Targeted cryotherapy using disposable biopsy punches.
Ontology highlight
ABSTRACT:
SUBMITTER: Prasad AJ
PROVIDER: S-EPMC4134645 | biostudies-literature | 2014 Apr
REPOSITORIES: biostudies-literature
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Project description:To describe a novel surgical technique for complete excision of a rectovaginal fistula tract using a disposable biopsy punch during a transvaginal rectovaginal fistula repair and to present our initial surgical experience.Description of 4 cases of simple rectovaginal fistulas and an innovative surgical technique for the complete excision of the fistula tract using a disposable biopsy punch.Successful 3-, 9-, and 12-month follow-up of 4 cases with simple rectovaginal fistulas after transvaginal rectovaginal fistula repair using a novel approach for complete fistula tract excision with a disposable biopsy punch and layered nonoverlapping suture closure. Demographic information reported included age, parity, medical and surgical history, as well as fistula characteristics including size, location, presenting symptoms, and duration of symptoms. We describe our operative technique with picture description.This novel approach using a disposable punch biopsy device to complete excision of simple rectovaginal fistula tracts during a transvaginal rectovaginal fistula repair can help with achieving a successful surgical outcome.
| S-EPMC3872741 | biostudies-literature
Project description:IntroductionWe aimed to determine the yield of second-round magnetic resonance imaging-ultrasound (MRI-US) fusion biopsy and factors that may predict eventual clinically significant (CS) prostate cancer (PCa) diagnosis.MethodsFrom 2013 to 2021, 85 men underwent second-round MRI-US fusion biopsy of 92 lesions (47.8% [44/92] peripheral zone and 52.2% [48/92] transition zone). Patient age, prostate-specific antigen (PSA), PSA density (PSAD), size/location of lesions, ADC value, Prostate Imaging-Reporting and Data System (PI-RADS), and PRECISE scores were recorded and compared to histopathological diagnosis (International Society of Urological Pathology [ISUP] grade-group 1 PCa, CS PCa=ISUP grade group ≥2 PCa) using logistic regression.ResultsMean patient age, PSA, and PSAD were 64±7 years, 8.5±7.0 ng/ml, and 0.17±0.11, respectively. Results from first-round targeted biopsy were 63% (58/92) negative and 37% (34/92) clinically insignificant (grade group 1) PCa. Overall, second-round targeted biopsy identified 25% (23/92) CS PCa (grade group 2, n=19; grade group 3, n=4). Considering only lesions with initial negative targeted-biopsy results (n=58), 21% (12/58; grade group 2, n=8; grade group 3, n=4) CS PCa and 13 grade group 1 PCa were diagnosed at second-round biopsy. There was no difference in PSA (p=0.564), size (p=0.595), location (p=0.293), or PI-RADS score (p=0.342) of lesions by eventual CS PCa diagnosis. PSAD (0.2±1.4 vs. 0.16±0.10, p=0.167), ADC (0.748±0.199 vs. 0.833±0.257, p=0.151), and PRECISE score (p<0.01) showed a trend towards association or association with eventual CS PCa diagnosis.ConclusionsRepeat second-round targeted MRI-US fusion biopsy yielded CS PCa diagnosis in the targeted biopsy specimen in approximately 20% of patients in our study. PRECISE score may be a useful marker to help predict which patients require second-round biopsy.
| S-EPMC10697702 | biostudies-literature
Project description:Modern cancer diagnosis requires histological, molecular, and genomic tumor analyses. Tumor sampling is often achieved using a targeted needle biopsy approach. Targeting errors and cancer heterogeneity causing inaccurate sampling are important limitations of this blind technique leading to non-diagnostic or poor quality samples, and the need for repeated biopsies pose elevated patient risk. An optical technology that can analyze the molecular nature of the tissue prior to harvesting could improve cancer targeting and mitigate patient risk. Here we report on the design, development, and validation of an in situ intraoperative, label-free, cancer detection system based on high wavenumber Raman spectroscopy. This optical detection device was engineered into a commercially available biopsy system allowing tumor analysis prior to tissue harvesting without disrupting workflow. Using a dual validation approach we show that high wavenumber Raman spectroscopy can detect human dense cancer with >60% cancer cells in situ during surgery with a sensitivity and specificity of 80% and 90%, respectively. We also demonstrate for the first time the use of this system in a swine brain biopsy model. These studies set the stage for the clinical translation of this optical molecular imaging method for high yield and safe targeted biopsy.
| S-EPMC5788981 | biostudies-literature
Project description:Gastric cancer (GC) remains the second tumor caused death threat worldwide, and personalized medicine for GC is far from expectation. Finding novel, recurrently mutated genes through next-generation sequencing (NGS) is a powerful and productive approach. However, previous genomic data for GC are based on surgical resected samples while a large proportion of advanced gastric cancer (AGC) patients have already missed the chance for operation. The aim of this study is to assess frequent genomic alteration in AGC via biopsy samples. Here we performed targeted genomic sequencing of 78 AGC patients' tumor biopsies along with matched lymphocyte samples based on a 118 cancer related gene panel. In total, we observed 301 somatic nonsynonymous genomic alterations in 92 different genes, as well as 37 copy number gain events among 15 different genes (fold change 2-12), and validated the fold changes of ERBB2 copy number gains with IHC and FISH test showed an accuracy of 81.8%. Previously reported driver genes for gastric cancer (TP53, KMT2D, KMT2B, EGFR, PIK3CA, GNAQ, and ARID1A), and several unreported mutations (TGFBR2, RNF213, NF1, NSD1, and LRP2) showed high non-silent mutation prevalence (7.7%-34.6%). When comparing intestinal-type gastric cancer (IGC) with diffuse-type gastric cancer (DGC), TP53 and GNAQ appear to be more frequently mutated in IGC (P=0.028 and P=0.023, respectively), whereas LRP2, BRCA2 and FGFR3 mutations are not observed in IGC, but have 12.8%, 7.7% and 7.7% mutation rates, respectively, in DGC patients. Patients with one or more mutations in adherens junction pathway (CREBBP, EP300, CDH1, CTNNB1, EGFR, MET, TGFBR2 and ERBB2) or TGF-β signaling pathway (CREBBP, EP300, MYST4, KRAS and TGFBR2) showed significantly better overall survival (P=0.007 and P=0.014, respectively), consistent with The Cancer Genome Atlas (TCGA) cohort data. Importantly, 57 (73.1%) patients harbored at least one genomic alteration with potential treatments, making NGS-based drug target screening a viable option for AGC patients. Our study established a comprehensive genomic portrait of AGC, and identified several mutation signatures highly associated with clinical features, survival outcomes, which may be used to design future personalized treatments.
| S-EPMC5523034 | biostudies-literature
Project description:BackgroundThis study aimed to estimate whether multiparametric magnetic resonance imaging (mpMRI)-transrectal ultrasound (TRUS) fusion biopsy (FUS-TB) increases the detection rates of clinically significant prostate cancer (csPCa) compared with TRUS-guided systematic biopsy (TRUS-GB).MethodsThis retrospective study focused on patients who underwent mpMRI before prostate biopsy (PB) with Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) scores ≥3 and prostate-specific antigen (PSA) level between 2.5 and 20 ng/mL. Before FUS-TB, the biopsy needle position was checked virtually using three-dimensional mapping. After confirming the position of the target within the prostate, biopsy needle was inserted and PB was performed. Suspicious lesions were generally targeted with 2 to 4 cores. Subsequently, 10-12 cores were biopsied for TRUS-GB. The primary endpoint was the PCa detection rate (PCDR) for patients with PCa who underwent combined FUS-TB and TRUS-GB.ResultsAccording to PI-RADS v2, 76.7% of the patients with PI-RADS v2 score ≥3 were diagnosed with PCa. The PCDRs in patients with PI-RADS v2 score of 4 or 5 were significantly higher than those in patients with PI-RADS v2 score of 3 (3 vs. 4, P<0.001; 3 vs. 5, P<0.001; 4 vs. 5, P=0.073). According to PCDR, the detection rates of PCa and csPCa in the FUS-TB were significantly higher than that in the TRUS-GB.ConclusionsFollowing detection of suspicious tumor lesions on mpMRI, FUS-TB use detects a higher number of PCa cases compared with TRUS-GB.
| S-EPMC8350232 | biostudies-literature
Project description:The use of electrocautery is universal in modern day surgery. Through decades electrocautery has reformed from larger electrodes to smaller ones. The latest modification is the micro-dissection cautery with a fine electrode tip. We have modified the electrocautery tip to replicate the usage of micro dissection-cautery using readily available, low cost disposable needle. The idea is to replicate the benefits of micro-dissection needle with a low cost construct which can be learned easily, used widely to provide optimum surgical results to the wider sections of the society. A video demonstration for creation of the micro-dissection cautery construct is also demonstrated.
| S-EPMC6967171 | biostudies-literature
Project description:As technology has evolved available guidelines for normal-phase flash chromatography have become less relevant. Years of experience performing chromatography with disposable columns have been condensed into simple guidelines useful for translating TLC results into either isocratic- or gradient-flash chromatography. The described studies should provide researchers with a means of selecting adequate columns and guidelines to reduce the waste of solvents, silica, time, and money.
| S-EPMC2780649 | biostudies-literature
Project description:ObjectivesTo describe a step-by-step guide for using the first transperineal targeted prostate biopsy platform available in the USA.Patients and methodsA total of 32 men with elevated prostate-specific antigen (PSA) levels were diagnosed with a region of interest on multiparametric magnetic resonance imaging (mpMRI) between February 2017 and January 2018. The transperineal targeted prostate biopsy procedure was accomplished via a transperineal approach and used a stepper, combined with advanced mpMRI/transrectal ultrasound fusion software, to perform targeted prostate biopsy. The detection of overall and clinically significant prostate cancer (PCa) was assessed as well as the rate of complications.ResultsThe median patient age was 68.0 years and the median PSA was 8.0 ng/mL. Two patients (6%) were active surveillance candidates and 16 (50%) had a prior negative prostate biopsy. The detection rates for overall and clinically significant PCa were 81% and 59%, respectively. The two candidates for active surveillance and eight of the patients with a prior negative prostate biopsy had clinically significant PCa confirmed on targeted biopsy. There were no peri-operative complications.ConclusionThese results demonstrate the promising potential of the first transperineal targeted prostate biopsy platform in the USA as an alternative diagnostic method for PCa.
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Project description:Gallium nitride (GaN) nanowires anchored on the surface of cost-effective pencil graphite electrodes (PGEs) have been developed as a new disposable nitric oxide (NO) sensor through a hydrothermal method followed by annealing treatment. The as-obtained nanomaterials were examined by field emission scanning electron microscopy, high-resolution transmission electron microscopy, Raman spectroscopy, X-ray photoelectron spectroscopy, and EIS. Concurrently, the electrocatalytic performance has been analyzed using cyclic voltammetry and amperometric measurements. The experimental results exhibit good electrochemical sensing performance toward the generated NO in NO2 - with a wide linear detection range of 1.0 μM to 1.0 mM with a correlation coefficient of 0.999 and a detection limit of 0.180 μM. In addition, the GaN nanowire-modified PGE surface showed high selectivity for the detection of NO as compared to other relevant biomolecules. This confirms that the PGE/GaN nanowire is a new promising electrochemical sensor for the sensitive detection of NO.
| S-EPMC6811847 | biostudies-other
Project description:Laparoscopic common bile duct exploration (LCBDE) remains underutilized in the management of common bile duct (CBD) stones. The exact cause of this under-utilization remains unclear; however, identified barriers to LCBDE implementation include lack of training and unavailability of dedicated instruments. LCBDE is an attractive alternative for stone retrieval in patients with Roux-en-Y gastric bypass given the anatomical difficulty in endoscopic retrograde cholangiopaneatography (ERCP). Direct visualization through choledochoscopy is the method of choice for LCBDE. However, dedicated choledoscopes are expensive and not widely available, which may lead surgeons to seek for alternatives at their particular environment. With the COVID-19 pandemic, disposable bronchoscopes have become widely accessible at our institution, raising the possibility of using one for direct vision of the biliary tract. We present the case of a 61-year-old male with past medical history of Roux-en-Y gastric bypass, who presented to the emergency department with a CBD stone. Successful LCBDE was achieved with the aid of a disposable bronchoscope for direct visualization of the biliary tract.Supplementary informationThe online version contains supplementary material available at 10.1007/s12262-022-03642-7.
| S-EPMC9750835 | biostudies-literature