OBJECTIVE: We wanted to compare the clinical usefulness of conventional galactography and MR contrast galactography for diagnosing patients with nipple discharge. MATERIALS AND METHODS: Both conventional galactography and MR contrast galactography were performed prospectively in 16 patients. Gadopentate dimeglumine (0.1 ml) was mixed with non-ionic contrast medium (0.9 ml) to obtain a resultant volume of 1 ml and this was used for both examinations. Following conventional galactography, MR contrast galactography was performed after direct injection of contrast media into the duct. RESULTS: Conventional galactography and MR contrast galactography were concordant in 13 (81%) of 16 patients; the results were normal in five, ductal dilatation was noted in four and intraductal filling defects were noted in four. The remaining three (19%) patients demonstrated discordant findings on the two examinations. While conventional galactography revealed filling defects, the MR contrast galactography results were normal in two patients. The third patient had kinks-stricture on conventional galactography and MR contrast galactography showed ductal dilatation. This suggested there were false positive results for the three patients' conventional galactography, and all the three patients with discordant results underwent surgery and the histopathologic evaluation showed fibrocystic changes. CONCLUSION: MR contrast galactography may be used as an alternative imaging modality for making the diagnosis of pathologic nipple discharge. However, statistically supported studies with large pools of subjects for comparing the galactography and MR contrast galactography results are needed to confirm our findings.
Adult ; Aged ; Breast Diseases/*diagnosis/pathology/radiography ; Contrast Media ; Exudates and Transudates ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Magnetic Resonance Imaging/*methods ; Middle Aged ; Nipples/*secretion ; Prospective Studies

This study was carried out to describe clinical, gross and histopathological findings in the respiratory tract in chickens infected intranasally with A96 strain of infectious laryngotracheitis virus (ILTV). In addition, the presence of ILTV antigens in formalin-fixed and paraffin-embedded larynx and trachea tissues was investigated with the immunoperoxidase (IP) method in the infected chickens. At various days of viral infection, nares, larynx, trachea, lungs and air sacs tissue samples of the infected chickens were obtained and fixed with formalin and embedded in paraffin. The cross sections were stained with hematoxylineosin, and the larynx and trachea sections were also stained with the IP method. Mild rales and gasping were observed in only 4 of 35 chickens. The virus caused mild inflammatory changes in the respiratory tract. It was shown that clinical, gross and histopathological findings were not specific for differential diagnosis of the disease. However, ILTV antigens were detected by the IP method in formalin-fixed and paraffin-embedded larynx and trachea sections. These results revealed that the study use of the IP method might be useful for the diagnosis of ILTV infections with non-specific lesions.
Animals ; Chickens ; Hemorrhage/pathology ; Herpesviridae Infections/*pathology ; Herpesvirus 1, Gallid/isolation & purification/*pathogenicity ; Immunohistochemistry ; Larynx/blood supply/pathology ; Mucous Membrane/pathology ; Virulence

Background/Aims: Advanced fibrosis (F≥3) indicates poor outcomes in nonalcoholic fatty liver disease (NAFLD). Here, we examined the diagnostic performance of the fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) for detecting (or excluding) advanced fibrosis in patients with biopsy-proven NAFLD. Methods: The diagnostic performance of each noninvasive test according to previously identified cutoff points indicating low and high risk for advanced fibrosis was determined in 463 patients with NAFLD. Patients who scored <1.3 and >2.67 on the FIB-4 were considered at low and high risk for advanced fibrosis, respectively. Patients who scored <–1.455 and >0.676 on the NFS were considered at low and high risk for advanced fibrosis, respectively. Results: Eighty-one patients (17.5%) had biopsy-proven advanced fibrosis (F≥3). The published FIB-4 cutoff values for low and high risk were able to exclude advanced fibrosis with negative predictive values (NPVs) of 0.907 and 0.843 and specificities of 74% and 97%, respectively. The published NFS cutoff values for low and high risk were able to exclude advanced fibrosis with NPVs of 0.913 and 0.842 and specificities of 63% and 96%, respectively. If biopsies were performed in only patients with a FIB-4 above the low cutoff point (≥1.3), 67.1% could be avoided. Conversely, if biopsies were performed in only patients with an NFS above the low cutoff point (≥–1.455), 57.0% could be avoided. Conclusions The main clinical utility of the FIB-4 and NFS in patients with NAFLD lies in the ability to exclude, not identify, advanced fibrosis.