Transbronchial catheter aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer

<p>Abstract</p> <p>Objective</p> <p>The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial catheter aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy.</p> <p>Methods</p> <p>We analysed the results of 51 consecutively examined patients (age 68.7 ± 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 ≤ 3 cm. Fluoroscopy provided guidance in biopsies for both techniques.</p> <p>Results</p> <p>The mean diameter of the lesion was 3.7 ± 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma ≤ 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14).</p> <p>Conclusions</p> <p>Even in lesions ≤ 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.</p

Highlights from the Pierre Auger Observatory

The Pierre Auger Observatory is the world's largest cosmic ray observatory. Our current exposure reaches nearly 40,000 km$^2$ str and provides us with an unprecedented quality data set. The performance and stability of the detectors and their enhancements are described. Data analyses have led to a number of major breakthroughs. Among these we discuss the energy spectrum and the searches for large-scale anisotropies. We present analyses of our X$_{max}$ data and show how it can be interpreted in terms of mass composition. We also describe some new analyses that extract mass sensitive parameters from the 100% duty cycle SD data. A coherent interpretation of all these recent results opens new directions. The consequences regarding the cosmic ray composition and the properties of UHECR sources are briefly discussed.Comment: 9 pages, 12 figures, talk given at the 33rd International Cosmic Ray Conference, Rio de Janeiro 201

A type III complement factor D deficiency: Structural insights for inhibition of the alternative pathway.

Abstract Background: Complement factor D (FD) is the rate-limiting enzyme of the alternative complement pathway. Previous reports of FD deficiency featured absent plasma FD (type I deficiency) and susceptibility to meningococcal infection. A new FD mutant, which is non-functional but fully expressed, was identified in a patient with invasive meningococcal disease. Objectives: We sought to investigate the molecular features of this novel FD mutant. Methods: We performed complement haemolytic assays, western blot analysis of serum FD and Sanger sequencing of the CFD gene. Recombinant mutant FD was assessed by in vitro catalytic assays, circular dichroism, thermal shift assays, esterolytic assays and surface plasmon resonance. Molecular dynamics simulation was used to visualise the structural changes in mutant FD. Results: A homozygous single-nucleotide variation of the CFD gene in the patient and their sibling resulted in an arginine to proline (R176P) substitution in FD. While R176P FD was stable and fully expressed in blood, it had minimal catalytic activity. Mutation R176P caused key FD-C3bB binding exosite loop 156-162 to lose its binding-competent conformation and stabilised the inactive conformation of FD. Consequently, R176P FD was unable to bind its natural substrate, C3bB. Neither patient nor sibling demonstrated the glucose homeostasis impairment that occurs in FD-null mice. Conclusions: Here, we report the first genetically confirmed functional, or type III, deficiency of an activating complement serine protease. This novel mechanism of FD inhibition can inform further development of alternative pathway inhibitors to treat common inflammatory diseases such as age-related macular degeneration

Grain Size Control of Tetragonal Zirconia Polycrystals Using the Space Charge Concept

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65680/1/j.1151-2916.1990.tb06449.x.pd

"To work, or not to work, that is the question" – recent trends and avenues for research on presenteeism

This position paper brings together recent and emerging developments in the field of presenteeism. A critical synthesis of the evidence is needed due to persisting conceptual and methodological challenges as well as the increased volume of research in the field. This paper integrates emerging evidence and critical thinking into three areas: (1) concept, (2) measurement and methodological issues, and (3) the context of presenteeism. First, due to the variety of existing definitions, competing understandings, as well as the notion of positive presenteeism, it is important to reconsider the notion of presenteeism. Second, it is important to reflect on the measurement of the act of presenteeism and the productivity loss associated with that. Third, following the call to investigate presenteeism in specific contexts, it is important to explain the social, occupational, cross-cultural aspects, as well as the contemporary workplace changes. Based on this critical synthesis, we conclude by identifying recommendations for future research on presenteeism

Results of a self-triggered prototype system for radio-detection of extensive air showers at the Pierre Auger Observatory

We describe the experimental setup and the results of RAuger, a small radio-antenna array, consisting of three fully autonomous and self-triggered radio-detection stations, installed close to the center of the Surface Detector (SD) of the Pierre Auger Observatory in Argentina. The setup has been designed for the detection of the electric field strength of air showers initiated by ultra-high energy cosmic rays, without using an auxiliary trigger from another detection system. Installed in December 2006, RAuger was terminated in May 2010 after 65 registered coincidences with the SD. The sky map in local angular coordinates (i.e., zenith and azimuth angles) of these events reveals a strong azimuthal asymmetry which is in agreement with a mechanism dominated by a geomagnetic emission process. The correlation between the electric field and the energy of the primary cosmic ray is presented for the first time, in an energy range covering two orders of magnitude between 0.1 EeV and 10 EeV. It is demonstrated that this setup is relatively more sensitive to inclined showers, with respect to the SD. In addition to these results, which underline the potential of the radio-detection technique, important information about the general behavior of self-triggering radio-detection systems has been obtained. In particular, we will discuss radio self-triggering under varying local electric-field conditions