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At least 145 records · Page 8Linked to original sources

PubMed1981

Prospective evaluation of aspiration needle, cutting needle, transbronchial, and open lung biopsy in patients with pulmonary infiltrates.

Twenty consecutive patients with pulmonary infiltrates undiagnosed by routine, noninvasive methods were entered into a prospective study designed to evaluate the diagnostic yield of four methods of lung biopsy. Percutaneous aspiration needle, cutting needle, transbronchial, and open (anterior thoracotomy) biopsy were performed synchronously on all patients. Specimens were evaluated by microbiological, virological, and pathological methods. The diagnostic yields of the four methods were as follows: aspiration needle, 29%; cutting needle, 53%; transbronchial, 59%; and open lung biopsy, 94%. Open lung biopsy was significantly better in yielding a diagnosis than aspiration needle (p less than 0.001), cutting needle (p less than 0.001), and transbronchial biopsy (p less than 0.04).

Adolescent↗

PubMed2003

Increasing sensitivity of morphological diagnosis in hepatocellular carcinoma (HCC) by combination of cytological and fine-needle histological examination after ultrasound guided fine needle biopsy.

UNLABELLED: Increasing sensitivity of morphological diagnosis by combination of cytological and fine-needle histological examination after ultrasound guided fine needle biopsy in hepatocellular carcinoma (HCC). AIM: We investigated the factors which may affect the sensitivity of morphological diagnostics (cytology and fine-needle histology) in HCC after ultrasound guided biopsy. METHOD: In 62 patients, an ultrasound guided cytological (n = 62) and fine-needle histological (n = 45) biopsy was performed. In addition, the smears were investigated by cytophotometry (n = 62). RESULTS: Considering each method separately, the sensitivity of both cytological and histological diagnostics was about 80%. The sensitivity could be raised to 89% by combining the two methods. In seven patients, the HCC could not be primarily confirmed morphologically. In nine patients, the result of histological and cytological investigation was not congruent. With regard to the size of the biopsied lesion, tumor stage, cytophotometric finding and survival these 16 patients (group A) were compared with the 46 patients in whom the HCC could be primarily confirmed morphologically (group B). The statistical analysis did reveal a significantly lower percentage of tumors with diploid or tetraploid (euploid) cells in group B. Euploid tumors were significantly more highly differentiated. In patients with euploid tumors, the sensitivity of the cytological investigation was 67% and respectively 75% of the histological investigation. The sensitivity could be raised to 82% in this population by combining the two investigations. On the other hand in aneuploid tumors, the sensitivity could only be increased from 93% and 88% respectively to 97% by combining cytology and fine-needle histology. SUMMARY: Our investigations show that the sensitivity of morphological diagnostics can be raised especially in the highly differentiated HCC with a physiological DNA content by combination of cytological and fine-needle histological investigations.

Adult↗

PubMed1990

[Comparison of ultrasound-controlled fine needle and coarse needle puncture of defined lesions in the abdomen].

Within a 2-year period 677 diagnostic fine needle (DFP) and coarse needle punctures (DGP) were performed in 536 patients. In 34 patients (14 women; 20 men; 54 +/- 17.6 years) the abdominal tumour mass was punctured with the fine needle (22 g) as well as with the coarse (18 g) needle. Sensitivity of DGP accounted for 72%, sensitivity of DFP was 82.6%. Specificity was 100%, respectively. Complications could not be observed, neither with the coarse needle nor with the fine needle. Due to the high sensitivity of DFP this method should be employed first in the diagnostic work up of abdominal tumours.

Abdominal Neoplasms↗

PubMed1992

Spinal anaesthesia for caesarean section: comparison of 22-gauge and 25-gauge Whitacre needles with 26-gauge Quincke needles.

We have studied 150 women undergoing elective Caesarean section under spinal anaesthesia. They were allocated randomly to have a 22-gauge Whitacre, a 25-gauge Whitacre or a 26-gauge Quincke needle inserted into the lumbar subarachnoid space. The groups were compared for ease of insertion, number of attempted needle insertions before identification of cerebrospinal fluid, quality of subsequent analgesia and incidence of postoperative complications. There were differences between groups, but they did not reach statistical significance. Postdural puncture headache (PDPH) was experienced by one mother in the 22-gauge Whitacre group, none in the 25-gauge Whitacre group and five in the 26-gauge Quincke group. Five of the six PDPH occurred after a single successful needle insertion. Seven of the 15 mothers in whom more than two needle insertions were made experienced backache, compared with 12 of the 129 receiving two or less (P < 0.001). We conclude that the use of 22- and 25-gauge Whitacre needles in elective Caesarean section patients is associated with a low incidence of PDPH and that postoperative backache is more likely when more than two attempts are made to insert a spinal needle.

Adolescent↗

PubMed1994

A comparison between digitally-guided fine needle aspiration and ultrasound-guided transperineal core needle biopsy of the prostate for the detection of prostate cancer.

OBJECTIVE: To prospectively examine the accuracy of fine needle aspiration (FNA) for the detection of prostate cancer. Ultrasound-guided core needle biopsy of the prostate was used as the standard to which the FNA results were compared. PATIENTS AND METHODS: One-hundred patients who had been referred for urological evaluation were suspected of having prostate cancer on the basis of digital rectal examination (DRE) and/or transrectal ultrasound (TRUS). All were further evaluated by digitally guided transrectal FNA and by TRUS-guided transperineal core needle biopsy. RESULTS: Prostate cancer was identified in 54 patients by core needle biopsy and in 45 by FNA. The sensitivity of FNA was 81% and both specificity and positive predictive value were 98%. CONCLUSION: FNA is easily performed, has negligible morbidity and offers prompt results. These data suggest that FNA is a reasonable initial diagnostic procedure for the detection of prostate cancer. Core needle biopsy may be reserved for patients with negative cytology who are clinically suspected of having prostate cancer. In selected patients, FNA may be used as an alternative to core needle biopsy for diagnosis, treatment planning and follow-up.

Aged↗

PubMed1991

Nonpalpable breast lesions: findings of stereotaxic needle-core biopsy and fine-needle aspiration cytology.

Two hundred fifty mammographically detected nonpalpable breast lesions suspicious for malignancy in women who underwent routine screening mammography were stereotaxically localized. Fine-needle-aspiration (FNA) cytologic specimens and needle-core biopsy specimens were obtained before open biopsy in every case. Seventy-six lesions (30.4%) were malignant. Sixty-three (83%) of these 76 cancers were 1 cm long or smaller. Needle-core biopsy alone was used to diagnose conclusively 41% (n = 31) of these cancers, while FNA cytologic study alone was used to diagnose 32% (n = 24). No false-positive results occurred with either test. The same diagnosis was reached in 54% (n = 41) when the combined results of both needle tests were considered. In applying the two needle tests to 125 mammographically defined low-suspicion lesions, 85 (68%) were found to be benign by means of either one or both needle tests; there was one lobular carcinoma in situ. By applying this algorithm, 85 (34%) of 250 patients with abnormal mammograms, or one-third of all patients recommended for open biopsy, might have avoided surgery.

Adult↗

PubMed2005

[Increases of intracranial pressure and changes of blood flow velocity due to acupressure, needle and laser needle acupuncture?].

BACKGROUND: Pressure on the acupoints St.7 and SJ.22 can lead to significant, reversible increases in intracranial pressure (ICP) in patients with elevated ICP. OBJECTIVE: In this study, we investigated whether changes in cerebral parameters in healthy volunteers can also be registered, when the mentioned acupoints associated with ICP, are stimulated. SUBJECTS AND METHODS: We investigated a total of 34 volunteers (24 females, 10 males) and a 15-year-old intensive care patient after severe head injury. The mean age of volunteers was 25.2 +/- 3.4 years (range 20-35). Stimulation was performed using acupressure techniques, manual needle and laser needle methods. We evaluated the main parameter of mean blood flow velocity in the middle cerebral artery (left and right) as well as the pulsatility index. In addition, near infrared spectroscopy and blood pressure parameters were registered. RESULTS: Acupressure, manual needle acupuncture and laser needle acupuncture partially led to significant changes in the main goal values. CONCLUSION: Acupressure as well as acupuncture (needle and laser needle) can evoke reproducible functional changes in the brain. These accompanying effects are not to be ignored, in particular in patients with increased ICP.

Acupressure↗

PubMedDate not supplied

Needle track seeding of papillary thyroid carcinoma from fine needle aspiration biopsy. A case report.

BACKGROUND: Dissemination of tumor cells from needle biopsy has been observed in a wide range of tumor types. Fine needle aspiration (FNA) biopsy has become accepted as the first-line test in the evaluation of thyroid nodules. Local recurrence of thyroid cancer from needle track seeding is an extremely rare complication of thyroid FNA. CASE: A 59-year-old woman developed local recurrence of papillary thyroid carcinoma three years after FNA of the primary cancer. Local metastases developed in the skin and sternocleidomastoid muscle. The location of the recurrent cancer and the linear relationship of the metastases indicated that local recurrence was due to needle track seeding at the time of FNA. CONCLUSION: Needle track seeding has been recognized as a possible, albeit rare, complication of FNA of thyroid cancer. Although proper FNA technique can reduce the potential for needle track seeding, its occurrence is an unavoidable complication of FNA evaluation of thyroid malignancies.

Biopsy, Needle↗

PubMedDate not supplied

Ultrasound-guided fine-needle aspiration biopsy for breast tumors: needle guide versus freehand technique.

BACKGROUND: We retrospectively studied whether a needle guide is necessary when performing ultrasound-guided fine-needle aspiration biopsy (US-FNAB) in patients with breast tumors. METHODS: A total of 47 patients (50 lesions) with breast tumors underwent US-FNAB with a needle guide and 127 patients (143 lesions) underwent the procedure without a needle guide (freehand biopsy). The diagnoses obtained by US-FNAB were compared with the surgical findings. RESULTS: The sensitivity of freehand biopsy for tumors < 3 cm in diameter was significantly higher than that of the needle guide technique. CONCLUSIONS: We recommend performing US-FNAB without a needle guide (freehand biopsy) in order to maximize the correct preoperative diagnosis rate, especially in patients with tumors < 3 cm in diameter.

Biopsy, Needle↗

PubMed1999

Diagnostic uncertainty expressed in prostate needle biopsies. A College of American Pathologists Q-probes Study of 15,753 prostate needle biopsies in 332 institutions.

OBJECTIVE: To determine the rate of diagnostic uncertainty in rendering diagnoses on prostate needle biopsies and to examine pathology practice variables that influence that rate. DESIGN: Anatomic pathology departments participating in the College of American Pathologists Q-Probes laboratory quality improvement program retrospectively reviewed their last 50 consecutive prostate needle biopsy diagnoses. For each diagnosis, participants provided information concerning patients' prostate-specific antigen levels; number, locations, and laterality of biopsy specimens; number of tissue levels examined; performance of high-molecular-weight cytokeratin immunoperoxidase staining; and acquisition of consultations from general pathologists or experts in prostate pathology. Characteristics of pathology practices included yearly surgical and prostate needle biopsy caseloads, number of pathologists rendering biopsy diagnoses, use of standard descriptive checklists, access to patients' prostate-specific antigen and digital rectal examination results, percentages of prostate needle biopsies routinely submitted for internal consultations, and presence of departmental experts in prostate pathology. SETTING AND PARTICIPANTS: Three hundred thirty-two public and private institutions located in the United States (n = 318), Canada (n = 6), Australia (n = 5), United Kingdom (n = 2), and Guam (n = 1). MAIN OUTCOME MEASURE: The rate of diagnostic uncertainty in prostate needle biopsy diagnoses. RESULTS: Participants submitted diagnoses on a total of 15 753 prostate needle biopsy cases, of which 33.4% were adenocarcinoma; 55.5% were benign; 3.9% were carcinoma in situ, prostatic intraepithelial neoplasia, or both; and 7.1% were diagnostically uncertain. The median rate of diagnostic uncertainty was 6%, ranging from 0 at the 10th percentile to 14% at the 90th percentile of all participating laboratories. Performing high-molecular-weight cytokeratin immunoperoxidase staining resolved diagnostic uncertainty in 68% of cases in which it was performed, and obtaining intradepartmental and extradepartmental consultations resolved diagnostic uncertainty in 70% to 87% of cases for which they were obtained. Knowledge of patients' prostate-specific antigen results and examining multiple biopsy cores had marginal effects on the rate of uncertainty. Thoroughness of prostate gland sampling and examination of multiple tissue block levels were not associated with the aggregate rate of diagnostic uncertainty. We found no particular pathology departmental practices or institutional demographic characteristics associated with institutional rates of diagnostic uncertainty. CONCLUSIONS: Use of high-molecular-weight cytokeratin immunoperoxidase staining and obtaining intradepartmental and extradepartmental consultations may be effective in reducing diagnostic uncertainty in prostate biopsies.

Adenocarcinoma↗

PubMed2006

[Observation on therapeutic effects of bird-pecking needling and needle warming moxibustion on bulging of lumbar intervertebral disc].

OBJECTIVE: To explore the best manipulating method for bulging of lumbar intervertebral disc. METHODS: Eighty cases were randomly divided into a treatment group (n=58) and a control group (n=22). The treatment group were treated with bird-pecking needling and needle warming moxibustion, and the control group with needle warming moxibustion of uniform reinforcing and reducing method. Their therapeutic effects were compared. RESULTS: The total effective rate was 100.0% in the treatment group and 81. 8% in the control group with a significant difference between the two groups (P < 0.01). CONCLUSION: Therapeutic effects of bird-pecking needling and needle warming moxibustion on bulging of lumbar intervertebral disc is significantly superior to that of needle warming moxibustion of uniform reinforcing and reducing method.

Animals↗

PubMed1989

Needle holder damage to surgical needles.

Clamping surgical needles between the jaws of needle holders with teeth markedly weaken the needles, making them prone to breakage. In contrast, clamping surgical needles between either smooth needle holder jaws or jaws embedded with tungsten carbide particles did not alter the ductility of surgical needles.

Alloys↗

PubMed1986

The efficacy of simultaneous fine-needle aspiration and large-needle biopsy of the thyroid gland.

Fine-needle aspirations and cutting needle biopsies were performed on 415 patients with solitary thyroid nodules. All nodules were considered hypofunctioning by scintiscans. Specimens were adequate in 399 patients. Ten percent of these patients had thyroid cancers documented by thyroidectomies. Results from either or both procedures were positive or suspicious in 58 patients (14.5%). Thyroid cancers were found in 40 of the 58 patients (69%). Aspirates alone detected 34 of 40 cancers (85%) and biopsy specimens alone detected 30 of 40 cancers (75%). All thyroid cancers were detected when both results were considered together, demonstrating that needle aspirates and cutting needle biopsies are complementary. The difficulty of making definitive diagnoses of follicular neoplasms by needle aspirates or cutting needle biopsies is reemphasized.

Biopsy, Needle↗

PubMed1987

Needle aspiration and needle biopsy procedures.

Needle biopsy of the prostate, employing large "core" needles and performed via the transperineal or transrectal routes, is a well-established method for diagnosing prostatic malignancy. This procedure can be performed safely under local anesthesia in an outpatient setting. Rectal cleansing and prophylactic antibiotics have minimized infectious complications following transrectal biopsy, and it remains the favored technique in patients with small lesions. Repeat biopsy under anesthesia is indicated when the clinical suspicion of malignancy remains high despite negative biopsies. In contrast to "core" needle biopsy, which obtains a cylinder of tissue for histologic examination, the fine-needle biopsy obtains a specimen for cytologic examination. If cytologic expertise is unavailable locally, the specimen may be fixed in the office and shipped to a major medical center for interpretation. Fine-needle aspiration may be safely employed to biopsy the prostate, pelvic masses, and inguinal and pelvic lymph nodes. Biopsy of palpable masses can be done simply and safely with morbidity akin to venipuncture. Nonpalpable tissues may be biopsied under radiographic guidance. Fine-needle aspiration biopsy is safe and cost-effective, has resulted in a significant improvement in the accuracy of our clinical staging, and has spared many patients unnecessary surgical procedures.

Ambulatory Care↗

PubMed1995

Contamination of blood cultures by switch-needle and nonswitch-needle techniques in a paediatric ward.

To compare the contamination rates of blood culture between the conventional switching to a sterile needle before inoculation of blood culture bottles and the nonswitch-needle technique, we conducted a prospective crossover study in a pediatric infectious disease ward at Lampang Hospital, Thailand from November 1991 to December 1992. The total number of blood cultures was 764 in which 358 were in the switch-needle group and 406 in the nonswitch-needle group. The rates of contamination were almost identical among the two groups (6.15% v.s. 6.16%). It is concluded that careful skin preparation and good handwashing practices of the phlebotomists and assistant are more important factors than switching needles in reducing contamination during collection of blood for culture. Switching needle technique should be discontinued to reduce the risk of needlestick injury and the cost of blood culture.

Blood↗

PubMedDate not supplied

The "left-hand rule" in directional changes of the needle holder with different needle grips. Suturing technique in a restricted operating space.

While using a needle for suturing in a restricted operating space, surgeons change the direction of the needle holder by modifying needle grips. Such directional changes, however, have not been analyzed systematically. The "left-hand rule", similar to Fleming's rule in physics, is proposed as a guide in comprehending these changes. When the thumb is assumed to represent the direction of the holder in the standard grip, the long axis of the index finger represents that of a grip in which the needle is held obliquely [oblique (Ob) grip]. In the usual (tip-ward) Ob grip with ordinary suturing (advancing the needle by supination), the holder is shifted in the direction opposite to the fingertip (towards the arm) and, in that with reversed suturing (by pronation), towards it. The middle finger represents a grip in which the needle is held after rotation [rotated (Ro) grip]. In the usual (counter-clockwise) Ro grip, the holder is shifted in the direction opposite to the fingertip (towards the back of the hand) in both ordinary and reversed suturing.

Ergonomics↗

PubMed1994

Are single-needle protocols equivalent to dual-needle protocols for platelet apheresis?

In light of the increasing demands being placed on cytapheresis donors and their occasional venous problems, it has become necessary to use 1-needle in addition to 2-needle separation techniques in thrombocytapheresis. We therefore compared five 1-needle and three 2-needle programs on four different cell separators and found that meanwhile both the platelet yields and the leukopenia (controlled by Nageotte chamber counting) of the products obtained with the 1-needle technique are equivalent to those obtained using the 2-needle technique, as long as the program is suitably adjusted.

Blood Cell Count↗

PubMed2006

Seasonal changes in needle water content and needle ABA concentration of Japanese red pine, Pinus densiflora, in declining forests on Mt. Gokurakuji, Hiroshima prefecture, Japan.

To evaluate the effects of air pollution on the decline of Pinus densiflora forests, various research has been conducted around Mt. Gokurakuji (34 degrees 23'N, 132 degrees 19'E, 693 m a.s.l.) north of the Seto Inland Sea, west Japan. To investigate the mechanisms responsible for decreases in photosynthesis (Pn) and stomatal conductance (gl), delta13C of needles and seasonal changes in the water content (WC) and abscisic acid concentration (ABA) of needles were measured in various stands. The delta13C values were less negative in declining stands and younger needles. ABA and WC were not correlated with each other. WC decreased consistently with needle age while the ABA showed a minimum in August and a smaller content in older needles. Monthly precipitation and the daily maximum vapor pressure were not correlated with ABA and WC. In declining stands, WC and ABA tended to be higher and lower, respectively, than in nondeclining stands. These results suggest that the trees in declining stands received less water stress than those in nondeclining stands and the differences in gl and delta13C are not caused by the difference in water stress. The possibilities of the effects of air pollution and the infection of pine-wood nematode on the physiological decline on the pine needles are discussed.

Abscisic Acid↗