 ◽  
Vol 74 (4) ◽  
pp. 309
Author(s):  
Cristiane Ferreira Alfenas ◽  
Inês de Fátima De Azevedo Jacinto Inojosa ◽  
Júlio César De Azevedo Carvalhal ◽  
Mariana Teixeira Maneschy Faria ◽  
Fernanda Freitas Lins ◽  
...  
Keyword(s):  
Root Canal ◽  
Ex Vivo ◽  
Nickel Titanium ◽  
Filling Material ◽  
Root Canal Filling ◽  
Apical Extrusion ◽  
Significant Difference ◽  
The Mean ◽  
Ex Vivo Study ◽  
One Way Anova

Objective: the aim of this study was to compare the amount of apically extruded debris during the removal of root canal filling material using nickel-titanium rotary retreatment instruments and Hedström files. Material and Methods: sixty mandibular incisors with a single canal were instrumented and obturated by cold lateral compaction. For retreatment, specimens were randomly divided into four groups (n = 15): Hedström files with or without solvent; D-RaCe system and Mtwo retreatment system. Debris extruded apically during the removal of canal filling material was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the preretreatment and postretreatment weight of the Eppendorf tubes for each group. The mean weights of extruded material were analyzed by one-way ANOVA. Results: the results showed that all retreatment techniques caused apical extrusion of debris, but no statistically significant difference was observed between groups (p>0.05). Conclusion: under the conditions of this study, all retreatment techniques caused apical debris extrusion.

scholarly journals Augmented Reality Guided Osteotomy in Hallux Valgus Correction

2020 ◽  
Author(s):  
Arnd Viehöfer ◽  
Stephan Hermann Wirth ◽  
Stefan Michael Zimmermann ◽  
Laurenz Jaberg ◽  
Cyrill Dennler ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Hallux Valgus ◽  
Ex Vivo ◽  
First Metatarsal ◽  
Second Metatarsal ◽  
Significant Difference ◽  
Improve Accuracy ◽  
Foot Model ◽  
Inexperienced Surgeon ◽  
Ex Vivo Study

Abstract Background An optimal osteotomy angle avoids shortening of the first metatarsal bone after hallux valgus surgery and therefore reduces the risk of transfer-metatarsalgia. The purpose of the present ex-vivo study was to investigate whether augmented reality (AR) would improve accuracy of the distal osteotomy during hallux valgus surgery. Methods Distal osteotomies of the first metatarsals were performed on a foot model by two surgeons with different levels of surgical experience each with (AR, n=15x2) or without (controls, n=15x2) overlay of a hologram depicting an angle of osteotomy perpendicular to the second metatarsal. Subsequently, the deviation of the osteotomy angle in the transverse plane was analyzed. Results Overall, the AR decreased the range of impression and the AR guided osteotomies were more accurate (4.9 ± 4.2°) compared to the freehand cuts (6.7± 6.1°) by tendency (p=0.2). However, while the inexperienced surgeon performed more accurate osteotomies with AR with a mean angle of 6.4± 3.5° compared to freehand 10.5 ± 5.5° (p=0.02), no significant difference was noticed for the experienced surgeon with an osteotomy angle of around 3° in both cases. Conclusion This pilot-study suggests that AR guided osteotomies can potentially improve accuracy during hallux valgus correction, particularly for less experienced surgeons.

scholarly journals Influence of Prior Exposure to Zidovudine on Stavudine Phosphorylation In Vivo and Ex Vivo

2001 ◽  
Vol 45 (2) ◽  
pp. 577-582 ◽  
Author(s):  
P. G. Hoggard ◽  
S. D. Sales ◽  
D. Phiboonbanakit ◽  
J. Lloyd ◽  
B. A. Maher ◽  
...  
Keyword(s):  
High Performance ◽  
Mononuclear Cells ◽  
Ex Vivo ◽  
Hiv Positive ◽  
Peripheral Blood Mononuclear ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Ex Vivo Study ◽  
Level 2

ABSTRACT Intracellular phosphorylation of stavudine (d4T) and zidovudine (ZDV) was investigated in peripheral blood mononuclear cells (PBMCs) isolated from ZDV-naive and ZDV-experienced human immunodeficiency virus (HIV)-positive patients. An in vivo study measured the amount of d4T triphosphate (d4TTP), while an ex vivo study assessed the capacity of cells to phosphorylate added d4T. Endogenous dTTP was also measured. d4TTP and dTTP were determined in vivo using a reverse transcriptase chain termination assay. In ex vivo studies, d4T (1 μM) was incubated in resting and phytohemagglutinin-stimulated (10 μg ml−1; 72 h) PBMCs for 24 h. After washing and methanol extraction, radiolabeled anabolites were detected by high-performance liquid chromatography. d4TTP reached its highest level 2 to 4 h after dosing (0.21 ± 0.14 pmol/106cells; n = 27 [mean ± standard deviation]). Comparison of ZDV-naive and ZDV-experienced individuals showed no significant difference in levels of d4TTP (ZDV naive, 0.23 ± 0.17 pmol/106 cells [n = 7] versus ZDV experienced, 0.20 ± 0.14 pmol/106 cells [n = 20]; P = 0.473) or the d4TTP/dTTP ratio (0.14 ± 0.12 [n = 7] and 0.10 ± 0.08 [n = 20], respectively;p = 0.391). Ex vivo data demonstrated no significant difference in the formation of d4TTP or total d4T phosphates in naive and experienced patients (0.086 ± 0.055 pmol/106cells in ZDV-naive patients [n = 17] versus 0.081 ± 0.038 pmol/106 cells in ZDV-experienced patients [n = 22]; P = 0.767). The ability of HIV-infected patients to phosphorylate d4T in vivo and ex vivo was unchanged with increasing exposure to ZDV.

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