RESUMEN
The aim of this paper is to describe the experiments carried out to evaluate the diagnostic efficacy of a dynamic-robotic telepathology system for the delivery of pathology services to distant hospitals. The system provides static/dynamic features and the remote control of a robotized microscope over 4 ISDN lines. For evaluation purposes, 184 consecutive cases of frozen sections (60), gastrointestinal pathology (64), and urinary cytology (60) have been diagnosed at a distance using the system, and the telediagnosis obtained in this way has been compared with the traditional microscopic diagnosis. Diagnostic agreement ranged from 90% in urinary cytology to 100% in frozen sections. The results obtained suggest that such a system can be considered a useful tool for supporting the pathology practice in isolated hospitals.
Asunto(s)
Microscopía/métodos , Patología/instrumentación , Patología/métodos , Telepatología/métodos , Sistema Digestivo/patología , Secciones por Congelación , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/patología , Humanos , Modems , Reproducibilidad de los Resultados , Robótica , Servicios de Salud Rural , Telepatología/instrumentación , Teléfono , Sistema Urinario/citología , Enfermedades Urológicas/diagnóstico , Enfermedades Urológicas/patologíaRESUMEN
To determine whether adult cardiac myocytes are capable of multiple divisions and whether this form of growth is restricted to a subpopulation of cells that retain this capacity with age, telomere lengths were measured in myocyte nuclei isolated from the left ventricle of fetal and neonatal Fischer 344 rats and rats at 4, 12, and 27 months after birth. Two independent methodologies were used for this analysis: laser scanning cytometer and confocal microscopy. In each case, fluorescence intensity of a peptide nucleic acid probe specific for telomeric sequence was evaluated. The two techniques yielded comparable results. Telomeric shortening increased with age in a subgroup of myocytes that constituted 16% of the entire cell population. In the remaining nondividing cells, progressive accumulation of a senescent associated nuclear protein, p16(INK4), was evidenced. In conclusion, a significant fraction of myocytes divides repeatedly from birth to senescence, counteracting the continuous death of cells in the aging mammalian rat heart.
Asunto(s)
Envejecimiento/fisiología , División Celular/fisiología , Ventrículos Cardíacos , Miocardio , Telómero/fisiología , Animales , Animales Recién Nacidos/crecimiento & desarrollo , Biomarcadores , Núcleo Celular/química , Núcleo Celular/ultraestructura , Inhibidor p16 de la Quinasa Dependiente de Ciclina/análisis , ADN/análisis , Desarrollo Embrionario y Fetal , Feto/embriología , Técnica del Anticuerpo Fluorescente Indirecta , Ventrículos Cardíacos/química , Ventrículos Cardíacos/citología , Ventrículos Cardíacos/embriología , Ventrículos Cardíacos/crecimiento & desarrollo , Citometría de Imagen/métodos , Rayos Láser , Microscopía Confocal/métodos , Miocardio/química , Miocardio/citología , Ratas , Ratas Endogámicas F344 , Telómero/ultraestructuraRESUMEN
We evaluated the diagnostic efficacy of a dynamic robotic telepathology system for the delivery of pathology services to distant hospitals. The system provided static/dynamic features and the remote control of a robotic microscope using four ISDN lines. For evaluation purposes, 184 consecutive cases were diagnosed at distance using the system. The cases were 60 frozen sections, 64 cases of gastrointestinal pathology and 60 cases of urinary cytology. The telemedicine diagnoses obtained in this way were compared with traditional microscopic diagnosis. Diagnostic agreement ranged from 90% in urinary cytology to 100% in frozen sections. The results suggest that a dynamic robotic telepathology system can be a useful tool for supporting the pathology practice of isolated hospitals.
Asunto(s)
Enfermedades Gastrointestinales/patología , Telepatología/métodos , Estudios de Evaluación como Asunto , Secciones por Congelación , Humanos , Italia , Servicios de Salud Rural , Telepatología/economía , Telepatología/instrumentación , Orina/citologíaRESUMEN
The aim of this study was to evaluate the diagnostic accuracy of large core breast biopsy with the use of the perforated compression grid (PCG) in a series of 106 consecutive mammographically detected breast lesions. The PCG consists in a fenestrated paddle that replaces the usual mammographic compressor. Each hole in the grid is marked by letters and numbers in order to obtain the coordinates of the area to biopsy. By analysing the two orthogonal projections, the depth of the lesion in the breast is calculated. With the breast positioned in the PCG, a skin incision is made. After calculations about the depth of needle insertion, the tip of the needle is inserted proximally to the target area. In such a way, taking into consideration the total running of the needle (23 mm), a correct sampling is assured, and multiple needle passes are performed. Sensitivity was of 90.62 and 90.90%, specificity was of 100 and 95.45% and positive predictive value was of 100 and 90.90% by excluding and including suspicious diagnoses, respectively, for each computation. In conclusion, the study indicated that image-guided core biopsy performed by the approach of PCG is a cost-effective, simple and accurate technique for the diagnosis of breast lesions, and it could be proposed as a low-cost alternative where the stereotactic equipment is not available.