Relationship Between Percutaneous Transhepatic Cholangioscopy Findings and Pattern of Carcinomatous Spread in the Bile Duct

To clarify the relationship between percutaneous transhepatic cholangioscopic findings such as papillogranular surface and vascular dilation, which are reportedly characteristic of carcinoma, and the pattern of spread for bile duct carcinomas, we compared endoscopic photographs with histological features of biopsy specimens in 57 regions of specimens from 35 patients with malignant stenosis of the bile duct. Regions with a papillogranular surface were associated with noninvasive mucosal carcinomas and papillary proliferation of superficial epithelia significantly more often than regions without such a surface (P<0.0001). The sensitivity and specificity of the papillogranular surface to noninvasive mucosal carcinoma was 79 and 95%, respectively, that of papillary proliferation of superficial epithelia was 100 and 98%, respectively. Regions with vascular dilation were associated with invasive carcinoma significantly more often than regions without vascular dilation (P<0.0001). The sensitivity and specificity of vascular dilation to invasive carcinoma were 90 and 86%, respectively. Results indicate that a papillogranular surface is related to noninvasive mucosal carcinomas while vascular dilation is related to invasive carcinomas. However, a papillogranular surface was even more closely related to papillary proliferation of superficial epithelia.

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Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

Journal of Biosocial Science ◽

10.1017/s0021932021000298 ◽

2021 ◽

pp. 1-12

Author(s):

Aparna Roy ◽

T. V. Sekher

Keyword(s):

Nutritional Status ◽

Sensitivity And Specificity ◽

Measurement Data ◽

Anthropometric Measurement ◽

Alternative Measure ◽

Upper Arm ◽

Male Adolescents ◽

Arm Circumference ◽

Mid Upper Arm Circumference ◽

The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

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Association between obstructive sleep apnea and persistent-postural perceptual dizziness

Journal of Vestibular Research ◽

10.3233/ves-201508 ◽

2021 ◽

pp. 1-6

Author(s):

Anand K. Bery ◽

Jayson Lee Azzi ◽

Andre Le ◽

Naomi S. Spitale ◽

Judith Leech ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sensitivity And Specificity ◽

Berlin Questionnaire ◽

Future Studies ◽

Obstructive Sleep ◽

Chronic Dizziness ◽

Patients At Risk ◽

The Mean ◽

The Relationship

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to vestibular dysfunction, but no prior studies have investigated the relationship between Persistent Postural Perceptual Dizziness (PPPD), a common cause of chronic dizziness, and OSA. OBJECTIVE AND METHODS: We determined the frequency of OSA in an uncontrolled group of PPPD patients from a tertiary dizziness clinic based on polysomnogram (PSG). We then assessed the sensitivity and specificity of common OSA questionnaires in this population. RESULTS: Twenty-five patients with PPPD underwent PSG (mean age 47, 60% female, mean BMI 29.5). A majority, or 56%, of patients were diagnosed with OSA, and in most, the OSA was severe. OSA patients were older (56 years versus 40 years, p = 0.0006) and had higher BMI (32 versus 26, p = 0.0078), but there was no clear gender bias (56% versus 64% female, p = 1.00). The mean sensitivity and specificity of the STOP BANG questionnaire for detecting OSA was 86% and 55%, respectively. Sensitivity and specificity of the Berlin Questionnaire was 79% and 45%, respectively. CONCLUSIONS: The prevalence of OSA was much higher in our small PPPD group than in the general population. Screening questionnaires appear to demonstrate good sensitivity to detect PPPD patients at risk of OSA in this small study. Future studies should confirm these findings and determine whether treatment of OSA improves symptoms in PPPD.

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Prognostic value of cell proliferation (ki-67 antigen) in resected or biopsy specimens of bile duct carcinoma

Gastroenterology ◽

10.1016/s0016-5085(08)82860-0 ◽

2001 ◽

Vol 120 (5) ◽

pp. A575

Author(s):

Masateru Murakami ◽

Akira Tsuchida ◽

Tamito Sasaki ◽

Yousuke Kawasaki ◽

Kenji Morinaka ◽

...

Keyword(s):

Cell Proliferation ◽

Bile Duct ◽

Prognostic Value ◽

Bile Duct Carcinoma ◽

Ki 67 ◽

Duct Carcinoma ◽

Biopsy Specimens

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Hepatic fibrosis and cirrhosis in the Fontan circulation: a detailed morphological study

Journal of Clinical Pathology ◽

10.1136/jcp.2007.052365 ◽

2007 ◽

Vol 61 (4) ◽

pp. 504-508 ◽

Cited By ~ 109

Author(s):

T J Kendall ◽

B Stedman ◽

N Hacking ◽

M Haw ◽

J J Vettukattill ◽

...

Keyword(s):

Preoperative Assessment ◽

Fontan Circulation ◽

Severe Tricuspid Regurgitation ◽

Histological Features ◽

Sinusoidal Dilatation ◽

Hepatocellular Damage ◽

Biopsy Specimens ◽

Inflammatory Mechanism ◽

Spur Formation ◽

Liver Biopsies

Aims:To describe the histological features of the liver in patients with a Fontan circulation.Methods:Specimens from liver biopsies carried out as part of preoperative assessment prior to extracardiac cavopulmonary conversion of an older style Fontan were examined and scored semi-quantitatively for pertinent histological features. To support the use of the scoring, biopsy specimens were also ranked by eye for severity to allow correlation with assigned scores.Results:Liver biopsy specimens from 18 patients with a Fontan circulation were assessed. All specimens showed sinusoidal fibrosis. In 17 cases there was at least fibrous spur formation, with 14 showing bridging fibrosis and 2 showing frank cirrhosis. In 17 cases at least some of the dense or sinusoidal fibrosis was orcein positive, although a larger proportion of the dense fibrous bands were orcein positive compared with the sinusoidal component. All specimens showed marked sinusoidal dilatation, and 14 showed bile ductular proliferation; 1 showed minimal iron deposition, and 1 showed mild lobular lymphocytic inflammation. There was no cholestasis or evidence of hepatocellular damage. Similar appearances were observed in 2 patients with severe tricuspid regurgitation.Discussion:The histological features of the liver in patients with a Fontan circulation are similar to those described in cardiac sclerosis. Sinusoidal dilatation and sinusoidal fibrosis are marked in the Fontan series. The presence of a significant amount of orcein negative sinusoidal fibrosis suggests there may be a remediable component, although the dense fibrous bands are predominantly orcein positive, suggesting chronicity and permanence. No inflammation or hepatocellular damage is evident, suggesting that fibrosis may be mediated by a non-inflammatory mechanism.

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The Usefulness of Percutaneous Transhepatic Cholangioscopy for Identifying Malignancies in Distal Commom Bile Duct Strictures

Journal of Korean Medical Science ◽

10.3346/jkms.2008.23.4.579 ◽

2008 ◽

Vol 23 (4) ◽

pp. 579 ◽

Cited By ~ 17

Author(s):

Eun Hee Kim ◽

Hyun-Joo Kim ◽

Hyoung-Chul Oh ◽

Kwang Ha Lee ◽

Ju Young Jung ◽

...

Keyword(s):

Bile Duct ◽

Percutaneous Transhepatic Cholangioscopy

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Percutaneous Transhepatic Cholangioscopy Versus Open Choledochotomy in Treatment of Difficult Common Bile Duct Stones

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(05)01159-4 ◽

2005 ◽

Vol 61 (5) ◽

pp. AB206

Author(s):

Jimin Han ◽

Sang Soo Lee ◽

Tae Joon Song ◽

Myung-Hwan Kim ◽

Dong Wan Seo ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Common Bile Duct Stones ◽

Bile Duct Stones ◽

Percutaneous Transhepatic Cholangioscopy

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Quantitative radioimmunohistochemical measurements of p185(erbB-2) in frozen tissue sections.

Journal of Histochemistry & Cytochemistry ◽

10.1177/44.11.8918900 ◽

1996 ◽

Vol 44 (11) ◽

pp. 1251-1259 ◽

Cited By ~ 12

Author(s):

J R Reeves ◽

J J Going ◽

G Smith ◽

T G Cooke ◽

B W Ozanne ◽

...

Keyword(s):

Tumor Biology ◽

Breast Carcinomas ◽

Tissue Sections ◽

Biopsy Specimens ◽

Formalin Fixed Paraffin ◽

Formalin Fixed Paraffin Embedded ◽

Interstudy Variability ◽

High Degree ◽

The Relationship ◽

Formalin Fixed

The relationship between expression of the c-erbB-2 proto-oncogene and the biology of breast cancer has been investigated widely, most studies using immunohistochemistry in formalin-fixed, paraffin-embedded tissues. This technique is at best semiquantitative and there is a high degree of interstudy variability because of its subjective nature and poor methodological standardization. The relationship between the levels of expression and biology can be examined thoroughly only with an accurately quantitative technique. We have developed a radioimmunohistochemical assay to measure p185(erbB-2) in tissue biopsy specimens. The method involves incubating frozen sections with 125I-labeled monoclonal antibody, microautoradiograpy, and grain counting with image analysis. Sections of cell pellets with known c-erbB-2 levels are processed with each batch of samples as internal calibration standards. We have quantified c-erbB-2 expression in 60 breast carcinomas and compared the results with conventional immunohistochemistry. Radioimmunohistochemistry measured receptor levels throughout the range of expression in breast carcinomas, whereas conventional immunohistochemistry detected the protein only in the highest expressing tumors. The quantitative, objective data produced by radioimmunohistochemistry allow a more thorough evaluation of the relationship between c-erbB-2 expression and tumor biology. This technique may have applications in other fields where quantitative data is required and relevant monoclonal antibodies are available.

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