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Rapid on-site evaluation of endoscopic-ultrasound-guided fine-needle aspiration diagnosis of pancreatic masses

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World Journal of Gastroenterology 2014年第28期20卷 9451-9457页

作者： julio iglesias-Garcia Jose Lario-Noia Ihab Abdulkader J Enrique Domínguez-Muoz Department of Gastroenterology and Hepatology Foundation for Research in Digestive DiseasesUniversity Hospital of Santiago de Compostela Department of Pathology University Hospital of Santiago de Compostela

Endoscopic ultrasound (EUs) has become an essential tool for the study of pancreatic diseases. specifically, EUs plays a pivotal role evaluating patients with a known or suspected pancreatic mass. In this setting, differential diagnosis remains a clinical challenge. EUs-guided fine-needle aspiration (FNA) and fine-needle biopsy (FNB) have been proven to be safe and useful tools in this setting. EUs-guided FNA and FNB, by obtaining cytological and/or histological samples, are able to diagnose pancreatic lesions with high sensitivity and specificity. In this context, several methodological features, trying to increase the diagnostic yield of EUs-guided FNA and FNB, have been evaluated. In this review, we focus on the role of rapid on-site evaluation (ROsE). From data reported in the literature, ROsE may increase diagnostic yield of EUs-FNA specimens by 10%-30%, and thus, diagnostic accuracy. However, we should point out that many recent studies have reported adequacy rates of > 90% without ROsE, indicating that, perhaps, at high-volume centers, ROsE may not be indispensable to achieve excellent results. The use of ROsE can be considered important during the learning curve of EUs-FNA, and also in hospital with diagnostic accuracy rates < 90%.

关键词： Endoscopic-ultrasound-guided fine-needle aspiration Rapid on-site evaluation solid pancreatic tumors Diagnostic accuracy

Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

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World Journal of Gastroenterology 2007年第2期13卷 289-293页

作者： julio iglesias-Garcia Enrique Dominguez-Munoz Antonio Lozano-Leon Ihab Abdulkader Jose Larino-Noia Jose Antunez Jeronimo Forteza Gastroenterology Department University Hospital Santiago de Compostela Spain Foundation for Research in Digestive Diseases Santiago de Compostela Spain Foundation for Research in Digestive Diseases Santiago de Compostela Spain Pathology Department University Hospital Santiago de Compostela Spain

AIM： To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound （EUs）-guided fine needle aspiration （FNA） material in the differential diagnosis of pancreatic solid masses. METHODs： sixty-two consecutive patients with pancreatic masses were prospectively studied. EUs was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs （22G needle） were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Haterials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study. REsULTs： Length of the core specimen obtained for histological analysis was 6.5±5.3 mm （range 1-22 mm）. Cytological and histological samples were considered as adequate in 51 （82.3%） and 52 cases （83.9%）, respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Conbary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases （90.3%）, with a global sensitivity of 84.21%, specificity of 100% and an overall accuracy of 90.32%. The complication rate was 1.6%.CONCLUsION： Adequate pancreatic core specimens for histological examination can be obtained by EUs-guided FNA. This technique is mainly useful for the diagnosis of different types of pancreatic tumours and evaluation of benign diseases.

关键词： Endoscopic ultrasound Fine needle aspiration Cytology Biopsy Pancreatic cancer

Accuracy of endoscopic ultrasound-guided tissue acquisition in the evaluation of lymph nodes enlargement in the absence of on-site pathologist

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World Journal of Gastroenterology 2017年第31期23卷 5755-5763页

作者： Yung Ka Chin julio iglesias-Garcia Daniel de la Iglesia Jose Larino-Noia Ihab Abdulkader-Nallib Hector Lázare susana Rebolledo Olmedo J Enrique Dominguez-Munoz Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Health Research Institute of santiago de Compostela (IDIs) University Hospital of Santiago de Compostela Department of Pathology University Hospital of Santiago de Compostela

To evaluate factors that influence the diagnostic accuracy of endoscopic ultrasound (EUs)-guided tissue acquisition for lymph node enlargement in the absence of an on-site pathologist. METHODsA retrospective analysis of patients who underwent EUs-guided tissue acquisition for the pathological diagnosis of lymph node enlargement between April 2012 and June 2015 is reported. Tissue acquisition was performed with both cytology and biopsy needles of different calibers. The variables evaluated were lymph node location and size, number of passes and type of needle used. Final diagnosis was based on surgical histopathology or, in non-operated cases, on EUs-guided tissue acquisition and imaging assessment with a minimum clinical follow-up of 6 mo. REsULTsDuring the study period, 168 lymph nodes with a median size of 20.3 mm (range 12.5-27) were sampled from 152 patients. Ninety lymph nodes (53.6%) were located at mediastinum, and 105 (62.5%) were acquired with biopsy needles. The final diagnosis was benign/reactive origin in 87 cases (51.8%), malignant in 65 cases (38.7%), and lymphoma in 16 cases (9.5%). The sensitivity, specificity, positive predictive value and negative predictive value for the detection of malignancy were 74.1%, 100%, 100% and 80.6%, respectively. The overall accuracy was 87.5% (95%CI: 81.7-91.7). No variables were independently associated with a correct final diagnosis according to the multivariate analysis. CONCLUsIONEUs-guided tissue acquisition is a highly accurate technique for assessing lymph node enlargement. None of the variables evaluated were associated with diagnostic accuracy.

关键词： Lymph node Endoscopic ultrasound Fine-needle aspiration Fine-needle biopsy Accuracy

Comparative effects of idazoxan, efaroxan, and BU 224 on insulin secretion in the rabbit: Not only interaction with pancreatic imidazoline I2 binding sites

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Health 2010年第2期2卷 112-123页

作者： María José García-Barrado María Francisca Pastor María Carmen iglesias-Osma Christian Carpéné julio Moratinos 不详

The nature of the binding site(s) involved in the insulin secretory activity of imidazoline compo- unds remains unclear. An imidazoline I2 binding site (I2Bs) has been neglected since the classic I2 ligand, idazoxan, does not release insulin. Using the rabbit as an appropriate model for the study of this type of binding sites, we have tried to re-evaluate the effects of idazoxan, the selective I2 compound BU 224, and efaroxan on insulin secretion. Mimicking efaroxan, idazoxan and BU 224 potentiated insulin release from perifused islets in the presence of 8 mM glucose. In static incubation, insulin secretion induced by idazoxan and BU 224 exhibited both dose and glucose dependencies. ATP-sensitive K+ (KATP) channel blockade, though at a different site from the sUR1 receptor, with subsequent Ca2+ entry, mediates the insulin releasing effect of the three ligands. However, additional MAO independent intracellular steps in stimulus- secretion coupling linked to PKA and PKC activation are only involved in the effect of BU 224. Therefore, both an I2 related binding site at the channel level shared by the three ligands and a putative I3-intracellularly located binding site stimulated by BU 224 would be mediating insulin release by these compounds. In vivo experiments reassess the abilities of idazoxan and BU 224 to enhance glucose-induced insulin secretion and to elicit a modest blood glucose lowering response.

关键词： BU 224 Efaroxan Idazoxan Imidazoline Ligands Insulin secretion IVGTT (Intravenous Glucose Tolerance Test) KATP Channel PK Activity Rabbit Pancreatic Islets

音乐人生，父子情怀——情歌王子胡里奥与父亲的故事

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新东方英语（中英文版） 2008年第6期 42-44页

作者： julio iglesias 史松宁

父亲的执着与支持成就了儿子健康的人生与音乐的梦想,儿子的关怀与照顾让心灵受创的老父年过花甲重又找回生活的意义和曾经的坚强。谁说父子之间非要剑拨弩张?谁说父子情深不能如此自然流露,这般苦乐同享?

关键词：父亲音乐人西班牙人生心灵镭辐射医生恶性肿瘤生活职业