Biopsy cores

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  • 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.

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  • 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.

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  • 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

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  • 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...

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  • 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

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  • 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.

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  • 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....

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  • 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 cancers.

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  • 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 without pain.

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  • 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.

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  • 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).

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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