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At least 127 records · Page 7Linked to original sources

PubMed2004

Ultrasound guided fine needle aspiration using 25G needle as a new technique for a wide range of pathological conditions.

OBJECTIVE: This study is to report on the use of 25 gauge (G) needle in ultrasound (US) guided fine needle aspiration (FNA), as a new technique for a wide range of pathological conditions, and to assess the yield of positive tissue material and the complications compared to those reported in the literature using larger needles. METHODS: One hundred and seventy-two patients presented consecutively at King Saud University Teaching Hospitals, Kingdom of Saudi Arabia, during the period 2000 to 2002, with various pathological conditions, underwent US guided FNA using 25G needle. The adequacy of the tissue obtained, and the pathological outcome were tabulated. The patients were discharged in the same day and followed for 4-6 weeks for complications. RESULTS: Adequate tissue was obtained from 165 (96%) patients. Seven (4.1%) patients had to be examined twice, to obtain a sufficient sample. The 172 patients also included 14 patients (8.1%) who had repeated procedure on the request of the clinician, who needed confirmation of the pathological diagnosis. Adequate sampling was obtained in the first attempt in 89%, in liver problems, and in other regions, and 86.8% in lung problems. The percentages of diagnostic categories revealed by the cytological analysis are similar to those obtained by other larger fine needles. CONCLUSION: No complications have been encountered. The technique can safely be repeated if the amount is inadequate or diagnosis is inconclusive, to reach 100% correct sampling. The results of positive findings are comparable to other studies using larger needles. The use of 25G needle is recommended for use under ultrasound guidance.

Adolescent↗

PubMed2005

[Review on studies of correlativity of needle retention duration and needling sequence with the therapeutic effect].

In the present paper, the authors review the influences of time factor in single treatment session, duration of needle retention and needling sequence on acupuncture effects in literatures of recent 20 years. In the aspect of relation between the duration of needle retention and acupuncture effect, more is laid on the exploring the proper duration of needle retention for different diseases through clinical and experimental researches. Regarding the influences of needling sequence on acupuncture effect, very few modern researches were carried out, and there are the gaps in the research on the influence of different duration of needle retention on acupuncture effects on basis of a certain needling sequence. Strengthening the studies on this aspect suits for the requirements of based-evidence medicine for acupuncture treatment model and has a guiding significance for clinical treatment.

Acupuncture Points↗

PubMed1989

A new peridural needle-the 'LOLO' needle.

Peridural needles in present day use have a compromised function because of their circular cross section. An ideal peridural needle must be sharp to cut the spinal ligaments and at the same time blunt enough to ensure prevention of dural perforation. This ideal function is only possible if the bevel and tip of the needle are not inversely related as is the case in circular cross section needles. The 'LOLO' peridural needle developed by us is free of this compromise. It has a square cross section with a long, sharp eccentric tip. The bevel is flat and rectangular. The side opening is 4 mms from the tip of the needle through which the catheter is deflected out. Such a design is sharp to traverse the spinal ligaments and also effectively ensures dural tenting and prevent perforation. These properties have been proved by a myelographic study and compared to other conventional needles.

Anesthesia, Epidural↗

PubMedDate not supplied

Thoracic fine needle aspiration biopsy versus fine needle cutting biopsy. A comparative study of 40 patients.

The fine needle aspiration (FNA) biopsy findings were compared with the results of fine needle cutting (FNC) biopsy in 40 patients. The lesions (38 pulmonary nodules, 1 mediastinal mass and one lytic rib lesion) were biopsied with 22-gauge Greene and 21-gauge E-Z-EM needles through a 19-gauge needle guide. The FNA biopsy findings were based on smears and cell blocks of material obtained with the Greene needles while the FNC biopsy findings were based on tissue cores obtained by the E-Z-EM needles. In 83% of the cases, both techniques yielded specimens with similar cellularity; in seven cases, the FNA samples were more cellular. Malignancy was diagnosed in 80% of the patients: by both techniques in 26 patients, by FNA biopsy only in 5 patients and by FNC biopsy only in 1 patient. The sensitivity of FNA biopsy was higher than that of FNC biopsy (96.8% vs. 84.3%). The specificity and predictive value of positive results were 100% for both techniques. The predictive value of negative results was higher for FNA biopsy (88.8% vs. 54.5%). The majority of FNC biopsy tissue cores consisted mostly of clotted blood, lung tissue and/or fibrous tissue and did not facilitate or improve the diagnosis. Those data suggest that the contribution of FNC biopsy to the diagnosis of thoracic neoplasms is very limited and that the performance of FNC biopsy with an E-Z-EM needle in addition to or instead of FNA biopsy is not justified.

Adenocarcinoma↗

PubMed2006

Pharmacokinetic bioequivalence of enfuvirtide using a needle-free device versus standard needle administration.

STUDY OBJECTIVES: To compare the relative bioavailability of enfuvirtide, a human immunodeficiency virus type 1 (HIV-1) fusion inhibitor, injected with the Biojector 2000 (B2000) needle-free device versus a 27-gauge half-inch needle-syringe; and to assess safety, tolerability, and patient preference for the two devices. DESIGN: Open-label, randomized, two-period crossover bioequivalence evaluation. SETTING: Clinical research center. PATIENTS: Twenty-seven adults with HIV-1 viral loads below 1000 copies/ml. INTERVENTION: Each patient received enfuvirtide 90 mg subcutaneously with the B2000 and with the needle-syringe, with a 1-week washout between treatments. MEASUREMENTS AND MAIN RESULTS: Twenty-six and 27 patients were included in the bioequivalence and safety analyses, respectively. Plasma enfuvirtide concentrations were measured at baseline and at several intervals after each injection. The B2000:needle-syringe ratios of maximum concentration (C(max)), area under the concentration-time curve from time zero extrapolated to infinity (AUC(0-infinity)), and AUC from time zero to tau (dosing interval) (AUC(0-tau)) served as criteria for bioequivalence determination. The two drug delivery systems were considered bioequivalent if the 90% confidence intervals (CIs) for the ratios were within 0.8-1.25. Safety and tolerability were evaluated based on documentation of adverse events, graded laboratory toxicities, and local injection-site reactions. Patient surveys provided feedback on device preference. Ratios of C(max), AUC(0-infinity), and AUC(0-tau) were 0.95 (90% CI 0.84-1.09), 0.99 (90% CI 0.93-1.05), and 0.99 (90% CI 0.93-1.05), respectively. The frequency of injection-site reactions was low, and severity was generally mild for both devices. Survey results showed 18 patients (69%) had a positive overall impression of the B2000 and 14 (54%) felt safer injecting with this device. Overall, 17 patients (65%) preferred the B2000 over the needle-syringe. CONCLUSION: Bioavailability of enfuvirtide with the B2000 and needle-syringe was equivalent based on C(max), AUC(0-tau), and AUC(0-infinity). Safety profiles and injection-site reactions were comparable between the devices, but patients preferred the B2000. Delivery of enfuvirtide with the B2000 is a feasible alternative to standard needle administration and warrants further evaluation.

Area Under Curve↗

PubMedDate not supplied

Angulated needle placement in CT-guided percutaneous needle biopsy of the thorax.

Computed tomography (CT)-guided percutaneous needle biopsy is often necessary to evaluate small intrathoracic lesions. Not infrequently, an overlying structure such as a rib or vessel precludes insertion of the biopsy needle within the CT slice containing the lesion. Insertion and angulation of the needle at a site within an adjacent CT slice is then required. In order to determine the optimal skin-entry site and degree of angulation for biopsy needle insertion, we analyzed the geometric relationship between lesion depth, needle length, and needle angulation.

Biopsy, Needle↗

PubMed1999

The effect of needle gauge and local anaesthetic on the diagnostic accuracy of breast fine-needle aspiration cytology.

AIMS: The value of breast fine needle aspiration cytology (FNAC) is well established. This prospective study evaluates the effects of local anaesthetic (LA) and different gauge needles on the diagnostic accuracy of breast FNAC. METHODS: Aspirates were obtained from 59 consecutive excised breast tumours (51 malignant, eight benign) using green (21-G) and blue-hub (23-G) needles, both before and after infiltration of LA at the aspiration site. RESULTS: There was good agreement for the cytological diagnosis of each tumour when compared by needle size (kappa = 0.85) and the presence of LA (kappa = 0.77). Diagnostic sensitivity ranged from 88 to 92%. None of the differences were statistically significant. In addition LA appeared to have no effect upon the cytological grading of breast carcinomas (chi2 = 1.98, (df 3, P = 0.58). DISCUSSION: The use of the smaller gauge blue-hub needle or LA does not appear to affect adversely the diagnostic accuracy of breast FNAC. Whether using LA or the blue needle routinely in the breast clinic will have an effect upon the discomfort experienced during FNAC remains to be proven.

Anesthetics, Local↗

PubMed2001

Initial experience with new dedicated needles for laparoscopic ultrasound-guided fine-needle aspiration and histological biopsies.

BACKGROUND AND STUDY AIMS: Laparoscopic ultrasonography (LUS) is an important imaging modality during laparoscopic staging of intra-abdominal malignancies, but LUS-assisted biopsy is often difficult or impossible. We report a newly developed inbuilt biopsy system for direct LUS-guided fine-needle aspiration (FNA) and Tru-cut biopsies. PATIENTS AND METHODS: LUS-guided biopsy was performed in 20 patients with upper gastrointestinal tract tumors. The biopsied lesions had either not been previously detected by other imaging modalities or had been inaccessible, or the biopsy sample had been inadequate. Primary diagnosis, duration of biopsy procedure, needle monitoring (visibility, penetration, and deviation), complications, technical failures, and pathological findings were prospectively recorded. RESULTS: 44 biopsies were performed with 25 needles (19, 20, and 22-G). Needle monitoring and penetration were good or acceptable in 18 patients (90%). Slight needle deviation (<10 mm) was seen in eight patients (40%). The LUS-guided biopsy specimen was sufficient for analysis in 13 patients (65%). In two additional patients, adequate material was obtained, but pathological examination was impossible owing to incorrect handling of the specimen. The biopsy procedures lasted 16.3 minutes (range 10-20 minutes) and no complications were seen. CONCLUSIONS: LUS-guided fine-needle aspiration or Trucut biopsy is possible using this newly developed biopsy system. These preliminary data suggest that LUS-guided biopsy may further improve the diagnostic possibilities of LUS.

Aged↗

PubMed2004

Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration.

BACKGROUND AND STUDY AIMS: The accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) depends on immediate specimen review by a cytopathologist. Stromal tumors, lymphoma, and well-differentiated pancreatic cancer are difficult to diagnose on the basis of cytology alone. To overcome these limitations, a 19-gauge Trucut needle has been developed to obtain histological samples at EUS. This pilot study compares the specimen adequacy and diagnostic accuracy of EUS-guided Trucut needle biopsy (EUS-TNB) with EUS-FNA. PATIENTS AND METHODS: A total of 18 patients underwent EUS-TNB and EUS-FNA. The specimen adequacy and diagnostic accuracy of the two techniques was compared. The technical performance and safety profile of the Trucut needle were also evaluated. RESULTS: The EUS-TNB specimen was adequate for evaluation in 15/18 patients compared with 18/18 with EUS-FNA (83 % vs. 100 %, not significant). The diagnostic accuracy of EUS-TNB was not significantly different from EUS-FNA (78 % vs. 89 %). Two complications were encountered: one patient developed mediastinitis and required surgery; another had immediate bleeding that was managed conservatively. One technical problem was encountered: the Trucut needle failed to deploy after two passes when a gastric stromal cell tumor was being biopsied. CONCLUSION: The diagnostic accuracy of the new EUS-TNB is comparable to that of EUS-FNA. In our experience, the overall efficacy and safety profile of the Trucut needle appears modest.

Adrenal Glands↗

PubMed1995

Percutaneous ultrasound-guided needle biopsy of hepatic mass lesions using a cytohistologic approach. Comparison of two needle types.

This study compared the ability to diagnose and accurately classify hepatic mass lesions by ultrasound-guided biopsy using two different needle types: a 20 gauge needle that yielded primarily cytologic material and an 18 gauge automated core biopsy needle. Slides prepared from each of the needle types were separately evaluated in a blinded fashion. The 20 gauge needle had a sensitivity of 90%, a specificity of 90%, and enabled exact tumor classification in 70% of cases. The 18 gauge core biopsy had a sensitivity of 85%, a specificity of 100%, and allowed exact tumor typing in 82% of cases. The sensitivity and specificity of both needle types combined was 98% and 100%, respectively, and all malignancies were correctly typed. A combined cytohistologic approach provides a highly accurate means of diagnosing and typing hepatic tumors and provides a suitable sample for confirmatory stains. Accurate tumor typing may affect therapeutic decisions.

Adult↗

PubMed1993

Percutaneous transthoracic fine-needle lung biopsy with 3 different needles. A retrospective study of results and complications in 224 patients.

During 1986-1990, 307 percutaneous transthoracic fine-needle biopsies (PTNB) were performed on 224 patients (mean age 63 years, range 27-83) with three types of needles (Nordenström, Vacu-Cut and Franzén). The overall sensitivity regarding malignant disease in central and peripheral pulmonary lesions was 67.0%. In 71 patients with suspected malignancy and a negative PTNB, the examination was repeated and the sensitivity was increased to 79.5%. Each needle had the following sensitivity: Nordenström 67.4%, Vacu-Cut 75.7%, Franzén 75.9%. The overall pneumothorax frequency was 24.7%, being highest with the Nordenström needle. Hemoptysis was seen in 5 examinations. In conclusion, the Franzén and Vacu-Cut needles have a significantly higher sensitivity and a lower complication frequency compared to the Nordenström needle.

Adult↗

PubMed2006

Ultrasound-assisted transthoracic biopsy: fine-needle aspiration or cutting-needle biopsy?

The present study compared the diagnostic yield of ultrasound-assisted cutting-needle biopsy (CNB) and fine-needle aspiration biopsy (FNAB) in chest lesions. A physician performed ultrasound and FNAB with a 22-G spinal needle in all patients, directly followed by a 14-G CNB in patients without contraindication. A total of 155 consecutive lesions arising from the lung (74%), pleura (12%), mediastinum (11%) or chest wall (3%) in patients with a final diagnosis of lung carcinoma (74%), other malignant tumours (12%), non-neoplastic disease (9%) or unknown (5%) were prospectively included. The overall diagnostic yield was 87%. Combined specimens were obtained in 123 lesions (79%). In these, yields of FNAB, CNB and both methods combined were 82, 76 and 89%, respectively. FNAB was significantly better than CNB in lung carcinoma (95 versus 81%) but CNB was superior in noncarcinomatous tumours and in benign lesions. On-site cytology was 90% sensitive and 100% specific for predicting a positive FNAB. One patient required drainage for pneumothorax (0.6%). Ultrasound-assisted fine-needle aspiration biopsy performed by chest physicians is an accurate and safe initial diagnostic procedure in patients with a high clinical probability of lung carcinoma. All other patients should undergo concurrent fine-needle aspiration biopsy and cutting-needle biopsy.

Adult↗

PubMed1995

Percutaneous needle biopsy of localized pulmonary, mediastinal, and pleural diseased tissue with an automatic disposable guillotine soft-tissue needle. Preliminary results.

Percutaneous needle biopsy (PNB) of localized thoracic disease has become a widespread procedure in many institutions. The development of special small caliber needles has increased the diagnostic yield of PNB partly by increasing the amount of tissue from biopsy, often enabling histologic examination. Nevertheless, in a significant number of patients only cytopathologic examination is possible on the retrieved biopsy fragments, necessitating the presence of a trained cytopathologist in the biopsy room. Furthermore multiple biopsy needle passages often are required, increasing the risk for complications such as pneumothorax. We have evaluated the use of a small-caliber tissue biopsy cutting needle, consistently yielding sufficient biopsy tissue for histologic examination. In 25 pleural and mediastinal lesions, which could be biopsied without passage through aerated lung, there was a 93% sensitivity (7% false-negative results) for neoplasm and a 100% accuracy for benign disease. There were no complications. In 32 patients with lesions of 1 cm in diameter or more surrounded with aerated lung tissue, adequate histologic examination was feasible on every biopsy specimen after only one needle passage. There was an 87% sensitivity of PNB in neoplastic disease (13% false-negatives). In the patients with benign disease, there was a 100% accuracy. There was a 15.6% risk for pneumothorax. In only one patient (3%), however, was chest drainage necessary. One patient (3%) had mild hemoptysis. We conclude that percutaneous biopsy of localized pulmonary, pleural, and mediastinal lesions with a new small-caliber automatic guillotine cutting needle is safe and efficient, enabling recovery of sufficient tissue for histologic examination with a single-pass procedure, thus minimizing the risk for pneumothorax, eliminating the need for a cytopathologist in the biopsy room, and shortening the duration of the procedure.

Adult↗

PubMed2003

A meta-analysis of needle sharing, lending, and borrowing behaviors of needle exchange program attenders.

This study used meta-analysis to examine cumulatively needle exchange program (NEP) change/comparison data from 47 studies between 1988 and 2001, based on data collected between 1986 and 1997. The research question posed was: Is NEP attendance associated with reductions in risky needle-related behaviors? Results indicated that needle sharing (r = -.189), variations on the outcome measure of needle sharing (r = -.161), and needle lending/borrowing (r = -.194) consistently declined among NEP attenders, suggesting the NEPs are effective in reducing risky needle-related behaviors of IDUs. The meta-analytic results lend support to the harm-reduction philosophy often used as the rationale for the establishment and maintenance of NEPs.

Female↗

PubMed1994

Transrectal ultrasound-guided core biopsies of the prostate. A comparison between the standard 1.2-mm needle and three thinner needles.

Transrectal ultrasound (TRUS) examination is a well established method for the diagnosis of prostate cancer. The examination technique has, however, certain limitations, and biopsies are needed to differentiate between malignant and benign lesions. In order to determine the influence of the thickness of the needle on the histopathological evaluation of specimens, core biopsies were taken from 36 patients with hypoechoic lesions suggestive of cancer detected by TRUS, using a 1.2-mm cutting needle followed by a thinner needle (0.9-, 0.8- or 0.7-mm). A total of 164 biopsies from 41 hypoechoic lesions were obtained. The specimens were coded and examined by a pathologist. They were judged according to amount of tissue obtained, quality, length, malignancy and grade. The best results were obtained with the 1.2- and 0.9-mm needles. The results were comparable and reliable for both needle types which can be recommended for clinical practice. The 0.8- and 0.7-mm needles were found to give more or less unsatisfactory results.

Adenocarcinoma↗

PubMed1997

HIV prevalence and risk behaviour in needle exchange attenders: a national study. The Collaboration of Australian Needle Exchanges.

OBJECTIVE: To determine whether needle and syringe exchange programs represent feasible sites to describe the prevalence of HIV and related risk behaviour among injecting drug users. DESIGN: Cross-sectional survey. SETTING: 21 needle and syringe exchange programs in all Australian jurisdictions. PARTICIPANTS: All persons attending the needle and syringe exchange programs over one week in March 1995 were eligible to participate in the study once. INTERVENTION: Needle and syringe exchange attenders were asked to complete a brief, self-administered questionnaire and provide a finger-prick blood sample. MAIN OUTCOME MEASURES: Prevalence of HIV antibody, drug injecting and sexual behaviour, and survey cost. RESULTS: Completed questionnaires with blood samples suitable for testing were provided by 1005 (42%) of 2373 individuals who attended the needle and syringe exchange programs during the survey week. Women were more likely than men to participate in the survey but there was no difference in the response rate by age group. The HIV prevalence was 2.1% and was significantly higher in men who described themselves as homosexual, compared to men who described themselves as heterosexual (22.5% v. 0.7%; P < 0.001). Thirty-one per cent of respondents reported using a syringe after someone else in the preceding month. CONCLUSION: Cross-sectional surveys of needle exchange clients offer a practical method for monitoring risk behaviour and seroprevalence of bloodborne viral infections.

Adolescent↗

PubMed1992

Processing of needle rinse material from fine-needle aspirations rarely detects malignancy not identified in smears.

When preparing FNA smears, we recover material left in the needle hub by forcefully striking the open hub against a slide. Material in the syringe tip is expressed by repeated forceful blasts of air (needle unattached). We investigated the utility of recovering additional material by rinsing the needle and syringe. Saline was used to flush the needle and syringe tip repeatedly. All material was processed by cytocentrifugation. We studied 159 needle rinse (NR) specimens from 152 patients (breast = 70, lymph node = 30, lung = 15, soft tissue = 14, salivary gland = 12, thyroid = 12, liver = 5, branchial cleft cyst = 1). Malignancy was identified in 21 FNAs (13%) from 21 patients (14%). All were diagnosed in smears (9 lung, 5 liver, 4 lymph node, 2 breast, 1 soft tissue). NR material identified 16 of these (76%). No case with benign smears (n = 138) showed malignancy in NR material. We conclude that if good technique is applied to preparation of smears and recovery of material from the needle hub and syringe tip, NR material will rarely identify additional malignancies. It thus represents an inefficient allocation of technical and human resources within the laboratory. However, NR may provide additional slides for special stains and may be useful for clinicians who do not always prepare high quality smears. Furthermore, the ease with which FNA of palpable masses can be repeated suggests that in the small number of cases requiring special stains, additional material can be readily obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy, Needle↗

PubMed2000

Needle-tract implantation from hepatocellular cancer: is needle biopsy of the liver always necessary?

Percutaneous needle biopsies are frequently used to evaluate focal lesions of the liver. Needle-tract implantation of hepatocellular cancer has been described in case reports, but the true risk for this problem has not been clearly defined. We retrospectively reviewed 91 cases of hepatocellular cancer during a 4-year period from 1994 to 1997. Data on diagnostic studies, therapy, and outcome were noted. Of 91 patients with hepatocellular cancer, 59 patients underwent percutaneous needle biopsy as part of their diagnostic workup for a liver mass. Three patients (5.1%) were identified with needle-tract implantation of tumor. Two patients required en bloc chest wall resections for implantation of hepatocellular cancer in the soft tissues and rib area. The third patient, who also received percutaneous ethanol injection of his tumor, required a thoracotomy and lung resection for implanted hepatocellular cancer. Percutaneous needle biopsy of suspicious hepatic lesions should not be performed indiscriminately because there is a significant risk for needle-tract implantation. These biopsies should be reserved for those lesions in which no definitive surgical intervention is planned and pathological confirmation is necessary for a nonsurgical therapy.

Adult↗