Cite as: Can Urol Assoc J 2013;7(5-6):e293-8. http://dx. Abstract Introduction: Prostate biopsies incur the risk of being false-negative and this risk has not yet been evaluated for 12-core prostate biopsy. We calculated the false-negative rate of 12-core prostate biopsy and determined the patient characteristics which might affect detection rate. Methods: We included 90 prostate cancer patients (mean age of 64, range: 49-77) diagnosed with transrectal ultrasound guided 12-core prostate biopsy between December 2005 and April 2008. All patients underwent radical retropubic prostatectomy and the 12-core prostate biopsy procedure was repeated on surgical specimen ex-vivo. Results of preoperative and postoperative prostate biopsies were compared. We analyzed the influence of patient age, prostate weight, serum prostate-specific antigen (PSA) level, free/ total PSA ratio, PSA density and Gleason score on detection rate. Results: In 67.8% of patients, prostate cancer was detected with repeated ex-vivo biopsies using the same mapping postoperative-ly. We found an increase in PSA level, PSA density and biopsy Gleason score; patient age, decreases in prostate weight and free/ total PSA ratio yielded higher detection rates. All cores, except the left-lateral cores, showed mild-moderate or moderate internal consistency. Preoperative in-vivo biopsy Gleason scores remained the same, decreased and increased in 43.3%, 8.9% and 47.8% of patients, respectively, on final specimen pathology. Conclusions: The detection rate of prostate cancer with 12-core biopsy in patients (all of whom had prostate cancer) was considerably low. Effectively, repeat biopsies can still be negative despite the patient's reality of having prostate cancer. The detection rate is higher if 12-core biopsies are repeated in younger patients, patients with high PSA levels, PSA density and Gleason scores, in addition in patients with smaller prostates, lower free/total PSA ratios. original research serefoglu et al.
E293Cite as: Can Urol Assoc J 2013;7(5-6):e293-8. http://dx.doi.org/10.5489/cuaj.11224 Published online May 13, 2013 (early released March 2, 2012). AbstractIntroduction: Prostate biopsies incur the risk of being false-negative and this risk has not yet been evaluated for 12-core prostate biopsy. We calculated the false-negative rate of 12-core prostate biopsy and determined the patient characteristics which might affect detection rate. Methods: We included 90 prostate cancer patients (mean age of 64, range: 49-77) diagnosed with transrectal ultrasound guided 12-core prostate biopsy between December 2005 and April 2008. All patients underwent radical retropubic prostatectomy and the 12-core prostate biopsy procedure was repeated on surgical specimen ex-vivo. Results of preoperative and postoperative prostate biopsies were compared. We analyzed the influence of patient age, prostate weight, serum prostate-specific antigen (PSA) level, free/ total PSA ratio, PSA density and Gleason score on detection rate. Results: In 67.8% of patients, prostate cancer was detected with repeated ex-vivo biopsies using the same mapping postoperatively. We found an increase in PSA level, PSA density and biopsy Gleason score; patient age, decreases in prostate weight and free/ total PSA ratio yielded higher detection rates. All cores, except the left-lateral cores, showed mild-moderate or moderate internal consistency. Preoperative in-vivo biopsy Gleason scores remained the same, decreased and increased in 43.3%, 8.9% and 47.8% of patients, respectively, on final specimen pathology. Conclusions: The detection rate of prostate cancer with 12-core biopsy in patients (all of whom had prostate cancer) was considerably low. Effectively, repeat biopsies can still be negative despite the patient's reality of having prostate cancer. The detection rate is higher if 12-core biopsies are repeated in younger patients, patients with high PSA levels, PSA density and Gleason scores, in addition in patients with smaller prostates, lower free/total PSA ratios. IntroductionThe most accurate way to detect cancer cells inside the prostate gland is the surgical removal and histopathological examination of the entire gland. As this approach is clinically inapplicable to each patient with suspicious findings, prostate biopsy is accepted as the best diagnostic technique to detect prostate cancer. Indeed, the introduction of transrectal ultrasound (TRUS)-guided systematic sextant biopsy method by Hodge and colleagues in 1989 revolutionized the early diagnosis of prostate cancer. 1 However, there are two shortcomings of this technique. Firstly, the amount of tissue sampled during prostate biopsy is limited and cancer cells can be missed. Secondly, the way prostate biopsy accurately diagnoses prostate cancer is unclear and various prostate biopsy regimens were introduced to optimize the detection rate. [2][3][4] Presumably, the most extensive and invasive regimens had better detection rates, compared to biopsy regimens with less biopsy cores. These regimens ar...
HYA and PRP can be safely injected into vocal cords. Our findings show that HYA is a biocompatible and safe injection material for clinical use. Only two of the six vocal cords showed HYA at the end of two months, suggesting that HYA is a short-term effective material. Similarly, PRP was also shown to be a short-term effective material and can be used in patients for testing purpose before using a long-term effective material. The advantages of PRP are that it is inexpensive, readily available, and completely inert as it is prepared from the subject itself.
Exogenous ochronosis is characterized by hyperpigmented skin lesions that arise in association with local suppression of homogentisic acid oxidase enzyme. Although it generally develops in association with topical application of chemical agents, it can occasionally develop in association with antimalarial drugs. Here we present the case of a patient with rheumatoid arthritis who developed hyperpigmentation on the face and neck regions during hydroxychloroquine treatment. Hydroxychloroquine is being widely used in rheumatology practice, and cutaneous hyperpigmentation may develop as an adverse effect. In the present case, we emphasize the potential underlying mechanisms through which it may cause cutaneous hyperpigmentation and determine the clinical and histopathological findings of exogenous ochronosis.
Adult intussusception is a rare entity accounting for 1% of all bowel obstructions. Unlike intussusceptions in children, which are idiopathic in 90% of cases, adult intussusceptions have an identifiable cause (lead point) in the majority of cases. Crohn's disease (CD) may affect any part of the gastrointestinal tract, including the appendix. It was shown to be a predisposing factor for intussusception. Here, we report a rare case of adult intussusception with a lead point, emphasizing diagnostic input of multidetector computed tomography (MDCT) in a patient with active CD that involves the appendix.
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