Prostate biopsy using transrectal ultrasonography; the optimal number of cores regarding cancer detection rate and complications

Background: Transrectal ultrasound guided biopsy of the prostate is the most common modality used to diagnose prostate cancer. Objectives: The aim of this study was to evaluate the optimal number of cores at prostate biopsy, which have the most diagnostic value with least adverse effects. Patients and Materials: Transrectal ultrasonography (TRUS) guided biopsy was performed in 180 patients suspicious for prostate cancer due to either abnormal rectal examination or elevated PSA. The patients were divided randomly into three groups of six-core, twelvecore and eighteen-core biopsies. The detection rate of prostate cancer in each group with the rate of post biopsy urinary infection and prostatitis were compared. Results: Prostate cancer was diagnosed in 8 (13.3), 21 (35) and 24 (40) patients in six, twelve and eighteen core biopsy groups, respectively. Urinary tract infection and prostatitis occurred in 17 (28.3), 23 (38.3) and 35 (58.3) patients in six, twelve and eighteen core biopsy groups, respectively. Considering the detection rate of prostate cancer, there was a significant difference between 6 and 12 core biopsy groups (P = 0.006) and 12-core biopsies detected more cases of prostate cancer, but there was no significant difference between 12 and 18 core biopsy groups (P = 0.572). Considering the infection rate, there was no significant difference between 6 and 12 core biopsy groups (P = 0.254), but there was a significant difference between 12 and 18 core biopsy groups (P = 0.028) and infectious complications occurred more frequently in 18-core biopsy group. Conclusions: The best balance between detection rate of prostate cancer and infectious complications of biopsies achieved in twelve-core biopsy protocol. Twelve-core biopsy enhances the rate of prostate cancer detection with minimum adverse effects. © 2015, Tehran University of Medical Sciences and Iranian Society of Radiology

Signature change from Schutz's canonical quantum cosmology and its classical analogue

We study the signature change in a perfect fluid Friedmann-Robertson-Walker quantum cosmological model. In this work the Schutz's variational formalism is applied to recover the notion of time. This gives rise to a Schrodinger-Wheeler-DeWitt equation with arbitrary ordering for the scale factor. We use the eigenfunctions in order to construct wave packets and evaluate the time-dependent expectation value of the scale factor which coincides with the ontological interpretation. We show that these solutions exhibit signature transitions from a finite Euclidean to a Lorentzian domain. Moreover, such models are equivalent to a classical system where, besides the perfect fluid, a repulsive fluid is present.Comment: 15 pages, 4 figures, to appear in PR

Bioaccumulation of heavy metals by Dyera costulata cultivated in sewage sludge contaminated soil

High concentrations of heavy metals are harmful to plants, animals and humans and their potential accumulation in human tissues and bio-magnification through the food chain cause serious health hazards. An experiment was conducted in the glasshouse to evaluate the potential of Dyera costulata as a bioaccumulator to absorb heavy metals from sewage sludge contaminated soils. D. costulata seedlings were planted in the following growth media: T0 (control soil), T1 (100% sludge), T2 (80% sludge + 20% soil), T3 (60% sludge + 40% soil), T4 (40% sludge + 60% soil) and T5 (20% sludge + 80% soil). T4 showed the best growth performance in terms of height, basal diameter and number of leaves. The maximum reduction of Cd, Cr and Pb was found in the 100% sludge treatment. Zn, Cd, Ni and Cr were highly concentrated in the leaves, while Pb accumulated mainly in the stems. D. costulata showed high potential to retain high amounts of Zn, Ni and Cr in the leaves and Pb in the stems. The species had high translocation factor (TF) and low bioconcentration factor (BCF) values in the soil at higher metal concentrations as well as it was able to tolerate and accumulate high concentrations of Zn, Cd, Ni, Cr and Pb. It means that, this species is a good accumulator of heavy metals and can be considered as a potential bioaccumulator species.Key words: Phytoremediation, Dyera costulata, heavy metals, sewage sludge

Sonographic evaluation of cervical lymphadenopathy; Comparison of metastatic and reactive lymph nodes in patients with head and neck squamous cell carcinoma using gray scale and doppler techniques

Background: Cervical lymphadenopathy could be seen in several pathologic processes. An accurate differentiation between these conditions is of utmost importance to select an appropriate therapy and assess the prognosis. Gray scale and Doppler are appropriate sonographic techniques for evaluating internal and external features of lymph nodes. Although, various criteria have been proposed to differentiate metastatic lymph nodes from benign ones, the most valuable and specific sonographic features are still under dispute. Objectives: The present study was designed to determine valuable sonographic features for differentiating metastasis from benign nodes using gray scale and Doppler sonography. Patients and Methods: A prospective diagnostic study was performed on 63 patients with head and neck squamous cell carcinoma (SCC) treated and referred to surgery clinic of Hazrat Rasoul Akram hospital from November 2010 to June 2012 with complaint of palpable cervical lymph node. All patients� necks were scanned multidirectionally by gray-scale and Doppler techniques. After sonography, lymph nodes were biopsied and investigated to find out whether they were metastatic or reactive. Finally, demographic, sonographic and pathologic data were statistically analyzed by SPSS ver. 16 software using t-test, a nonparametric test and ROC analysis. Ninety five percent confidence interval was considered for all parameters. Results: The study included 41 males and 22 females with a mean age of 57.56 ± 13.79 years. The number of metastatic lymph nodes was 47, while the remaining 16 were reactive. There were significant differences in length (P = 0.037), width (P = 0.001), resistance index (P < 0.001), pulsatility index (P < 0.001) and systolic velocity (P < 0.001) of metastatic and reactive lymph nodes. Cut points for resistive and pulsatility indexes and systolic velocity were calculated as 0.695, 1.35 and 16.5, respectively. The most valuable factor for defining a lymph node as metastatic was circulation pattern with accuracy, sensitivity and specificity of 94, 85 and 93, respectively. Conclusion: Gray scale sonography in combination with Doppler sonography could be a trustworthy technique in differentiating metastatic lymph nodes from reactive ones. Although, circulation pattern had a higher diagnostic accuracy in the present study, combination of sonographic characteristics could be more beneficial in differentiating metastatic cervical nodes from reactive ones. © 2015, Tehran University of Medical Sciences and Iranian Society of Radiology

Efficacy of Probiotic Escherichia coli Nissle 1917 in Patients with Irritable Bowel Syndrome: a Double Blind Placebo-controlled Randomized Trial

AIM: to evaluate potential improvement effect for probiotic E. coliNissle 1917 in the management of refractory IBS in an Iranian population. METHODS: a double blind placebo controlled approach has been used in the current clinical trial. 139 confirmed IBS patients were included into the study, and were given probiotic E.coli Nissle 1917 for 6 weeks. 11 items Birmingham IBS Symptom Questionnairehas been used for evaluation of changes in the symptoms every 2 weeks. CONCLUSION: probiotic therapy with E.coli Nissle 1917 was not able to induce significant improvement in the symptoms of patients with non-categorized IBS. Nevertheless, when IBS patients were recategorized to subgroups according to their main symptoms, evaluation of the efficacy of the probiotic on some individual items in the symptom list reached the significance level. Prospective clinical trials are recommended to confirm our findings. RESULTS: sixty eight subjects (49) were males. Mean±SD age of the participants was 38±13.3 years. 49(35.3) of the patients were diarrhea-predominant. The total scores showed no significant difference between the intervention vs. control group(-6.7±6.8 vs. -6.7±6.5, respectively; p=0.95); neither did any of the questionnaire items any significant alterations in the two groups. After stratification of patients based on their IBS type, diarrhea-predominant patients showed a positive response to the probiotic improving their sleep (p=0.05 and 0.03 at weeks 2 and 6, respectively). Patients with constipation-predominant IBS showed no response to the probiotic; while patients with diarrhea-constipation mixed IBS showed unfavorable response to the probiotic in the need for strain to pass a motion compared to the placebo (p=0.03 and 0.02 at weeks 4 and 6, respectively)

4D printing of recoverable buckling-induced architected iron-based shape memory alloys

Architected materials exhibit extraordinary properties in comparison with conventional materials and structures, resulting in additional functionality and efficiency by engineering the geometry in harmony with the base material. Buckling-induced architected materials (BIAMs) are a class of architected materials that exhibit a significant potential to absorb and dissipate energy owing to their local instabilities. Previous studies have shown a trade-off between energy dissipation and geometrical recoverability in metallic BIAM, which limits their use in applications that require both of these features. This study, for the first time, presents 4D printing of buckling-induced architected iron-based shape memory alloys (BIA Fe-SMAs) using laser powder bed fusion (LPBF). The results show that 4D printing of BIA Fe-SMAs can offer both energy dissipation and geometrical recoverability (i.e., recentring). The study was conducted on two different alloy compositions of Fe-17Mn-5Si-10Cr-4Ni. Quasi-static cyclic tests were performed on the two BIA Fe-SMAs, and the samples were subsequently heated to 200 °C to activate the shape memory effect (SME) of the base material. The samples could recover the residual deformations accumulated during the cyclic load owing to the SME of the base material, which led to shape-recovery ratios of 96.8 and 98.7% for the studied BIA Fe-SMAs. The results of this study demonstrate that 4D printing of BIA Fe-SMAs can yield an enhanced multi-functional behavior by combining the material's inherent functional behavior with the functionalities of the architected structure. Notably, BIA Fe-SMA samples could reconfigure their initial shape without damage after densification, which sets them apart from conventional crushable lattices

Classical and quantum spinor cosmology with signature change

We study the classical and quantum cosmology of a universe in which the matter source is a massive Dirac spinor field and consider cases where such fields are either free or self-interacting. We focus attention on the spatially flat Robertson-Walker cosmology and classify the solutions of the Einstein-Dirac system in the case of zero, negative and positive cosmological constant $\Lambda$. For $\Lambda<0$, these solutions exhibit signature transitions from a Euclidean to a Lorentzian domain. In the case of massless spinor fields it is found that signature changing solutions do not exist when the field is free while in the case of a self-interacting spinor field such solutions may exist. The resulting quantum cosmology and the corresponding Wheeler-DeWitt equation are also studied for both free and self interacting spinor fields and closed form expressions for the wavefunction of the universe are presented. These solutions suggest a quantization rule for the energy.Comment: 13 pages, 4 figure

MRI in prostate cancer

Imaging studies play an important role in detection and management of prostate cancer and MRI especially with the use of endorectal coil because of high contrast resolution is recognized as the best imaging modality in evaluation of prostate cancer. Multiparametric MR study including T1 and T2 weighted images, diffusion weighted images, dynamic contrast study and MR spectroscopy is useful for detection and local staging of prostate cancer as well as posts treatment evaluation of patients either after surgery or radiation therapy for detection of local recurrence. © 2013, Iranian Red Crescent Medical Journal

Using Spectral Method as an Approximation for Solving Hyperbolic PDEs

We demonstrate an application of the spectral method as a numerical approximation for solving Hyperbolic PDEs. In this method a finite basis is used for approximating the solutions. In particular, we demonstrate a set of such solutions for cases which would be otherwise almost impossible to solve by the more routine methods such as the Finite Difference Method. Eigenvalue problems are included in the class of PDEs that are solvable by this method. Although any complete orthonormal basis can be used, we discuss two particularly interesting bases: the Fourier basis and the quantum oscillator eigenfunction basis. We compare and discuss the relative advantages of each of these two bases.Comment: 19 pages, 14 figures. to appear in Computer Physics Communicatio