Complication Rate after Percutaneous Liver Biopsy Using a Real-time Ultrasound Approach and Introducing a Uniform Methodology: A Brief Report

Following the initial liver biopsy attempts, several techniques using a wide range of methodologies and materials were developed. Many studies on the evaluation of post-liver biopsy complications were conducted. However, their fundamental limitation was significant variance in patient demographics and methodology, which might account for the inconsistent outcomes. Therefore, a uniform methodology to perform percutaneous liver biopsies that result in comparable outcomes around the world is required. This study aimed to determine the precise complication rate following percutaneous liver biopsy using a consistent method in all individuals. It also aimed to establish a consistent operating procedure for a percutaneous liver biopsy that yielded comparable outcomes. Between July 2018 and July 2019, 116 patients were enrolled in this retrospective study for percutaneous liver biopsy. All individuals underwent a biopsy using the same procedure. There was an attempt to exclude elements that could have an impact on the complication rate. For this purpose, the same type and size of needle were utilized. Moreover, a single needle pass, a subcostal approach, deep inspiration breath holding, identical pre- and post-biopsy preparation, real-time ultrasonography guidance, the use of a single operator, and the absence of sedation or general anesthesia were the other approaches that were used to minimize the impact of variables that could raise complication rates. The overall complication rate was 19.8%, of which 18.9% of patients experienced pain and mild bleeding, and one patient (0.9%) experienced hematoma necessitating precautionary hospitalization. The overall percentage of patients who experienced pain was 13.8%. No further complications were observed. The findings of this study could provide an accurate estimate of the post-liver biopsy complication rate. Furthermore, due to a lower complication rate than other practiced procedures, this uniform methodology could be an attractive alternative in clinical practice. However, more research is required to confirm these results

Differential agronomic responses of bread wheat cultivars to drought stress in the west of Iran

Two similar and concurrent experiments were carried out in 2007- 2008 on dry land agriculture research sub- institute Sararood and Mahidasht agricultural research center to study the effects of drought stress on yield and yield components of wheat cultivars under field conditions. The experimental design was split plot based on randomized complete block design with three replications. Main plots consisted of four drought stress treatments which was imposed by irrigation stoppage at different growth stages, that is, at initiation of stem elongation stage (31 of the Zadoks) (I1), at booting stage (43 of the Zadoks) ( I2), at initiation of grain – filling stage (70 of the Zadoks) (I3), and full irrigation (I4). Subplots included three cultivars, that is, Chamran (C1), Marvdasht (C2), and Shahriar (C3). Compared to control treatment (I4), treatments (I1), (I2) and (I3) exhibited 85, 57 and 43% yield decreases, respectively. In response to moisture stress during different growth stages, Shahriar CV (C3) was damaged more severely than Chamran CV (C1), the latter enjoyed more yield stability under such conditions. The result of stepwise regression analysis showed that the most important yield component was number of grains per spike followed by number of spikes per unit area, then, by 1000 grain weight. Analysis of simple correlation and path analysis showed that, in overall, given direct and indirect effects of yield components on grain yields, number of grain per spike had the largest effect on grain yield.Keywords: Bread wheat, cultivar, drought stress, path analysis, grain yield, yield component

Differentiation between metastatic and tumour-free cervical lymph nodes in patients with papillary thyroid carcinoma by grey-scale sonographic texture analysis

Purpose: Papillary thyroid carcinoma (PTC) is the most common thyroid cancer, and cervical lymph nodes (LNs) are the most common extrathyroid metastatic involvement. Early detection and reliable diagnosis of LNs can lead to improved cure rates and management costs. This study explored the potential of texture analysis for texture-based classification of tumour-free and metastatic cervical LNs of PTC in ultrasound imaging. Material and methods: A total of 274 LNs (137 tumour-free and 137 metastatic) were explored using the texture analysis (TA) method. Up to 300 features were extracted for texture analysis in three normalisations (default, 3sigma, and 1-99%). Linear discriminant analysis was employed to transform raw data to lower-dimensional spaces and increase discriminative power. The features were classified by the first nearest neighbour classifier. Results: Normalisation reflected improvement on the performance of the classifier; hence, the features under 3sigma normalisation schemes through FFPA (fusion Fisher plus the probability of classification error [POE] + average correlation coefficients [ACC]) features indicated high performance in classifying tumour-free and metastatic LNs with a sensitivity of 99.27%, specificity of 98.54%, accuracy of 98.90%, positive predictive value of 98.55%, and negative predictive value of 99.26%. The area under the receiver operating characteristic curve was 0.996. Conclusions: TA was determined to be a reliable method with the potential for characterisation. This method can be applied by physicians to differentiate between tumour-free and metastatic LNs in patients with PTC in conventional ultrasound imaging

The importance of localizing pulmonary veins in atrial septal defect closure!

An 8-year-old girl was admitted for a simple closure of echocardiographically diagnosed Atrial Septal Defect (ASD). During the operation the right pulmonary veins orifices were not detected in the left atrium and attempt to localize them led to the discovery of three additional anomalies, namely Interrupted Inferior Vena Cava (IIVC), Scimitar syndrome, and systemic arterial supply of the lung. Postoperatively these finding were confirmed by CT angiography. This case report emphasizes the need for adequate preoperative diagnosis and presents a very rare constellation of four congenital anomalies that to the best of our knowledge is not reported before

Renal cell carcinoma in a child

Renal cell carcinoma is a rare disease in children and adolescent. Less than <i> 2&#x0025; </i> of cases occur in childhood and no treatment protocols exist among urologists and oncologists for management. We present a case of renal cell carcinoma in a child with uncommon presentation

The use of micro pulse oximetery as a new detector of tissue perfusion in solid organ transplantation

Vascular complications are a frequent cause of transplant failure; angiography, duplex sonography, computerized tomography (CT) scan, CT-angiography and microdialysis are the methods that were suggested for the detection of arterial obstruction after transplantation. In this study, we suggest a new method. Eight healthy adult dogs were included in the trial. All cases were operated by the same surgeon and the liver, pancreas, spleen, kidney and bowel tissue were exposed. The probes of the device, which were designed for this study, were inserted on the organ parenchyma. The device, a neonatal pulse oximeter, has two probes that were fixed by a holder in front of each other; the distance between the probes was changeable via a spring. The pulse and the oxygen saturation of the tissue were measured initially. Following this, by inducing ischemia with vessel clamping, the pulse and the oxygen saturation were measured again. The collected data were analyzed under the supervision of a statistician. In the liver and spleen, we could not detect a clear pulse wave and oxygenation. On the other hand, in the pancreas, kidney and bowel, we detected a clear curve of oxygenation and pulse in all cases. Obstruction caused significant changes: the pulse was not detected and the oxygenation decreased significantly. Our study suggests that with early diagnosis, the surgeons can detect arterial occlusion immediately and early intervention may decrease parenchymal damage. This study is the first experience in this field, and these findings need to be validated with further studies

The role of renal autotransplantation in treatment of nutcracker syndrome

To report our experience with renal autotransplantation in treatment of gross hema-turia caused by nutcracker Syndrome (NCS). Between September 2005 and January 2008, four pa-tients of mean age 25.5 years (range: 23-28) with gross hematuria were diagnosed to have NCS. Investigations revealed isolated hematuria on urinalysis, a bloody efflux from left ureteral orifice by urethrocystoscopy, dilatation of left renal vein (LRV) with significant difference in peak sys-tolic velocity in Colour Doppler UltraSonography (CDUS) and dilatation and compression of LRV between aorta and superior mesenteric artery in MRA. After operation, hematuria dis-appeared in all patients. No vascular or urological complication was seen. Follow up ranged from 4 to 24 months. In conclusion, autotransplatation of left kidney is very effective for the treatment of symptomatic NCS