Endobronchial ultrasound-guided transbronchial needle aspiration: performance of biomedical scientists on rapid on-site evaluation and preliminary diagnosis.

OBJECTIVES: Rapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) followed by a subsequent preliminary adequacy assessment and a preliminary diagnosis, was performed at Aarhus University Hospital by biomedical scientists (BMS). The aim of this study was to evaluate the BMS accuracy of ROSE adequacy assessment, the preliminary adequacy assessment and the preliminary diagnosis as compared with the cytopathologist-rendered final adequacy assessment and final diagnosis. METHODS: The BMS-rendered assessments for 717 sites from 319 consecutive patients over a 4-month period were compared with the cytopathologist-rendered assessments. Comparisons of adequacy and preliminary diagnoses were based on inter-observer Cohen's Kappa coefficient with a 95% confidence interval (CI). RESULTS: Strong correlations between ROSE and final adequacy assessments [Kappa coefficient of 0.90 (CI: 0.85-0.96)] and between the preliminary and final adequacy assessments [Kappa coefficient of 0.93 (CI: 0.87-0.99)] were found. As for the correlation between the preliminary and final diagnoses, the Kappa coefficient was 0.99 (CI: 0.98-1). CONCLUSION: Both ROSE and preliminary adequacy assessments as well as preliminary diagnoses, all performed by BMS, were highly accurate when compared with the final assessment by the cytopathologist.

Vasovasostomy in rabbits using fibrin adhesive prepared from a single human source.

We were interested in determining whether fibrin glue derived from a single human source could be used effectively to produce a sutureless vasovasostomy in the rabbit model. Fifteen rabbits were divided into two groups (7 control, 8 experimental) and underwent vasal transection and reanastomosis by conventional microsurgical suture techniques (control group) and sutureless anastomosis using single source fibrin glue (experimental group). The patency and tensile strength of the anastomoses were compared at four weeks and the anastomotic sites underwent histologic examination. This study demonstrated that a vasovasal anastomosis in the rabbit could be achieved using human single source fibrin glue with patency equivalent to a standard sutured anastomosis. The tensile strength of the glued anastomosis at four weeks was greater than the tensile strength of the sutured anastomosis.

A local direct effect of pituitary graft on growth of the lateral prostate in rats.

Prolactin and testosterone are synergistic in stimulating growth of the rat prostate. The lateral lobe is more sensitive to this synergism than the ventral and dorsal lobes. To investigate whether prolactin acts directly in the rat prostate or indirectly through another systemic mediator, anterior pituitary grafts (1 mm3) were implanted in the lateral prostate of castrated Sprague-Dawley rats in whom a 0.5 cm or 1.0 cm testosterone-filled silastic tubing was implanted subcutaneously at the same time. Rats were randomly assigned to receive either the pituitary or a muscle chip of similar size grafted beneath the fascia lateral to the lateral prostate. Twenty-one days later, serum prolactin levels were not elevated in pituitary-grafted animals and were not significantly different from those in muscle-grafted rats. The mean lateral prostate weight on the grafted side in pituitary-implanted rats with 1.0 cm testosterone tubing was 43% heavier than either that of the contralateral side or the corresponding weights in muscle-implanted rats. In pituitary-implanted rats with 0.5 cm testosterone tubing, the mean lateral prostate weight on the grafted side was 60% heavier than either that of the contralateral side or that of the corresponding weights in muscle-implanted rats. The weight of the ventral and dorsal lobes of the prostate was not significantly affected by the presence of pituitary grafts in one of the lateral lobes. The local effect of prolactin on the lateral prostate was further demonstrated by an overall decline in tissue concentrations of dihydrotestosterone in the grafted side. These results provided evidence to indicate that there was a direct effect of prolactin on growth of the lateral prostate in rats.

Biochemical markers in prostatic cancer.

The status of the biochemical markers explored for use in patients with carcinoma of the prostate is reviewed. No unique marker has been identified. However, a variety of substances, primarily enzymes and specific proteins, found in the serum, urine, and prostatic fluid, have been evaluated. Their main value remains in the staging of disease and the monitoring of response to therapy.

Ureteroceles in children. A simplified and successful approach to management.

This review documents the success that we have experienced in treating most ureteroceles that present in children by heminephroureterectomy. If excision of the ureterocele is required, or reimplantation of a ureter other than the ureter obstructed by the ureterocele, this is deferred until the degree of hydronephrosis is reduced or bladder thickening and trabeculation have returned toward normal. In instances where there is function in the upper pole segment obstructed by the ureterocele, ureteropyelostomy has enabled us to preserve renal function by removing the obstructed ureter to permit the ureterocele to collapse.