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Biomedical subjects

Mary Lou Jondal

Publications and source records attributed to Mary Lou Jondal.

5 recordsLinked to original sources
PubMed2003

Evaluation of a new curved linear array echoendoscopy system for EUS.

BACKGROUND: EUS-FNA can be used to accurately diagnose and stage GI and pulmonary neoplasms. This study evaluated the performance characteristics of a new compact linear EUS system during EUS-FNA. METHODS: A total of 37 patients enrolled in this prospective pilot study underwent clinically indicated EUS-FNA and/or celiac plexus neurolysis with the compact EUS system. RESULTS: The mean time to perform a radial and linear array EUS with FNA and/or celiac plexus neurolysis was 24 minutes shorter with the compact EUS system compared with that for an historical control procedure in which a conventional linear EUS unit was used (p = 0.0007). The EUS images and visualization of the needle during EUS-FNA were rated good to excellent in greater than 95% of the patients. With respect to ease of esophageal intubation, duodenal intubation, and general maneuverability, the performance of the new linear echoendoscope, compared with a radial scanning videoechoendoscope, was the same or better in, respectively, 85%, 87%, and 100% of procedures. The video image quality of the new linear array echoendoscope was superior to that of the radial scanning videoechoendoscope in all patients. No complications were encountered. CONCLUSIONS: EUS-FNA and celiac plexus neurolysis can be performed safely with the new compact EUS system. The efficiency of this procedure is enhanced compared with historical experience with other instruments. Although image quality is sufficient for EUS-FNA and celiac plexus neurolysis, the compact unit cannot be used as a "stand-alone" system for routine diagnostic EUS, and its use must be complemented by standard radial imaging.

Biopsy, Needle↗
PubMed2003

Prospective risk assessment of bacteremia and other infectious complications in patients undergoing EUS-guided FNA.

BACKGROUND: There are few data regarding the risk of bacteremia with EUS-guided FNA. This study prospectively evaluated the frequency of bacteremia and other infectious complications after EUS-guided FNA. METHODS: Patients referred for EUS-guided FNA of the upper GI tract lesions were considered for enrollment. Patients were excluded if there was an indication for preprocedure administration of antibiotics based on ASGE guidelines, had taken antibiotics within the prior 7 days, or if they had a pancreatic cystic lesion. Blood cultures were obtained immediately before the procedure, after routine endoscopy/radial EUS, and 15 minutes after EUS-guided FNA. RESULTS: Fifty-two patients underwent EUS-guided FNA at 74 sites (mean 1.4 sites/patient) totaling 266 passes of the fine needle (mean 5.1 FNA/patient). Coagulase negative Staphylococcus was grown in cultures from 3 patients (5.8%; 95% CI [1%, 15%]) and was considered a contaminant. Three patients (5.8%; 95% CI [1%, 15%]) developed bacteremia: Streptococcus viridans (n = 2), unidentified gram-negative bacillus (n = 1). No signs or symptoms of infection developed in any patient. CONCLUSION: EUS-guided FNA of solid lesions in the upper GI tract should be considered a low-risk procedure for infectious complications that does not warrant prophylactic administration of antibiotics for prevention of bacterial endocarditis.

Adult↗
PubMed2003

Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA.

BACKGROUND: EUS-guided FNA is a sensitive method for the diagnosis of malignancy. However, EUS-FNA is often laborious and usually requires the presence of a cytopathologist or cytotechnician. The development of an EUS-guided Trucut biopsy (EUS-TCB) needle may simplify the procedure and expand the application of EUS-directed procurement of biopsy specimens. The aim of this study was to determine the feasibility of using the EUS-TCB for the diagnosis of intraintestinal and extraintestinal lesions and compare the results with this needle with those of EUS-FNA. METHODS: The EUS-TCB and EUS-FNA were used to evaluate patients with known or suspected intraintestinal or extraintestinal mass lesions and/or lymphadenopathy. Patient records were retrospectively reviewed to determine the accuracy and safety of both techniques. RESULTS: Nineteen patients had tissue samples obtained with both the EUS-TCB and EUS-FNA from 20 sites (2 sites in 1 patient) between December 2001 and March 2002. Accuracy was higher with EUS-TCB than EUS-FNA, although the difference was not significant (85% vs. 60%), despite performing fewer passes with the former (mean [SD] 2.0 [0.7], range 1-4; vs. mean 3.3 [1.5], range 1-10; p < 0.05). No complications were identified. CONCLUSIONS: This preliminary study suggests EUS-TCB can safely be used to obtain biopsy specimens of intraintestinal and extraintestinal mass lesions and lymphadenopathy. Its use may reduce the number of needle passes compared with EUS-FNA. This may reduce costs by shortening the procedure, diminishing the need for an onsite cytopathologist or technician, and lowering the frequency of nondiagnostic procedures. Prospective studies are needed to verify these findings.

Aged↗
PubMed2002

Initial experience with EUS-guided trucut needle biopsies of perigastric organs.

BACKGROUND: The aims of this study were to determine the feasibility, safety, and yield of a 19-gauge EUS-guided-trucut needle for obtaining biopsy specimens of perigastric organs. METHODS: The study was performed in swine under general anesthesia. EUS-guided trucut needle biopsy specimens were obtained from the spleen, liver, pancreas body, and left kidney. Biopsy specimens were assessed for size, fragmentation, and representation of the target organ. OBSERVATIONS: Twenty-eight biopsy specimens were obtained from the 4 target organs with two needles. Median biopsy length was 6 mm (spleen), 4 mm (liver), 6 mm (left kidney), and 2 mm (pancreas body). Of all the specimens, 75% to 100% had tissue representative of the target organ. EUS visualization of the needle was excellent and no complications were identified. CONCLUSIONS: Use of the trucut needle under EUS guidance to obtain biopsy specimens of perigastric organs appears safe and yields specimens that are representative of the target organ sampled. Further study of the utility and safety of this needle in humans is warranted.

Animals↗