Clinical Application of a Modified Bone Cement Pusher in Percutaneous Vertebroplasty Combined with Multi-Target Negative Pressure Rotary-Cutting Technique in Puncture Biopsy for Bone Tumors

Purpose To assess the efficiency and safety of a modified bone cement pusher in percutaneous vertebroplasty (PVP) combined with a multi-target negative pressure rotary-cutting technique in puncture biopsy of bone tumors. Methods The biopsy performed with the modified bone cement pusher commonly used in PVP, and a multi-target negative pressure rotary-cutting technique. A total of 120 patients with spinal and pelvic tumors undergoing needle biopsy in our department were recruited and assigned to new biopsy device group (group A, n=60) or and conventional biopsy device group (group B, n=60). The puncture time, positive rate, consistency rate, and dependence rate between group A and B were compared to assess the efficiency and safety of the new device. Results No biopsy-related complications were reported in both groups. The puncture time (39.44±8.885 min vs. 61.61±9.880 min), positive rate (96.67% vs. 61.67%), consistency rate (96.55% vs. 81.8%), and dependence rate (100% vs. 83.33%) were significantly superb in group A compared with those in group B (all P<0.05). Patients in group A did not require repeated biopsies, and sufficient samples were obtained through the needle trajectory in PVP. All patients with a definite diagnosis were managed with appropriate treatments. Conclusions Featuring high safety, positive rate and consistency rate, the new device can be performed to collect sufficient pathological samples from multiple angles. Wide clinical replication can be expected considering its evident diagnostic efficiency for bone tumor.

IMPROVEMENT OF THE ALGORITHM FOR DIFFERENTIAL DIAGNOSIS OF INTRACYSTIC BREAST CANCER AND CYSTIC MASTOPATHY

Breast cancer is one of the most important problems of modern oncology. Intracystic cancer in the structure of malignant breast neoplasms belongs to one of the most rare forms and is a variant of intraductal papillary cancer. The issues of early diagnosis of this pathology remain controversial today. The aim of this work was to improve the algorithm of differential diagnosis of intracystic breast cancer and cystic mastopathy. Within the framework of this study, we examined 153 female patients of the prospective group with suspected breast cyst cancer and analyzed the results of examinations carried out for 59 patients of the retrospective group who were examined and treated for intracystic breast cancer in the period from 2010 to 2015 on the basis of Smolensk Regional Oncological Clinical Dispensary. The standard algorithm for examining the patients with suspected intracystic breast cancer in the framework of this study included multiparametric ultrasound (ultrasound in B-mode, ultrasonic Doppler examination, strain elastography, shear wave elastography) and fine needle aspiration puncture biopsy according to our improved technique with subsequent evaluation of the new algorithm's effectiveness. We drew conclusions on low sensitivity and specificity of the traditional algorithm for examining patients with suspected intracystic breast cancer, about a greater effectiveness of the improved algorithm for this diagnosis and advisability to use fine needle aspiration puncture biopsy using the ozone-oxygen mixture to improve the diagnosis of intracystic cancer at the preoperative stage.

Puncture biopsy of bifurcation lymph nodes in the diagnosis of lung cancer

Clinical, radiological and pathological data of a number of authors testify to the frequent defeat of the lymph nodes of the mediastinum with cancer metastases (MN Goryunova, 1951; Ya. G. Dillon, 1947; BK Osipov, 1959, etc.). Anatomical works of Ruvier (1932), DA Zhdanov (1947) and others testify to broad afferent connections of bifurcation lymph nodes in normal conditions with the organs of the chest cavity. These factors create the possibility of lymphogenous metastasis of cancer of the lung and esophagus in the mediastinal lymph nodes, in particular, in the bifurcation.

PBF-Guided Biopsy with a Novel Puncture Biopsy Forceps Needle—Feasibility Study

Endoscopic ultrasound (EUS) with fine needle aspiration (FNA) or biopsy (FNB) to diagnose lesions in the gastrointestinal tract is common. Demand for histology sampling to identify treatment-specific targets is increasing. Various core biopsy FNB needles to obtain tissue for histology are currently available, however, with variable (37–97%) histology yields. In this multicenter study, we evaluated performance, safety, and user experience of a novel device (the puncture biopsy forceps (PBF) needle). Twenty-four procedures with the PBF needle were performed in 24 patients with a suspected pancreatic lesion (n = 10), subepithelial lesion (n = 10), lymph node (n = 3), or pararectal mass (n = 1). In 20/24 (83%) procedures, the PBF needle yielded sufficient material for interpretation (sample adequacy). In 17/24 (71%), a correct diagnosis was made with the material from the PBF needle (diagnostic accuracy). All participating endoscopists experienced a learning curve. (Per)procedural technical issues occurred in four cases (17%), but there were no adverse events. The PBF needle is a safe and potentially useful device to obtain an EUS-guided biopsy specimen. As the design of the PBF needle is different to core biopsy FNB needles, specific training will likely further improve the performance of the PBF needle. Furthermore, the design of the needle needs further improvement to make it more robust in clinical practice.

Application of B-ultrasound information image in Renal Puncture Biopsy treatment and Nursing

Objectives: This study was to explore the application value of B-ultrasound in guiding puncture biopsy of chronic kidney disease (CKD) and the clinical nursing effects under the guidance of B-ultrasound. Methods: Pathological examination of kidney biopsy was performed on 94 patients with CKD under the guidance of ultrasound from August 2020 to December 2020.; patients were observed for symptoms such as low back pain, backache, hematuria, and subcapsular hematoma. Color Doppler ultrasonography was performed on the punctured patients on day 1, 2, and 3 to observe whether there was subrental hematoma. The pathological results were analyzed and the success rate of percutaneous renal biopsy under ultrasound guidance was analyzed. Before the patient was discharged, investigate the satisfaction with the nursing work. Results: (1) After the puncture, 45 patients developed low back pain and low back pain symptoms, 12 cases developed subcapsular hematoma; 8 cases showed gross hematuria, 62 cases showed microscopic hematuria, and the rest had no obvious symptoms; (2) the nursing satisfaction rate of 94 cases was as high as 95.7%. Conclusion: US-PRB is a safe and effective auxiliary examination method, which can improve the success rate of puncture and reduce postoperative complications. Effective nursing can reduce the incidence of postoperative complications and improve patient satisfaction. doi: https://doi.org/10.12669/pjms.37.6-WIT.4831 How to cite this:Dong L, Li J, Zhao M, Ren J. Application of B-ultrasound information image in Renal Puncture Biopsy treatment and Nursing. Pak J Med Sci. 2021;37(6):1564-1568. doi: https://doi.org/10.12669/pjms.37.6-WIT.4831 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Two cases of tuberculous retropharyngeal abscess in adults

Retropharyngeal abscess (RPA) is an acute or chronic deep neck tissue infection. Tuberculous RPA is chronic and extremely rare in adults. A 20-year-old female patient visited the local hospital due to cough and sputum. The sputum smear was positive for acid-fast staining, and lung computed tomography (CT) indicated pulmonary tuberculosis (TB). The patient received the standard regimen of isoniazid+rifampicin+pyrazinamide+ethambutol (HRZE) for 6 months. After HRZE, pulmonary symptoms improved, but some pharyngeal discomfort remained. In another case, a 25-year-old male patient was admitted to our hospital because of a mass on the left side of his neck. Lymph node TB was considered after a puncture biopsy. Lung CT showed no obvious abnormality. After HRZE for 5 months, the mass had progressively enlarged. Both patients underwent B-ultrasonography-guided puncture, and Xpert® MTB/RIF of the abscess was positive and rifampin-sensitive. Tuberculous RPA was diagnosed and treated with isoniazid+rifampicin (HR) for 12 months. After combination anti-TB therapy and surgical drainage, both patients fully recovered. Tuberculous RPA is rare in adults; because of pharyngeal symptoms or progressive enlargement of a neck mass with anti-TB treatment, clinicians need to suspect tuberculous RPA in adults, which is treated with anti-TB therapy and surgery.

The role of puncture biopsy in the treatment of pathological fractures of the cervical vertebrae

The aim is to analyze the data obtained during biopsy of primary and secondary lesions and pathological fractures of the cervical vertebrae and their influence on the tactics of treatment of patients. Evaluation of the effectiveness of biopsy of pathological processes in the cervical vertebrae. Materials. The results of biopsies of 20 patients with lesions of the cervical vertebrae of unknown etiology or with the presence of pathological fractures with compression of the spinal cord and roots by a vertebra or a soft tissue component were analyzed. The following results were obtained: the presence of a secondary lesion of the cervical vertebrae was revealed: metastatic nature – 10, primary tumors – 1, lymphoproliferative tumors – 3, no tumor lesion was detected – 3, not enough material for the study – 3. Conclusion. The results obtained indicate the high efficiency and sufficient safety of puncture biopsy in diagnosing lesions of the cervical vertebrae, even in complex localizations (C2). Revealing the nature of vertebral lesions in the absence of absolute indications for decompression and stabilization interventions significantly affects the tactics and order of treatment of the patient.

Application of modified closed biopsy in rabbit model of VX2-transplanted bone tumor

Background This study was aimed to explore the application value of modified closed biopsy technique in puncture biopsy of rabbit VX2 transplanted bone tumor model. Methods VX2 tumor was transplanted into the bilateral tibia of 30 rabbits through the tibial plateau to make the model of VX2 transplanted bone tumor. Seven days after modeling, the proximal tibia biopsy was performed under the guidance of X-ray, and the biopsy specimen was examined pathologically. The left leg was biopsied with modified closed biopsy technique (experimental group), and the right leg was biopsied with hollow needle (control group). After 14 days of modeling, all rabbits were killed after X-ray examination around the puncture hole, and the soft tissue around the puncture hole was taken for pathological examination, and the expression levels of PCNA and CD34 in the tissue extract were detected by enzyme-linked immunosorbent assay (ELISA). Results By the end of the experiment, a total of 3 rabbits died, and finally, 27 rabbits were included in the study. Tumor cells were detected in all the intramedullary specimens obtained by puncture biopsy. On the 14th day after modeling, X-ray showed that the occurrence rate of periosteal reaction and extraosseous high-density shadow around the puncture hole was 14.81% (4/27) in the experimental group and 40.74% (11/27) in the control group. The difference was statistically significant (P<0.05). The pathological results of soft tissue around the puncture hole showed that the tumor cell metastasis rate was 29.63% (8/27) in the experimental group and 100% (27/27) in the control group, and the difference was statistically significant (P<0.05). The expression levels of PCNA and CD34 in the experimental group were lower than those in the control group (P < 0.05). Conclusion Both the modified closed biopsy technique and needle aspiration biopsy can provide sufficient biopsy tissue for the diagnosis of VX2-transplanted bone tumor in rabbits. At the same time, the improved closed biopsy technique has a certain application value in preventing local metastasis of tumor cells along the puncture channel.

Application of Modified Closed Biopsy in Rabbit Model of VX2 Transplanted Bone Tumor

Aim To explore the application value of modified closed biopsy technique in puncture biopsy of rabbit VX2 transplanted bone tumor model.Methods VX2 tumor was transplanted into the bilateral tibia of 30 rabbits through the tibial plateau to make the model of VX2 transplanted bone tumor. Seven days after modeling, the proximal tibia biopsy was performed under the guidance of X-ray, and the biopsy specimen was examined pathologically. The left leg was biopsied with modified closed biopsy technique (experimental group) and the right leg was biopsied with hollow needle (control group). After 14 days of modeling, all rabbits were killed after X-ray examination around the puncture hole, and the soft tissue around the puncture hole was taken for pathological examination, and the expression levels of PCNA and CD34 in the tissue extract were detected by enzyme-linked immunosorbent assay (ELISA).Results By the end of the experiment, a total of 3 rabbits died, and finally 27 rabbits were included in the study. Tumor cells were detected in all the intramedullary specimens obtained by puncture biopsy. On the 14th day after modeling, X-ray showed that the occurrence rate of periosteal reaction and extraosseous high density shadow around the puncture hole was 14.81% (4/27) in the experimental group and 40.74% (11/27) in the control group. the difference was statistically significant (P<0.05). The pathological results of soft tissue around the puncture hole showed that the tumor cell metastasis rate was 29.63% (8/27) in the experimental group and 100% (27/27) in the control group, and the difference was statistically significant (P<0.05).The expression levels of PCNA and CD34 in the experimental group were lower than those in the control group (P < 0.05). Conclusion Both the modified closed biopsy technique and needle aspiration biopsy can provide sufficient biopsy tissue for the diagnosis of VX2 transplanted bone tumor in rabbits. At the same time, the improved closed biopsy technique has a certain application value in preventing local metastasis of tumor cells along the puncture channel.