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PubMed1983

Brain abscess in childhood. A study of 34 cases treated by puncture and antibiotics.

During the last 15 years, 34 children were treated for a brain abscess. 13 (38%) had cyanotic heart disease; 12 (35%) had an ENT infection. The standardized treatment protocol included puncture of the abscess and administration of antibiotic and antiedematous drugs. Postoperative permanent epidural monitoring of intracranial pressure and, in the last 5 years, repeated CT scans indicated if retapping the abscess or reinforcing the antiedematous treatment was necessary. In 7 out of these 34 cases the abscess had to be excised. Postoperative mortality rate was 6%. Overall mortality rate was 12%. Neurological sequelae were slight. Epilepsy frequency was 10%. Mental retardation (18%) was found only in cyanotic congenital heart disease to which it is related. Repeated CT scans demonstrated the progressive disappearance of the capsule within a few months. This study shows an improvement in the results when brain abscesses in children are punctured rather than excised.

Adolescent↗
PubMedDate not supplied

[X-ray localizer for transthoracic puncture biopsy].

A spot-centring appliance whose purpose is to guide an instrument for transthoracic puncture biopsy with maximum precision into the spector of the thoracic cavity chosen during roentgenoscopy. The X-ray locator is made up of a centring device, depth gauge and a spotting device with roentgen-contrast orientation points which ensure all the spotting and centring manipulations. The transthoracic puncture biopsy is performed outside the range of the X-ray action.

Biopsy, Needle↗
PubMed1982

[Use of ultrasound, ultrasound-directed fine needle puncture and aspiration in amebic abscess of the liver. Case report and short overview].

Case report on a 48-year-old Swiss male living in Burundi who suddenly fell ill with vomiting and anorexia, followed by pappy stools, weakness and impotence. He presented with hepatomegaly, while sedimentation rate and alkaline phosphatase were both elevated. Stool examination revealed cysts and vegetative forms of Entamoeba histolytica, while amebic serology was negative. Treatment with ornidazole and later with diloxanide furoate was given. Sonography showed two cystoid areas in the right lobe of the liver. In the third sonographically guided fine-needle puncture both lesions were fully aspirated. Amebic serological tests were now positive for the first time. Six weeks later the sonogram showed a normal liver feature. The symptomatology and diagnosis of hepatic amebic abscess are discussed, with special reference to the important role of sonographically guided fine-needle puncture and drainage. Sonographic technique and differential diagnosis are briefly demonstrated.

Biopsy, Needle↗
PubMed1978

[Antegrade catheterization of the aorta with a flow-directed balloon catheter following transseptal left atrial puncture: a new technique].

The described heart catheterization technique allows the antegrade catheterization of the aorta from the left ventricle with a Swan-Ganz-flow-directed catheter via the saphenous vein and subsequent puncture of the intact atrial septum. The transseptal Brockenbrough-technique is modified by the use of a long thin polythene sheath which is fitted over the transseptal left heart catheter and can be advanced over the catheter after atrial septal puncture. A Swan-Ganz-flow-directed catheter can be passed directly to the left ventricle toward the outflow tract before it enters the aorta. This technique was used successfully on 18 children. By avoiding the retrograde arterial catheter technique additional information will be obtained.

Adolescent↗
PubMed1980

Thermal coagulation of puncture lesions in the cholestatic rabbit liver with Nd: YAG laser and and high-frequency current.

The coagulatory effect of the Nd: YAG laser after puncture of the cholestatic liver was compared with the effect of electrocoagulation. In 11 rabbits, the liver was punctured 7 days after ligature of the common bile duct with a Menghini needle 1.2 mm. The site of injury was coagulated by laser light in 5 animals and by unipolar electrocoagulation in 6 animals. Bleeding and bile leakage was stopped in all cases. Histologically there was no crucial difference between the two methods in their effect on the liver tissue. Autopsy 14 days after common bile duct ligature revealed no bile peritonitis in any rabbit.

Animals↗
PubMed1981

[Relevance of cul-de-sac puncture to diagnosis and differentiation of ovarian tumours (author's transl)].

Cul-de-sac puncture was tested for its accuracy in identifying the presence of ovarian tumours. The accuracy of the technique amounted to 82.4 per cent. Technical and methodical failures were observed in 16.5 per cent of the cases. More detailed cytological differentiation of tumours proved to be possible in 42.8 per cent of benign cases and in 17.6 per cent of malignant cases. The accuracy of the method proved to be sufficiently reliable in early malignancy, as well (69.2 per cent in Stage I of ovarian carcinoma). Cul-de-sac puncture thus is a good method for diagnosis of ovarian carcinoma.

Biopsy, Needle↗
PubMedDate not supplied

[A clinico-neurophysiological analysis of the single action of laser puncture].

Mechanisms were studied of a single exposure to laser puncture on the basis of clinico-neurophysiological investigations in 50 patients with cochleovestibular dysfunctions in the presence of vascular affections of the brain. In a comparative evaluation of endaural versus auricular laser puncture, more pronounced changes were revealed in all the parameters studied during the course of treatment with the former modality than they were with the latter, these parameters being the patients' general well-being as judged by subjective evidence, the ability of the points to conduct electrical current, and the findings from rheoencephalography, encephaloradiothermometry, audiovestibulometry.

Acupuncture Points↗
PubMed1994

[Pulmonary aspiration puncture in the etiological diagnosis of pneumonias].

In pneumonias, the short diagnostic results of non-invasive procedures lead frequently to use invasive techniques, among which we find pulmonary puncture aspiration (PPA). In this study, the profitability of PPA in the diagnosis of pneumonias is evaluated. One hundred and thirteen PPA were performed on 107 patients diagnosed of pneumonia. The PPA was performed with a 22-25 G needle without radioscopic control. Hemocultures were gathered in 104 cases, serological tests for productive agents of atypical pneumonia were applied in 50 cases, sputum test in 95 cases, and bronchofibroscopy with occluded telescopic brush in 25. The PPA had a specificity of 98 percent and a sensibility of 54% which rose to 73% in patients without antibiotic treatment prior to the puncture. Only 10 patients had complications with pneumothorax (9 percent) and four (3 percent) presented hemoptysic sputum. In the 53 patients with a positive PPA, knowledge of an etiological agent allowed the antibiotic treatment to be switched in 32 cases (60 percent). In addition, a decrease in the number of days of hospitalization was confirmed in the group of patients who received an etiological diagnosis while alive (p < 0.03). In conclusion, the PPA is a technique with excellent specificity, acceptable sensitivity, and a short rate of complications which allowed the treatment to be changed in 60 percent of the cases and reduced the number of days of hospitalization for patients who received a diagnosis. Thus, it constitutes a very useful technique in the etiological diagnosis of severe pulmonary infections.

Adult↗
PubMed1993

Infections following nail puncture wound of the foot: case reports and review of the literature.

Between July 1989 and August 1990, five children (four boys and one girl, age 10-14 years) were hospitalized due to foot infection following nail puncture wound. Symptoms and signs at presentation included cellulitis and deep tissue abscess in all five, fever in three, high erythrocyte sedimentation rate in four, and leukocytosis in two patients. Pseudomonas aeruginosa was grown in pus culture that was taken from all the children at presentation. In three children who were initially treated by local debridement and drainage followed by anti-pseudomonal agents, plantar Pseudomonas osteochondritis later developed. In two children extensive debridement of affected tissues and drainage of pus were performed followed by 2 weeks of parenteral anti-Pseudomonas antibiotics. No further complication occurred. The clinician should be aware that any complication of nail puncture wound of the foot may require surgery.

Abscess↗
PubMed1993

[Failure factors of guided puncture of hepatic masses].

This study was carried out to assess the failure factors of guided hepatic mass puncture in 320 biopsies. Results of the puncture, follow-up or surgery allowed us to divide 320 biopsies into true positives or false negatives. Compared with the group of true positive diagnosis, the group of false negative diagnosis revealed a significantly higher percentage either of lesions less than 2 cm (52.5% versus 34%), of benign tumors (19% versus 5%), or of pseudotumors (24% versus 1.5%). Compared with the group with cytology and histology diagnosis, the group in which only histology established the diagnosis revealed a significantly higher percentage of hepatocellular carcinoma (52.5% versus 34%) and of benign tumors (21% versus 0%). A diameter less than 2 cm, a histology of benign tumors or pseudotumors, are failure factors of guided biopsy. The use of histology is useful for the diagnosis of benign tumors and increases the accuracy of diagnosis for hepatocellular carcinoma.

Biopsy, Needle↗
PubMed1993

Pseudomonas osteomyelitis following puncture wounds of the foot.

The management of puncture wounds of the foot should include routine wound care, tetanus prophylaxis and warnings of what to look for and expect. Pseudomonas aeruginosa is the most commonly recovered organism in puncture wounds. Should symptoms develop, aggressive intravenous antibiotic treatment should be initiated if symptoms occur within seven days. Clinical presentation is characterized by minimal systemic symptoms, few laboratory abnormalities, and asymptomatic patients until the obvious presentation of osteomyelitis. After seven to 14 days, the would should be surgically treated and appropriate antibiotics administered.

Foot Diseases↗
PubMed1993

[A psychoautonomic syndrome in duodenal peptic ulcer patients and its correction by magnetic puncture using an alternating magnetic field].

86 duodenal ulcer patients were diagnosed to have serious psychovegetative disorders. Among other treatment, the patients were exposed to AMF puncture of biologically active points. The puncture produced optimization of the function of cerebral (suprasegmental) vegetative structures, promoted a regress of vegetative dystonia clinical symptoms and speeded up ulcer healing.

Acupuncture Points↗
PubMedDate not supplied

[Fine needle puncture biopsy and methods to image the thyroid gland in the diagnosis of nodular goiter].

A retrospective analysis of the findings of fine needle puncture biopsy of the thyroid in 256 patients operated on for nodular goiter is presented. Cytologic findings coincided with the histologic in 84.8% of cases. The coincidences were the most frequent in (multiple) nodular colloid goiter and thyroid cysts (95.7 = 100%) and the least so in solitary adenoma (65.4%) predominantly of a follicular structure. In thyroid cancer the data correlated in 75% of cases. The presence of cystous changes in adenoma made the investigation less informative. Findings of ultrasonic examination of the thyroid coincided with operative findings in 87.5% of patients with (multiple) nodular goiter and in 86.1% of those with adenomas. Ultrasonography as a method for thyroid imaging is preferable to scintigraphy (scanning) and is an optimal supplement to puncture biopsy of the thyroid.

Adenoma↗
PubMed1993

[Relation between fingertip temperature pattern and epidural puncture site during epidural anesthesia combined with general anesthesia].

We are employing fingertip temperature monitoring to estimate the spread of epidural anesthesia in patients who received combined epidural and general anesthesia. In this study we examined the relation between fingertip temperature pattern and epidural puncture site. One hundred patients scheduled for elective digestive tract surgery were studied. They were divided into three groups according to the epidural puncture sites as follow; Group 1, T7-9 (n = 26); group 2, T9-12 (n = 48); and group 3, T12-L5 (n = 26). Fingertip temperature was determined by Anritsu thermocouples. These probes were attached to the thumb and the big toe (hand and foot fingertip). The changes of these temperatures were classified to four types. In type 1, the hand fingertip temperatures were elevated after administration of the local anesthetics. In type 2, both hand and foot fingertip temperatures were elevated. In type 3, the foot fingertip temperature was elevated. In type 4, the hand and foot fingertip temperatures were unchanged. In group 1, we found 10 cases of type 1, 13 cases of type 2 and 3 cases of type 3. In group 2; 15, 22, 11 cases respectively. In group 3; 1, 16 cases respectively and 1 case in type 4. In group 1 and 2, the type 1 temperature pattern was observed more than in group 3 (P < 0.01). And in group 3, the type 3 temperature pattern was observed more than in group 1 and 2 (P < 0.01). We found no intergroup difference in type 2 pattern. But there were some exceptions.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1995

Haemorrhage due to laceration of an aberrant inferior epigastric artery during femoropopliteal PTA in an obese patient; a rare complication of a high antegrade femoral puncture.

Haemorrhage due to laceration of the proximal inferior epigastric artery during femoro-popliteal PTA in an obese 79-year-old woman is reported as a rare complication of a high antegrade femoral puncture. The post procedural haemorrhage was caused by a high antegrade puncture lacerating a low overriding inferior epigastric artery.

Aged↗
PubMed1995

The effect of needle gauge on recirculation, venous pressure and bleeding from puncture sites.

We performed a prospective, randomized study of various needle gauges and the effect on recirculation, venous pressure, and puncture site bleeding. All patients (n = 21) in our unit consented and participated. We studied 14, 15, 16, and 17 gauge needles, 2.5 cm in length with a "backeye" conformation. Each of the four needle gauges were studied twice in a randomized order. Needle were placed with the arterial needle pointed toward the arterial anastomosis and the venous needle pointed toward the venous anastomosis. The arterial and venous needles were placed at least 6 cm apart. Venous pressure and bleeding from puncture sites were recorded and analyzed in relation to needle gauge. Recirculation was calculated using the 3 needle technique. Blood pump flow rates (QBS) of 200 and 500 cc/min were studied with each needle gauge during the first 0.5 hour of dialysis. Data were analyzed using MANOVA and chi square. Recirculation at a QB of 200 cc/min was similar for all needle gauges (13-15%). At a QB of 500 cc/min the recirculation was 19% for the 17 gauge needles and 27% for the 14 gauge needles (p < 0.01). Venous pressure increased with decreasing needle size: 83 mmHg at QB 200 cc/min for 14 gauge needles, 147 mmHg at QB 200 cc/min for 17 gauge needles, and 204 mmHg and 382 mmHg respectively for QB 500 cc/min with needle gauges of 14 and 17. Bleeding occurred with 15 gauge needles on two occasions and four times with 14 gauge needles. There were no bleeding episodes with 16 or 17 gauge needles (p < 0.03). In conclusion, recirculation is greater with larger gauge needles at QB 500 cc/min. Bleeding is related to larger gauge needles. Hence, smaller gauge needles (17 gauge) appear move advantageous than larger gauge needles.

Catheterization, Peripheral↗
PubMed1995

[Intraoperative anaphylactic shock following the percutaneous puncture of a hepatic echinococcal cyst].

This is a report on a case of severe intraoperative anaphylactic shock, developing within several hours of percutaneous puncture of a liver hydatid cyst, performed under echographic control, necessitating recovery from the shock state and discontinuation of the operative intervention. Inferences are reached regarding the most adequate treatment tactics to be adopted in handling such cases. Percutaneous puncture is discarded as a therapeutic approach because of the great risk of anaphylaxis with eventual lethal outcome, and the likelihood of severe abdominal echinococcosis development at a later period.

Acute Disease↗