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PubMed2002

Host feeding preferences of Anopheles species collected by manual aspiration, mechanical aspiration, and from a vehicle-mounted trap in the Toledo District, Belize, Central America.

The host-feeding patterns of Anopheles albimanus, Anopheles vestitipennis, and Anopheles punctimacula from the Toledo District in southern Belize were studied with blood-fed females that were collected by manual aspiration, a backpack aspirator, and a vehicle-mounted trap for sampling in-flight mosquito populations. Female An. vestitipennis collected from both inside and outside house walls by manual aspiration tested positive for human blood meals (88 and 67%, respectively). At increasing distances from the houses, specimens of An. vestitipennis collected from vegetation with the backpack aspirator were equally positive for human and cattle blood (44 and 43%, respectively). In contrast, 68% of the An. albimanus specimens (148) collected by backpack aspiration tested positive for cattle blood. Engorged An. vestitipennis from vehicle-mounted trap collections tested positive for cattle (108) and human (52) blood. Almost all specimens of An. albimanus from these collections were positive for cow (95%). After analyzing the data from the An. vestitipennis samples using the feeding index, the ratio of human blood to all other bloodmeal sources showed indices greater than 1. Both An. albimanus and An. punctimacula fed mostly on cattle and rarely fed on humans. Foraging ratios for the 3 Anopheles species were very similar to the feeding indexes. Ratios based on data from all collection methods showed that An. vestitipennis feeds predominately on humans. The foraging ratios for An. albimanus demonstrated consistent preferences for nonhuman hosts. As with previous studies. An. albimanus seemed to prefer cattle and pigs to almost all other host species.

Animals↗

PubMed1989

Computerized microscopic analysis of prostatic fine needle aspirates. Comparison with breast aspirates.

Computerized image analysis was employed to analyze fine needle aspiration smears of the prostate and breast using both high-resolution images of individual cells and medium-resolution images of scenes and clusters (contextual analysis). A linear discriminant analysis was used to demonstrate the computer's ability to discriminate between benign and malignant categories for both types of tissue. Correct classification as benign or malignant using contextual analysis was achieved in 22 of 26 prostatic aspirates and in 15 of 18 breast aspirates, as determined by comparison with histology. The addition of high-resolution single-cell analysis resulted in correct classification of 24 of 26 prostatic aspirates and all breast aspirates. For virtually all features, the distinction between benign and malignant was more subtle for prostatic than for breast tissue. The data indicate that contextual analysis may be less effective as an adjunct to high-resolution single-cell microscopy of prostatic specimens than it is for breast specimens.

Biopsy, Needle↗

PubMedDate not supplied

Transthoracic fine needle aspiration cytology: a study of 301 aspirations from 221 cases.

Our existing cytologic and radiologic service enabled us to introduce transthoracic fine needle aspiration cytology (FNAC). The results of 301 aspirations on 221 patients during the first three years and the histologic, hematologic or clinical correlations are presented. Cytologically, 127 cases were reported positive for malignancy. No false-positive diagnosis was made. Most cases reported as suspicious for or suggestive of malignancy were also found to be malignant. In 23 cases (18%), the cytologic diagnosis of malignancy was made only upon repeated aspiration. Half of the cases reported as "insufficient" or "negative" on the first aspiration attempt were subjected to repeat aspirations, yielding representive samples in 57% of theses cases. FNAC helped to isolate cases of small-cell undifferentiated carcinoma and lymphoma as well as metastases from a group of patients presenting radiologic and clinical symptoms of malignancy and thus was instrumental in establishing proper treatment and preventing contraindicated surgery. It is suggested that in cases considered inoperable, where exfoliative cytology has failed, transthoracic FNAC, rather than bronchoscopy, mediastinoscopy or thoracotomy, should be applied.

Biopsy, Needle↗

PubMed1995

[Simple determination methods for blood grouping from biological stains. 1. Immunologic gold colloid aspiration test and dot ELISA test by membrane aspiration method for determining ABO blood groups from saliva specimens].

Two immunologic tests using nitrocellulose membrane and an aspiration device were applied to determine the ABO blood groups and secretor status from saliva specimens. First, immunologic gold colloid membrane aspiration test (IMAT) was performed with orange-red colloidal gold particles (GP) sensitized with anti-A or anti-B antibody or anti-H lectin (A chicken antiserum to O secretor saliva was also used as an anti-H reagent in some experiments). The boiled saliva specimens were serially diluted and dotted to the nitrocellulose membrane, which was equipped to a disposable aspiration kit, and the antibody- or lectin-coated GP was aspirated through the membrane. The stained saliva changed red by the immunologic binding of the GP. Test results could be obtained within some minutes. Detection limits of IMAT shown by saliva dilution were 1:100 to 1:10,000 for secretor salivas, whereas those for non-secretor salivas were 1:10 or lower. Second, a revised dot ELISA was performed by using the membrane aspiration device. The requisite time for this test (Dot ELISA-A) was 40 to 45 minutes, whereas that for conventional dot ELISA was 3 to 4 hours. The detection limits of the dot ELISA-A shown by the saliva dilutions were 1:1,000 to 1:100,000 for secretor salivas, whereas those for non-secretor salivas were 1:1,000 or below.

ABO Blood-Group System↗

PubMed1993

Fine-needle aspiration anchor. A simple device to prevent needle-stick injury at fine-needle aspiration.

Pathologists and clinicians performing fine-needle aspiration for cytologic diagnosis are at risk of finger injury by the needle during the aspiration procedure. To prevent this occurrence and its accompanying potential for transmitting serious pathogens such as the human immunodeficiency virus and hepatitis B virus, we have designed a simple acrylic device (fine-needle aspiration anchor) consisting of two curved prongs with an attached handle, to take up the functions of the fingers for stabilization of the target lesion. Use of the fine-needle aspiration anchor on more than 1000 patients with various mass lesions has confirmed enhanced immobilization of the lesions for aspiration, safety for the person performing the procedure, and excellent patient acceptance.

Biopsy, Needle↗

PubMed2001

Severe meconium aspiration syndrome is not caused by aspiration of meconium.

Meconium aspiration syndrome can present clinically with different degrees of severity, ranging from a mild form of respiratory compromise to severe forms that may result in perinatal death despite mechanical ventilation or extracorporeal membrane oxygenation. However, advances in our knowledge concerning meconium aspiration syndrome have revealed that most cases of severe meconium aspiration syndrome are not in fact causally related to the aspiration of meconium but rather are caused by other pathologic processes occurring in utero, primarily chronic asphyxia and infection. Proper understanding of the causative processes underlying fetal or neonatal compromise in these cases is essential to direct future research into preventive or therapeutic treatments and for counseling of the parents of an affected child.

Asphyxia↗

PubMed1994

Acid aspiration prophylaxis in elective biliary surgery. A comparison of omeprazole and famotidine using manually aided gastric aspiration.

We have compared the effects of single oral doses of omeprazole 40 mg, famotidine 40 mg or placebo on gastric secretion in 45 non-obese patients the night before elective biliary surgery. After stable anaesthesia had been established, a Salem orogastric tube was introduced and gastric contents were aspirated by a blinded observer. The volume and pH were noted. After the abdomen was opened aspiration was repeated but on this occasion with the surgeon's manual assistance. We found that the initial aspirate volume underestimated total gastric volume by an average (SD) of 7.1 (6.6) ml. Famotidine, but not omeprazole, produced a significant decrease in gastric volume and acidity. Patients were considered to be at risk if pH < 2.5 and volume > 0.4 ml.kg-1. Three patients in the omeprazole group, three in the placebo group and none in the famotidine group came into this category. We conclude that a single oral dose of omeprazole 40 mg given the night before surgery does not afford adequate prophylaxis for acid aspiration syndrome.

Adult↗

PubMed2004

[The improvement of quality of life of patients with aspiration pneumonia after surgical therapy for intractable aspiration].

Sixteen patients with recurrent aspiration pneumonia that could not be controlled by appropriate medical therapies. These patients had no hope of recovering laryngeal function. Eight underwent laryngectomy, six underwent laryngotracheal separation and four underwent tracheoesophageal anastomosis. After surgery, we evaluated the efficacy of the therapy and the patients' satisfaction with therapy. Before and after surgery, the following clinical markers were examined to evaluate the efficacy of surgery: scores of aspiration pneumonia, WBC count, C-reactive protein, erythrocyte sedimentation rate, hematocrit, body mass index, total protein, albumin, and the Barthel index, an indicator of daily activity. Furthermore, the grade of Depression and mood, and satisfaction of patients and their carers among family members were scored using the Zung self-rating depression scale, a 20-picture face scale, the visual analog scale, and feeding status. After surgical therapy, we confirmed that aspiration was prevented in fourteen patients of sixteen, and the state of inflammation and nutrition, the state of depression and mood were improved. Thirteen patients from sixteen were able to ingest a meal orally. The quality of life of patients with intractable aspiration was improved.

Adult↗

PubMed1996

Prophylaxis against acid aspiration in regional anesthesia for elective cesarean section: a comparison between oral single-dose ranitidine, famotidine and omeprazole assessed with fiberoptic gastric aspiration.

BACKGROUND: Acid aspiration syndrome is still an important cause which contributes to maternal mortality in obstetric anesthesia. In this study, we compared famotidine, ranitidine, omeprazole with placebo for prophylaxis against aspiration pneumonitis in elective Cesarean section under regional anesthesia. METHODS: One hundred and sixty patients undergoing elective Cesarean section under spinal anesthesia were allocated randomly into four groups: Group P (n = 40) received placebo only; Group F (n = 40) received famotidine 40 mg Group R (n = 40) received ranitidine 300 mg; and Group O (n = 40) received omeprazole 40 mg. All drugs were given orally at least three hours before the patients entering the operating room. Gastric content was directly aspirated and measured respectively with a flexible fiberoscope under visualization and by a pH meter after delivery. RESULTS: Although these three drugs (F, R, and O) were all effective in controlling the secretion of gastric acid, from gastric analysis it was demonstrated that famotidine and ranitidine could be more defective to neutralize acidity than omeprazole (p < 0.05). Percentages of patients with pH < or = 2.5 in Groups P, F, R, and O were respectively 88%, 10%, 8%, and 21%, showing that the innate pH of gastric juice was far lower than expected. Patients receiving omeprazole in single oral dose regimen retained a greater gastric volume (> or = 0.4 ml/kg) than those who received famotidine or ranitidine (p < 0.005). From the criteria defining the patients "at risk" (pH < or = 2.5 and gastric volume > or = 0.4 ml/kg), it is speculated that all these three regimens could potentially reduce the incidence of patients with calculated risk. CONCLUSIONS: Our data demonstrated that parturients under regional anesthesia were at a higher risk of aspiration pneumonitis than generally thought. Single dose of ranitidine or famotidine administered orally three hours before surgery provided a more effective means to control and neutralize gastric secretion than omeprazole in parturients.

Administration, Oral↗

PubMed1991

The diagnostic impact of needle aspiration cytology of the breast on clinical decision making with an emphasis on the aspiration cytodiagnosis of male breast masses.

Our experience with a total of 7,231 needle aspirates of the breast was reviewed. Ninety-nine cases from the total of 7,231 aspirates studied were from male patients. While an aspiration cytodiagnosis of gynecomastia was made in most of these cases, carcinoma was diagnosed in four cases. Although a clinical distinction between male breast cancer and gynecomastia is often difficult, we found needle aspiration cytology a very useful initial investigation for making this distinction.

Adolescent↗

PubMed1992

Accuracy of diagnosis of malignant lymphoma by combining fine-needle aspiration cytomorphology with immunocytochemistry and in selected cases, Southern blotting of aspirated cells: a tissue-controlled study of 86 patients.

Fine-needle aspiration (FNA) cytology of lymph nodes in malignant lymphoma is fraught with difficulty. In certain clinical situations, cytology has been documented to be useful in patients with malignant lymphoma. The intent of our investigation was to determine the accuracy of a multiparameter approach in diagnosing lymphoma. We reviewed the results of FNA cytology combined with the immunocytochemistry and, in some cases, the Southern blots of aspirated cell suspensions obtained from 86 suspected lymphoma patients who subsequently underwent surgical biopsy of the aspirated site. In four cases, in which FNA was unable to retrieve sufficient material for diagnosis, the histology showed extensive fibrosis. When the FNA diagnoses were compared with the histologic diagnoses, the diagnosis concurred in 69 cases (56 malignant lymphomas, 12 reactive, 1 atypical lymphoid proliferation). There was one false-positive, six false-negatives, and eight cases diagnosed as atypical lymphoid proliferation. Overall accuracy was 91%. There were two types of false-negative cases: those in which a diagnosis of another malignancy or unspecified malignant neoplasm was made and those that were diagnosed as reactive when the histology showed lymphoma. In seven cases, the DNA rearrangement studies of the antigen receptor genes were successfully performed on the aspirated cells and were useful in establishing lineage and clonality of both B and T lymphoid cells. Our study indicated that the use of a multiparameter approach in the diagnosis of malignant lymphoma by FNA enhanced the accuracy of diagnosis of the non-Hodgkin's lymphomas. In Hodgkin's disease, no benefit was derived from the approach.

Biopsy, Needle↗

PubMed1987

Percentage of S-phase cells in bone marrow aspirates, biopsy specimens and bone marrow aspirates corrected for blood dilution from patients with acute leukemia.

For 14 patients with acute leukemia flow cytometry was used to determine the percentage of cells in S-phase flushed out of a bone marrow biopsy compared with the percentage in a bone marrow aspirate; there was a statistically significant difference (p less than 0.01) between the two. The percentage dilution of the bone marrow aspirate by peripheral blood was then calculated, according to Holdrinet et al. [1], in order to correct the percentage S-phase cells in the aspirate. The data presented show that when the percentage S-phase cells in the aspirate is corrected for blood dilution, it closely approaches the percentage S-phase cells in the biopsy (p greater than 0.10).

Biopsy↗

PubMed2000

Microsurgical epididymal sperm aspiration: aspirate analysis and straws available after cryopreservation in patients with non-reconstructable obstructive azoospermia. MESA/TESE Group Giessen.

Microsurgical epididymal sperm aspiration (MESA) combined with intracytoplasmic sperm injection (ICSI) represents a great advance in the therapy of non-reconstructable obstructive azoospermia. For procedure synchronization, a great number of organizational facilities are needed. Intentional cryopreservation of the aspirate may reduce these problems, therefore the aim of this study was to analyse the amount and quality of aspirate fluid obtained by means of MESA and the quality of the vials after thawing. Furthermore, the available cryopreserved straws were calculated. A total of 93 consecutive MESA procedures were performed and epididymal spermatozoa were obtained in 88 patients. Mean sperm concentration was 40.9 x 10(6) spermatozoa/ml. Global and progressive motility were 24.8 and 7.5% respectively. In one-third of the aspirates, no progressive motile spermatozoa were found. The mean number of straws available was 7.6. In 33 ICSI cycles with frozen-thawed epididymal spermatozoa, a pregnancy rate of 42.4% was achieved. In conclusion, these data show that enough spermatozoa are available for various ICSI cycles following a single MESA procedure in men with non-reconstructable obstructive azoospermia. Furthermore, ICSI with cryopreserved spermatozoa leads to excellent pregnancy rates

Adult↗

PubMedDate not supplied

Aspiration cytology of ovarian cysts and cystic neoplasms. A study of 235 aspirates.

OBJECTIVE: To assess the diagnostic value of aspiration cytology in individual cystic lesions of the ovary. STUDY DESIGN: During a 42-month period, 235 cystic ovarian lesions were investigated by fine needle aspiration with cytologic examination (FNA). RESULTS: Almost 56% (131/235) of the aspirates were devoid of diagnostic cells. The 104 diagnostic aspirates comprised 49 follicular cysts, 4 endometriotic cysts, 45 neoplastic lesions and 6 paraovarian/paratubal cysts. Cyst fluid estradiol (E2) content > 20 nmol/L identified an additional 43 follicular cysts. Histologic examination of the ovarian lesions with acellular cyst fluid containing low E2 revealed 2 corpus luteum hematomas, 1 atretic follicular cyst, 7 endometriotic cysts and 27 serous/mucinous epithelial tumors. The remaining 51 lesions were composed of other entities. Although the specificity of FNA for most nonfollicular cystic ovarian lesions approaches 100%, the sensitivity ranged from 36% for endometriotic cysts to 83% for proliferating/malignant serous tumors. CONCLUSION: Prior to FNA of the ovary in an individual patient, consideration should be given to the likely diagnosis, the limitations of the technique and the high false negative rate for nonfollicular cystic lesions.

Biopsy, Needle↗

PubMed2003

Cytokeratin 19 immunolocalization in cell block preparation of thyroid aspirates. An adjunct to fine-needle aspiration diagnosis of papillary thyroid carcinoma.

CONTEXT: Immunohistochemical staining for cytokeratin 19 (CK-19) is a useful ancillary technique for diagnosing papillary thyroid carcinoma (papillary carcinoma) in histologic specimens. Although similar results have been obtained on aspirate smears, to our knowledge the utility of CK-19 immunolocalization in cell block preparations as an adjunct to fine-needle aspiration diagnosis of papillary carcinoma has not been examined. OBJECTIVE: The purpose of this study was to determine whether CK-19 immunostaining of cell block preparations of thyroid aspirates is a useful ancillary technique for diagnosing papillary carcinoma. MATERIALS AND METHODS: Using a monoclonal antibody to CK-19 and a standard avidin-biotin complex technique, immunostaining was performed on paraffin-embedded cell blocks of 57 cases with the following cytologic diagnoses: (a) papillary carcinoma (20 cases); (b) atypical cytology, cannot exclude papillary carcinoma (19 cases); and (c) nonneoplastic thyroid (18 cases). The staining reaction in each case was graded on the basis of percentage of epithelial cells stained (1+, <10%; 2+, <10%-50%; 3+, >50). Tissue follow-up was available in all cases. RESULTS: Nineteen (95%) of 20 cases with an unequivocal diagnosis of papillary carcinoma were positive for CK-19 (3+). Tissue follow-up confirmed papillary carcinoma in all 20 cases. Of the 19 cases with a diagnosis of atypical cytology, cannot exclude papillary carcinoma, 7 (37%) cases displayed 3+ immunostaining and subsequent excision confirmed papillary carcinoma in all 7 cases. The remaining 12 cases with 1+ immunostaining included surgically confirmed goiter (6 cases), adenoma (2 cases), lymphocytic thyroiditis (3 cases), and papillary carcinoma (1 case). The follicular cells in 18 cases with a cytologic diagnosis of nonneoplastic thyroid showed 1+ immunostaining. Histologic follow-up of these cases confirmed the nonneoplastic cytologic diagnoses. CONCLUSIONS: Cytokeratin 19 immunostaining of cell block preparations of thyroid aspirates serves as a useful tool for the diagnosis of papillary carcinoma. Strong immunostaining (3+) for CK-19 aids in accurate diagnosis of malignancy in cytomorphologically equivocal cases of papillary carcinoma.

Biopsy, Needle↗

PubMed1999

[Transthoracic aspiration. Evaluation of cytologic and histologic diagnosis in a pulmonary nodule by retrospective comparison of 2 series of 267 cytoaspirations and 292 coaxial needle aspirations].

Percutaneous fine-needle aspiration is a well established method for the diagnosis of peripheral lung lesion. In order to compare different methods of aspiration, we analyze retrospectively two different series: 267 fine needle aspirations (FNA) compared with the histological diagnosis on surgical specimens and 292 lung biopsies using a coaxial technique with comparison between cytological diagnosis--smears and imprints--and histological diagnosis simultaneously obtained on the same specimen. The sensitivity (91%), the specificity (90%) and the overall typing accuracy related to the histological types obtained by FNAB are equivalent to those of the literature. The low rate of pneumothorax in the series (6%) is related to the use of immediate interpretation of the specimen. Automated biopsy with a coaxial cutting needle provide cytological specimens--smears and imprint--with a high rate of sensibility (95.3%) and of sensibility (98%). The overall sensitivity of the cytological methods alone is better than biopsy (95.3% vs. 92.9%), but the typing accuracy is not as good as biopsy alone (98% vs. 100%). False-positive and false-negative diagnoses are the same in both series. In conclusion the percutaneous aspiration method choose to establish a morphological diagnosis in lung lesion depends now on the habits of the radiologist and the pathologist.

Biopsy, Needle↗

PubMedDate not supplied

Fine needle aspiration of palpable breast lesions. Results obtained with cytocentrifuge preparation of aspirates.

The use of cytocentrifugation in the preparation of fine needle aspiration (FNA) specimens from the breast was evaluated. A total of 174 fine needle aspirates of breast masses were flushed into cytospin Collection Fluid, from which Papanicolaou-stained Cytospin preparations were made in the laboratory. Comparison of these preparations to conventional smears of aspirates showed no significant differences in the number or morphology of the cells. In 148 cases, the FNA cytologic study was followed up by excisional biopsy, Tru-Cut biopsy and/or a combination of mammography and clinical follow-up of two to nine months. Of 36 verified carcinomas, 31 (86%) were correctly diagnosed, with a zero false-positive rate. Among the 74 cytologically benign aspirates, 2 carcinomas were found on open biopsy, giving a false-negative rate of 3%. Lipomas were not diagnosable with this technique. This technique should be considered in institutions with a high turnover of junior staff members, which frequently results in a higher number of poorly smeared specimens or in poorly fixed/air-dried specimens that give suboptimal results with the Papanicolaou stain. With this method, there is less risk of creation of potentially hazardous aerosols and further preparations for additional studies may be made if required.

Adenofibroma↗

PubMed1978

[Emergencies and aspiration. Can the usual methods for the prophylaxis of aspiration be further developed? (author's transl)].

There are two prerequisites for aspiration of gastric contents, namely material near the larynx and the possibility for an influx into the tracheobronchial system. We discussed the value of common measures in protecting against aspiration. To take notice of the normal emptying time of the stomach, suction of liquid gastric contents by a stomach tube, evacuation of the stomach by inducing vomiting (large bore stomach tube or apomorphine), mechanical blockade of the oesophagus or of the gastrooesophageal junction, modification of general anaesthesia (induction with an inhalation anaesthetic or intravenous agents), cricoid pressure, foot-down, lateral or horizontal position are not able to prevent the passage of gastric contents into the oro- and nasopharynx. Aspiration is unavoidable if there is a possibility of influx into the tracheobronchial system. Induction of anaesthesia with the patient lying on his left side in the head-down position gives the maximum protection against the danger of aspiration. An easy method of enabling a patient to be placed in the left lateral, head-down position, when only two persons are present, is highly desirable.

Anesthesia, General↗