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Gender dimorphism in differential peripheral blood leukocyte counts in mice using cardiac, tail, foot, and saphenous vein puncture methods.

BACKGROUND: In many animal models that investigate the pathology of various diseases, there is a need to monitor leukocyte counts and differentials. However, various researchers use a range of different techniques in male and female laboratory animals to collect such blood variable information. These studies are then compared to one another without consideration of the possibility that different bleeding sites or techniques as well as gender may produce varying results. In light of this, the peripheral blood leukocyte counts and differentials of C57BL/6 male and female mice were determined using four blood-sampling techniques: cardiac, tail, foot, and saphenous vein punctures. METHODS: Blood smears were prepared and stained with Wright-stain for differential cell analysis. The total number of peripheral blood leukocytes was determined with the aid of a hemocytometer. Applying ANOVA and Student t-test analysis made comparisons between groups. RESULTS: The total leukocyte counts obtained using the cardiac puncture method were significantly lower as compared to the other three blood sources; saphenous, tail and foot. There were no significant differences between leukocyte counts of blood samples collected from the tail, saphenous, and foot. Additionally, no significant differences were observed in total leukocyte counts between male and female mice. Differential analysis showed lymphocytes as the predominant cell type present in the peripheral blood of both male and female mice, comprising 75-90% of the total leukocytes. While no significant differences were observed between male and female differential counts of blood collected from saphenous and tail veins, a significant difference in differential counts of blood obtained via cardiac puncture was observed between the male and female groups, suggesting the role of sex hormones. Further, of the four methods, cardiac puncture appeared to be the fastest and more reliable technique, yielding the maximum blood volume with the least amount of stress being exerted on the sampling site. CONCLUSIONS: This information suggests that in studies concerning leukocyte counts and differentials, the animal gender and the sampling site of blood collection should be kept consistent as to avoid introducing any misleading experimental variation, and that cardiac puncture is the best method of blood collection in mice.

Journal Article↗

Clinical results with the acoustic puncture assist device, a new acoustic device to identify the epidural space.

UNLABELLED: Sixty patients scheduled for lumbar epidural anesthesia were included in a study in which we evaluated the efficacy of localizing the epidural space by means of an acoustic signal. A prototype of an acoustic puncture assist device, connected to the epidural needle by an extension tube, generated the pressure needed to perform the epidural puncture and translated this pressure into corresponding acoustic and visible signals. The device frees the anesthesiologist to handle the epidural needle with both hands and to detect the epidural space by means of these signals. In all 60 patients (100%), the epidural space was successfully located by using the acoustic signal. In all cases, this was confirmed by the pressure measurement, which proved to be a reliable indicator for correct identification of the epidural space. We conclude that it is possible to locate the epidural space by means of the acoustic puncture assist device. The method proved to be reliable, safe, and simple in this study. The benefits of this new epidural puncture technique include better needle control, teaching, control of correct catheter placement, and documentation. The last can be an important adjunct to anesthesia practice. IMPLICATIONS: The authors demonstrate that it is possible to identify the epidural space by an acoustic and visible signal. An experimental setup constructed for this purpose makes the epidural puncture procedure audible and visible.

Acoustic Stimulation↗

Ease of donning of new powder-free non-latex and latex double-glove hole puncture indication systems.

Cornstarch on surgical gloves is often used as a detackifying agent and a lubricant to facilitate glove donning. During the last century, scientific studies have demonstrated that cornstarch produces tissue injury in literally every part of the body. Because this glove lubricant cannot be removed from the glove, Dr. David Podell, an ophthalmologic surgeon, and his cousin, Howard Podell, a chemical engineer, devised the first powder-free surgical glove that could be donned easily. They coated the inner surface of the surgical glove with a methacrylate polymer lining that was bonded to the natural rubber latex. This special coating acts as a lubricant to facilitate donning with damp, wet, or dry hands. In our earlier experimental studies, we confirmed that these polymer-lined latex gloves could be donned with either wet or dry hands. More recently, the polymer-coated latex gloves were incorporated into a double-glove hole puncture indication system that accurately detected glove holes in the presence of fluid. Because this discovery has been expanded into the development of a non-latex double-glove hole puncture indication system, we have expanded our biomechanical performance studies to examine the glove donning forces of the latex and non-latex glove hole puncture indication systems. The maximum donning forces recorded for the non-latex undergloves were significantly lower than those encountered by the same respective sizes of the latex underglove. The donning forces of the thin Biogel Super-Sensitive outer gloves were remarkably similar to the donning forces of the Biogel Indicator undergloves. The thicker Biogel outer gloves encountered greater donning forces than that noted for the Biogel Super-Sensitive outer gloves. The donning forces recorded for the non-latex outer gloves were remarkably similar to those noted for the latex Biogel outer gloves. Because the results of this biomechanical performance study demonstrated that the latex and non-latex double-glove hole puncture indication systems can be easily donned by surgeons using relatively low donning forces, this study provides convincing evidence that these double-glove hole puncture indication systems can be used in all surgical procedures.

Biomechanical Phenomena↗

Infected puncture wounds in diabetic and nondiabetic adults.

OBJECTIVE: To evaluate bone and soft tissue pathogens resulting from puncture wounds among diabetic and nondiabetic adults. RESEARCH DESIGN AND METHODS: We used a case-control design to compare bacterial pathogens in diabetic and nondiabetic subjects with foot infections precipitated by puncture injuries. We used ICD-9-CM code E920.8 to identify 77 diabetic and 69 nondiabetic patients admitted to the hospital for infected puncture wounds. We identified surgical bone and soft tissue cultures and number and type of organisms per culture. RESULTS: Nondiabetic subjects had significantly less osteomyelitis (13 vs. 35%, P < 0.01) than diabetic subjects and were infected by fewer organisms. Pseudomonas was the most common cause of osteomyelitis among nondiabetic subjects (P < 0.001). Staphylococcus aureus was more common in diabetic bone (P < 0.001) and soft tissue (P < 0.001) infections. Polymicrobial osteomyelitis was more common in diabetic subjects. There was a longer delay until diabetic subjects received medical treatment compared with nondiabetic subjects (8.7 vs. 5.3 days, P < 0.002). Diabetic subjects were more likely to have neuropathy (P < 0.001) and to have sustained their injuries while barefoot (P < 0.006). CONCLUSIONS: Puncture wounds in diabetic subjects were commonly associated with polymicrobial infections. Pseudomonas was the most common cause of nondiabetic osteomyelitis. These results have implications for differential emergent and chronic treatment of puncture wounds in diabetic versus nondiabetic subjects.

Adult↗

[Accidental punctures: ten years of experience with our protocol].

OBJECTIVE: We report our experience during the past 10 years in the management of accidental punctures. PATIENTS AND METHODS: A study was made of all hypodermic needle punctures recorded in children aged 0-14 years in our center since 1987. A clinical protocol consisting of 5 visits and duration of 6-7 months was used in all cases. RESULTS: A total of 150 punctures were recorded during the study period with a decrease in prevalence over time. All cases the clinical protocol was accepted and correct follow-up procedures were performed. In no case was post-puncture sero-conversion detected for HCV, HBV, or HIV among correctly immunized children. CONCLUSIONS: The protocol employed is useful and well accepted with the risk of infection caused by accidental puncture being remote provided initial patient care was adequate.

Accidents↗

[Ascitic fluid puncture in the treatment of severe forms of ovarian hyperstimulation syndrome].

OBJECTIVE: Evaluate the contribution and complications of ascitic fluid puncture in the treatment of severe ovarian hyperstimulation syndrome. DESIGN: Retrospective analysis of 18 patients. SETTING: Department of Gynaecology and Obstetrics, University Hospital, Palacky University, Olomouc. METHODS: 18 patients with the diagnosis of severe ovarian hyperstimulation syndrome admitted to intensive care unit from January 1996 to June 2000 were analysed. As a part of the therapy of severe OHSS 11 punctures of ascitic fluid was performed. In 3 patients the reinfusion of the ascites into the blood circulation was performed. RESULTS: The transabdominal paracentesis under the ultrasound control in 11 patients was performed. In 6 patients the puncture had to be repeated. The amount of removed ascitic fluid in single procedure was between 600-3750 ml. Total amount of fluid in different patients was between 1500-17,300 ml. Sterility of ascites and high contents of proteins was proved. In 3 patients with the refractory ascites the reinfusion of the ascitic fluid to the circulation was performed. No serious complications of the punctures were observed, 4 patients had a slight rise of body temperature, which fell down without antibiotics therapy. CONCLUSION: Puncture of the ascitic fluid is a save and effective part of the therapy of severe OHSS. In the treatment of the refractory ascites the reinfusion of the ascitic fluid should be used.

Ascites↗

Observations on the analgesic effects of needle puncture (acupuncture).

The present study was undertaken in order to investigate the analgesic effect of needle puncture in a small self-selected group of patients with chronic or acute pain, and to examine the factors which determine success or failure of this treatment modality. We have found that in chronic painful conditions, needle puncture may be very effective in producing at least transient analgesia. It also can produce permanent relief of acute (self-limited) pains. Needle puncture was not helpful in the management of pain resulting from nerve damage. High score on psychometric indicators of anxiety and depression is a significant predictor os successful needle puncture analgesia in patients with chronic pain. Comparison of our results to studies of counterirritation indicate that the analgesia produced by needle puncture involves a mechanism similar to that of counterirritation-induced analgesia.

Acupuncture Therapy↗

Effect of age and abomasal puncture on peritoneal fluid, hematology, and serum biochemical analyses in young calves.

The goals of this study were to evaluate techniques for collection of peritoneal fluid from calves, establish reference ranges for fibrinogen in peritoneal fluid during the 1st month of life, and determine if abomasal puncture would alter peritoneal fluid or hematologic variables. Twenty-two healthy Holstein calves underwent 3 peritoneal fluid collections on day 1, day 15, and day 30 of age. Fibrinogen concentration in peritoneal fluid was 0.20 g/dL and 0.10 g/dL (P < .05) for day 1 and day 30, respectively, and 0.10 at day 15 (P > .05) for calves without abomasal puncture. Plasma fibrinogen concentration was 0.60 g/dL and 0.70 g/ dL (P < .05) for days 15 and 30, respectively, in calves without abomasal puncture. There were no significant differences (P < or = .05) in peritoneal fluid and peripheral blood total protein and fibrinogen concentrations, specific gravity, total and differential cell count, or erythrocyte counts between calves with or without abomasal puncture. We concluded that the reference ranges established for fibrinogen and total protein concentration are important for accurate evaluation of peritoneal fluid in calves for further comparison with similar-aged animals with gastrointestinal-tract or abdominal-cavity disease. Additionally, accidental abomasal puncture does not alter values of fibrinogen, total protein, and nucleated cell count in peritoneal fluid and does not cause apparent clinical abnormalities.

Abomasum↗

Cholesterol determinations from skin puncture and venous blood have similar imprecisions.

Comparison of cholesterol values from venous blood and skin puncture blood is difficult, because biological differences between both materials may be concealed or increased by the preanalytical imprecision of skin puncture. In 12 adults, we studied the variance of cholesterol and urea determination in 8 blood samples obtained by the puncture of 8 fingers and compared the results with the 8-fold determination of a venous sample drawn simultaneously. Our results show that the additional imprecision of skin puncture is low, and that the differences are not statistically significant. The mean values for cholesterol were 3.9% lower in skin puncture plasma than in venous plasma, whereas the mean values for urea were very similar.

Blood Specimen Collection↗

[Fine-needle puncture and aspiration of pathologic lesions in the abdomen using ultrasound guidance].

The aim of this study was the echo-guided fine-needle aspiration puncture of abdominal lesions to be evaluated. 91 punctures of 85 patients with local lesions were performed. In 6 cases the puncture was repeated because of the lack of material for cytologic study just blood presence in the needle. In 47 cases with carcinoma or metastatic masses the puncture allowed aspiration of malignant cells. In 7 cases the puncture was therapeutic aspiration of pus collection and antibiotical application. The accuracy of this method was 92.9%, sensitivity 87.8% and specificity 96.1%. No significant complication to report occurred.

Abscess↗

Anterior stromal puncture for recurrent erosion: further experience and new instrumentation.

Anterior stromal puncture has recently been proposed as a new treatment for recalcitrant cases of recurrent corneal erosion. Concerns about the risks of corneal perforation and scarring, as well as doubts regarding its efficacy have prevented many patients from benefiting from this procedure. We introduce a new, inexpensive, commercially available instrument designed to standardize this technique, minimize scarring, and prevent corneal perforation. In a clinical trial involving 25 consecutive patients with recurrent erosions resistant to vigorous conservative treatment, the first 11 patients underwent stromal puncture in which a straight tuberculin needle was used; the following 14 were treated with a newly designed prototype needle. All patients in this series remained free of erosions after completion of stromal puncture, except for one woman with marked diffuse anterior basement membrane dystrophy, who went on to develop spontaneous bilateral erosions. Follow-up ranged from 2 months to 30 months (mean, 13 months). There were no complications of stromal puncture, and subjective and objective evaluations revealed no significant postoperative glare. Microscopic analysis of eye bank eyes subjected to anterior stromal puncture procedures demonstrated that the new prototype needle provided shallower penetration and thus less likelihood of perforation or excessive scarring than the straight needle. Also, postoperative discomfort and scarring appeared to be significantly less in patients treated with the prototype needle.

Adult↗

Anterior stromal puncture with the Nd:YAG laser.

A simple and consistent puncture of the anterior stroma was created with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in a rabbit model. Varying energy levels were tested, and settings at 2.0 mJ produced well-formed anterior stromal breaks. The laser shock wave disrupted Descemet's membrane in only 1 of 50 animals. The wound healed normally in vivo over a 3-month period. Compared to needle puncture, the laser puncture created less stromal scarring. Initial human studies also showed that energy levels from 1.5-2.5 mJ were sufficient to create local breaks in Bowman's layer. Further human studies will be needed to determine if Nd:YAG laser puncture offers any advantages over current techniques for stromal puncture in the treatment of traumatic recurrent corneal erosions.

Animals↗

Emergency department management of puncture wounds and needlestick exposure.

Puncture wounds are common and challenging problems facing the physician. In general, puncture wounds can be classified into two distinct types. In one type, a child usually sustains a puncture wound of the foot. The other type of puncture wounds occur among hospital employees. These seemingly innocuous injuries may have serious sequelae that can be averted by prompt appropriate care of the wound. The fundamental trends of treatment of puncture wounds include cleansing the wound, débridement of any necrotic or devitalized tissue, and appropriate immunoprophylaxis.

Adolescent↗

[Ultrasound guided fine- and coarse-needle puncture of the abdominal and retroperitoneal space].

Within a period of 21 months, 167 fine-needle and 86 cannula (1.67 mm external diameter) punctures of the abdominal or retroperitoneal space were performed under sonographic control. Sufficient material was obtained with 93.4% of fine-needle punctures. With regard to differentiation between malignant and benign lesions, fine-needle punctures had a sensitivity of 86% and specificity of 100%, if the material was examined by an experienced cytologist. Sensitivity dropped to 55,1% if the same material was interpreted by a less experienced cytologist, but specificity was still 98.1%. Sufficient material for histological examination was always obtained with the cannula, already at the first puncture. With cannula puncture there were two complications: bleeding requiring transfusion and peritonitis.

Abdomen↗

Studies on the quality of specimens obtained by skin-puncture of children. 2. An analysis of blood-collecting practices in a pediatric hospital.

We quantified blood-collecting practices for chemistry in a pediatric hospital. Skin-puncture provided 67% of samples, and in-dwelling catheters (lines), 31%. About 46% of samples collected (day-shift) were urgent ("stats"). A single skin-puncture provided 448 microL (range, 150-1350) of blood, and 80% of requests, but only 58% of stats. About 1.3 punctures per request were required. Time spent collecting blood was 11.0 min per single request. Patients undergoing total parenteral nutrition took 17.9 min and 3.6 skin-punctures per request. Analytical time for stat blood gases was about 6 min, total ("turnaround") time, about 16 min. Turnaround time for stat requests involving the Ektachem 400TM instrument was 32.4 min; for non-stat, at least 56 min. Other tests required 151 min. Blood gases and electrolytes represented the majority of all tests ordered, and 97% of in-dwelling line blood-draws. There was no correlation between age and number of tests per request, but the youngest patients (0 to 1 year) had more skin-punctures per request (1.4), along with the greatest number (55.5%) and frequency of tests.

Acid-Base Equilibrium↗

[Value and limitations of puncture guided by x-ray computed tomography in hematology].

Interpretable cytologic data were obtained in 63% of a series of 68 punctures, for biopsy of hematologic affections, guided by CT scanning. The frequency of puncture of post-therapy residual masses (44 cases) explains the high incidence of non-significant examination results after lymph node puncture. The technique was most effective (78% of punctures exploitable) when used for thoracic masses and visceral localizations. The method is very safe: lack of serious incidents and minor reactions, mainly during thoracic puncture, in only 4.4%. The method is simple in use and should be employed, within certain limits that should be recognized, very widely in hematologic diseases.

Abdomen↗

[The reliability of needle puncture in the diagnosis of benign renal cysts? (author's transl)].

Confirmation of the diagnosis of a benign renal cyst through needle puncture is being reported with increased frequency. The puncture reveals either a clear, cloudy or bloody fluid, or no fluid at all. The authors analyze 88 of their own and 805 cyst punctures from the literature. A benign cyst was always present when the aspirated fluid was clear (763 cases). When the aspirated fluid was cloudy or bloody (130 cases) a malignant kidney tumor was found in 35% of the cases. Complications from cyst punctures are described. The authors feel that needle puncture is a highly effective method in the differential diagnosis of renal masses. It can also be used when multiple cysts are present on one or both sides.

Biopsy, Needle↗

Puncture wounds.

Puncture wounds are common and challenging problems facing the physician. In general, puncture wounds can be classified into two distinct types. In one type a child usually sustains a puncture wound of the foot. The other group of puncture wounds occurs among hospital employees. These seemingly innocuous injuries may have serious sequelae that can be averted by prompt appropriate care of the wound. The fundamental trends of treatment of puncture wounds include cleansing the wound, debridement of any necrotic or devitalized tissue, and appropriate immunoprophylaxis.

Accidents, Occupational↗