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At least 19 recordsLinked to original sources

[Study on usefulness of an aspirating biopsy needle (Vacu-Cut) and an automatic biopsy needle (Biopty-Cut) for renal biopsy--comparison with a Tru-Cut biopsy needle].

Our medical team conducted the percutaneous renal biopsy, using an aspirating biopsy needle (Vacu-Cut) in 101 cases, and an automatic biopsy needle (Biopty-Cut) in 82 cases. Thereafter, we examined the usefulness of the two types of needles in comparison with that of Tru-Cut used in 101 cases. The test confirmed that in the cases of Vacu-Cut, 7.6 glomeruli (p less than 0.01), on the average, existed in LM specimen; 9.0 glomeruli (ns), Biopty-Cut, and 10.7 glomeruli, Tru-Cut, respectively. However the incidence of cases containing more than 5 glomeruli was not significant statistically between Vacu-Cut/Biopty-Cut and Tru-Cut. The incidence that each type of needles obtained more than one glomerulus in IF specimen was as follows: 73.3%, Vacu-Cut (p less than 0.05), 81.7%, Biopty-Cut (ns), 87.1%, Tru-Cut, respectively. As for in EM specimen, 61.4%, Vacu-Cut (ns), 67.1%, Biopty-Cut (ns), and 70.3%, Tru-Cut, respectively. As for complications, in the cases of Vacu-Cut and Biopty-Cut, gross hematuria and post-biopsy pain occurred in 6.9 to 9.8% (p less than 0.01- p less than 0.05), whereas in Tru-Cut, they occurred in 20.7 to 24.8%. As for blood pressure lowering (less than 90 mmHg) and anemia (the cases in which blood transfusion was required), 0%, Vacu-Cut and Biopty-Cut, 2 to 3%, Tru-Cut, respectively. As for fever, Vacu-Cut 0%, Vacu-Cut (p less than 0.01), 3.7%, Biopty-Cut (ns), and 7.9%, Tru-Cut, respectively. The above findings lead to conclusion that both Vacu-Cut and Biopty-Cut are useful instruments for renal biopsy.

Adolescent

[Comparative study of fine needle aspiration and large caliber needle biopsy under echographic control for the diagnosis of abdominal tumors].

The aim of this study was to compare the results of fine needle aspiration (22 G) with large caliber needle biopsy (18 G) in patients suspected of having abdominal malignancy. From November 1988 to December 1989, 73 patients aged 32 to 78 years (mean 66 years), suspected sonographically of having hepatic malignancy (66 cases) or extrahepatic tumors (7 cases), underwent ultrasonography guided percutaneous fine needle aspiration (22 G) and biopsy with a large caliber needle (18 G). There were no complications. Overall sensitivity for diagnosis of malignancy was significantly better (p less than 0.01) with 18 G needle biopsies (91.2 percent) than with fine needle cytology (71.4 percent). Specificity was 100 percent. The distinction between primary and secondary malignant tumor was possible in 87.5 percent with the large caliber needle and in only 42.9 percent with the fine needle (p less than 0.001). Histological findings were adequate hepatic metastases in 86.5 percent with the 18 gauge needle and in 51.4 percent with the 22 gauge needle (p less than 0.001). In the 7 extra-hepatic tumors, the 18 G biopsy was always positive whereas fine needle cytology was positive in only 5 out of 7 cases. Correct diagnosis for benign diseases was possible in 7 out of 10 cases with the large caliber needle whereas the fine needle cytology was always negative. These results show the superiority of large caliber needle (18 G) compared to fine needle (22 G) guided punction for both diagnosis of malignancy and origin of the tumor. Complications did not occur more frequently than with fine caliber needles.

Adult

Fine-needle aspiration biopsy of abdominal lesions: diagnostic yield for different needle tip configurations.

Four fine-needle aspiration biopsy needles with different tip configurations were used in 133 patients with abdominal lesions. The 20-gauge needles were used in random sequence by several physicians. The specimen from each of the 522 needle passes was evaluated by two cytopathologists for adequacy to render a diagnosis and for the presence of cell block material. The Franseen needle produced a 16% and 9% better yield for diagnostic material than did the cut biopsy and spinal needles (P less than .05), respectively. The Westcott needle was better than the cut biopsy needle by 13%, and the spinal needle produced an 11% better yield than did the cut biopsy needle. Differences did not exist in liver biopsies but were present in pancreatic biopsies. The spinal needle was the least successful in yielding cell block material. Use of the cut biopsy needle resulted in the largest proportion of inadequate specimens, except its yield in cell blocks in the liver was 25% higher than that of the Westcott needle. The authors conclude that not all unusual designs for 20-gauge needle tips render results superior to those of the simple spinal needle.

Adolescent

Raja pleural biopsy needle. A comparison with the Abrams needle in experimental pleural effusion.

The Raja pleural biopsy needle, 3 mm in external diameter and fitted with a titanium alloy biopsy flap, was compared with the Abrams needle in six dogs with experimentally induced pleural effusion. One hundred twenty-four pleural biopsies were performed using either the Raja needle or the Abrams needle (62 with each needle). No complication occurred with either needle. The Raja pleural biopsy needle yielded a statistically significant larger pleural tissue specimen with a statistically significant lower frequency of crush artifacts. The size of the pleura obtained by the Abrams needle averaged 4,401 +/- 559 microns2 (mean +/- SE) compared with 8,652 +/- 1,099 microns2 with the Raja needle (p less than 0.01; Student two-tailed t test). Biopsies by the Abrams needle showed crush artifacts in 25.8% of the specimens, whereas 8.06% of biopsies with the Raja needle showed crush artifacts (p less than 0.02; Fisher's two-tailed exact test). In conclusion, the Raja pleural biopsy needle is safe to use and, despite its smaller diameter (3mm versus 4mm external diameter of the Abrams needle), yields significantly larger and less frequently distorted pleural specimens.

Animals

Comparison between the 21-gauge Urocut needle and the 21-gauge Surecut needle in echo-guided percutaneous biopsy of neoplastic liver lesions.

Fine cutting needles for histology are now widely used in echo-guided biopsies of various organs. In this study we compared the results obtained in the biopsy of neoplastic hepatic lesions using two different 21-gauge cutting needles: Trucut needle (Urocut) and a modified Menghini needle (Surecut). Eighty-five patients with primary or metastatic hepatic neoplasms were biopsied with a Urocut needle and a further 85 patients underwent biopsy with a Surecut needle. The two groups were comparable for size and nature of hepatic neoplasms. The Urocut needle provided a much higher percentage of diagnostic material than the Surecut needle (94.8% vs 70.5%) regardless of the primary or metastatic nature of the lesion or its size. The diagnostic accuracy was only identical for both needles (91.3% for Urocut vs 91.5% for Surecut) whenever the diagnostic material was compared in cases in which both types of needles had been used to take the biopsy specimens. There were no complications in either of the two groups studied. Given the smaller incidence of non-diagnostic biopsies with the Urocut needle, we consider that this needle should be preferred in echo-guided biopsies of neoplastic hepatic lesions.

Adult

Scientific basis for selecting surgical needles and needle holders for wound closure.

Standardized reproducible tests have been devised to determine surgical needle sharpness, resistance to bending, and ductility. Three comparable groups of reverse cutting edge needles were selected from different manufacturers for measurement of these needle performance parameters. This testing demonstrated that needle diameter, manufacturing process, needle material composition, cross-sectional design, and the manufacturer were all important determinants of surgical needle performance. In addition, the biomechanics of curved surgical needle bending has been related to the clamping moment of surgical needle holders. This relationship identifies the surgical needle holder that can be used with surgical needles without deformation. The results of these studies provide a scientific basis for the selection of surgical needles and needle holders for use in surgery.

Equipment Design

Endoscopic needle biopsy: a comparative study of forceps biopsy, two different types of needles, and salvage cytology in gastrointestinal cancer.

One of the goals of gastrointestinal endoscopy is to diagnose whether a lesion is malignant. The desire to improve the sensitivity of biopsy-sampling techniques prompted us to compare prospectively the reliability and accuracy of obtaining tissue by forceps biopsy, needle biopsy (21 gauge 13-mm long metal needles versus 18 gauge 20-mm long plastic needles), and salvage cytology in patients with endoscopically suspected malignancy. Samples were obtained in the order of needle biopsy (the order of metal and plastic needle biopsy was randomized), forceps biopsy, followed by salvage cytology. Needle biopsies were obtained by puncturing the lesion under direct vision while aspirating with a syringe. Twenty-three patients with gastrointestinal malignancy were studied (7 esophageal, 4 gastric, and 12 colonic). Forceps biopsies were positive in 18 of 23 (78%), missing 1 gastric and 4 colon malignancies. Metal needle biopsy was positive in 16 of 19 (84%), plastic needle biopsy in 17 of 22 (77%), and salvage cytology in 20 of 22 (91%). Accuracy was increased by a combination of techniques. Endoscopic needle biopsy is a simple and rapid method to evaluate lesions seen at endoscopy and is especially useful in evaluation of submucosal lesions.

Biopsy, Needle

Needle-use practices among intravenous drug users in an area where needle purchase is legal.

Needle-use practices of intravenous drug users (IVDUs) were examined in a region (Seattle, King Country, Washington State, USA) where needle purchase is legal. IVDUs in treatment (n = 313) were administered extensive structured interviews concerning drug and injection equipment-use practices. Of the 80.2% reporting intravenous drug use in the previous year, 78.3% reported sharing needles. Of the 47.7% reporting intravenous use in the previous 30 days, only 40.5% shared needles, with 59.3% sharing with only one other person. Most needle-sharing partners were very well known (63%) or well known (17%) to the subjects. The most frequent method for obtaining needles was 'buying in a drug store', ranked first by 65% of the sample. Subjects whose primary source was 'buying in a drug store' shared equipment less frequently during drug-use events in the previous year (mean: 16.2%) than those with other primary sources (mean: 28.5%). Compared with findings from other regions where needle purchase and possession are illegal without a prescription, fewer subjects in the current investigation shared needles, and those who did shared with a smaller number of people. The apparent association between legalized injection equipment and reduced sharing of equipment among IVDUs should be further examined in longitudinal studies of needle-sharing before and after legalization is instituted.

Adult

Two-needle calculation of recirculation compared with the standard three-needle method.

A two-needle method for calculating recirculation was compared with the standard three-needle method, substituting the standard phlebotomy of a remote vessel during dialysis with blood obtained from the dialyzer inlet needle 15 minutes after the termination of dialysis. Twenty patients were studied prospectively. There was no significant difference between corrected blood flow calculated with the standard and two-needle methods. The BUN obtained from the inlet line needle 15 minutes after conclusion of the treatment did not differ significantly from the BUN concentration in the specimen from a contralateral arm drawn five minutes before termination of dialysis. Recirculation calculated by the two-needle method correlated well with the results obtained with the standard three-needle method. The two-needle method provides a convenient alternative to the standard three-needle method of determining recirculation.

Aged

[Is the Tru-Cut needle more efficient than the fine needle in the diagnosis of hepatic lesions? Comparative study of 45 echography-guided punctures].

A comparison of diagnostic efficiency of fine needle biopsy (22 G) versus coarse needle biopsy (Tru-Cut 14 G) was performed on ultrasound-guided liver biopsies in 45 patients. Diagnosis was established through clinical, paraclinical and pathologic features. For each patient pathologic examination of both fine needle biopsy (cytology and histology) and coarse needle biopsy (histology) were performed by a pathologist unaware of any clinical data. Of 36 malignant tumors, diagnosis of malignancy was made in 83 percent of the cases by fine needle biopsy and in 81 percent of the cases by Tru-Cut biopsy, and distinction between primary and secondary cancer, in 83 and 86 percent of cases respectively. Specificity was 100 percent with both techniques. Of 9 benign lesions, the 6 focalized fatty infiltrations were diagnosed by both fine and coarse needle biopsies. As fine needle biopsy is less invasive than coarse needle biopsy and gave equally satisfying results, we suggest that it should be used preferentially in the diagnosis of focalized liver lesions.

Biopsy, Needle

[A case of pulmonary metastasis from carcinosarcoma of uterus with subcutaneous implantation of tumor cells along the needle tract after percutaneous needle biopsy of lung].

A 68-year-old female who had undergone total hysterectomy for carcinosarcoma five months previously was noted to have a solitary nodular shadow in the right lung on chest X-ray. Percutaneous needle biopsy of the lung was performed via the right anterior chest wall, and the histologic findings showed metastasis from carcinosarcoma of uterus. Two months after needle biopsy, a chest wall mass appeared of the site of puncture of the lung needle biopsy. The mass was resected to relieve the chest wall pain and the specimen showed carcinosarcoma of uterus histologically. We consider that tumor cells were implanted to the chest wall along the needle tract after percutaneous needle biopsy of the lung. The postoperative chest computed tomogram showed the route of tumor implantation from the metastasis of right lung into the right chest wall. Dissemination and chest wall implantation of malignant cells after percutaneous lung needle biopsy have been rarely reported. However there are no reports of tumor implantation of sarcoma. The possibility of implantation of tumor cells along the needle tract after percutaneous lung needle biopsy should be carefully considered in cases of carcinosarcoma.

Aged

[Comparison of the results of transthoracic needle biopsy of the lungs using the Nordenström and the Rotex needles].

In the diagnostics of nodular and infiltrative lung lesions in 28 patients the transthoracic needle biopsy of the lung was performed both by Nordenström and Rotex needle. In confirming the cancer, both needles were equally satisfactory. By Rotex needle the tissue sample was obtained also from hard lesions from which the tissue sample with Nordenström needle couldn't be obtained. By transthoracic needle biopsy of the lung the diagnosis of benign disease was confirmed in two patients with isolation of Mycobacterium tuberculosis from the sample obtained by Rotex needle.

Adolescent

A simultaneous comparison of acupuncture needle and insulated needle sphenoidal electrodes for detection of anterior temporal spikes.

Uninsulated acupuncture needles have been used as sphenoidal electrodes, but the issue of insulation has not been adequately addressed. In this report, acupuncture needles and insulated needle sphenoidal electrodes were simultaneously used to compare the rate of spike detection, spike amplitude and distribution of maximal spikes from eight spike foci in seven patients with temporal lobe epilepsy. When compared to the insulated needle electrode, the acupuncture needle electrode was equally effective in spike detection, but spike amplitudes tended to be smaller and maximal spikes were less frequently encountered. Thus, insulation has an influence on the spikes recorded by the acupuncture needle sphenoidal electrode. However, the overall effect appears to be not sufficiently different from the insulated needle electrode for the purpose of detecting anterior temporal spikes in outpatient EEG recordings for the diagnosis of temporal lobe epilepsy.

Acupuncture Therapy

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

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

[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

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

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