Real-time Telepathology Is Substantially Equivalent to In-Person Intraoperative Frozen Section Diagnosis

CONTEXT.—: Intraoperative diagnosis by frozen section is a mainstay of surgical pathology practice, providing immediate feedback to the surgical team. Despite good accuracy with modern methods, access to intraoperative surgical pathology with an appropriate turnaround time (TAT) has been a limiting factor for small or remote surgical centers, with negative impacts on cost and patient care. Telepathology offers immediate expert anatomic pathology consultation to sites without an in-house or subspecialized pathologist. OBJECTIVE.—: To assess the utility of live telepathology in frozen section practice. DESIGN.—: Frozen section diagnoses by telemicroscopy from 2 tertiary care centers with combined 3 satellite hospitals were queried for anatomic site, TAT per block, pathologist, and concordance with paraffin diagnosis. TAT and concordance were compared to glass diagnoses in the same period. RESULTS.—: For 748 intraoperative diagnoses by telemicroscopy, 694 had TATs with a mean of 18 minutes 56 seconds ± 8 minutes 45 seconds, which was slower than on glass (14 minutes 25 seconds ± 7 minutes 8 seconds, P \u3c .001). Twenty-two (2.89% of available) were discordant, which was not significantly different from the on-glass rate (P = .44) or categorical distribution (P = .31). Two cases (0.27%) had technical failures. CONCLUSIONS.—: Although in-person diagnoses were statistically faster, the great majority of telemicroscopic diagnoses were returned in less than 20 minutes. This remained true through numerous pathologists, pathology assistants and/or technicians, different hospitals, and during a combined 6 years. The concentration of discordant diagnoses among relatively few pathologists suggests individual comfort with telepathology and/or frozen section diagnosis. In rare cases, technologic issues prevented telemicroscopic diagnosis. Overall, this justifies continued use and expansion of telemicroscopic services in primary intraoperative diagnoses

Field theoretic calculation of the surface tension for a model electrolyte system

We carry out the calculation of the surface tension for a model electrolyte to first order in a cumulant expansion about a free field theory equivalent to the Debye-H\"uckel approximation. In contrast with previous calculations, the surface tension is calculated directly without recourse to integrating thermodynamic relations. The system considered is a monovalent electrolyte with a region at the interface, of width h, from which the ionic species are excluded. In the case where the external dielectric constant epsilon_0 is smaller than the electrolyte solution's dielectric constant epsilon we show that the calculation at this order can be fully regularized. In the case where h is taken to be zero the Onsager-Samaras limiting law for the excess surface tension of dilute electrolyte solutions is recovered, with corrections coming from a non-zero value of epsilon_0/epsilon.Comment: LaTeX, 14 pages, 3 figures, 1 tabl

Expression of Epstein–Barr Virus–Encoded Small RNA (by the EBER-1 Gene) in Liver Specimens from Transplant Recipients with Post-Transplantation Lymphoproliferative Disease

Epstein-Barr virus (EBV)—associated post-transplantation lymphoproliferative disease (PTLD) develops in 1 to 10 percent of transplant recipients, in whom it can be treated by a reduction in the level of immunosuppression. We postulated that the tissue expression of the small RNA transcribed by the EBER-1 gene during latent EBV infection would identify patients at risk for PTLD. We studied EBER-1 gene expression in liver specimens obtained from 24 patients 2 days to 22 months before the development of PTLD, using in situ hybridization with an oligonucleotide probe. Control specimens were obtained from 20 recipients of allografts with signs of injury due to organ retrieval, acute graft rejection, or viral hepatitis in whom PTLD had not developed 9 to 71 months after the biopsy. Of the 24 patients with PTLD, 17 (71 percent) had specimens in which 1 to 40 percent of mononuclear cells were positive for the EBER-1 gene. In addition, 10 of these 17 patients (59 percent) had specimens with histopathological changes suggestive of EBV hepatitis. In every case, EBER-1—positive cells were found within the lymphoproliferative lesions identified at autopsy. Only 2 of the 20 controls (10 percent) had specimens with EBER-1—positive cells (P<0.001), and such cells were rare. EBER-1 gene expression in liver tissue precedes the occurrence of clinical and histologic PTLD. The possibility of identifying patients at risk by the method we describe here and preventing the occurrence of PTLD by a timely reduction of immunosuppression needs to be addressed by future prospective studies. (N Engl J Med 1992;327:1710–4.), POST-TRANSPLANTATION lymphoproliferative disease (PTLD), either polyclonal or monoclonal, complicates the clinical course of 1 to 10 percent of organ-transplant recipients.123 Immunohistochemical studies have demonstrated that the lymphoid cells within the lesions of PTLD almost invariably contain Epstein–Barr virus (EBV), primarily in a state of latent infection.4,5 The EBER-1 gene is expressed early during latent EBV infection and codes for a small messenger RNA (mRNA) expressed at up to 107 copies per cell.6 We and others have previously demonstrated the value of the detection of EBER-1 RNA for identifying EBV-infected cells in formalin-fixed paraffin-embedded tissues.7,8 In the current investigation, we used… © 1992, Massachusetts Medical Society. All rights reserved

Curvature-Induced Defect Unbinding in Toroidal Geometries

Toroidal templates such as vesicles with hexatic bond orientational order are discussed. The total energy including disclination charges is explicitly computed for hexatic order embedded in a toroidal geometry. Related results apply for tilt or nematic order on the torus in the one Frank constant approximation. Although there is no topological necessity for defects in the ground state, we find that excess disclination defects are nevertheless energetically favored for fat torii or moderate vesicle sizes. Some experimental consequences are discussed.Comment: 12 pages, 15 eps figure

Spatters and Spills: Spreading Dynamics for Partially Wetting Droplets

We present a solvable model inspired by dimensional analysis for the time-dependent spreading of droplets that partially wet a substrate, where the spreading eventually stops and the contact angle reaches a nonzero equilibrium value. We separately consider small droplets driven by capillarity and large droplets driven by gravity. To explore both regimes, we first measure the equilibrium radius vs a comprehensive range of droplet volumes for four household fluids, and we compare the results with predictions based on minimizing the sum of gravitational and interfacial energies. The agreement is good and gives a reliable measurement of an equilibrium contact angle that is consistent in both small and large droplet regimes. Next, we use energy considerations to develop equations of motion for the time dependence of the spreading, in both regimes, where the driving forces are balanced against viscous drag in the bulk of the droplet and by friction at the moving contact line. Our approach leads to explicit prediction of the functional form of the spreading dynamics. It successfully describes prior data for a small capillary-driven droplet, and it fits well to new data we obtain for large gravity-driven droplets with a wide range of volumes. While our prediction for the dynamics of small capillary-driven droplets assumes the case of thin nearly wetting droplets, with a small contact angle, this restriction is not otherwise invoked

Spatters and Spills: Spreading Dynamics for Partially Wetting Droplets

We present a solvable model inspired by dimensional analysis for the time-dependent spreading of droplets that partially wet a substrate, where the spreading eventually stops and the contact angle reaches a nonzero equilibrium value. We separately consider small droplets driven by capillarity and large droplets driven by gravity. To explore both regimes, we first measure the equilibrium radius vs a comprehensive range of droplet volumes for four household fluids, and we compare the results with predictions based on minimizing the sum of gravitational and interfacial energies. The agreement is good and gives a reliable measurement of an equilibrium contact angle that is consistent in both small and large droplet regimes. Next, we use energy considerations to develop equations of motion for the time dependence of the spreading, in both regimes, where the driving forces are balanced against viscous drag in the bulk of the droplet and by friction at the moving contact line. Our approach leads to explicit prediction of the functional form of the spreading dynamics. It successfully describes prior data for a small capillary-driven droplet, and it fits well to new data we obtain for large gravity-driven droplets with a wide range of volumes. While our prediction for the dynamics of small capillary-driven droplets assumes the case of thin nearly wetting droplets, with a small contact angle, this restriction is not otherwise invoked

An integrated neuromechanical model of the mouse to study neural control of locomotion

The 11th International Symposium on Adaptive Motion of Animals and Machines. Kobe University, Japan. 2023-06-06/09. Adaptive Motion of Animals and Machines Organizing Committee.Poster Session P7

Continuous selections of multivalued mappings

This survey covers in our opinion the most important results in the theory of continuous selections of multivalued mappings (approximately) from 2002 through 2012. It extends and continues our previous such survey which appeared in Recent Progress in General Topology, II, which was published in 2002. In comparison, our present survey considers more restricted and specific areas of mathematics. Note that we do not consider the theory of selectors (i.e. continuous choices of elements from subsets of topological spaces) since this topics is covered by another survey in this volume