Introduction and Objectives: There is a need to improve prescreening determination of prostate cancer to better select patients who need biopsy. Such a strategy properly implemented, will decrease the number of negative biopsies for prostate cancer and in turn better balance the risks and morbidity for patients recommended for biopsy. The aim of study is to investigate Doppler spectral waveform parameters of neurovascular bundle (NVB) vessels and determine differences between benign and malignant pathologies. Patients and Methods:We performed a prospective analysis involving 292 patients who received prostate biopsy for elevated prostate-specific antigen (PSA) values or abnormal digital rectal examination, as well as 174 patients with symptomatic benign prostatic hyperplasia. Doppler spectral waveform (DSW) parameters (peaksystolic velocity [PSV], end-diastolic velocity [EDV], and resistive index [RI]) were measured at bilateral NVB vessels through Doppler transrectal ultrasound at the right lateral decubitus position, compared, and analyzed among patients with benign versus malignant histology for each side. Results: Overall, both PSV and EDV at malignant sides were significantly higher than those at benign sides, as well as lower RI (all p-values < 0.05, unpaired t-test). In subgroup analysis with 93 patients of serum PSA between 10 and 20 ng/mL and 56 patients with one-side malignancy, higher EDV and lower RI were significantly associated with malignancies (all p < 0.05). The values of PSV and EDV rather than RI might be influenced by the patients' position and RI by the prostate volume. Conclusions: In this study, DSW parameters (mainly EDV and RI) at NVB vessels were significantly associated with prostate cancer, particularly in patients with serum PSA of 10-20 ng/mL. It should be in caution that the patients' position and prostate volume may influence the Doppler signal as demonstrated in the current study. These findings can provide more diagnostic information before prostate biopsy.
Background: Post-biopsy infection is one of the major concerns of urologists and patients for prostate biopsy. Many efforts have been made to reduce the infection rate. We conducted a study at a single institution with the goal of describing the bacteriology and incidence trends of febrile infections following trans-rectal ultrasound (TRUS)-guided biopsy of the prostate. (Period 4), 1,406 patients underwent prostate biopsy at our hospital. All biopsies were conducted under TRUS guidance without preparation by enemas. Several steps were taken to reduce infectious complications following biopsy, including a shift to levofloxacin prophylaxis starting from Period 3 of our study and thorough instructions in post-biopsy self-care starting from the beginning of Period 4. The incidence and bacteriology of urinary tract infection (UTI) following the prostate biopsies were reviewed from chart records. Results: Twenty-eight of 514 (5.4%), 13 of 276 (4.7%) nine of 274 (3.2%), and three of 342 (0.9%) patients had postbiopsy febrile infections during the four periods of the study, respectively. Fifteen of 28 (53.5%), four of 13 (30.8%), five of nine (55.6%), and zero of three patients, respectively, had positive cultures of blood, urine, or both during the four study periods. Escherichia coli was the pathogen isolated most commonly and ampicillinand fluoroquinolone-resistant strains of this organism were identified at a high frequency. The times to onset of fever after biopsy in the four study periods were 1.5 -1.3 d, 3.7 -2.7 d, 2.2 -1.6 d, and 2.5 -0.9 d, respectively. Conclusions: Ampicillin-and fluoroquinolone-resistant strains of E. coli were the uropathogenic bacteria identified most commonly after prostate biopsy at our hospital. The incidence of UTI following prostate biopsy can be reduced by explaining instructions for medication and self-care thoroughly to patients undergoing such biopsy.
In this paper, we have designed and integrated an automatic optical inspection system, emphasizing on software implementation of the image processing, measurement and analysis utilities. As for the hardware equipments, we design an LED illumination unit and the custom-tailored machinery. By comparing the support functions of several main import brands of the optical inspection machine, we propose an optical inspecting procedure. By using the Windows-based user interface, we implement nine inspecting software tools, namely, the average gray level tool, the thresholding tool, the positioning tool, the edge detection tool, the binary large object (BLOB) tool, the template building tool, the smart matching tool, the inspection sequence tool, and the platform operation tool. All these tools can be used in an inspection with single operation and can also be arranged in a proper sequence of operations to fulfill a complicated inspection procedure. We use several part sample images with defects provided by the supplier to verify our fulfilled system.
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