Ultrasound-guided mammotome vacuum biopsy for the diagnosis of impalpable breast lesions.
(17/240)
OBJECTIVES: To assess the diagnostic accuracy of ultrasound-guided mammotome vacuum biopsy in impalpable breast lesions. METHODS: Seventy-three patients who presented with impalpable breast lesions that were suspicious for malignancy at mammography and/or sonography were included in the study. In the first instance the women underwent ultrasound-guided fine-needle aspiration cytology, then, 3 days later, histological biopsy with an ultrasound-guided mammotome device. The patients with both cytological and histological diagnoses of malignancy underwent surgery; those with a negative (for malignancy) cytological diagnosis, but with a histological diagnosis of atypical hyperplasia or sclerosing adenosis, underwent surgical biopsy. RESULTS: The diagnostic accuracy of fine-needle aspiration cytology was 67.2%; the sensitivity was 86.7%, the specificity was 48.4%, the negative predictive value was 78.9% and the positive predictive value was 61.9%. In comparison, the diagnostic accuracy of histological sampling by mammotome vacuum biopsy was 97.3%; the sensitivity was 94.7%, the specificity was 100%, the negative predictive value was 94.6% and the positive predictive value was 100%. Thus there was a statistically significant difference in diagnostic accuracy between fine-needle aspiration cytology and mammotome vacuum biopsy (67.2% vs. 97.3%; chi2 test, P < 0.001). The 2.7% (2/73) failure rate of mammotome biopsy was likely to be due to an error in the positioning of the needle. The subsequent surgical biopsy proved that two cases, negative for malignancy by mammotome biopsy, were in fact malignant. CONCLUSIONS: Our data confirm the value of sonography for the diagnosis of breast carcinoma in the preclinical phase and the efficacy of ultrasound sampling using a mammotome device to confirm the diagnosis in impalpable breast lesions. (+info)
Lactobacillus fuchuensis sp. nov., isolated from vacuum-packaged refrigerated beef.
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Four strains of a hitherto unknown bacterium isolated from vacuum-packaged refrigerated beef were characterized by using phenotypic and phylogenetic methods. The novel strains were Gram-positive, catalase-negative, psychrophilic, rod-shaped bacteria with lactic acid-homofermentative mechanism. Comparative 16S rDNA gene sequencing demonstrated that the unknown strains represent a novel subline within the genus Lactobacillus, close to but distinct from Lactobacillus curvatus and Lactobacillus sakei. The unknown strains were readily distinguished from all currently described members of the genus Lactobacillus by biochemical properties and SDS-PAGE whole-cell protein profiles. Based on phylogenetic and phenotypic evidence, it is proposed that the unknown bacterium be classified as Lactobacillus fuchuensis sp. nov. The type strain is strain B5M10T (= JCM 11249T = DSM 14340T). (+info)
Vacuum assisted closure system in the management of enterocutaneous fistulae.
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BACKGROUND: A very important yet often troublesome element in the conservative management of enterocutaneous fistulae is the protection of the surrounding skin from contact with the effluent. This report describes the successful use of a vacuum assisted closure (VAC) system in dealing with this problem. METHODS: The results of using the VAC system were studied in three patients with moderate or high volume output enterocutaneous fistulae where conventional treatment had failed to prevent skin excoriation. RESULTS: The VAC system was found to be highly effective in controlling fistula effluent and in promoting healing of excoriated skin in all three patients. Complete healing of the fistula was also achieved in two of the three patients. CONCLUSION: The VAC system can be an effective and economically viable method of containing fistula effluent and protecting the skin of patients with enterocutaneous fistulae. Contrary to conventional thought, the VAC system may also actually promote healing of the fistula. (+info)
Comparison of home lead dust reduction techniques on hard surfaces: the New Jersey assessment of cleaning techniques trial.
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High efficiency particulate air filter (HEPA) vacuums, which collect particles > 0.3 micro m, and trisodium phosphate (TSP), a detergent claimed to selectively remove lead, have been included in the HUD Guidelines for the Evaluation and Control of Lead Based Paint Hazards in Housing without systematic validation of their effectiveness. At the time the study was initiated, both HEPA vacuums and TSP were relatively expensive, they were not readily found in urban retail centers, and there were environmental concerns about the use and disposal of high-phosphate detergents. A randomized, controlled trial was conducted in urban high-risk homes in northern New Jersey to determine whether a more readily available and less expensive low-phosphate, non-TSP detergent and non-HEPA vacuum could perform as well as TSP and a HEPA vacuum in a cleaning protocol. Homes were randomized to one of three cleaning methods: TSP/HEPA vacuum, TSP/non-HEPA vacuum, or non-TSP/non-HEPA vacuum. Change in log-transformed lead loading was used in mixed models to compare the efficacy of the three cleaning techniques separately for uncarpeted floors, window sills, and window troughs. After we adjusted for baseline lead loading, the non-HEPA vacuum produced larger reductions on hard floors [19%; 95% confidence interval (CI), 3-38%], but the HEPA vacuum produced larger reductions on window sills (22%; 95% CI, 11-32%) and larger reductions on window troughs (16%; 95% CI, -4 to 33%). The non-TSP produced larger reductions on window troughs (21%; 95% CI, -2 to 50%), but TSP produced larger reductions on hard floors (5%; 95% CI, -12 to 19%) and window sills (8%; 95% CI, -5 to 20%). TSP/HEPA produced larger reductions on window sills (28%; 95% CI, 18-37%) and larger reductions on window troughs (2%; 95% CI, -24 to 23%), whereas the non-TSP/non-HEPA method produced larger reductions on hard floors (13%; 95% CI, -5 to 34%). Because neither vacuum nor detergent produced consistent results across surface types, the use of low-phosphate detergents and non-HEPA vacuums in a temporary control measure is supported. (+info)
Influence of packaging method and storage time on shear value and mechanical strength of intramuscular connective tissue of chevon.
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The objectives of this study were to determine the effects of storage time (ST) and packaging method (PM) on tenderness and changes in intramuscular connective tissue (IMCT) strength of chevon. Spanish does (8 mo of age, average BW 25 kg) were harvested (n = 12), chilled at 4 degrees C for 24 h, and then fabricated into 2.5-cm-thick leg, shoulder/arm, and loin/rib cuts. The cuts from six carcasses were vacuum-packed and aged at 2 degrees C for 0, 4, 8, or 12 d. To assess the influence of a packaging method that favors oxidation on postmortem tenderization, the cuts from the remaining six carcasses were placed on styrofoam trays, overwrapped with polyvinyl-chloride film, and stored at 2 degrees C for similar periods. At each ST, longissimus (LM), semimembranosus (SM), and triceps brachii (TB) muscles were assessed for Warner-Bratzler shear (WBS) values. The WBS of uncooked meat, myofibrillar fragmentation index (MFI), and collagen solubility were assessed on LM. The IMCT samples were prepared to assess changes in mechanical strengths and for scanning electron microscopy (SEM). Intact honeycomb structures of endomysium, with no muscle fiber elements, were observable under SEM. The PM or ST did not influence the mechanical strength of IMCT preparations, as measured by a texture analyzer. Collagen solubility of LM muscles also did not change during aging. For both PM, cooked meat WBS values were higher (P < 0.01) in SM and TB than in LM. In the SM samples, the average WBS values were higher (P < 0.01) at d 0 than at other ST. Although MFI of LM increased with increasing aging time (P < 0.05), changes in WBS over ST were minimal in TB and LM samples. The WBS of uncooked LM decreased sharply up to 8 d postmortem in both PM (P < 0.05). However, there was no PM x ST interaction to indicate any adverse influence of packaging on tenderization of chevon. The results suggest that aging chevon cuts for more than 4 d may not result in significant additional improvement in tenderness. (+info)
Mapping intramuscular tenderness variation in four major muscles of the beef round.
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The objective of this study was to quantify intramuscular tenderness variation within four muscles from the beef round: biceps femoris (BF), semitendinosus (ST), semimembranosus (SM), and adductor (AD). At 48 h postmortem, the BF, ST, SM, and AD were dissected from either the left or right side of ten carcasses, vacuum packaged, and aged for an additional 8 d. Each muscle was then frozen and cut into 2.54-cm-thick steaks perpendicular to the long axis of the muscle. Steaks were broiled on electric broilers to an internal temperature of 71 degrees C. Location-specific cores were obtained from each cooked steak, and Warner-Bratzler shear force was evaluated. Definable intramuscular shear force variation (SD = 0.56 kg) was almost twice as large as between-animal shear force variation (SD = 0.29 kg) and 2.8 times as large as between-muscle variation (SD = 0.20 kg). The ranking of muscles from greatest to least definable intramuscular shear force variation was BF, SM, ST, and AD (SD = 1.09, 0.72, 0.29, and 0.15 kg, respectively). The BF had its lowest shear force values at the origin (sirloin end), intermediate shear force values at the insertion, and its highest shear force values in a middle region 7 to 10 cm posterior to the sirloin-round break point (P < 0.05). The BF had lower shear force values toward the ST side than toward the vastus lateralis side (P < 0.05). The ST had its lowest shear force values in a 10-cm region in the middle, and its highest shear force values toward each end (P < 0.05). The SM had its lowest shear force values in the first 10-cm from the ischial end (origin), and its highest shear force values in a 13-cm region at the insertion end (P < 0.05). Generally, shear force was lower toward the superficial (medial) side than toward the deep side of the SM (P < 0.05). There were no intramuscular differences in shear force values within the AD (P > 0.05). These data indicate that definable intramuscular tenderness variation is substantial and could be used to develop alternative fabrication and(or) merchandising methods for beef round muscles. (+info)
Comparison of techniques to reduce residential lead dust on carpet and upholstery: the new jersey assessment of cleaning techniques trial.
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High-efficiency particulate air (HEPA) filtered vacuum cleaners are recommended by the U.S. Department of Housing and Urban Development for cleaning lead-contaminated house dust. We performed a randomized field study to determine whether a conventional (non-HEPA) vacuum cleaner could achieve cleaning results comparable with those of a HEPA vacuum cleaner. We compared the lead loading reductions of these two vacuum cleaners in a total of 127 New Jersey homes of lead-exposed children. We used wet towelettes and a vacuum sampler to collect lead dust from carpets and upholstery before and after vacuum cleaning. The vacuum sampling data showed that the HEPA and non-HEPA vacuum cleaners resulted in 54.7% (p = 0.006) and 36.4% (p = 0.020) reductions in lead loading, respectively, when used on soiled carpets, although the overall difference in lead loading reduction between the two vacuum cleaners was not statistically significant (p = 0.293). The wipe sampling data did not show any significant lead loading reduction for either of the vacuum cleaners, suggesting that both vacuum cleaners fail to clean the surfaces of carpet effectively, considering that wipe sampling media simulate surface contact. On upholstery, the wipe sampling data showed a significant reduction in lead loading for the non-HEPA vacuum cleaner (22.2%, p = 0.047). Even with the significant reduction, the postcleaning lead loadings on upholstery were similar to those on carpets. The similar lead loading results for carpets and upholstery indicate that soiled upholstery may be as important a source of childhood lead exposure as carpets. (+info)
Atypical ductal hyperplasia diagnosis by directional vacuum-assisted stereotactic biopsy of breast microcalcifications. Considerations for surgical excision.
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In 824 patients who underwent directional vacuum-assisted biopsies (DVABs) of breast microcalcifications, 61 (7.4%) showed atypical ductal hyperplasia (ADH). The 42 who subsequently underwent excision were the subjects of this study. Cases were evaluated for the mammographic characteristics of the lesion, the percentage of lesion removed according to mammography, and histologic findings (including number of large ducts and/or terminal duct-lobular units involved with ADH) in DVAB specimens. Pathologic findings in the surgical specimens in the area of the biopsy site also were recorded. In the DVAB specimens, ADH was confined to an average of 1.5 large ducts or lobular units and was associated with microcalcifications in all of the patients. Surgical specimens showed ADH in 15 cases, no residual lesion in 24 cases, and ductal carcinoma in situ in 3 cases. We found that microcalcifications that contain ADH in less than 3 lobules or ducts and/or that are removed completely by DVAB do not reveal higher-risk lesions on excision; thus, removal is unnecessary. When assessing microcalcifications with ADH, clinicians should consider the percentage of microcalcifications removed by DVAB and the extent of lobular involvement to better assess the need for excision. (+info)