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At least 361 records · Page 20Linked to original sources
PubMed2006

Afferent intussuscepted antireflux nipple valve complications in the Kock pouch for continent urinary diversion Early results with a modified technique.

OBJECTIVES: To analyse the risk of afferent nipple valve stenosis and its consequences and management in patients with a Kock pouch for continent urinary diversion and to study the early results after using an alternative antireflux technique. MATERIAL AND METHODS: Sixty patients consecutively operated on with a conventional Kock reservoir for continent cutaneous urinary diversion between 1988 and 2001 were analysed with regard to the occurrence of afferent nipple valve stenosis and its clinical characteristics. Sixteen patients operated on for continent urinary diversion during the period 2002-04 had the antireflux valve constructed according to the serous-lined extramural ileal valve technique. RESULTS: Eight patients with a conventional Kock pouch developed true afferent nipple valve stenosis and the risk approached 30% after 15 years. Dilatation and stenting were usually successful. CONCLUSIONS: The high risk of afferent nipple valve stenosis when using the intussuscepted nipple valve in the construction of a Kock reservoir for continent cutaneous urinary diversion calls for an alternative method for anastomosing the ureters to the reservoir. Our early results with the combined Kock/T-pouch are promising.

Colonic Pouches↗
PubMed2001

The effect of nipple height on broiler performance.

Two trials, using a total of 3,200 male broilers, were conducted to compare the effects of a trough drinker versus three different heights on a nipple drinker system on body weight gain and feed:gain. The broilers were housed in temperature-controlled litter pens at 25 or 30 C. An 8-ft open trough was used. The nipple drinker heights were adjusted as 1) low (no neck stretch and drink from the side of the beak), 2) medium (stretch neck and drink from the end of the beak), and 3) high (first elevate breast, then stretch neck and drink from the end of the beak) positions. The nipple heights were adjusted twice weekly by visual inspection. The open drinker produced the heaviest birds. No significant treatment differences were observed for feed:gain at 25 C but increased numerically with increasing nipple height. This same pattern was evident at 30 C, but statistically significant differences did occur. Drinking from a nipple drinker is an unnatural drinking act for birds, and the greater the neck extension, especially during a panting situation, the more detrimental the effect on both body weight and feed:gain.

Animal Feed↗
PubMedDate not supplied

Physiological responses of preterm infants to breast-feeding and bottle-feeding with the orthodontic nipple.

BACKGROUND: Although the orthodontic nipple has been recommended for many years to supplement breast-feeding infants, it is not known if this nipple is suitable for hospitalized preterm infants whose mothers wish to breast-feed. OBJECTIVES: To describe and compare short-term physiologic responses of preterm infants serving as their own controls for two feeding methods, breast-feeding and bottle-feeding with the orthodontic nipple. METHOD: The sample consisted of eight preterm infants, mean birth weight of 1,370 grams and mean gestational age at birth of 30.2 weeks' gestation, who served as their own controls for breast- and bottle-feeding sessions. The dependent variables, sucking, breathing, and oxygen saturation, were measured noninvasively throughout breast- and bottle-feeding sessions and recorded on a polygraph. Data were analyzed quantitatively and qualitatively for 14 breast-feeding sessions and 15 bottle-feeding sessions. RESULTS: Statistically significant differences were found in that infants breathed more during sucking bursts for breast-feeding sessions when compared to bottle-feeding sessions and had fewer episodes of oxygen desaturation during breast-feeding. A characteristic sucking waveform associated with organized breathing was observed for some infants during bottle-feeding with the orthodontic nipple. CONCLUSIONS: These data suggest that the orthodontic nipple is appropriate for supplementing breast-feeding for some preterm infants. Further research is needed to examine long-term outcomes.

Bottle Feeding↗
PubMed2005

Direct nipple ureteroneocystostomy in adults with primary obstructed megaureter.

PURPOSE: We evaluated the results of direct nipple ureteroneocystostomy technique in adults with primary obstructed megaureter. MATERIALS AND METHODS: Five patients with a mean age of 32.5 years had a total of 6 primary obstructed megaureters with complaints of flank pain. Two patients were female and 3 were male. In patient 1 disease was bilateral, in 3 it was on the right side and in 1 it was on the left side. In male patient 1 a thick walled right ureter could be directly inserted into the bladder without eversion or tapering. The left nipple was created with spatulation. In 2 cases the ureters were thin walled (2 mm or less) and the nipples were created without spatulation. In the other 2 cases the nipples were created following spatulation since the ureteral walls were thicker (2 to 3 mm). RESULTS: Mean followup was 36 months. Flank pain complaints resolved in the postoperative period. Early postoperative Whitaker tests revealed nonobstructed renal units. At later followup visits excretory urograms and/or ultrasound showed partially resolved hydroureteronephrosis. CONCLUSIONS: Ease of application, a high success rate and no need to taper or plicate the ureter, or prepare a submucosal tunnel might be the reasons to consider the direct nipple technique for megaureters of different etiologies.

Adult↗
PubMed1993

ErbB-2 protein levels in nipple discharge: role in diagnosis of early breast cancer.

The levels of c-erbB-2 oncoprotein (ErbB-2 protein) in nipple discharge were evaluated together with those of carcinoembryonic antigen (CEA) in 9 patients with breast cancer, 2 patients with borderline lesions, 8 patients with intraductal papilloma, and 19 patients with fibrocystic change. When the tentative cutoff value was set at 40 ng/ml in the nipple discharge, elevated ErbB-2 protein levels were found in all 3 patients with palpable breast cancer and 3 of the 6 patients with nonpalpable cancer. Two of the 8 patients with intraductal papilloma had high ErbB-2 protein levels. A combination test with CEA resulted in positive detection in all cancer patients. Two patients with borderline lesions, 2 with intraductal papilloma and 2 with fibrocystic change were positive in a combination test. In addition, elevated ErbB-2 protein levels in nipple discharge correlated well with the overexpression of ErbB-2 protein in the tumor. All the patients with ErbB-2 protein levels over 100 ng/ml in their nipple discharge had comedo or solid intraductal carcinomas. Thus, measurement of ErbB-2 protein levels in nipple discharge can assist in the diagnosis of intraductal carcinoma and also in detecting tumors with a high proliferation rate and an overexpression of ErbB-2 protein: usually comedo or solid carcinomas.

Adult↗
PubMed2004

A failed RCT to determine if antibiotics prevent mastitis: Cracked nipples colonized with Staphylococcus aureus: A randomized treatment trial [ISRCTN65289389].

BACKGROUND: A small, non-blinded, RCT (randomised controlled trial) had reported that oral antibiotics reduced the incidence of mastitis in lactating women with Staphylococcus aureus (S. aureus)- colonized cracked nipples. We aimed to replicate the study with a more rigorous design and adequate sample size. METHODS: Our intention was to conduct a double-blind placebo-controlled trial to determine if an antibiotic (flucloxacillin) could prevent mastitis in lactating women with S. aureus-colonized cracked nipples. We planned to recruit two groups of 133 women with S. aureus-colonized cracked nipples. RESULTS: We spent over twelve months submitting applications to five hospital ethics committees and seven funding bodies, before commencing the trial. Recruitment to the trial was very slow and only ten women were randomized to the trial after twelve months, and therefore the trial was stopped early. CONCLUSIONS: In retrospect we should have conducted a feasibility study, which would have revealed the low number of women in these Melbourne hospitals (maternity wards and breastfeeding clinics) with damaged nipples. The appropriate use of antibiotics for breastfeeding women with cracked nipples still needs to be tested.

Journal Article↗
PubMed1998

[Bilateral ureter within single nipple for cutaneous ureterostomy after radical cystectomy].

OBJECTIVE: To evaluate the effect of bilateral ureter within single nipple for cutaneous ureterostomy after radical cystectomy. METHOD: Bilateral ureter within single nipple for cutaneous ureterostomy was performed on 36 patients after radical cystectomy. RESULT: The nipple was formed well, and urinary drainage was patent. No death or severe complication occurred. The patients have been followed up for 3 months to 3.5 years. Urinary, electrolyte and renal functions were within normal levels. No pyelonephritis or hydronephrosis was observed in IVP, retrograde pyelography and/or sonographic examination of kidneys, no nipple constriction. A right ureter was pulled to the left retroperitoneum and formed a nipple with ureter left on the left abdominal wall. CONCLUSION: This is a simple and safe operation, especially suitable to the old and weak patients.

Adult↗
PubMed2004

Nipple-sparing mastectomy: technique and results of 54 procedures.

HYPOTHESIS: The rationale for removal of the nipple-areolar complex (NAC) during total mastectomy centers on long-standing concerns about possible neoplastic involvement of the NAC and its postoperative viability. Nipple-sparing mastectomy (NSM) combines a skin-sparing mastectomy with preservation of the NAC, intraoperative pathological assessment of the nipple tissue core, and immediate reconstruction, thereby permitting better cosmesis for patients undergoing total mastectomy. Neoplastic involvement of the NAC can be predicted before surgery and assessed during the operation, and sustained postoperative viability of the NAC is likely with appropriate surgical technique. RESULTS: Fifty-four NSMs with immediate reconstruction were attempted among 44 patients. Six NAC core specimens revealed neoplastic involvement on frozen section analysis, resulting in conversion to total mastectomies. Forty-five of the 48 completed NSMs maintained postoperative viability of the NAC; 3 NACs had partial loss. CONCLUSION: Nipple-sparing mastectomy is a reasonable option for carefully screened patients.

Adult↗
PubMed1996

Nipple-areolar preservation during breast-conserving therapy for subareolar breast carcinomas.

OBJECTIVE: To determine if women with subareolar breast carcinoma can be successfully treated by breast-conserving therapy consisting of segmental mastectomy that preserves the nipple-areolar complex, axillary lymph node dissection, and postoperative irradiation. DESIGN: Prospective study. SETTING: Tertiary care cancer center. PATIENTS: Twenty-five patients; median age, 56 years; median tumor diameter, 1.4 cm; and median follow-up, 48 months. INTERVENTION: Breast-conserving therapy for subareolar primary breast carcinoma. RESULTS: Two patients had positive surgical margins of resection, and another patient underwent simple mastectomy after developing a local recurrence. Nipple-areolar distortion was the most common cosmetic deformity after breast-conserving therapy, but overall cosmesis was good. At the most recent follow-up, all patients were free of disease. CONCLUSION: Patients who have small subareolar primary breast carcinomas without evidence of nipple involvement are candidates for breast-conserving therapy with nipple-areolar preservation.

Adult↗
PubMed1979

Carcinoma in a heterotopically auto-implanted nipple.

Modified radical mastectomy with transplantation of the nipple in the groin for possible breast reconstruction was performed in a patient. Carcinoma developed in the transplanted nipple. Careful pathological examination of the breast tissue from the site of excised nipple should be carried out. In patients showing presence of tumor cells at that site, nipple transplantation may be deleterious.

Adult↗
PubMed1985

Involvement of nipple and areola in early breast cancer.

In 141 mastectomy specimens, performed for invasive or noninvasive carcinomas, histopathologic study was performed to assess the extent of nipple-areola involvement by the tumor. In this study, patients were excluded if the tumor was located beneath the areola; and nipple and/or areola abnormalities were clinically present. Tumor involvement of the nipple and/or areola was found in 44 of 141 specimens (31%), with intraductal growth in 36 (82%) of 44, stromal invasion in 3 (7%), and ductal and stromal invasion in 5 (11%). Analysis of nipple-areolar involvement with consideration of the different variables indicates that it occurred in association with tumor size, tumor-areola distance, and histologic type. Such information provides clinically relevant guidelines in decision making for limited breast surgery.

Adenocarcinoma, Mucinous↗
PubMed1994

Scalp-ear-nipple syndrome: additional manifestations.

Scalp-ear-nipple (SEN) syndrome is a rare, autosomal dominant condition that causes aplasia cutis congenita of the scalp, alteration of the shape of the external ear, and hypoplasia of the nipple. Women in a new family, the fifth to be described, had virtually complete aplasia of the breast and a small skin dimple without any pigmentation instead of a normal nipple, although other affected women had normal breast and nipple development. Dental changes included widely spaced or missing secondary teeth; the ears were cupped or folded and stood out from the head, axillary apocrine secretion and axillary hair growth were reduced; and finger nails were brittle. There was no generalized abnormality of sweating. Some patients had partial syndactyly of the 3rd and 4th fingers, and complete cutaneous syndactyly of the 2nd and 3rd toes. and 3rd toes.

Abnormalities, Multiple↗
PubMed1977

Nipple retraction in duct ectasia.

Thirty patients with nipple retraction associated with duct ectasia have been studied to determine the clinical features of this condition. This association is a common one and the similarity of these nipple changes to those produced by cancer is emphasized. While clinical evaluation of the nipple changes may give an indication of the diagnosis, it is by no means absolute and mammography is advocated in all cases. Combined clinical and mammographic assessment will allow confident differentiation of the two causes in many cases, and a policy for management of nipple retraction is presented.

Adult↗
PubMed1991

Paget's disease of the nipple.

A total of 48 women with Paget's disease of the nipple (nipple eczema containing Paget cells but without a palpable lump) presented to one surgeon over a 13-year period. Temporary healing of the nipple eczema occurred in six patients. In all, 21 of 34 patients with in situ (DCIS) or invasive ductal carcinoma had mammographic abnormalities. Treatment was by simple mastectomy (37 cases), cone excision of the nipple-areola complex (ten cases) and tamoxifen (one case). DCIS was found in 45 operative specimens (96 per cent); eight had associated invasion. The DCIS was predominantly large cell solid/comedo in type and was multifocal in seven cases (19 per cent). At a median (range) follow-up of 56 (18-96) months, four of the ten patients treated by cone excision have developed a local recurrence, two of these patients have also developed metastases. Two of the 37 patients who underwent mastectomy developed loco-regional recurrences; both had invasive foci at their first operation and remain disease free at 8 years. We no longer feel that cone excision is appropriate treatment.

Adult↗
PubMed2004

Anatomy of the nipple and breast ducts revisited.

BACKGROUND: Increasing interest in the intraductal approach to the breast has necessitated revisiting the anatomy of the breast. METHODS: Using six different complementary in vivo and in vitro approaches, the authors determined the number, distribution, and anatomic properties of the ductal systems of the breast, which extend from the nipple orifices to the terminal duct lobular units. RESULTS: More than 90% of all nipples examined contained 5-9 ductal orifices, generally arranged as a central group and a peripheral group. Each nipple orifice communicated with a separate, nonanastomosing ductal system, which extended to the terminal duct lobular unit. CONCLUSIONS: Increased knowledge of the ductal anatomy of the breast and the ability to access the nipple ductal orifices will provide a foundation for the intraductal approach to the breast.

Breast↗
PubMed2002

Characterization of foam cells in nipple aspirate fluid.

Foam cells with abundant vacuolated cytoplasm are prominent in most samples of spontaneous nipple discharge, nipple aspirate fluid, and ductal lavage. Although several investigators have attempted to characterize these cells, there is no consensus about whether these cells are derived entirely from macrophages or from both ductal epithelial cells and macrophages. Using immunocytochemical methods, we studied 20 paired specimens of nipple aspirate fluid containing abundant foam cells obtained from the involved breast of women with in situ or invasive carcinoma and from the contralateral normal breast. We used a cocktail of anticytokeratin antibodies including AE1, AE3, and CAM5.2 and the macrophage marker KP1 (CD68). In addition, we examined samples by electron microscopy. The foam cells were consistently negative for cytokeratin and positive for CD68. In every case electron microscopy of these cells revealed irregular outlines with short cytoplasmic processes. The cytoplasm was abundant and contained numerous lysosomes, a small Golgi complex, lipid droplets, mitochondria, and short profiles of rough endoplasmic reticulum. There was no evidence, however, of cell junctions or tonofilaments. The immunocytochemical and electron microscopic findings of our study together clearly support a macrophage derivation for foam cells in nipple aspirate fluid.

Antigens, CD↗
PubMed1982

The role of perioral sensation in nipple attachment by weanling rat pups.

Injecting .05 ml of 1% lidocaine into each vibrissal pad, or cutting the infraorbital nerves, abolished nipple attachment in weanling Wistar rat pups. Nipple attachment recovered following infraorbital section. Injecting the local anesthetic intraperitoneally, or into the region of the masseter muscles, did not disrupt attachment, indicating that the effect of the drug on suckling was specific to the site of injection and could not be attributed to systemic toxicity or paralysis of the masseter muscles. Performance on an olfactory-guided orientation task was not disrupted by lidocaine, indicating that the drug did not render pups anosmic. Tactile sensation in the vibrissal pads, rhinarium, and upper lip was abolished after injecting the drug into the vibrissal pads. Vibrissal movement was absent following injection of lidocaine into either the vibrissal pads or the region of the masseter muscles. Shaving the vibrissae did not disrupt nipple attachment. The results are interpreted as suggesting that the nipples' textural qualities elicit attachment in weanling pups.

Animals↗
PubMed1987

Pregnancy-induced autogrooming in mice: the effects of nipple removal.

As pregnancy advances, Rockland-Swiss albino mice spend increasingly more time engaged in autogrooming. By gestation day 18 (the day prior to parturition), the total duration of autogrooming (a composite measure) as well as the duration of nipple line grooming is significantly longer than that displayed by virgin and early pregnant females. Nipple excision (i.e., thelectomy) performed prior to pregnancy reduces the time GD 18 dams spend licking nipple line regions without producing a concomitant decrease in the duration of grooming all regions. It is unlikely, therefore, that peripheral stimulation of the nipple line regions via self-licking contributes to the heightened display of grooming by pregnant mice.

Anal Canal↗