In implementing a programme of privatisation and restructuring, it should be recognised that the
restructuring process, if left solely to the market forces, may create substantial unemployment and incur
considerable social costs. Supporting a programme of careful restructuring by the creation of new business
out of the old, engaging under-utilised assets, with or without an element of public subsidy, may add
considerable value to local economies. The experience of the transitional economies in Europe shows the
potential for creating small businesses out of large company restructuring.
In the early 1990's when systematic biopsy of prostate using transrectal ultrasonography
(TRUS) had just begun, there was enthusiasm for identifying abnormalities and obtaining
appropriate samples. Since the occurrences of early small prostate cancer are increasing and
identifying tumors using TRUS are somewhat subjective, the efficiency of the method in
detecting and staging prostate cancer has decreased. (Ohori, et al. 2003) Instead, many
physicians discuss about where and how many biopsy cores should be taken in order to
improve the detection-rate of cancer.
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Predictive factors for breast cancer in patients diagnosed atypical ductal hyperplasia at core needle biopsy
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Research Transperineal prostate biopsy: analysis of a uniform core sampling pattern that yields data on tumor volume limits in negative biopsies...
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach
Biopsy (BY-op-see): The removal of cells or tissues for
examination by a pathologist. The pathologist may
study the tissue under a microscope or perform other
tests on the cells or tissue. When only a sample of
tissue is removed, the procedure is called an incisional
biopsy. When an entire lump or suspicious area is
removed, the procedure is called an excisional biopsy.
When a sample of tissue or fluid is removed with a
needle, the procedure is called a needle biopsy, core
biopsy, or fine-needle aspiration.
To be considered as a “peer reviewed, funded project,” the responsible funding agency or organization
should meet the general NIH standards of peer review and funding. These include meeting three
criteria: (1) a peer review system which uses primarily external reviewers and is free of
conflict-of-interest; (2) a ranking or rating system in the review process based on the scientific merit of
the proposed research; and (3) a funding system based primarily on the peer review ranking or rating of
the research applications....
Presti et al. took two extra biopsies laterally on each side at the base and mid gland in
addition to the traditional sextant technique in an effort to include more peripheral zone
tissue in their sampling (Presti et al., 2000). This produced a 10-core biopsy. They enrolled
483 men with either abnormal DRE or a PSA 4 ng/mL. On analysis of the cancer detection
rate from each side, it was discovered that the traditional sextant technique missed 20% of
Some years later Stamey modified the sextant technique and took sextant biopsies that were
lateral to the mid-sagittal plane in the peripheral zone where most prostate cancers are
typically located (Stamey, 1995). Other investigators went on to study alternatives to the
traditional sextant biopsy, namely the optimum number of core biopsies for diagnosis as
well as sampling of the transition zone in an effort to improve the negative predictive value
of prostate biopsy.
Intuitively researchers began sampling more prostatic tissue however the procedure was not
Eskew et al. introduced the systematic extended biopsy technique and described the 5-
region biopsy protocol whereby conventional sextant biopsies were taken along with two
additional cores from the far lateral portion of each side and three centralized cores (Eskew
et al., 1997). When the prostate gland was over 50cc, one additional core is taken per region.
Thirty-five percent of those patients diagnosed with prostate cancer were found to have
cancers in the extra five biopsies sites and not in the sextant regions.
Studies were also carried out on digitally-reconstructed radical prostatectomy specimens
which showed the inadequacy of the traditional sextant biopsy method. In one study by
Chen et al., simulation biopsy strategies were conducted on whole-mount radical
prostatectomy specimens from 180 patients and it was found that only 73% of cancers were
detected by sextant biopsy (Chen et al., 1997).
With increasing number of cores came the concept of saturation biopsy, a term coined by
Stewart et al. (Stewart et al., 2001), in which 20 or more systematic cores were taken. Djavan
et al. developed tables to recommend more cores for larger glands, but these met with little
clinical acceptance (Djavan et al., 1999).
These saturation biopsies have been offered to those who have had previous negative
biopsies but continue to have clinical suspicion for prostate cancer.
We started the treatment by giving alpha-blocker. His PSA at first
visit was 4.20 ng/mL, and became slightly elevated to 5.47 ng/mL after two months.
Transrectal prostate biopsy revealed prostate cancer confined in the right lobe. Gleason
scores were 6 (3 + 3) in two out of 14 cores. He underwent standard TURP of the transition
and central zone, and then we made a deeper resection of the peripheral zone of the right
lobe. The operation took 80 minutes with no blood transfusion and water intoxication, and
the resected weight was 27.0 g.
When the needle is moved in different directions, it samples a much wider area than a
core biopsy (FNA is thus more representative than a core biopsy). The to and fro
movements and changing the direction of the needle, while it is still inside the lesion are
the two crucial steps in procuring an adequate representative sample.
Movement of the needle is adjusted according to the type of lesion. A sclerotic lesion will
require more force than a soft tumor. A cyst will almost aspirate by itself.
If a nonpalpable mammographic lesion has a low index of suspicion, mammographic follow-up in 3–6 months is reasonable. Workup of indeterminate and suspicious lesions has been rendered more complex by the advent of stereotactic biopsies. Morrow and colleagues have suggested that these procedures are indicated for lesions that require biopsy but are likely to be benign—that is, for cases in which the procedure probably will eliminate additional surgery. When a lesion is more probably malignant, open biopsy should be performed with a needle localization technique.
The history of the development of prostate biopsy has changed significantly from random
biopsies, to systematic to extended biopsy schemes. Systematic sextant biopsies, even when
laterally directed, do not provide adequate sampling of the prostate. Ultimately the sextant
biopsy technique has now become obsolete in favour of more extended biopsy protocols. To
date there is no consensus on the optimal number of cores without significantly increasing
morbidity but it has been shown that as prostate gland size increases, the yield of sextant
biopsy has decreased (Karakiewicz et al.
The second group was formed of men with a suspicion of prostate cancer based on an
elevated serum PSA and/or abnormal digital rectal examination, and the blood sample
taken immediately before the prostate biopsy. The presence or absence of CPCs was to be
compared with the biopsy results, the Gleason score, percent of sample infiltrated with
cancer, and number of positive cores. The sensitivity, specificity, positive and negative
predictive values were to be calculated. In men with a false negative test the details of the
cancer detected would be evaluated.