Effective Technique For Diagnosis Research Articles

HEMATOLOGICAL AND MOLECULAR STUDY OF TRYPANOSOMA EVANSI IN EXPERIMENTALLY INFECTION IN RABBITS

The lack of a sensitive diagnostic test for trypanosomasis in animals may hamper epidemiological data and control program implementation. This study aimed to detection of Trypanosoma evansi in rabbits that experimentally infected by this parasite which identified from camels of iraq by polymerase chain reaction. A study was conducted on 24 males rabbit divided into two groups (12 rabbits for each group). The first group was injected intra peritoneal (i/p) with 0.5 ml containing 1x105 trypanosome. The second group injected with distilled water and considered as control. At 7 and 10 days post infection, blood sample were collected from these rabbits. White blood cells count was conducted after 14 and 28 days post infection. The results showed that the 18S RNA and RoTat 1.2 genes related to T. evansi were identified .Furthermore ,there was significant elevation of Neutrophils ,Monocytes ,Lymphocytes ,Eosinophil and Basophils in infected rabbits compared with the control group. From this study we can conclude that PCR is a sensitive and effective technique for diagnosis of T.evansi through using 18S RNA and RoTat 1.2 genes. In addition ,WBC count was significantly elevated in an infected rabbits compared to the control. Whereas ,Lymphocyte was significantly higher in control group compared with infected group.

Optimizing lung cancer classification through hyperparameter tuning.

Artificial intelligence is steadily permeating various sectors, including healthcare. This research specifically addresses lung cancer, the world's deadliest disease with the highest mortality rate. Two primary factors contribute to its onset: genetic predisposition and environmental factors, such as smoking and exposure to pollutants. Recognizing the need for more effective diagnosis techniques, our study embarked on devising a machine learning strategy tailored to boost precision in lung cancer detection. Our aim was to devise a diagnostic method that is both less invasive and cost-effective. To this end, we proposed four methods, benchmarking them against prevalent techniques using a universally recognized dataset from Kaggle. Among our methods, one emerged as particularly promising, outperforming the competition in accuracy, precision and sensitivity. This method utilized hyperparameter tuning, focusing on the Gamma and C parameters, which were set at a value of 10. These parameters influence kernel width and regularization strength, respectively. As a result, we achieved an accuracy of 99.16%, a precision of 98% and a sensitivity rate of 100%. In conclusion, our enhanced prediction mechanism has proven to surpass traditional and contemporary strategies in lung cancer detection.

BCG Induced Lymphadenitis: A Prerequisite in Parental Counseling during Pre and Post Vaccination Program

Bacillus-Calmette-Guerin (BCG) is a live attenuated vaccine and used to prevent tuberculosis since 1921. BCG vaccination is performed as a part of expanded program of immunization (EPI). BCG vaccine is considered as a safe technique of tuberculosis prevention because there are only local adverse reactions seen with this and serious adverse reactions are rare. Lymphadenitis is the most frequent side effect of BCG vaccination. Intradermal BCG vaccination gives rise to erythromatous formation that consists of a cutaneous nodule at the site of injection and subclinical involvement of the regional lymph nodes, which is self limiting and requires no treatment. Lymphadenitis is the most frequent side effect of BCG vaccination. Fine needle aspiration is the quick, safe, and cost effective technique for diagnosis in addition to the management of BCG lymphadenitis. Here we report a case of 10- months’ healthy male patient with left axillary lymphadenitis post BCG vaccination.

Diagnostic Value of Virtual Bronchoscopic Navigation Combined With Endobronchial Ultrasound Guided Transbronchial Lung Biopsy for Peripheral Pulmonary Lesions.

Objective:X-ray guided transbronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) can improve the diagnostic yield of peripheral pulmonary lesions (PPLs), but it needs special requirements. The purpose of this study was to investigate the clinical value of virtual bronchoscopy navigation (VBN) combined with EBUS-TBLB in the diagnosis of PPLs without X-ray guidance.Methods:The 105 patients with PPLs underwent EBUS-TBLB with or without VBN randomly. The diagnostic yield, the operation time and complications were evaluated in the 2 groups.Results:No significant difference was found between the VBN+EBUS group and the EBUS group (76.0% vs. 65.5%, P = 0.287). The operation time of VBN+EBUS group was significantly shorter than that of EBUS group (20.6 ± 12.8 min vs. 28.6 ± 14.3 min, P = 0.023). No severe procedure related complications occurred.Conclusions:VBN can shorten the operation time. The combination of VBN and EBUS-TBLB is a safe and effective diagnosis technique for PPLs.

Endobronchial ultrasound guided transbronchial cryobiopsy versus forceps biopsy in peripheral lung lesions.

Radial probe endobronchial ultrasound (RP-EBUS) is a modern technique for diagnosis of peripheral lung lesions. It is assumed that the addition of transbronchial cryobiopsy (TBCB) could increase the diagnostic value for RP-EBUS. The main objectives were to evaluate the efficacy and safety of RP-EBUS-guided TBCB for diagnosis of peripheral lung lesions and comparing it with RP-EBUS-guided transbronchial forceps biopsy. Sixty patients with peripheral lung diseases were divided into two groups. Group I included 45 patients who were eligible for TBCB and they subjected to forceps transbronchial biopsy (forceps TBB) and TBCB guided by RP-EBUS. Fifteen patients who were not eligible for TBCB were included in group II and they were subjected to forceps TBB and/or cytology retrieval procedures guided by RP-EBUS. In group I, forceps TBB had sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of; 67.5%, 100%, 100%, 18.8%, and 69.8%, respectively, while TBCB had sensitivity, specificity, PPV, NPV, and accuracy of 75%, 100%, 100%, 23.1%, and 76.7%, respectively. The sensitivity in group II was 80% and the overall results including both groups were sensitivity, specificity, PPV, NPV, and accuracy of 85.2%, 100%, 100%, 42.8%, and 86.7%, respectively. Regarding the complications, only one patient (1.7%) had significant bleeding. One patient (1.7%) had pneumothorax and another patient (1.7%) suffered from hypoxemia. RP-EBUS-guided TBCB is a safe and effective technique for diagnosis of peripheral lung lesions. TBCB has achieved higher diagnostic values and better quality of samples.

P2.05-15 Radial Endobronchial Ultrasound-Guided Transbronchial Biopsy in Peripheral Lung Lesions. What Can Cryobiopsy Contribute?

Radial probe endobronchial ultrasound (RP-EBUS) is a modern technique for diagnosis of peripheral lung lesions. The addition of transbronchial cryobiopsy (TBCB) could increase the diagnostic value for RP-EBUS. AIM: To evaluate the efficacy of RP-EBUS guided TBCB for diagnosis of peripheral lung lesions. We collected 60 patients with peripheral lung diseases. Were excluded 15 patients for not be fit for general anesthesia (necessary for TBCB) or high risk of bleeding. 45 patients were subjected to forceps transbronchial biopsy (forceps TBB) and TBCB guided by RP-EBUS. The diagnostic outcomes including digital assessment for qualitative and quantitative measures of collected samples were detected. Also, the associated complications were recorded. The diagnostic yields for forceps TBB versus TBCB is detailed in Table 1. TBCB has achieved higher accuracy than forceps TBB (ROC area of 0.88 versus 0.84 respectively), with no statistical difference between their values (p=0.32). The combination between both techniques has achieved excellent accuracy (ROC area 0.91). In 36 cases were possible the anatomopathological diagnosis with both type of samples, there were significant statistical differences (p ≤0.05) in favour of TBCB when compared to forcep TBB regarding; mean biopsy diameter, mean biopsy surface area, mean biopsy necrosis, percentage and mean biopsy viable tissue area. Only two patients had significant complications (pneumothorax; hypoxemia), and 8 moderate bleeding. RP-EBUS guided TBCB is a safe and effective technique for diagnosis of peripheral lung lesions. TBCB could achieve higher diagnostic value than forceps TBB due to better quantity and quality of the samples. The project was partially funded by SEPAR, grant AEER 2016, grant FUCAP 2017 and Egyptian Ministry of Higher Education.

A Multi-Center Retrospective Study of 420 EUS-Guided Fine Needle Core Liver Biopsy with a Modified 1-Pass 1-Actuation Wet Suction Technique Comparing Two Types of EUS Core Needles

Introduction: Endoscopic Ultrasound guided (EUS) Fine Needle Core Biopsy (FNCB) has proven to be safe and effective technique for diagnosis and staging of liver parenchymal disease. We evaluated the diagnostic yield, specimen adequacy in EUS-guided parenchymal biopsies and documented adverse events. We compared two types of EUS 19 G core needles. Methods: This is a multi-center, retrospective study of 420 patients with unexplained abnormal liver function tests who were referred for EUS evaluation of elevated liver enzymes to evaluate for biliary obstruction and pancreatic pathology. EUS-guided liver biopsy (EUS-LB) was performed at the same session after biliary obstruction was excluded. We compared EUS-LB in 210 patients using a Franseen needle to 210 patients using a Fork-tip needle, using a modified 1-pass 1-actuation wet suction technique in patients referred for abnormal liver function tests. We compared intact specimen length (ISL), total specimen length (TSL), complete portal triads (CPT) and adverse events (AE). Comparison between means used a 2-sample Z test and Levene's test found equal variance between all compared means except for mean TSL of patients with a fibrosis score of 0-2. Results: 420 consecutive patients underwent EUS-LB and data were retrospectively evaluated. Median patient age was 52 yrs(range 7-84) and 185(44%) were male. The fork tip needle had an average ISL of 2.7 cm, TSL of 6 cm, and mean 19.5 CPT(range 7-73). Abdominal pain occurred in 35 patients(17%) immediately post-procedure, which resolved in all patients except two after intravenous administration of a low-dose narcotic. Subcapsular hematomas occurred in 1(0.5%) patients. The Franseen needle had an average ISL of 3.1 cm, TSL of 6.5 cm, and mean of 24 CPT(range 8-49). Abdominal pain occurred in 4 patients(2%) immediately post-procedure, which resolved in all patients after intravenous administration of a low-dose narcotic. Subcapsular hematoma occurred in 1(0.5%) and bile leak in 1(0.4%) patients. Conclusion: This is a multi-center comparative study of 2 19G second generation EUS needles of different designs, in patient undergoing EUS-LB. The average CPT and ISL were significantly higher in the Franseen needle compared to fork-tip needle. Both needles using a modified 1-pass 1-actuation wet suction technique met 100% AASLD specimen adequacy (>11 CPT or TSL >2.5cm). AE were comparable between both needles.752_A Figure 1. Gross Specimen752_B Figure 2. Comparison between needle type based on fibrosis score752_C Figure 3. Comparison between Franseen and Fork-tip needles

An alternative DNA extraction method for detection of Blastocystis spp. in human fecal samples

Polymerase chain reaction (PCR) is an effective technique for diagnosis of Blastocystis infection. Notably, DNA isolation procedure is extremely critical for the PCR step. In the present study, a recently described extraction procedure, named as the “sand method” was modified and adapted for isolation of Blastocystis DNA. To evaluate its efficacy, the current method and QIAamp DNA Stool Mini Kit (Qiagen) were applied to fresh human stool samples. Our results indicated that, the mean DNA concentrations obtained by the sand method and the commercial kit were 48 and 55 ng/μl, respectively. Also, no DNA inhibitors were detected in two methods. The sand method was capable of detecting 16 parasites per 50 mg feces. DNA samples extracted by both methods were subjected to PCR. Blastocystis spp. were detected in 11 (31.4%) of 35 samples, and perfect agreement (κ: 1.000) was found between the PCR-sand method and PCR-commercial kit method. The samples that were detected positive by PCR-sand method were successfully sequenced, and Blastocystis subtypes (STs) were identified as ST3, ST2 and ST1. In conclusion, the present study indicates that the sand method provides a simple, rapid and inexpensive procedure for reliable extraction of Blastocystis DNA from stool samples.

FNAC and histopathological correlation of salivary gland lesions: an observational study

Background: Fine needle aspiration cytology (FNAC) is a sensitive and specific and yet an economically effective technique for diagnosis of salivary gland lesions. FNAC of salivary glands has achieved a pivotal role in the diagnosis and management of salivary gland lesions since its induction by Stewart et al in 1933. However, it has always been under scrutiny when compared to histopathology. Histopathology of salivary gland lesions is still the final method to establish diagnosis and predicting prognosis in these lesions.1Methods: A prospective observational study of 50 patients with salivary gland lesions was done at Gauhati Medical College and hospital from June 2011 to May 2012. 39 patients underwent histopathological confirmation. Cases with histopathological correlation were included in calculating diagnostic accuracy. The cytological findings were correlated with that of the histopathological diagnosis to obtain the accuracy of the cytological diagnosis. The parameters of diagnostic validity of the cytological technique in terms of sensitivity, specificity and predictive value were evaluated.Results: Study population included patients of age group ranging from 13-70 years with median age group being 31-40 years (30%). 54% of the affected patients were male with the parotid being the most commonly involved gland (62%). Neoplastic lesions constituted the major bulk of the lesions (39 cases, 78%) with benign tumours constituting 54%. The most commonly involved benign neoplastic lesion was pleomorphic adenoma (22cases, 44%). Among the non-neoplastic lesions (22%), the acute sialadenitis was frequently noted. Histopathological correlations were available in 39 cases with 11 cases being the malignant lesions. The acute sialadenitis lesions did not undergo histological examination. 28 cases of non-malignant lesions underwent the histological confirmation. In the present study, the specificity and the sensitivity were found to be 96.42% and 90.91% respectively. The predictive value of salivary gland cytology was 90.91% and diagnostic accuracy was 94.87%.Conclusions: Fine Needle Aspiration Cytology is thus a safe, reliable, quick, convenient and accurate method of diagnosis and should be considered as one of the first line of investigations in the evaluation of salivary gland lesions.

EUS-guided fine-needle core liver biopsy sampling using a novel 19-gauge needle with modified 1-pass, 1 actuation wet suction technique

EUS-guided fine-needle core biopsy sampling is a safe and effective technique for diagnosis of focal liver lesions. However, data are limited in its role in parenchymal disease. We evaluated the utility of EUS-guided parenchymal liver biopsy sampling with a modified 1-pass wet suction technique (EUS-modified liver biopsy sampling [EUS-MLB]) in patients with unexplained increase in liver-associated tests. We retrospectively evaluated the safety and efficacy of EUS-MLB in patients referred for EUS to evaluate for biliary obstruction and pancreatic disorders but with associated unexplained liver tests. EUS-MLB was performed during the same session after biliary obstruction was excluded. One hundred sixty-five consecutive patients underwent EUS-MLB. The median age was 52 years (interquartile range [IQR], 42-65). Sixty-eight patients (41%) were men. The median of the maximum intact core tissue length was 2.4 cm (IQR, 1.8-3.5). The median total specimen length (TSL) was 6 cm (IQR, 4.3-8). The median number of complete portal tracts (CPTs) per TSL was 18 (IQR, 13- 24). The mean number of CPTs per sample length was 7.5 cm. Adverse events were uncommon (1.8%) and included abdominal pain and self-limited hematoma. EUS-guided fine-needle biopsy sampling using a novel 19-gauge core needle with a modified 1-pass 1 actuation wet suction technique (EUS-MLB) is a safe and effective way to evaluate patients with unexplained liver tests abnormalities who are undergoing EUS for exclusion of biliary obstruction.

Online technique for insulation assessment of induction motor stator windings under different load conditions

This paper presents a new condition monitoring system which is able to evaluate and diagnose the stator winding insulation deterioration (SWID) at its initial stages. During the last few decades, considerable efforts have been made in condition monitoring of SWID in induction motors. Nevertheless, an effective diagnosis technique that can lead to a fast and accurate detection of SWID shortly after its occurrence remains a challenge. A new modelling technique is introduced using finite element method which enables detailed simulation (two turn-to-turn resolution) of insulation degradation in a stator slot. Experimental setup is then used to validate the proposed modelling technique. The detail and approximation coefficients of the discrete wavelet transform are shown to provide effective detection of SWID within a few seconds after its occurrence. The proposed system continuously monitors the status of the induction motor and is able to detect the insulation deterioration of only 1.2% turns of phase winding when it starts to take place. The proposed method is only applicable to turn insulation failure detection. Its viability under different load conditions is validated for a small-sized induction motor with simulated turn insulation fault.

Endoscopic Ultrasound-Guided Fine Needle Core Liver Biopsy Using a Novel 19 G Needle with a Modified Wet Suction Technique in Patients with Abnormal Liver Function Tests: 2016 ACG Presidential Poster Award

Introduction: Endoscopic Ultrasound-guided Fine Needle Core Biopsy has proven to be safe and effective technique for diagnosis of focal liver lesions. However, data are limited in its role in parenchymal disease. We evaluated the utility of EUS-guided parenchymal liver biopsies (LB) and documented adverse events (AE) using a novel 19G needle (Sharkcore, Medtronic) with a modified wet suction technique in patients (pts) referred for abnormal liver function tests (LFTs).Figure 1Figure 2Figure 3Methods: This was a single-center retrospective study of pts with unexplained abnormal LFTs who were referred for EUS of elevated LFTs to evaluate for biliary obstruction and pancreatic pathology. EUS-LB was performed at the same session after biliary obstruction was excluded. EUS-LB was performed using a modified wet suction technique. The needle was primed with saline and maximal suction was used. A rapid-puncture technique was used to sample each lobe for a total of one pass per lobe. Acquired tissue was placed into formalin, then stained with Hematoxylin and Eosin, Trichrome, and iron. The specimen length was assessed grossly and the number of complete portal triads (CPT) was determined on microscopic examination. Results: 105 consecutive pts underwent EUS-LB and data were retrospectively evaluated. Median age was 52 years (21-81) and 48 (45%) were male. The main indication was elevated LFTs with no signs of biliary obstruction, and absence of pancreas pathology during EUS. Adequacy of specimen for diagnosis was obtained in 100% of cases. Two pts previously underwent percutaneous LB, which were nondiagnostic. 25% of pts had undergone MRI elastography to assess degree of fibrosis. EUS-LB changed the fibrosis score in 54% of these pts, and altered the treatment course. The average maximum core tissue length was 2.5 cm, with a median of 16 CPT (7-35). Abdominal pain occurred in 35 pts (33.3%) immediately post-procedure, which resolved in all pts after intravenous administration of a low-dose narcotic. There was one early adverse event; a patient presented within 48 hours to the emergency room with worsened LFTs and abdominal pain. CT was normal and there was improvement in LFTs and abdominal pain in less than 24 hours. Conclusion: EUS-LB using a new needle proved to be safe with a low AE rate, and produced adequate samples measured by number of CPT and tissue specimen length. Diagnostic yield was achieved in 100% of patients and changed patient management in 12% of pts, with alteration in prior MRI fibrosis scores in half.

Expression of Basophil Activation Markers in Pediatric Asthma.

Asthma is very common in children and its diagnosis is based on clinical manifestations, which can be misdiagnosed as other respiratory diseases with similar signs and symptoms. To analyze the expression of ST2L and CD203c in the diagnosis of pediatric asthma. Basophils were purified from whole blood samples of patients and healthy controls using Ficol-Paque gradient and Basophil Isolation Kit. RNA extraction was done by RNX-Plus solution and after synthesis of cDNA, the gene expression was analyzed by means of real time PCR. Patients expressed significantly higher levels of CD203c than healthy controls (p=0.01). Although there was an increase in the transcription level of ST2L gene in patients, the results were not statistically significant compared to those obtained from the healthy controls (p>0.05). A Specificity of 60% and a sensitivity of 73% were found using ROC curve for CD203c expression. Patients with positive family history of asthma exhibited more CD203c and ST2L expression (p<0.05). It is proposed that determining CD203c expression by real time PCR may be an effective technique for diagnosis of pediatric asthma.

Diagnosis of carbonation induced corrosion initiation and progression in reinforced concrete structures using piezo-impedance transducers

In addition to chloride induced corrosion, the other commonly occurring type of rebar corrosion in reinforced concrete structures is that induced by the ingress of atmospheric carbon dioxide into concrete, commonly referred to as ‘carbonation induced corrosion’. This paper presents a new approach for detecting the onset and quantifying the level of carbonation induced rebar corrosion. The approach is based on the changes in the mechanical impedance parameters acquired using the electro-mechanical coupling of a piezoelectric lead zirconate titanate (PZT) ceramic patch bonded to the surface of the rebar. The approach is non-destructive and is demonstrated though accelerated tests on reinforced concrete specimens subjected to controlled carbon dioxide exposure for a period spanning over 230days. The equivalent stiffness parameter, extracted from the frequency response of the admittance signatures of the PZT patch, is found to increase with penetration of carbon dioxide inside the surface and the consequent carbonation, an observation that is correlated with phenolphthalein staining. After the onset of rebar corrosion, the equivalent stiffness parameter exhibited a reduction in magnitude over time, providing a clear indication of the occurrence of corrosion and the results are correlated with scanning electron microscope images and Raman spectroscopy measurements. The average rate of corrosion is determined using the equivalent mass parameter. The use of PZT ceramic transducers, therefore, provides an alternate and effective technique for diagnosis of carbonation induced rebar corrosion initiation and progression in reinforced concrete structures non-destructively.

To scoop or not to scoop: the diagnostic and therapeutic utility of the scoop-shave biopsy for pigmented lesions.

Concern over transection of melanomas has inhibited many practitioners from using the scoop-shave for removal of pigmented lesions. To assess the safety and efficacy of the scoop-shave for pigmented lesions. The practitioner's clinical diagnosis, intent (sample or completely remove), and removal technique (excision, punch, shave biopsy, or scoop-shave) were recorded. Pathology results including the status of the peripheral and deep margins were subsequently documented. Over an 8-month period, 333 procedures were performed. Of the 11 melanomas (6 in situ and 5 invasive) removed by the scoop-shave, none had positive deep margins and 6 (2 in situ and 4 invasive) were completely removed. One of the 50 dysplastic nevi removed by scoop-shave had a positive deep margin (moderately dysplastic). Forty-six dysplastic nevi were completely removed by the scoop-shave. When the practitioner's intent was "complete removal," the lesion was completely removed 73.1% of the time by scoop-shave, 91% by standard excision, 18.1% by shave biopsy, and 78.6% by punch excision (p < .0001). The scoop-shave is a safe and effective technique for diagnosis and treatment of melanocytic lesions.

Evaluating the Diagnoses of Gastric Antral Lesions Using Magnifying Endoscopy with Narrow-Band Imaging in a Chinese Population

To evaluate the accuracy of diagnosing gastric antral lesions in routine clinical practice using magnifying endoscopy with narrow-band imaging (M-NBI) as a real-time diagnosing technique. Consecutive patients undergoing upper endoscopy were selected for the study. In each patient, the mucosa of the gastric antrum was observed by M-NBI, and the gastric microstructure was categorized into five types (A-E). Based on these patterns, histological types were predicted in a real-time manner. The accuracy of these predictions was evaluated based on histological findings. Inter-observer agreement was also assessed. A total of 207 sites in 90 patients were examined by M-NBI. Compared with type A gastric microstructure, types B and C gastric microstructure showed a significantly higher degree of inflammation (P < 0.001). The sensitivity, specificity and accuracy of types B + C microstructure as a predictor of gastric inflammation were 85.4, 81.7 and 83.1 %, respectively. Similarly, the sensitivity, specificity and accuracy of type D microstructure as a predictor of gastric intestinal metaplasia were 71.8, 95.2 and 90.8 %, respectively, and those of type E microstructure as a predictor of early gastric cancer were 80.0, 98.9 and 97.6 %, respectively. The sensitivity and specificity of type B alone, type C alone and types B + C combined for the detection of Helicobacter pylori infection were 52.2 and 87.0 %, 22.8 and 92.2 %, 75.0 and 79.1 %, respectively. The kappa value for the inter-observer agreement was 0.715 (95 % confidence interval 0.655-0.895). In conclusion, M-NBI can significantly improve the accuracy of the prediction of histopathology of gastric antral lesions in vivo, implying the possibility of using M-NBI as an effective diagnosis technique.

Highly effective and inexpensive parasitological technique for diagnosis of intestinal parasites in developing countries: spontaneous sedimentation technique in tube

Millions of low-income people in the world are affected by intestinal parasites. Inexpensive, simple, and effective techniques for diagnosis are necessary. The spontaneous sedimentation technique in tube (SSTT), for application in poor healthcare settings and under field-work conditions, was described 25 years ago in Peru by Tello. The advantages of the SSTT are its ability to detect the majority of intestinal parasites, including eggs, larvae, cysts, and trophozoites, and its low cost.

The diagnostic value of endobronchial ultrasound‐guided needle biopsy in lung cancer and mediastinal adenopathy

Endobronchial ultrasonography (EBUS) has emerged as a new diagnostic tool that allows the bronchoscopist to see beyond the airway, including pulmonary and mediastinal lesion. The real time EBUS-guided transbronchial needle aspiration (TBNA) has advanced the diagnostic yield in primary lung pathology and mediastinal lymph node staging of lung carcinoma. Sixty-four patients (36 males, 28 females, ages ranging from 16 to 86 years) with peribronchial lung lesions and mediastinal and/or hilar lymph node lesions underwent EBUS-TBNA. All patients had intraoperative cytological assessment by smears on aspiration samples or touch preparation on needle core biopsies.The cytological final diagnoses were categorized as negative, suspicious/positive, and non-diagnostic. Forty-nine samples were obtained from lymph node lesions and 15 samples were obtained from lung lesions. In cytology specimens, 32 patients had suspicious/positive diagnoses and 32 patients had negative diagnosis. In follow-up histology specimens, 35 patients had malignant diagnoses, including 18 adenocarcinomas, 8 small cell carcinomas, 6 squamous cell carcinomas, 1 metastatic hepatocellular carcinoma, 1 metastatic melanoma, and 1 lymphoma. Twenty-nine patients had negative diagnoses. Sensitivity and specificity were 88.9% and 96.4%, respectively. Positive and negative predictive values were 97.0% and 87.1%, respectively. Diagnostic accuracy was 92.2%. EBUS-TBNA is an efficient and effective technique for diagnosis of intrapulmonary and mediastinal/hilar lymph nodes. It becomes significantly invaluable on clinical management for staging in those patients with lung cancer of other metastatic malignancies. This technique enables us to obtain tissue samples for quick diagnoses beyond central airway with minimal complications.

New Statistical Moments for Diagnostics of Rolling Element Bearings

Statistical moment analysis has proven to be a very effective technique for diagnosis of rolling element bearings. The fourth normalized central statistical moment, kurtosis, has been the major parameter in this method. In this paper it will be shown that the third normalized statistical moment can be as effective as kurtosis if the data is initially rectified. The advantage of this moment over the traditional kurtosis value is its lesser susceptibility to spurious vibrations, which is considered to be one of the shortcomings of higher statistical moments including kurtosis. The sensitivity of this moment to changes of load and speed is also less than kurtosis. The proposed method can also be applied to higher odd statistical moments.

Arthroscopy in Food Animal Practice

Arthroscopy can be an effective technique for diagnosis and treatment of various orthopedic disorders in cattle, including septic arthritis and osteochondrosis. Cost of equipment and surgery may be prohibitive for some individuals, yet the techniques of arthroscopic surgery are proven efficacious when applied to cattle. Arthroscopic techniques may also be quite useful in the evaluation and treatment of the same disorders in sheep, goats, and camillids. The technology remains the same and applicability rests with financial constraints and the physical aspects of specific species and joints. We speculate that arthroscopy would be quite useful for exploration and treatment of the larger joints and other selected joints of these species.