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At least 469 records · Page 26Linked to original sources

PubMed1999

Seminal vesicle sperm aspiration in the diagnosis of ejaculatory duct obstruction.

OBJECTIVE: To determine the effectiveness of seminal vesicle aspiration in the diagnosis and treatment of patients with ejaculatory duct obstruction. PATIENTS, SUBJECTS AND METHODS: Between March 1998 and February 1999, 10 infertile men with ejaculatory duct obstruction (EDO, mean age 32.7 years, range 25-47) and 10 fertile volunteers (mean age 33.2 years, range 25-42) underwent transrectal ultrasonography (TRUS) and TRUS-guided seminal vesicle aspiration. The volume of and presence of motile sperm in the aspirate was compared with the TRUS findings for both groups. RESULTS: From TRUS of the patients with EDO, the mean (sd, range) transverse diameter of the right and left seminal vesicles were 1.97 (0.54, 0.8-2.6) cm and 1.93 (0.53, 0.9-2.6) cm; the corresponding values in the control group were 1.03 (0.15, 0.8-1.3) cm and 1.0 (0. 12, 0.8-1.4) cm, respectively (P<0.001). In all, 20 aspirate samples were obtained from the patients with EDO by bilateral seminal vesicle aspiration and only one (10%) had no sperm within the aspirate fluid. Of these 10 patients, two had immotile sperm and the remaining seven (14 samples) had a mean motile sperm count of 0.63 (0.45, 0.1-1.0)x106 /mL, whereas seven of eight men assessed in the control group had no motile sperm (one patient had immotile sperm within the aspirate fluid); this difference was significant (P<0.01). CONCLUSIONS: The aspiration of significant numbers of motile sperm from the seminal vesicles suggests the presence of distal obstructions of the ejaculatory duct and enables infertile couples to be candidates for assisted reproduction. However, there is a need for further research to determine the use of this technique in the diagnosis of partial EDO.

Adult↗

PubMed1975

[The value of suprapubic bladder aspiration in the diagnosis of bacteriuria (author's transl)].

Urine obtained simultaneously by midstream voiding and supra-public bladder aspiration from 500 patients were compared by bacteriological and, in some, microscopic examination. In a second series a similar examination was undertaken on 1000 samples each, obtained by midstream voiding, catheterisation or suprapublic bladder aspiration from different patients. There was no significant difference in sediments or Stansfeld count between midstream and aspirated samples. Qualitative false-positive results for protein were obtained in 20% of midstream samples from women. The Kass count for significant bacteriuria was false-positive in 3.4% of midstream compared with bladder-aspiration samples, in 7.6% for "questionable bacteriuria". Positive counts of under 10(5)/ml were obtained in 41.3%, of under 10(4)/ml in 26.7% of aspirated samples. Counts under 10(4)/ml in midstream-voided samples are usually considered the result of contamination, at times falsely so. "Mixed infections" were 7.8 times more common in catheter and 11.4 to 11.8 times more common in midstream than in aspirated samples. The presence of microorganisms in suprapublic bladder aspiration is always abnormal. Chemotherapy is indicated only on results from bladder aspiration.

Bacteriuria↗

PubMed2006

[Transbronchial biopsy in comparison with catheter aspiration in the diagnosis of peripheral pulmonary nodules].

BACKGROUND: Usually, transbronchial biopsy (TBB) is performed in the evaluation of bronchoscopically invisible solitary nodules and peripheral lesions of the lung. Additionally catheter aspiration can be done with the fiberbronchoscope, also under fluoroscopic guidance, to get cytological material. Despite of its simplicity, the catheter aspiration technique is widely unknown. METHOD: In a prospective study we compared the diagnostic yield of both procedures concerning malignancy. 28 consecutive patients (age 69.4 +/- 8.9 years) underwent both TBB and catheter aspiration. RESULTS: The tumor size measured 41.4 +/- 14.5 mm. The frequency of TBB was 3.4 +/- 1.8 and of catheter aspiration 2.6 +/- 1.2 per patient. A malignant tumor was diagnosed in 13 cases by TBB and in 20 cases by catheter aspiration. With the combination of both methods, a malignancy was diagnosed in 23 cases. 3 of 5 bronchoscopically not malignant tumors turned out to be bronchial cancer by surgery, the other 2 were benign in a 2 year follow up. CONCLUSION: The diagnostic yield of catheter aspiration is significantly superior to transbronchial biopsy (77 % compared with 50 %, p < 0.05 chi square test). When combining both methods the result is further improved by about 10 %. Composed to of other cytological methods (transbronchial needle aspiration, brush cytology) aspiration by catheter seems at least comparable, but with cost saving advantages.

Biopsy↗

PubMed2002

The rate of false-positive results with EUS-guided fine-needle aspiration.

BACKGROUND: The aims of this study were to determine the rate of false-positive diagnosis with EUS-guided fine-needle aspiration and to identify factors contributing to this type of error. METHODS: The records of 577 patients undergoing EUS-guided fine-needle aspiration were reviewed and a subset of 188 patients with malignant cytology who underwent surgery was identified. Operative histopathology was compared with EUS-guided fine-needle aspiration cytopathology and false-positive cases were identified. An experienced cytopathologist, who was not involved with the original interpretation of the specimens, reviewed these cases to identify any factor(s) contributing to the errors. RESULTS: Three cases of false-positive diagnosis were identified (1.6%; 95% CI [0.3%, 4.6%]). By aspiration site, the false-positive rates were as follows: pancreas 2/39 (5.1%), 95% CI [0.6%, 17.3%]; lymph nodes 1/136 (0.7%), 95% CI [0.02%, 4.0%]; and other sites 0/13, 95% CI [0.0%, 24.7%]. In both instances of a false-positive diagnosis for a pancreatic aspiration cytologic specimen, interpretative errors were identified. The false-positive interpretation of cytologic material aspirated from a lymph node occurred in a patient without any evidence for malignancy at surgery. In 111 patients with confirmed esophageal, gastric, or rectal malignancy undergoing EUS-guided fine-needle aspiration of nonperitumoral lymph nodes, there was no false-positive diagnosis, suggesting that specimen contamination by luminal tumor is rare. CONCLUSION: The overall rate of false-positive diagnosis for EUS-guided fine-needle aspiration is similar to that reported for other modalities. Most false-positive diagnoses are caused by interpretation errors.

Biopsy, Needle↗

PubMed1998

Value of re-aspirations in benign nodular thyroid disease.

Fine-needle aspiration cytology (FNAC) is the most useful procedure for the evaluation of thyroid nodules. The requirement for repeated aspirations in the follow-up of benign nodular thyroid disease, however, is controversial. To determine the value of re-aspirations in benign nodular thyroid disease, we studied 457 fine-needle reaspirations performed on 216 patients (197 female, 19 male) aged 42.9+/-12 years with uninodular (n = 65) and multinodular (n = 151) thyroid disease. Two hundred fifty-seven of these were second, 137 were third, 46 were fourth, and 17 were fifth re-aspirations of the same nodule, performed in a mean follow-up time of 43.9+/-31 (3-156) months. FNAC results were benign in 407 (89%), insufficient for diagnosis in 31 (6.8%), suspicious in 16 (3.5%), and papillary carcinoma (PC) in 3 (0.7%). An initial benign diagnosis did not change after multiple aspirations in 213 (98.61%) of the cases. Three patients with initial aspirations read as benign had a diagnosis of PC from their second biopsies, (diagnosis confirmed at surgery). Re-examination of the initial FNAC revealed atypical features in 1 of the 3 patients. These 3 patients likely represent a false-negative result of the initial FNAC rather than benign nodular disease transformed to a malignant one during the follow-up period. In conclusion, a second aspiration of clinically suspicious nodules may correct a few initial false-negative results, but routine additional re-aspirations are not useful for clinically stable disease.

Adult↗

PubMed1999

A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization.

The aim of the present study was to evaluate the anaesthetic effect during oocyte aspiration of a paracervical block (PCB) in combination with either electro-acupuncture (EA) or intravenous alfentanil. In all, 150 women undergoing in-vitro fertilization (IVF) and embryo transfer were randomized to receive either EA plus PCB or alfentanil plus PCB. Visual analogue scales (VAS) were used to evaluate subjective experiences during oocyte aspiration, and IVF outcome parameters were recorded. No differences in pain directly related to oocyte aspiration, adequacy of anaesthesia during oocyte aspiration, abdominal pain, or degree of nausea were found between the two groups in the VAS ratings. Before oocyte aspiration, the level of stress was significantly higher in the EA group than in the alfentanil group (P < 0.05), and the EA group experienced discomfort for a significantly longer period during oocyte aspiration (P < 0. 01). Compared with the alfentanil group, the EA group had a significantly higher implantation rate (P < 0.05), pregnancy rate (P < 0.05), and take home baby rate (P < 0.05) per embryo transfer. In conclusion, EA has been shown to be as good an anaesthetic method as alfentanil during oocyte aspiration, and we suggest that EA may be a good alternative to conventional anaesthesia during oocyte aspiration.

Adult↗

PubMed2005

Leukocyte origin and profile in follicular aspirates at oocyte retrieval.

BACKGROUND: Follicular aspirates represent a snapshot in time of conditions within the follicle at oocyte retrieval in women undergoing in vitro fertilization and embryo transfer. This clinical material has been much investigated and yet its cellular composition remains unclear. In this study we investigated the origin and profile of leukocytes found within follicular aspirates. METHODS: We performed morphological and immunohistochemical analyses of follicular aspirates and peripheral blood obtained concurrently at oocyte retrieval. RESULTS: There was no correlation between erythrocyte and leukocyte numbers in follicular aspirates. The profile of leukocyte subtypes within follicular aspirates was variable and differed significantly from the peripheral circulation in a significant proportion of the analysed samples. A subset of follicular aspirates displayed a marked increase in monocytes/macrophages and an apparent concomitant reduction in polymorphonuclear leukocytes compared with peripheral blood. CONCLUSIONS: Leukocytes within follicular aspirates cannot be accounted for solely as a result of blood vessel damage during oocyte retrieval. The variation in leukocyte subtypes observed in some follicular aspirates may reflect a coordinated infiltration of these cells, characteristic of progressive inflammatory responses in other systems. The possibility that leukocyte variation is indicative of follicular maturation deserves further investigation due to its potential relevance in optimizing oocyte selection.

Adult↗

PubMed1999

Frequent detection of HIV-1 in the gastric aspirates of neonates born to HIV-infected mothers.

OBJECTIVE: To evaluate the frequency and correlates of oral route exposure of infants born to HIV-1-infected women. METHODS: A multicenter study was performed within the prospective French Perinatal Cohort Study of mother-to-child HIV transmission. Oropharyngeal and gastric aspirates from 122 neonates were studied by reverse transcriptase (RT) polymerase chain reaction (PCR) for the presence of HIV-1, as well as for standard microbiology (Gram staining and culture). RESULTS: Aspirates from 101 neonates were analyzed by RT-PCR; 28% of these were positive for HIV RNA. Another 21 aspirates could not be tested because of PCR inhibition. The median concentration of HIV RNA in the positive aspirates was 126 copies/ml (range: 8-1270). Detection of HIV-1 in the aspirate was significantly related to high maternal plasma-viral load, presence of blood in the aspirate, positive Gram stain or culture, episiotomy or perineal lesions, and sexually transmitted infections during the pregnancy. Most of the mothers received zidovudine prophylaxis during pregnancy and delivery. Among the six infants who were infected with HIV, three had positive aspirates. Of the three assumed to have acquired the infection intrapartum, only one had an HIV RNA-positive aspirate. CONCLUSION: Exposure of the fetus to HIV via the oral route occurs frequently, even in the presence of zidovudine prophylaxis, and is likely to be one of the mechanisms of intrapartum transmission, but not the only one.

Adult↗

PubMed1998

Experience with vasal sperm aspiration.

PURPOSE: We describe our experience with vasal aspiration of sperm in patients with azoospermia secondary to neurogenic anejaculation or obstruction of the vas deferens. MATERIALS AND METHODS: We performed 15 vasal sperm aspirations on 11 patients with neurogenic anejaculation or vasal obstruction. RESULTS: Adequate sperm was obtained from all 15 aspirations with an average sperm count of 42 x 10[6] (range 0.5 to 252 x 10[6]) and an average motility of 73.4% (range 16 to 100%). Aspirations were performed for use with assisted reproductive techniques in 12 cases and for cryopreservation alone in 3. Following assisted reproductive techniques 6 of the 12 aspirations (50%) resulted in pregnancy. CONCLUSIONS: Vasal aspiration of sperm should be considered when electroejaculation fails, is not available or is contraindicated. Although the overall sperm quality and pregnancy rate are higher with vasal aspiration and in vitro fertilization than electroejaculation and intrauterine insemination, vasal aspiration is a more technically demanding and costly approach to conception.

Adult↗

PubMed1996

Scintigraphic quantification of aspiration reduction with the Passy-Muir valve.

The Passy-Muir "speaking" tracheostomy valve has been noted to aid in swallowing, based on videofluoroscopy to assess aspiration. In this study scintigraphy was used to quantify the amount of material aspirated. Eleven patients were studied who currently had a tracheostomy in place and were either known to aspirate or were suspected of aspirating. Most were post-treatment head and neck cancer patients who were tumor free at the time of testing. Swallowing was evaluated using videofluoroscopy and scintigraphy. Videofluoroscopy was performed to assess anatomy and determine whether aspiration had occurred. Scintigraphic testing was then performed when the patient had the one-way valve on, and again with it off and tracheostomy open. Following a swallow, the amount (%) of aspirate with the valve in place was found to be significantly less than with the tracheostomy open. A one-way valve can be helpful in reducing aspiration in patients who are at risk for aspiration and who require that their tracheostomy be open.

Humans↗

PubMed1997

Standardization of gastric aspirate technique improves yield in the diagnosis of tuberculosis in children.

BACKGROUND: The diagnosis of tuberculous disease in children remains a difficult one, based on epidemiologic investigation, Mantoux skin testing and suggestive radiologic findings. Because children with pulmonary tuberculosis are unable to produce sputum, gastric aspirates remain the procedure of choice for microbiologic confirmation of tuberculous disease; however, yield is frequently low. OBJECTIVES: To evaluate the effect of a standardized gastric aspirate collection protocol on diagnostic culture yield. METHODS: The gastric aspirate culture yield for Mycobacterium tuberculosis in 13 historical control children with clinically confirmed tuberculosis from 1979 to 1994 was compared with the yield in 8 children with tuberculous disease after institution of a standardized gastric aspirate collection protocol involving physician education, strict timing of collection, base neutralization of aspirate specimens and expedited processing. RESULTS: Retrospective survey of gastric aspirate results in Rhode Island from 1979 to 1994 revealed that only 1 of 13 cases (8%) of pediatric pulmonary tuberculosis were confirmed in this manner. During a 12-month period after institution of a protocol, gastric aspirates yielded positive cultures in 4 of 8 children (50%) with pulmonary tuberculosis, a yield that compares favorably with the sensitivities of 20 to 52% published in the literature. CONCLUSIONS: Attention to the technique of gastric aspirate collection, and expedited processing in particular, appears to improve the yield of this diagnostic procedure for pediatric tuberculosis.

Child↗

PubMed2002

Does the use of volumetric bladder ultrasound improve the success rate of suprapubic aspiration of urine?

OBJECTIVE: To determine whether a volumetric bladder scanner can improve the success rate of suprapubic aspiration and whether there is an optimal volume of urine required in the bladder before suprapubic aspiration should be attempted. DESIGN: Two-phase prospective study. SETTING: The emergency department of a tertiary children's hospital. SUBJECTS: Children younger than 2 years who required an uncontaminated urine specimen for microscopy and culture. METHODS: In phase one, all patients had an ultrasound followed by suprapubic aspiration. In phase two, patients were randomized to either ultrasound or no ultrasound. RESULTS: In phase one, 37 subjects had ultrasound measurement prior to attempting suprapubic aspiration; 28 of 31 (90%) had successful suprapubic aspiration when a minimum volume of 10 mL was detected on ultrasound and no 0-mL readings were encountered. In phase two, the overall success rate of obtaining urine with the aid of the bladder scanner was 31 of 39 subjects (79%), compared with 16 of 36 subjects (44%) without ultrasound. Ultrasound was also useful in deferring an attempt when less than 10 mL of urine was noted on the scan. CONCLUSIONS: The volumetric bladder scanner is a rapid, safe, and accurate device that, in this study, greatly improved the success rate of suprapubic aspiration in small children. It also helped to avoid time delays or multiple blind attempts at suprapubic aspiration by predicting volumes at which suprapubic aspiration should or should not be attempted.

Female↗

PubMed2003

Efficiency of percutaneous testicular sperm aspiration as a mode of sperm collection for intracytoplasmic sperm injection in nonobstructive azoospermia.

PURPOSE: We determined the feasibility of obtaining mature spermatozoa for intracytoplasmic sperm injection (ICSI) by percutaneous testicular sperm aspiration in men with nonobstructive azoospermia. We also compared the results of ICSI using spermatozoa recovered by open excisional biopsy versus percutaneous testicular sperm aspiration. MATERIALS AND METHODS: A total of 84 men with nonobstructive azoospermia underwent percutaneous testicular sperm aspiration to recover testicular spermatozoa for ICSI on the day of ova retrieval from the wife. Percutaneous testicular sperm aspiration was performed with the patient under general anesthesia in the upper and lower poles of each testis. It was followed by immediate microscopic search of the aspirate to confirm the presence of spermatozoa. In the absence of spermatozoa open excisional biopsy was performed in the same setting. RESULTS: Percutaneous testicular sperm aspiration resulted in the recovery of mature spermatozoa in 45 men (53.6%). Of the remaining 39 men (46.4%) requiring open biopsy adequate spermatozoa were recovered in 28 (71.8%). Although the fertilization rate was significantly higher in the sperm aspiration group, the cleavage and pregnancy rates were similar in the 2 groups. CONCLUSIONS: Percutaneous testicular sperm aspiration was a successful initial approach to collect mature spermatozoa in a high proportion of men with nonobstructive azoospermia. It is safe, minimally invasive and well tolerated by all patients.

Adolescent↗

PubMedDate not supplied

Does aspiration of bones and joints affect results of later bone scanning?

To determine the effect, if any, of needle aspiration on 99mTc bone scanning, three different areas of 15 dogs were first aspirated and then imaged with technetium bone scintigraphy. The hip joint was aspirated, the distal femoral metaphysis was drilled and aspirated, and the tibial periosteum was scraped with an 18- or 20-gauge needle. Varying amounts of trauma were inflicted to simulate varying difficulties at aspiration. 99mTc bone scans were obtained from 5 h to 10 days later. There was no evidence of focal technetium uptake after any hip joint aspiration. This was consistent regardless of the amount of trauma inflicted or the time from aspiration to bone scanning. Metaphyseal cortical drilling and tibial periosteal scraping occasionally caused some focal uptake when scanning was delayed greater than 2 days. When osteomyelitis or pyarthrosis is clinically suspected, joint aspiration can be performed without fear of producing a false-positive bone scan.

Animals↗

PubMed2005

Diagnostic evaluation of Karman endometrial aspiration in patients with abnormal uterine bleeding.

AIM: To assess sensitivity and specificity of Karman aspiration in the diagnosis of abnormal endometrium compared with the final diagnosis and evaluate tissue adequacy obtained by Karman aspiration. METHODS: The study group were women who presented with abnormal uterine bleeding to Songklanagarind Hospital between August 2003 and July 2004 and who underwent Karman aspiration prior to conventional curettage. The final diagnosis was defined as the most severe histopathology from either Karman aspiration or conventional curettage. Abnormal endometrium included inflammation, polyp, hyperplasia and malignant changes. RESULTS: Two hundred and twenty-six women were assessed. Endometrial aspiration showed a sensitivity of 89.6% and specificity 100.0% in diagnosis of abnormal endometrium. Abnormal endometrium was detected in 58 women. Of 11 women diagnosed with endometrial cancer, only one case was undetected by Karman aspiration due to a failure to create negative pressure in the uterus. Endometrial aspiration yielded adequate tissue in 86.7%. CONCLUSION: Karman endometrial aspiration is an accurate and easy procedure, and should be considered in the initial evaluation of abnormal uterine bleeding.

Adult↗

PubMed2002

An axisymmetric boundary integral model for assessing elastic cell properties in the micropipette aspiration contact problem.

The micropipette aspiration technique has been used extensively in recent years to measure the mechanical properties of living cells. In the present study, a boundary integral formulation with quadratic elements is used to predict the elastic equilibrium response in the micropipette aspiration contact problem for a three-dimensional incompressible spherical continuum cell model (Young's modulus E). In contrast to the halfspace model, the spherical cell model accounts for nonlinearities in the cell response which result from a consideration of geometric factors including the finite cell dimension (radius R), curvature of the cell boundary, evolution of the cell-micropipette contact region and curvature of the edges of the micropipette (inner radius a, edge curvature radius epsilon). The efficiency of the boundary element method facilitates the quantification of cell response as a function of the scaled pressure p/E, for the range of parameters a/R = 0.4-0.7, epsilon/a = 0.02-0.08, in terms of two measures that can be quantified using video microscopy. These are the aspiration length, which measures projection of the cell into the micropipette, and a characteristic strain, which measures stretching along the symmetry axis. For both measures of cell response, the resistance to aspiration is found to decrease with increasing values of the aspect ratio a/R and curvature parameter epsilon/a, and the nonlinearities in the cell response are most pronounced in the earlier portion of the aspiration test. The aspiration length is found to exhibit less sensitivity to the aspect ratio a/R than to the curvature parameter epsilon/a, whereas the characteristic strain, which provides a more realistic measure of overall cell stiffness, exhibits sensitivity to the aspect ratio a/R. The resistance to aspiration in the spherical cell model is initially less than that of the half space model but eventually exceeds the halfspace prediction and the deviation between the two models increases as the parameter epsilon/a decreases. Adjustment factors for the Young's modulus E, as predicted by the halfspace model, are presented and the deviation from the spherical cell model is found to be as large as 35%, when measured locally on the response curve. In practice, the deviation will be less than the maximum figure but its precise value will depend on the number of data points available in the experiment and the specific curve-fitting procedure. The spherical cell model allows for efficient and more realistic simulations of the micropipette aspiration contact problem and quantifies two observable measures of cell response that, using video microscopy, can facilitate the determination of Young's modulus for various cell populations while, simultaneously, providing a means of evaluating the validity of continuum cell models. Furthermore, this numerical model may be readily extended to account for more complex geometries, inhomogeneities in cellular properties, or more complex constitutive descriptions of the cell.

Cell Adhesion↗

PubMed1990

Fine needle aspiration cytology of rectal masses.

This paper describes the results of transproctoscopic fine needle aspiration cytology in the diagnosis of rectal lesions. Fifty one consecutive patients referred with a presumptive diagnosis of rectal mass were subjected to proctoscopic examination when fine needle aspiration cytology, brush cytology and biopsy samples were taken. Of the 30 patients of malignancy of rectum in whom all the three sampling techniques were applied, the biopsy was positive in 27 (90%), brush cytology in 25 (83.3%) and fine needle aspiration cytology in 29 (96.6%). A combination of fine needle aspiration cytology with brush cytology gave a positive yield in 96.6% while that fine needle aspiration cytology with brush cytology gave a yield of 100%. Fine needle aspiration cytology was most helpful in infiltrative tumours. All 10 patients with secondaries in the pouch of Douglas or rectovesical pouch, and the single patient with submucosal rectal carcinoma were correctly diagnosed at fine needle aspiration cytology. There were no false positive results with fine needle aspiration cytology and no complications were encountered with the procedure.

Adenocarcinoma↗

PubMed2003

A tale of three aspirations: foreign bodies in the airway.

Tracheobronchial foreign body aspiration is a serious medical problem, with clinical manifestations ranging from acute asphyxiation to insidious lung damage, as demonstrated by the three presented cases. Patient 1 aspirated during dinner, emergency bronchoscopy retrieved pieces of food, and she fully recovered the following day. Patient 2 presented with recurrent pneumonia and a right lower lobe lung abscess. After right lower lobectomy, pathology revealed a foreign object in the right main stem bronchus, a peanut aspirated one year earlier. Patient 3 became unresponsive several days after spinal surgery. The differential diagnosis included myocardial infarction, stroke, and foreign body aspiration. The patient died and necropsy revealed a foreign body in the right main stem bronchus (cooked meat). Thus, foreign body aspiration is not always suspected clinically, and the pathologist may play an important role in making the diagnosis. Histological identification of the aspirated material may be necessary for definitive diagnosis. Therefore, sections of commonly aspirated foods are presented, together with a 10 year history of aspirated objects received by this institution's surgical pathology department.

Aged↗