Minimal invasive complete excision of benign breast tumors using a three-dimensional ultrasound-guided mammotome vacuum device.

OBJECTIVE: The aim of this study was to evaluate the use of three-dimensional (3D) ultrasonography in the complete excision of benign breast tumors using ultrasound-guided vacuum-assisted core-needle biopsy (Mammotome). A protocol for the management of benign breast tumors is proposed. METHOD: Twenty consecutive patients with sonographically benign breast lesions underwent 3D ultrasound-guided mammotome biopsy under local anesthesia. The indication for surgical biopsy was a solid lesion with benign characteristics on both two-dimensional (2D) and 3D ultrasound imaging, increasing in size over time or causing pain or irritation. Preoperatively, the size of the lesion was assessed using 2D and 3D volumetry. During vacuum biopsy the needle was visualized sonographically in all three dimensions, including the coronal plane. Excisional biopsy was considered complete when no residual tumor tissue could be seen sonographically. Ultrasonographic follow-up examinations were performed on the following day and 3-6 months later to assess residual tissue and scarring. RESULTS: All lesions were histologically benign. Follow-up examinations revealed complete excision of all lesions of < 1.5 mL in volume as assessed by 3D volumetry. 3D ultrasonographic volume assessment was more accurate than 2D using the ellipsoid formula or assessment of the maximum diameter for the prediction of complete excision of the tumor. No bleeding or infections occurred postoperatively and no scarring was seen ultrasonographically on follow-up examinations. CONCLUSIONS: Ultrasound-guided vacuum-assisted biopsy allows complete excision of benign breast lesions that are 相似文献   

Accuracy assessment of three‐dimensional surface reconstructions of teeth from Cone Beam Computed Tomography scans

Summary The use of three‐dimensional (3D) models of the dentition obtained from cone beam computed tomography (CBCT) is becoming increasingly more popular in dentistry. A recent trend is to replace the traditional dental casts with digital CBCT models for diagnosis, treatment planning and simulation. The accuracy of these models was previously assessed through comparing linear physical and radiographical measurements. However, this assessment technique is both observer and landmark dependent. The accuracy of 3D CBCT teeth reconstructions is yet to be reliably measured. To assess the accuracy of 3D CBCT reconstructions of the teeth using a semi‐automated and observer‐independent method and to assess the influence of field of view (FoV) selection on reconstruction accuracy. Fully dentate upper and lower dry human jaws, placed in a plastic box and immersed in water, were scanned using CBCT with small, medium and large FoV. The teeth were then scanned separately using MicroCT. Cone beam computed tomography and MicroCT 3D teeth models were compared, and mean surface difference was calculated per tooth for each FoV. Mean and (maximum) differences between MicroCT and CBCT were 120 ± 40 (max. 679) μm, 157 ± 39 (max. 824) μ and 207 ± 80 (max. 862) μm for the small, medium and large FoV, respectively. Cone beam computed tomography models were larger than MicroCT because of larger voxel size. Our results indicate that CBCT may provide accurate 3D reconstructions of the teeth that can be useful for some clinical applications.     

Length polymorphism of heterochromatic segment of the Y chromosome in boys with acute leukemia

The extent of length polymorphisms of the heterochromatic and euchromatic segment of the human Y chromosome were investigated in 15 boys with acute leukemia and were compared with 15 normal controls. A greater value of the Yh/F index in relation to controls was established (P < 0.05). The length of the euchromatic segment was also shorter in the patients than the controls (P < 0.05).     

Effects on Plasma Glucose Concentration of Light-for-date Infants and Infants of Diabetic Mothers of Feeds Supplemented with a Glucose Polymer

ABSTRACT. Serial plasma glucose estimations were performed in 44 light-for-date infants and 17 infants of diabetic mothers fed 2, 3 or 4-hourly with feeds containing 10 % additional carbohydrate in the form of a glucose polymer (Caloreen). In the infants fed 2 and 3-hourly, plasma glucose was higher following the high carbohydrate feeds, particularly immediately before the next feed was due. Given 4-hourly, the high carbohydrate feed had little effect in most light-for-date infants, and in one light-for-date infant and two infants of diabetic mothers the plasma glucose was lower at the end of 4 hours than following normal formula. It is concluded that the addition of glucose polymer to feeds given 2 and 3 hourly has a potentially useful effect in neonates at risk of developing hypoglycaemia, but it cannot be used to increase the feed interval to 4 hours.     

Pharyngeal diverticula

A series of 73 hypopharyngeal (Zenker's) diverticula is reported and the choice of treatment and technique of excision are discussed. The problems of excision include operation on an infected site with limited access but few patients are unfit for the procedure. Preoperatively the sac should be packed and the oesophagus stented. The side of approach is unimportant as the condition is essentially midline. Cricopharyngeal myotomy appears to reduce the recurrence rate, possibly by improving coordination of pharyngeal contraction and upper oesophageal relaxation. The use of electrocoagulation is not recommended as 20% of patients require repeated general anaesthesia and the procedure fails in 13%. For all but the smallest pouches, excision is the treatment of choice.     

Increased anxiety-related behavior in mice deficient for metabotropic glutamate 8 (mGlu8) receptor

Pre-synaptic metabotropic glutamate (mGlu) receptors modulate neuronal excitability by controlling glutamate and gamma-aminobutyric acid (GABA) release. The mGlu8 receptor is predominantly found in pre-synaptic terminals and its expression is highly restricted. To study the role of this receptor, mGlu8 receptor-deficient mice were generated. Here we report that na?ve mGlu8 receptor-deficient mice showed increased anxiety-related behavior in the elevated plus maze in low illumination conditions (red light). Open arm avoidance and risk assessment behavior were both significantly increased in mutant mice. Increased stressfulness of the testing conditions abolished this behavioral difference. Fluorescent light or prior restraint stress decreased the open arm activity of wild-type mice, while the open arm activity of mutant mice was essentially unaffected, leading to similar values in both strains. The total number of arm entries or closed arm entries was not significantly different between strains, indicating that the lack of mGlu8 receptor does not affect locomotor activity. No gross behavioral changes, or changes in the function of the autonomic nervous system or somatomotor systems were observed in mutant mice. Moreover, no significant differences in seizure susceptibility were detected between strains. Our results suggest that mGlu8 receptor may play a role in responses to novel stressful environment.     

Complementary spiritual beliefs in the Latino community: the interface with psychotherapy

A model involving a dynamic spectrum of belief by Latinos in the spiritual traditions of Santeria and Espiritismo is proposed as replacement for the more static prevalence model. The issue of clinical responsiveness to such material is examined and illustrated, and implications for research and practice are discussed.