Biometry ; Clinical Protocols ; Cryoultramicrotomy ; methods ; Diagnostic Techniques and Procedures ; Frozen Sections ; utilization ; Humans ; Orthopedics ; methods

Spinal trauma produced from motor vehicle accidents, diving accidents, or falls occur at high rates of loading. This study was undertaken to reproduce clinically relevant cervical spine injuries under controlled conditions. Six isolated head-T2 human cadaveric preparations were tested using an electrohydraulic piston actuator at loading rates from 295 to 813 cm/sec. The Hybrid III head-neck was tested similarly at rates from 401 to 683 cm/sec. The input forces for specimen tests were of higher magnitude and shorter duration than the distally measured forces. In contrast, the Hybrid III head-neck revealed similar magnitude and duration force traces from input to output. The specimen preparations were analyzed kinematically at 1200 frame/sec with 20 to 30 retroreflective targets fixed to each level of the cervical spine. With this technique it is possible to temporally follow cervical damage as a function of applied forces. Wedge, burst, and anterior compression fractures were documented using CT and cryosectioning techniques. This pathology can be evaluated quantitatively using the target analysis. For example, a burst fracture occurred suddenly and 2.5 msec, whereas wedge fractures were progressive and took 4 to 5 msec to occur.
Cadaver* ; Cryoultramicrotomy ; Diving ; Fractures, Compression ; Humans* ; Motor Vehicles ; Pathology ; Spine

Breast Neoplasms ; pathology ; surgery ; Carcinoma, Ductal, Breast ; pathology ; surgery ; Cryoultramicrotomy ; Cytodiagnosis ; methods ; Female ; Histocytological Preparation Techniques ; methods ; Humans ; Intraoperative Care ; methods ; Precancerous Conditions ; pathology ; surgery

Objective: This study aimed to determine the accuracy, sensitivity and specificity of frozen section (FS) in the diagnosis of uterine neoplasm in a tertiary government training hospital. Methodology: This is a retrospective validation study from 2004-2015 involving cases of uterine lesions from gynecologic surgeries. All histopathologic results of frozen and paraffin sections were retrieved and reviewed. Chi square test with 2x2 Fischer Exact test adjustment was used to check for associations. Accuracy indices of FS tool were estimated such as sensitivity, specificity, likelihood ratios, negative and positive predictive values, and overall accuracy. A p-value of < 0.05 alpha is considered significant. Results: A total of 143 uterine specimens were submitted for frozen section analysis. The utilization rate of FS is 1% per year. The FS results were correlated with the final histopathologic diagnosis with 96% agreement rate. Utilizing a median number of 3 sections per specimen provides an overall accuracy rate of 97%. The accuracy rate of FS is equal between combined benign-premalignant and malignant cases at 96%. The accuracy rate is not statistically affected by the procedure by which the specimen was taken, as well as the source and gross morphology of the specimen. Moreover, a minimum of 11 sections per specimen is needed to obtain an accuracy rate of 99-100%. The accuracy rate particularly for endometrial lesions is between 94 and 100%. Conclusion Accuracy rates of frozen section on uterine lesions are high regardless of the sampling procedure and source of the specimen. Increasing the number of sections during FS parallels that of the final histopathologic diagnosis. FS for uterine lesions is a vital and cost-effective intraoperative decision tool to maximize care of patients.
Frozen Sections

OBJECTIVE: As frozen sections play the role of determining the method or scope of operation for ovarian tumors, the present study examined the accuracy, limitations and clinical utility of frozen sections. METHODS: Among 1583 cases of ovarian tumor surgery conducted during the period from January 1999 to September 2005, 372 for which frozen sections were sent to the Department of Pathology were analyzed through comparison between their frozen section diagnosis and final histopathological diagnosis. RESULTS: Among the ovarian tumor cases, the accuracy of frozen section diagnosis was 91.1% and its sensitive to final diagnosis was highest as 96.0% for benign tumors, and 85.7% for malignant tumors, and as low as 62.9% for borderline?tumors (p<0.01). The positive predictive value was 87.1% for malignant tumors, 68.8% for borderline tumors, and 94.6% for benign tumors. Among the 33 cases for which frozen section did not agree with final diagnosis, 15 cases were false positive and 18 cases were false negative. Among them, 14 cases were mucinous tumors (15.4%, 14/91), showing difficulty in diagnosis compared to non-mucinous tumors (6.8%, 19/281) (p=0.018). CONCLUSION: Despite its limitations, frozen section is a very useful method of high accuracy in diagnosing ovarian tumors. Thus, gynecologists and pathologists need to make efforts to understand the limitations and problems of frozen section, which is not highly sensitive to borderline tumors and mucinous tumors, and to make accurate diagnosis.
Diagnosis* ; Frozen Sections* ; Mucins ; Pathology

The liver is a common visceral site for metastatic tumours. Radiological features of the liver, fine needle aspiration cytology (FNAC) and histopathological evaluation (HPE) of liver nodules have a significant role in pre-operative diagnosis of liver lesions. In an intraoperative setting, frozen section biopsy plays a major diagnostic modality but the role of imprint cytology of liver nodules is also appealing. Imprint cytology is a valuable and precise tool in diagnosing the lesions for a rapid intraoperative diagnosis. This study presents a case of colorectal cancer liver metastasis diagnosed by imprint cytology intraoperatively.
Frozen Sections ; Adenocarcinoma ; Liver ; secondary

We compared all frozen section examination of ovarian tumors during a 5 year period in our institute with permanent section diagnosis from paraffin sections. In this period, 604 ovarian tumors had frozen section examination. Final histologic diagnosis was divided into benign, low malignant potential and malignant. Sensitivity of frozen section diagnosis for malignant was 80 %, low malignant potential 73,1%, and benign 99.8%. Predictive value for malignancy was 98.5%, for low malignant potential 76.6%, and for benign disease 96.2%. Diagnostic problems occurred in huge tumors and low malignat potential mucinous tumors. Analysis of the 32 false negative(miss or under diagnosis) revealed that a sampling error was involved almostly. The cases of discrepancy between frozen section diagnosis and permanent section diagnosis, were 26/34 in mucinous tumors and 33/34 in huge size of tumors(more than 10cm). Although surgeons and pathologist are aware of the limitations of frozen section diagnosis of ovarian tumors, peroperative histologic examination can be worthwhile and prevent under or over treatment of ovarian malignancies.
Diagnosis* ; Frozen Sections* ; Mucins ; Paraffin ; Selection Bias

We have experienced an unusual case of hemorrhagic infarct in the right testis at the age of 59 years. The spermatic cord showed normal appearance and no torsion was noted. Orchiectomy was performed as frozen section revealed hemorrhagic infarction of the testis. Herein, hemorrhagic infarction of testis, a rare clinical entity, was reported with review of literatures.
Frozen Sections ; Infarction ; Orchiectomy ; Spermatic Cord ; Testis*

BACKGROUND/AIMS: The treatment of choice of intraductal papillary mucinous neoplasm (IPMN) is partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMN. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting the extension of IPMN and selecting the resection methods of pancreas. METHODS: A preoperative assessment of IPMN by IDUS was performed in 12 patients who underwent a surgical resection of IPMN. According to the preoperative localization of IPMN by IDUS, various types of limited pancreatic resections were planned. The histologic examination of the frozen section of the pancreatic cut surface was performed in all patient. In the cases of tumor involvement as cut surface margin, a modification of the planned pancreatic resection was done. RESULTS: Technical success was achieved in all 12 cases (100%). There were positive tumor margin of cut surfaces in 2 patients. Of 10 cases whose frozen tissue evaluation of the pancreatic cut surface had been negative at first, one patieat has turned out to be margin positive in permanent section examination, finally. Overall accuracy of IDUS in predicting the continuous extension of IPMN was 75%. CONCLUSIONS: IDUS is a reliable diagnostic modality to guide the resection extent of the pancreas in patients with IPMN.
Frozen Sections ; Humans ; Mucins* ; Pancreas* ; Ultrasonography*

We report a very rare case of simple intra-testicular cyst, a 1.7 x l.2 cm sized round lesion fulfilling the criteria of a simple cyst on ultrasound in a 4-month-old male infant in whom the lesion was confirmed as a simple intra-testicular cyst on frozen section and subsequently underwent excision with successful preservation or the testis.
Frozen Sections ; Humans ; Infant* ; Male ; Testis* ; Ultrasonography*