Fine-needle Aspiration Biopsy For Breast Lesions: A Comparison Between Two Devices For Obtaining Cytological Samples

Context and Objective: Fine-needle aspiration biopsy has been accepted worldwide for breast lesions. However, some questions remain, including the appropriateness of the puncture method. The objective of this work was to compare aspirates obtained by the auto-vacuum device and by the syringe pistol holder. Design and Setting: Randomized trial for validation of diagnostic method, at Hospital das Clinicas do Universidade Federal de Goiás and Hospital Araújo Jorge, Goiânio. Methods: 351 patients presenting breast lumps underwent fine-needle aspiration biopsy, either with the auto-vacuum device or the syringe pistol holder. A single cytopathologist analyzed all of the cytology slides. The rates of insufficient material, cellularity, cell distortion and background hemorrhage were evaluated. Results: The percentages of insufficient material were 16% and 22% (p = 0.18), for the auto-vacuum and pistol aspirates, respectively. Good cellularity was seen in 34% of autovacuum and 29% of pistol samples (p = 0.4). Cell distortion was seen in 31 and 26 cases, respectively (p = 07). Background hemorrhage occurred in 63 (35%) and 54 cases (31%) (p = 0.2), for auto-vacuum and pistol. The sensitivity was 88% and 86%; specificity 99% and 100%, positive predictive value 96% and and 100%, negative predictive value 96% and 95% and total occuracy 76% and 75% for the auto-vacuum and pistol, respectively. Conclusion: The results obtained from the two fine-needle aspiration biopsy methods were equivalent. Therefore, the auto-vacuum device is a good option for obtaining aspirates for cytology.1236271276Catania, S., Ciatto, S., Breast cytology: Instruments and technique (1992) Breast Cytology in Clinical Practice, pp. 11-60. , In: Ciatto S, editor. London: Martin DunitzDe Freitas Jr., R., Hamed, H., Fentiman, I., Fine needle aspiration cytology of palpable breast lesions (1992) Br J Clin Pract, 46 (3), pp. 187-190Franzen, S., Zajicek, J., Aspiration biopsy in diagnosis of palpable lesions of the breast. Critical review of 3479 consecutive biopsies Acta (1968) Radiol Ther Phys Biol, 7 (4), pp. 241-262Souza, J.A., Freitas Jr., R., Moreita, M.A.R., Philocreon, G.R., Acurácia da sensação tátil da PAAF no diagnóstico de less̄ocs mamárias (1995) Rev Bras Mastologia, 5 (3), pp. 7-10Freitas Júnior, R., Hamed, H., Millis, R.R., Tomas, N.M.A., Fentiman, I.S., Fine needle aspiration of breast lesions using auto-vacuum dispositive (1996) Rev Bras Mastologia, 6 (3), pp. 126-128de Freitas Júnior, R., Giraldo, P.C., Rerrori, O., Vieira-Matos, A.N., Tambascia, J.K., Fine needle aspiration biopsy of solid tumours by auto-vacuum system: A study in rats (1992) Eur J Surg Oncol, 18 (6), pp. 605-607Boccato, P., How to treat the aspirated material (1992) Breast Cytology in Clinical Practice, pp. 61-64. , In: Ciatto, S, editor London: Martin Dunitz(1987) International Union Against Cancer, , UICC. TNM classification of malignant tumors. Berlin: Springer-Verlag(1982) Am J Clin Pathol, 78 (6), pp. 806-816. , The World Health Organization Histological Typing of Breast Tumors - Second Edition. The World OrganizationGelabert, H.A., Hsiu, J.G., Mullen, J.T., Jaffe, A.H., D'Amato, N.A., Prospective evaluation of the rate of fine-needle aspiration biopsy in the diagnosis and management of patiencs with palpable solid breast lesions (1990) Am Surg, 56 (4), pp. 263-267Rouquayrol, M.Z., Epidemiologia e saúde (1988), Rio de Janeiro: Medsi - Editora CientíficaRoberts, J.C., Rainsbury, R.M., 'Tactile sensation: A new clinical sign during fine needle aspiration of breast lumps Ann (1994) R Coll Surg Eng, 76 (2), pp. 136-138Henderson, M.A., McCready, D.R., A simple technique for fine needle aspiration cytology (1994) J Am Coll Surg, 179 (4), pp. 471-473Sasaki, J., Izu, K., Automatic fine needle aspiration pistol specially designed for small tumors (1998) Acta Cytol, 42 (3), pp. 829-830Tao, L.C., Smith, J.W., Fine-needle aspiration biopsy using a newly-developed pencil-grip syringe holder (1999) Diagn Cytopathol, 20 (2), pp. 99-104Parel, J.J., Garrell, P.C., Smallwood, J.A., Fine needle aspiration cytology of breast masses: An evaluation of its accuracy and reasons for diagnostic failure (1987) Ann R Coll Surg Engl, 69 (4), pp. 156-159Abele, J., Stanley, M.W., Rollnis, S.D., Miller, T.R., What constitutes an adequate smear in fine-needle aspiration cytology of the breast? (1998) Cancer, 84 (1), pp. 57-61Zajdela, A., Ghossein, N.A., Pilleron, J.P., Ennuyer, A., The value of aspiration cytology in the diagnosis of breast cancer: Experience at the Fondation Curie (1975) Cancer, 35 (2), pp. 499-506Layfield, L.J., Dodd, L.G., Cytologically low grade malignancies: An important interpretative pitfall responsible for false negative diagnoses in fine-needle aspiration of the breast (1996) Diagn Cytopathol, 15 (3), pp. 250-259Feichter, G.E., Haberthür, F., Gobat, S., Dalquen, P., Breast cytology. Statistical analysis and cytohistologic correlations (1997) Acta Cytol, 41 (2), pp. 327-332Arisio, R., Cuccorese, C., Accinelli, G., Mano, M.P., Bordon, R., Fessia, L., Role of fine-needle aspiration biopsy in breast lesions: Analysis of a series of 4,110 cases (1998) Diagn Cytopathol, 18 (6), pp. 462-467Ariga, R., Bloom, K., Reddy, V.B., Fine-needle aspiration of clinically suspicious palpable breast masses with histopathologic correlation (2002) Am J Surg, 184 (5), pp. 410-41

Processing second-order stochastic dominance models using cutting-plane representations

This is the post-print version of the Article. The official published version can be accessed from the links below. Copyright @ 2011 Springer-VerlagSecond-order stochastic dominance (SSD) is widely recognised as an important decision criterion in portfolio selection. Unfortunately, stochastic dominance models are known to be very demanding from a computational point of view. In this paper we consider two classes of models which use SSD as a choice criterion. The first, proposed by Dentcheva and Ruszczyński (J Bank Finance 30:433–451, 2006), uses a SSD constraint, which can be expressed as integrated chance constraints (ICCs). The second, proposed by Roman et al. (Math Program, Ser B 108:541–569, 2006) uses SSD through a multi-objective formulation with CVaR objectives. Cutting plane representations and algorithms were proposed by Klein Haneveld and Van der Vlerk (Comput Manage Sci 3:245–269, 2006) for ICCs, and by Künzi-Bay and Mayer (Comput Manage Sci 3:3–27, 2006) for CVaR minimization. These concepts are taken into consideration to propose representations and solution methods for the above class of SSD based models. We describe a cutting plane based solution algorithm and outline implementation details. A computational study is presented, which demonstrates the effectiveness and the scale-up properties of the solution algorithm, as applied to the SSD model of Roman et al. (Math Program, Ser B 108:541–569, 2006).This study was funded by OTKA, Hungarian National Fund for Scientific Research, project 47340; by Mobile Innovation Centre, Budapest University of Technology, project 2.2; Optirisk Systems, Uxbridge, UK and by BRIEF (Brunel University Research Innovation and Enterprise Fund)

Aviremia 10 Years Postdiscontinuation of Antiretroviral Therapy Initiated During Primary Human Immunodeficiency Virus-1 Infection and Association With Gag-Specific T-Cell Responses.

Combination antiretroviral therapy during primary human immunodeficiency virus-1 infection may enable long-term drug-free virological control in rare individuals. We describe a female who maintained aviremia and a normal CD4(+)/CD8(+) T cell ratio for 10 years after stopping therapy, despite a persistent viral reservoir. Cellular immune responses may have contributed to this outcome

Notes on entropic characteristics of quantum channels

One of most important issues in quantum information theory concerns transmission of information through noisy quantum channels. We discuss few channel characteristics expressed by means of generalized entropies. Such characteristics can often be dealt in line with more usual treatment based on the von Neumann entropies. For any channel, we show that the $q$-average output entropy of degree $q\geq1$ is bounded from above by the $q$-entropy of the input density matrix. Concavity properties of the $(q,s)$-entropy exchange are considered. Fano type quantum bounds on the $(q,s)$-entropy exchange are derived. We also give upper bounds on the map $(q,s)$-entropies in terms of the output entropy, corresponding to the completely mixed input.Comment: 10 pages, no figures. The statement of Proposition 1 is explicitly illustrated with the depolarizing channel. The bibliography is extended and updated. More explanations. To be published in Cent. Eur. J. Phy

Molecular dynamics simulation of the order-disorder phase transition in solid NaNO2_2

We present molecular dynamics simulations of solid NaNO$_2$ using pair potentials with the rigid-ion model. The crystal potential surface is calculated by using an \emph{a priori} method which integrates the \emph{ab initio} calculations with the Gordon-Kim electron gas theory. This approach is carefully examined by using different population analysis methods and comparing the intermolecular interactions resulting from this approach with those from the \emph{ab initio} Hartree-Fock calculations. Our numerics shows that the ferroelectric-paraelectric phase transition in solid NaNO$_2$ is triggered by rotation of the nitrite ions around the crystallographical c axis, in agreement with recent X-ray experiments [Gohda \textit{et al.}, Phys. Rev. B \textbf{63}, 14101 (2000)]. The crystal-field effects on the nitrite ion are also addressed. Remarkable internal charge-transfer effect is found.Comment: RevTeX 4.0, 11 figure

Entangled-Photon Generation from Parametric Down-Conversion in Media with Inhomogeneous Nonlinearity

We develop and experimentally verify a theory of Type-II spontaneous parametric down-conversion (SPDC) in media with inhomogeneous distributions of second-order nonlinearity. As a special case, we explore interference effects from SPDC generated in a cascade of two bulk crystals separated by an air gap. The polarization quantum-interference pattern is found to vary strongly with the spacing between the two crystals. This is found to be a cooperative effect due to two mechanisms: the chromatic dispersion of the medium separating the crystals and spatiotemporal effects which arise from the inclusion of transverse wave vectors. These effects provide two concomitant avenues for controlling the quantum state generated in SPDC. We expect these results to be of interest for the development of quantum technologies and the generation of SPDC in periodically varying nonlinear materials.Comment: submitted to Physical Review

Erratum: Author Correction: Transitions from Ideal to Intermediate Cholesterol Levels may vary by Cholesterol Metric (Scientific reports (2018) 8 1 (2782))

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper

Transitions from Ideal to Intermediate Cholesterol Levels may vary by Cholesterol Metric

To examine the ability of total cholesterol (TC), a low-density lipoprotein cholesterol (LDL-C) proxy widely used in public health initiatives, to capture important population-level shifts away from ideal and intermediate LDL-C throughout adulthood. We estimated age (≥20 years)-, race/ethnic (Caucasian, African American, and Hispanic/Latino)-, and sex- specific net transition probabilities between ideal, intermediate, and poor TC and LDL-C using National Health and Nutrition Examination Survey (2007–2014; N = 13,584) and Hispanic Community Health Study/Study of Latinos (2008–2011; N = 15,612) data in 2016 and validated and calibrated novel Markov-type models designed for cross-sectional data. At age 20, >80% of participants had ideal TC, whereas the race/ethnic- and sex-specific prevalence of ideal LDL-C ranged from 39.2%-59.6%. Net transition estimates suggested that the largest one-year net shifts away from ideal and intermediate LDL-C occurred approximately two decades earlier than peak net population shifts away from ideal and intermediate TC. Public health and clinical initiatives focused on monitoring TC in middle-adulthood may miss important shifts away from ideal and intermediate LDL-C, potentially increasing the duration, perhaps by decades, that large segments of the population are exposed to suboptimal LDL-C

QED3 theory of underdoped high temperature superconductors

Low-energy theory of d-wave quasiparticles coupled to fluctuating vortex loops that describes the loss of phase coherence in a two dimensional d-wave superconductor at T=0 is derived. The theory has the form of 2+1 dimensional quantum electrodynamics (QED3), and is proposed as an effective description of the T=0 superconductor-insulator transition in underdoped cuprates. The coupling constant ("charge") in this theory is proportional to the dual order parameter of the XY model, which is assumed to be describing the quantum fluctuations of the phase of the superconducting order parameter. The principal result is that the destruction of phase coherence in d-wave superconductors typically, and immediately, leads to antiferromagnetism. The transition can be understood in terms of the spontaneous breaking of an approximate "chiral" SU(2) symmetry, which may be discerned at low enough energies in the standard d-wave superconductor. The mechanism of the symmetry breaking is analogous to the dynamical mass generation in the QED3, with the "mass" here being proportional to staggered magnetization. Other insulating phases that break chiral symmetry include the translationally invariant "d+ip" and "d+is" insulators, and various one dimensional charge-density and spin-density waves. The theory offers an explanation for the rounded d-wave-like dispersion seen in ARPES experiments on Ca2CuO2Cl2 (F. Ronning et. al., Science 282, 2067 (1998)).Comment: Revtex, 20 pages, 5 figures; this is a much extended follow-up to the Phys. Rev. Lett. vol.88, 047006 (2002) (cond-mat/0110188); improved presentation, many additional explanations, comments, and references added, sec. IV rewritten. Final version, to appear in Phys. Rev.

Mercury concentrations in two “great waters”

Although many sources of Hg to surface waters have been identified including atmospheric deposition, resuspension of contaminated sediments, and direct discharges, there are very few recent data on ambient concentrations in the large lakes. Thus, an investigation of Hg concentrations in Lake Champlain and Lake Michigan was completed in the summer of 1993. Three depths of water including the microlayer, 30 cm below the surface, and 1 m below the thermocline were collected for each sampling event using ultra-clean techniques. All samples were processed in the field for dissolved and particulate fractions in a portable plastic enclosure equipped with a HEPA filter, and then analyzed by dual amalgamation and cold vapor atomic fluorescence spectroscopy in a Class 100 clean room at the University of Michigan. In addition, samples were analyzed for other trace metals by ICP-MS. Results from the two field investigations include the following: (1) On average, Lake Michigan water samples had higher concentrations of Hg than Lake Champlain; (2) There was no consistent pattern of Hg concentrations in the water column; (3) There was variability in the concentrations of Hg from the same depths over consecutive sampling periods. This paper discusses these results, and examines the relationship between the patterns in mercury concentrations and other physical and chemical data collected during the investigation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43914/1/11270_2005_Article_BF01189709.pd