PubMed · 11115948
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P D Stevens, M J Wiersema. 2000. Coding for EUS.. https://doi.org/10.1067/mge.2000.110715
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BACKGROUND: When sextant prostate biopsy specimens are performed, noting the location from which cancer-containing cores were taken aids in treatment planning. However, many institutions include several cores in a single container, to cut costs. We have tried several methods of ink application and combining ink-labeled biopsy specimens into fewer containers with the goal of maintaining information regarding location while minimizing the expense. METHODS: Several approaches to the application of tissue-marking ink to biopsy cores, core-preparation methods, color combinations, and numbers of cores in each container were assessed. RESULTS: The ink adheres well to dry cores, but these cores often exhibit dehydration artifact. Placing the cores on a wet sponge avoids dehydration but causes ink spread. Excessive ink application occurs with eyedroppers and syringes but is avoided by touching each core with an ink-moistened cotton swab. Application of 1% acetic acid to the inked core promotes congealing of the ink onto the tissue. Yellow, orange, and red ink are more difficult to distinguish than blue, black, or green. Deciphering distinct cores when three or more cores are combined is difficult, especially if cores are fragmented. CONCLUSIONS: With our current protocol, all biopsy specimens are placed on separate moistened gauze sponges. Specimens from the right side of the prostate are marked by green ink, and those from the left side are marked by black ink with a cotton swab. After applying 1% acetic acid to each core, the left and right cores from each location are placed in a single container. This method curbs pathology expenses and maintains tumor location information.
BACKGROUND: Percutaneous pancreas allograft biopsy is the technique of choice for evaluation of pancreatic allograft rejection or dysfunction. The safety and success rate of the procedure with current surgical techniques is unclear. We report the complications and success rate in 426 consecutive percutaneous pancreas allograft biopsies performed at a single center. METHODS: One hundred eighty-three patients (50% simultaneous pancreas-kidney transplant, 42% pancreas after kidney transplant, 8% pancreas transplant alone) were biopsied. Biopsies were performed using an 18-gauge automated needle with ultrasound guidance. RESULTS: Thirty-seven patients had four or more biopsies (maximum, 11). Two hundred fifteen (50%) biopsies were in patients with bladder exocrine drainage, 211 (50%) in patients with enteric exocrine drainage. Of the latter, 33 (16%) were in patients with portal venous drainage. Eighty-eight percent of biopsy specimens were adequate for histologic diagnosis. There were 12 biopsy-related complications (2.8%), including eight episodes of bleeding (1.9%), five of which (1.2%) required surgical intervention and one possible extra-graft exocrine leak. Other complications included inadvertent liver (1), kidney (1), and small bowel (1) biopsy. CONCLUSIONS: Percutaneous pancreas allograft biopsy has a low rate of complication and a high success rate.
BACKGROUND: The impact of hepatitis C virus (HCV) infection recurrence after orthotopic liver transplantation (OLT) on graft viability is still not accurately defined. Our study aims to evaluate the magnitude and rate of progression of HCV-induced liver damage after OLT in a single institution cohort of 122 HCV-infected recipients. METHODS: All patients transplanted at our institution between 1988 and 1996 with positive serum HCV antibodies before OLT, minimum postoperative survival of 6 months, and without hepatitis B virus coinfection or severe non-HCV-related graft complications were retrospectively included in the study. RESULTS: HCV infection recurrence was almost universal, and genotype 1b was observed in 87% of the cases. After a median histological follow-up of 43 months (range: 7-96), evidences of HCV-induced histological damage were found in 94% of the cases. The actuarial rates of severe graft damage (including cirrhosis, fibrosing cholestatic hepatitis, and submassive liver necrosis) were 15%, 33%, and 44% at 3, 5, and 7 years, respectively, and among these patients, 52% developed decompensated liver disease during the follow-up and 36% lost their grafts. The biochemical severity at the onset of the recurrent hepatitis and the development of cholestasis or cytomegalovirus disease were independent predictors of severe HCV-related graft damage. No differences were found in graft and patient survival when positive-HCV OLT recipients were compared with a coetaneous cohort of 215 non-HCV OLT recipients. CONCLUSIONS: HCV infection recurrence leads to severe liver damage and subsequently to clinical decompensation in a significant proportion of OLT recipients. Some clinical and biochemical characteristics can predict the severity of HCV-induced graft damage.