sensitivity and specificity of ultrasound-guided core-needle biopsy of neck masses

Neck masses are common presentations that often require tissue sampling to guide therapy. While open biopsy is invasive, fine needle aspiration cytology includes a high rate of nondiagnostic samples. We performed a retrospective analysis on 166 ultrasound-guided core-needle biopsies form the necks of 68 patients. The target tissue was correctly sampled in 64 patients, and on revision biopsy it reached to 66 patients [97%]. We experienced 97% success in obtaining high quality histopathologic specimens [66 out of 68 cases]. In these 66 patients the sensitivity and specificity in differentiating benign from malignant lesions was 97.6%, and 100% respectively. We conclude that ultrasound-guided core-needle biopsy is a safe and reliable technique in the diagnosis of neck masses with high diagnostic yield and high tissue quality for histopathology that represents a sufficient alternative to open biopsy, even in diagnosis of lymphoma

Impact of high dose aprotinin on cardiac function and cerebral oxygenation in valve replacement

The aim of this study is to evaluate the effects of full dose aprotinin administration on early and late postoperative myocardial function, cerebral oxygenation by monitoring of jugular bulb oxygen saturation and neurological outcome after cardiac surgery. Sixty patients underwent elective single valve [mitral or aortic] replacement were randomly classified into two groups: High dose aprotinin group [n=30] and control group [n=30]. Patients' parameters were recorded perioperatively, early post operative and after 3 months. Patients parameters include echocardiographic evaluation, operative parameters [spontaneous recovery of the heart, the need for inotropic support to wean the heart from cardiopulmonary bypass], ICU parameters [[duration of intropic support, ventilatory hours, ICU stay] and complications [including low COP syndrome, myocardial infraction, and renal impairment]], lastly jugular venous bulb oxygen saturation, neurological deficits, and mortality rate. The patients who received high dose aprotinin showed a significantly less intraoperative and early postoperative blood loss than control group patients, with significant reduction of postoperative ventilator support, need for inotropes and total ICU stay. The early postoperative period showed that high dose aprotinin group had marked improvement in the echocardiographic measurements. This was maintained throughout the follow up period. Significant cerebral desaturation was recorded in control group in the early postoperative period. The neurological deficits and hospital mortality were significantly higher in control group than aprotinin group. We concluded that in elective valve replacement surgery, high dose aprotinin administration provides better intraoperative myocardial and cerebral protection reflected in better postoperative cardiac and cerebral functional recovery