AIM: To determine factors influencing diagnostic yield in computed tomography (CT)-guided biopsy of lung lesions. MATERIALS AND METHODS: One hundred and ninety-five consecutive CT-guided lung biopsies were performed i...
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AIM: To determine factors influencing diagnostic yield in computed tomography (CT)-guided biopsy of lung lesions. MATERIALS AND METHODS: One hundred and ninety-five consecutive CT-guided lung biopsies were performed in 182 patients between August 1995 and September 2000 and either fine-needle aspirate samples for cytology or core biopsy samples for histology were collected. Procedures were divided into a diagnostic group (true-positive and true-negative results) and a non-diagnostic group (false-positive and false-negative results) and the factors affecting diagnostic accuracy assessed. RESULTS: One hundred and fifty-six lesions (86%) were malignant, and 26 (14%) were benign. More than one biopsy was performed for 12 lesions. One hundred and thirty-two biopsies were true-positive, 27 true-negative and 36 false-negative. No false-positive results occurred in the study. Overall diagnostic accuracy was 81.5%. Significantly more core biopsies than fine-needle aspirates were diagnostic: 93 versus 78% (p < 0.005). No difference was found in frequency of pneumothorax between these two groups. There was a difference in the average depth from the pleural surface of lesions in the diagnostic and non-diagnostic groups, but this did not attain statistical significance: 9.8 versus 17.2 mm (p = 0.054). CONCLUSION: In this study CT-guided lung biopsy core biopsy was a more accurate method of tissue sampling than fine-needle aspiration, and was not associated with an excess of complications. (C) 2003 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Caenorhabditis elegans has two genes, unc-59 and unc-61, encoding septin-family GTPases. Mutations in the septin genes cause defects in locomotory behavior that have been previously attributed to cytokinesis failures ...
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Caenorhabditis elegans has two genes, unc-59 and unc-61, encoding septin-family GTPases. Mutations in the septin genes cause defects in locomotory behavior that have been previously attributed to cytokinesis failures in postembryonic neuroblasts. We find that mutations in either septin gene frequently cause uncoordination in newly hatched larvae in the absence of cytokinesis failures. The septins exhibit developmentally regulated expression, including expression in various neurons at times when processes are extending and synapses are forming. Motor neurons in the mutant larvae display defects in multiple aspects of axonal migration and guidance that are likely to be responsible for the locomotory behavior defects. The septins are also expressed in migrating distal. tip cells, which are leaders for gonad arm extension. Septin mutants affect morphology of the distal tip cells, as well as their migration and guidance during gonadogenesis, These results suggest that septins may be generally required for developmental migrations and pathfinding. (C) 2003 Elsevier Inc. All rights reserved.
The Institution of Electrical Engineers (IEE, London, UK) has recently published a professional guidance document on "EMC and Functional Safety". This issue is becoming more important as more safety-related ...
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ISBN:
(纸本)0780365690
The Institution of Electrical Engineers (IEE, London, UK) has recently published a professional guidance document on "EMC and Functional Safety". This issue is becoming more important as more safety-related functions are controlled by electronics, as the electromagnetic environment worsens, and as electronic devices become more susceptible to interference. Meeting EMC immunity standards (e.g. those under Europe's EMC directive) may well be inadequate for safety-related applications. The procedures recommended in this new guide will help compliance with safety and liability legislation for products, vehicles, systems, or large construction projects.
The European EMC Directive is being re-written. This paper describes the requirements in the latest draft where they differ from the current directive, and offers practical guidance to manufacturers to minimise advers...
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ISBN:
(纸本)0780365690
The European EMC Directive is being re-written. This paper describes the requirements in the latest draft where they differ from the current directive, and offers practical guidance to manufacturers to minimise adverse impact, and take advantage of the positive changes.
Excipients are essential components of drug products. They are also potential toxicants. Examples of known excipient-induced toxicities include renal failure and death from diethylene glycol, osmotic diarrhea caused b...
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Excipients are essential components of drug products. They are also potential toxicants. Examples of known excipient-induced toxicities include renal failure and death from diethylene glycol, osmotic diarrhea caused by ingested mannitol, hypersensitivity reactions from lanolin, and cardiotoxicity induced by propylene glycol. Proposals to test or market new drug products in the United States should adequately address the safety of the proposed exposure to the excipients in those products. The specific safety data that may be needed will vary depending upon the clinical situation, including such factors as the duration, level, and route of exposure, but may include acute, repeat-dose, reproductive, and genetic toxicity data, carcinogenicity data, and specialized toxicology information, such as sensitization or local irritation data. Many guidances exist to aid in the development of pharmaceuticals, including the International Conference on Harmonization (ICH) documents and various Food and Drug Administration/Center for Drug Evaluation and Research (FDA/CDER) pharmacology and toxicology guidances. The FDA/CDER has recently adopted a new guidance for industry, "Nonclinical Studies for Development of Pharmaceutical Excipients," which focuses on issues associated with development of safety databases that will support clinical use of excipients in drug products. The new guidance document is introduced and discussed in this article.
A new drug is approved for use if its efficacy and safety have been demonstrated. However, healthcare decision makers may also require data on the cost-effectiveness of new drugs if they are to make informed decisions...
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A new drug is approved for use if its efficacy and safety have been demonstrated. However, healthcare decision makers may also require data on the cost-effectiveness of new drugs if they are to make informed decisions about their place in therapy. Cost-effectiveness evidence may lag behind the effectiveness data in terms of its availability. We explored the timeliness of delivering cost-effectiveness information about new drugs with established effectiveness and significant financial impact. Drugs were identified, based on guidance documents and reports published by the UK National Institute for Clinical Excellence (NICE), and the following data were collected: dates of publication of first effectiveness and cost-effectiveness evidence, methodology of the cost-effectiveness analysis, quality scores of the clinical studies. Eighteen guidance documents on the use of new drugs/drug groups published by NICE by October 2001 covered 30 health technologies, which were included in the analysis. The analysis of the evidence showed that their effectiveness had been demonstrated in the last 12 years, with only two exceptions. However, cost-effectiveness evidence had been published for 21 (70%) of the technologies. The cost-effectiveness was estimated in 52.4% of cases using models. The good quality effectiveness evidence lagged behind the first effectiveness evidence by 1.40 years (95% Cl 0.57-2.23), while the mean lag between the first effectiveness evidence and the first cost-effectiveness publications was estimated as 3.20 years (95% Cl 1.76-4.65). Cost-effectiveness evidence thus often lags behind the effectiveness evidence. As a result healthcare decision makers are sometimes in a position of having to take decisions without having adequate cost-effectiveness data at their disposal.
This paper begins with a discussion and analysis of the relevance of work-based learning to contemporary education and training needs. It then briefly outlines changes in attitudes and approaches to higher education a...
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The introduction of problem-based learning (PBL) into any programme demands a period of adjustment on the part of faculty. Similarly, students new to PBL take time to adapt to what is, for the majority of them, an unf...
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The last decade, and particularly the last few years, have witnessed a remarkable transformation in the construction industry. Today, this industry is one of the most dynamic, innovative and technically advanced of an...
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This short paper outlines the work of the advisory group established by the Welsh Assembly Government to monitor implementation progress and identify possible weakness in the adult protection guidance In Safe Hands. &...
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