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At least 469 records · Page 26Linked to original sources
PubMed1987

Nipple (papilla) development in puberty: longitudinal observations in girls.

The purpose of this study was to determine the manner of breast nipple (papilla) development occurring during puberty in girls on a longitudinal basis and to compare this development to the established criteria of sexual maturation. Forty-six girls (19 white and 27 black) were followed for periods of 2 to 5 years (mean 2.67 years). In each, the nipple diameter was measured and the Tanner stage assessed. Minimal nipple development occurred from stages PH1 to PH3 (3.24 to 4.44 mm) and B1 to B3 (3.00 to 4.72 mm) or more than 1 year prior to menarche (3.75 mm). Significant growth occurred beyond stages PH3 (PH4 6.54 mm, PH5 8.98 mm) and B3 (B4 7.25 mm, B5 9.41 mm) and from less than 1 year prior to menarche to more than 1 year after menarche (5.92 mm for girls less than 1 year premenarche, 7.88 mm for girls in their first year after menarche, and 9.05 mm for girls more than 1 year beyond menarche). A more objective definition for breast stages B4 and B5, based upon nipple diameter, is now feasible. Thus, these data enhance the precision with which physiologic events occurring toward the close of puberty in girls can be studied.

Adolescent↗
PubMed1985

[Supplementation of antenatal cardiotocography (nonstress test) by nipple self stimulation].

Self-stimulations of nipples were performed in 155 late pregnant women in connection with antenatal cardiotocography (nonstress test). Cardiotocographs were interpreted using an own score. Uterine contractions could be produced by nipple stimulation in 111 women (71.6 per cent). In 13 cases with score 6 to 8 these contraction contributed to explantation of fetal condition. In additional 11 cases with score 9 to 10 the attention was focussed to the reduced fetal or placental capacity by the suspect cardiotocogram. In this group frequency of caesarean section was increased significantly. In cases with successful nipple stimulation the rate of labour induction with effect was higher. Oxytocin liberation by nipple stimulation may be regarded as endogenous oxytocin stress test. This simple procedure which can be done quickly and without danger is supposed to be a good supplement to nonstress test. Its reliability can be improved and the success of induction of labour estimated.

Breast↗
PubMed1983

Syringomatous adenoma of the nipple.

A benign, locally infiltrating tumor histologically similar to syringoma of skin adnexal origin has been found in the nipple in five patients. Four women were 28-41 years of age (mean 36 years) and a man was 76 years old. The lesion was solitary and unilateral in each case. Grossly, minute cystic areas were noted in some specimens. Microscopically, typical tubular, duct-like structures and keratinizing cysts were present throughout the lesion. Follow-up is available for four patients. Two were free of recurrence 2 and 2.5 years after nipple resection. A third patient treated by mastectomy 3 years ago is also disease-free. In a fourth woman, the lesion persisted and slowly enlarged over 22 years after incomplete excision. Eventually partial mastectomy was required and she died of colonic carcinoma 2 years later. Syringomatous adenoma is a morphologically characteristic neoplasm that can be distinguished from florid papillomatosis of nipple ducts; it is capable of local invasion and recurrence if not completely excised. Adequate treatment may require nipple resection.

Adenoma↗
PubMed1980

Selection of patients for heterotopic implantation of the areola and nipple.

In a prospective analysis of 291 specimens taken at mastectomy for carcinoma, 48 contained tumor in the nipple-areola complex. The characteristics of greater tumor size, higher frequency of lymph node involvement, midbreast tumor location and multifocality of tumor correlated well with the probability of involvement of the nipple. The findings emphasize the importance of close clinical and histopathologic examination of the nipple and areola when preservation of the nipple is being considered.

Adult↗
PubMedDate not supplied

Reconstruction of the nipple-areolar complex after radical mastectomy.

Reconstruction of the nipple areolar complex should be done as a second stage procedure about three months after volume replacement. Symmetry in position, size, and color is of utmost importance for the overall aspect of a breast reconstruction. One piece full thickness grafts from the opposite areola and nipple give the best results. When the remaining areola is too small to provide a full thickness graft, shaving of its surface may be used but often leads to later depigmentation. In these cases inguinal or perineal full thickness skin grafts seem preferable. Projection of the nipple remains a difficult goal. Experience of the authors with 74 nipple areolar reconstructions is discussed.

Breast↗
PubMed1994

[Early detection of non-palpable (T0) breast cancer: the diagnostic procedure for pathological discharge from the nipple].

Detection of non-palpable (T0) breast cancer by pathological nipple discharge is possible 3 years or more earlier than tumorous breast cancer. However, the definite diagnosis of T0 breast cancer has been considered to be very difficult because the standard diagnostic method such as exfoliative cytology and ductography were not totally reliable. In 1985 we first demonstrated the significance of CEA measurement in nipple discharge for diagnosis of T0 breast cancer. Since then CEA activity in nipple discharge was estimated in 60 patients with breast diseases by means of enzyme immunoassay using monoclonal anti CEA antibody. They include 17 with T0 breast cancer, 9 with borderline lesion, 20 with intraductal papilloma and 14 with fibrocystic diseases. When the cut off value of CEA concentration was set at 600 ng/ml, the sensitivity, specificity and accuracy were 76.5%, 100% and 92.2%, respectively. These levels were higher than those for mammography or cytology. In the past 7 years, 13 cases of T0 breast cancer were detected in our hospital. They accounted for 2.5% of total breast cancer cases. In conclusion, CEA measurement in nipple discharge is a useful method for the diagnosis of non-palpable breast cancer.

Biomarkers, Tumor↗
PubMed1977

When is there nipple involvement in carcinoma of the breast?

Two hundred cases of carcinoma of the breast were examined to determine the extent of nipple involvement. Carcinoma was present in 8 percent of the specimens. Fourteen of the 16 nipples which contained tumor were macroscopically abnormal in reappearance--being either ulcerated, retracted, or attached to an underlying indurated mass. Clinically normal niples are not likely to contain carcinoma. A frozen section across the nipple base should also be used as a safeguard if the nipple is to be used in reconstruction.

Adenocarcinoma↗
PubMed1995

Coexistence of nipple duct adenoma and breast carcinoma: a clinicopathologic study of five cases and review of the literature.

The simultaneous occurrence of nipple duct adenoma (NDA) and carcinoma in the same breast is rare and generally considered an incidental finding. Five examples of such concurrent lesions are reported. The patients ranged in age from 48 to 70 y, and they all presented with a palpable mass that was subareolar in three and in the lower inner quadrant in two women. The presence of distorted nipple with discharge in two patients and nipple erosion in another had raised the possibility of Paget's disease clinically. Microscopically, an infiltrating duct carcinoma was present in four women and an intraductal carcinoma in the fifth--all along with a NDA. Two of the invasive carcinomas were adjacent to the NDA and immediately beneath the surface epithelium of the nipple; the NDA in one of these had atypical intraductal hyperplasia. Three women had mastectomy and axillary node dissection, two had excisional biopsy only. Follow-up was available in four women and ranged from 1.5 to 8 y. One of these women developed metastasis and died 8 y postdiagnosis; the remaining three are alive and well. In at least three cases, the invasive carcinoma was not suspected clinically, and the initial procedure was done because of symptomatology secondary to the NDA.

Adenoma↗
PubMed1996

Ductography is a useful technique in evaluation of abnormal nipple discharge.

The purpose of this study was to evaluate the utility of ductography, or galactography, in identifying ductal abnormalities in patients presenting with abnormal nipple discharge and to correlate these findings with pathologic results. Abnormal nipple discharge was defined as either bloody or testing positive for occult blood. Milky discharge (galactorrhea) was not evaluated. From July 1992 to June 1994, a total of 43 women presented to the UCLA Breast Center with complaints of abnormal nipple discharge. Mean age of the patients was 54.9 years. All patients underwent technically adequate ductography. A total of 25 patients then underwent 26 excisional biopsies for abnormal ductographic findings. Surgery was usually simplified by the appropriate ductal injection of methylene blue immediately preoperatively. No complications from the procedure were identified. Pathologic entities were correlated with ductographic findings. Ductography identified ductal abnormalities in 33/45 (73%) of ductograms. Filling defects were noted in 19/45 (42%) of ductograms, ductal dilatation in 3/45 (7%), both filling defects and dilatation were noted in 11/45 (24%) of ductograms, and 12/45 (27%) were normal ductograms. Pathologically, ductographic anomalies correlated well with histologic findings. We conclude that ductography is an effective and safe means of identifying ductal abnormalities in patients with abnormal breast discharge. A high incidence of benign intraductal papilloma and a moderate risk of cancer and precancerous lesions were identified. We believe that patients with abnormal nipple discharge should undergo routine ductography and dye localization before surgery.

Breast Diseases↗
PubMed1997

A comprehensive approach to evaluating nipple discharge.

While emphasis is justifiably placed on the importance of detecting breast masses during breast examination, the equally important need for accurate assessment of nipple discharge is often overlooked. Inspection and palpation for nipple discharge should be part of every breast examination. When detected, a critical analysis should be made of every nipple discharge, with the ultimate objective being differentiation between benign and malignant discharges. All nipple discharges can be defined by the physical characteristics of laterality, spontaneity, color, consistency, number of ducts involved, and duration. By correlating these characteristics with certain historical features (e.g., age, pregnancy, trauma, drugs), accurate determination of etiology can be made. A four-step approach is presented that offers a logical method for making the essential correlations. The sequence of the four relevant questions proposed gives the examiner a logical basis from which to assign clinical importance to each discharge. An algorithm is outlined that correlates diagnostic considerations with therapeutic actions.

Breast↗
PubMed1996

Manipulation of the dopamine system affects fetal and neonatal responses to an artificial nipple.

Rat fetuses respond to stimuli that they will encounter later while suckling. When exposed to an artificial nipple (AN) E21 fetuses show overall behavioral activation, mouthing, facial wiping, and oral grasping of the AN. The present experiments examined fetal and neonatal responses to the AN after central nervous system injection of receptor-binding drugs for the dopamine system. The D2 agonist drug quinpirole increased appetitive responses to the AN in the fetus and neonate. Activity at the D2 dopamine receptor promotes expression of fetal behavioral responses that are similar to those shown by the neonatal rat at the nipple. Motor responses also were elicited in neonatal pups that normally do not attach to the artificial nipple. These findings suggest that the dopamine system may regulate oral capture of the nipple in the neonatal rat.

Animals↗
PubMed1998

Maternal cradling and infant nipple preferences in rhesus monkeys (Macaca mulatta).

This study investigated lateral biases in nipple preferences, maternal cradling, carrying, and retrieval in 41 rhesus macaque (Macaca mulatta) mother-infant dyads living in two captive social groups. Observations were made during the first 6 weeks of infant life using a combination of scan sampling and ad-libitum sampling techniques. Infants exhibited a significant left-nipple preference in the first weeks of life but the bias decreased with infant age. Mothers showed a left-arm bias in carrying their infants but no significant lateral bias in cradling or retrieval. Our results suggest that the left-side cradling bias reported in studies of humans and some other primates reflects a bias in the infant's nipple preference rather than in maternal behavior. The infants' preference for the left nipple is consistent with both Salk's (1960) heartbeat hypothesis and with more recent hypotheses linking this lateral bias with brain asymmetry and hemispheric specialization for mother-infant communication.

Age Factors↗
PubMed1985

Do newborn rabbits learn the odor stimuli releasing nipple-search behavior?

Rabbit pups do not need to learn postnatally the pheromonal cues releasing nipple-search behavior. Pups delivered by caesarean section were able to attach to nipples as quickly as normally delivered controls in their first encounter with a lactating doe (Experiment I), and pups hand raised to Day 5 without postnatal experience of the nipple-search pheromone even showed an improvement in their reactivity to it similar to normally raised controls (Experiment II). However, 1-day-old pups could be conditioned during the first nursing episode to respond with nipple-search behavior to artificial odors painted on the mother's ventrum (Experiment III). Finally, pups conditioned on Day 1 but subsequently raised by hand or normally nursed showed retention of the conditioned responsiveness when tested on Day 5 (Experiment IV). These experiments suggest that although rabbit pups are capable of rapidly associating odors with suckling, they do not appear to depend on this ability under normal nursing conditions.

Animal Population Groups↗
PubMed1985

The contribution of the olfactory and tactile modalities to the nipple-search behaviour of newborn rabbits.

By performing uni- and bilateral olfactory bulb lesions and uni- and bilateral transsections of the infraorbital branches of the trigeminal nerves in 2-day-old rabbits, it could be shown that: Both the olfactory and tactile modalities are essential for the successful performance of nipple-search behaviour. While bilateral bulbectomy completely eliminates searching, and hence suckling, unilateral bulbectomy has relatively little effect. Bilateral denervation of the muzzle does not eliminate searching, but pups are unable to suckle as they fail to show the mouth-opening component necessary for nipple attachment. In contrast to unilateral bulbectomy, unilateral denervation of the muzzle results in a lateralization of head movements during searching, nipple grasping and nipple release.

Animal Population Groups↗
PubMed1999

A Case of Phyllodes Tumor with Bloody Nipple Discharge in Juvenile Patient.

We report a rare case of phyllodes tumor of the breast in a juvenile patient with bloody nipple discharge. An 11-year-old girl had a chief complaint of a palpable 5 cm well-circumscribed tumor with nipple discharge in the left breast. The histopathological diagnosis of the resected specimen was benign phyllodes tumor showing extensive areas of hemorrhagic necrosis. The bloody nipple discharge was caused by spontaneous infarction of the tumor. Preoperative ultrasonography and galactography were helpful in evaluating the mechanism of nipple dicharge from the tumor. Although phyllodes tumor must be differentiated from fibroadenoma, the present case was histopathologically identical to phyllodes tumor.

Journal Article↗
PubMed1984

Microbiologic efficacy of a surgically constructed nipple valve.

The efficacy of a surgically constructed nipple valve in preventing reflux of colonic bacteria into the small bowel was evaluated. The nipple valve significantly decreased the number of S. marcescens, a marker bacterium, in the small bowel when compared with plain ileocolic anastomosis. In this study, the nipple valve prevented the reflux of bacteria similar to an intact ileocecal valve which suggests that the nipple valve is an effective bacteriologic barrier and may be used as a substitute for the ileocecal valve in patients with short bowel syndrome.

Animals↗
PubMedDate not supplied

Prognostic significance of the white nipple sign in variceal bleeding.

The prognostic significance of the white nipple sign in variceal bleeding was evaluated prospectively in 203 separate admissions for bleeding esophageal varices in 145 cirrhotic patients. During all admissions a standardized protocol of management defined the failure of transfusion and vasoactive drugs (conservative measures) to stop bleeding and the occurrence of early rebleeding, at which time either emergency sclerotherapy or a staple transection of the esophagus was used. The finding of a white nipple in 18 admissions (9%) did not have predictive value as regards the failure of conservative measures to stop bleeding within 24 hours or rebleeding within 5 days, and there was no association with increased mortality. In one case, a white nipple was seen to occur after spontaneous cessation of a variceal venous spurt, suggesting it is a platelet-fibrin plug. The white nipple sign is diagnostic of a varix that has bled but has no adverse prognostic significance.

Aged↗
PubMed1999

Selective venous thrombolysis with the nipple-balloon catheter: comparative evaluation in vivo.

PURPOSE: To compare in an animal model of deep vein thrombosis, an intramural drug delivery catheter, the nipple-balloon catheter, with an occlusion balloon-infusion guide wire system. MATERIALS AND METHODS: Ten juvenile pigs were used for the study. Deep vein thrombosis was induced in both hind limbs by using a previously described technique. Heparin was administered 30 minutes later (2,500 IU intravenously) and bilateral thrombolysis was attempted with use of 8 mg of alteplase as a 0.25 mg/mL solution containing heparin 50 IU/mL (n = 10) and sodium/meglumine ioxaglate 40 mgI2/mL (n = 5). In one limb, the external iliac vein was endoluminally occluded, and 0.8 mL of alteplase was administered every 3 minutes through a multisideport infusion wire placed coaxially through the balloon catheter. On the other side, a nipple-balloon catheter was used: alteplase was injected as two 0.4-mL aliquots every 3 minutes in overlapping segments of the vessel. Blood samples were taken at predetermined intervals to determine the partial thromboplastin time and plasma fibrinogen concentration. At autopsy, the thrombus mass in the iliofemoral veins was measured, and the extent of residual thrombosis in the venous tributaries was graded at four sites. The heart and the lungs were also examined for thromboemboli (n = 5). Venous specimens were then subjected to X-ray fluorescence spectrometry to determine iodine content (n = 5). RESULTS: Bilateral thrombolysis could be successfully completed in all animals. No procedural problem associated with the use of the nipple-balloon catheter was encountered. The mass of residual thrombus in the axial veins was significantly lower in this group (P = .005). The drug delivery system used did not appreciably influence thrombolysis in the tributaries. Signs of macroscopic damage to the veins were not observed in any animal. None of the venous specimens had detectable levels of iodine. Small thromboemboli were found in the pulmonary circulation in three of five animals. Fibrinogen levels did not decrease during the procedure. CONCLUSIONS: The significantly lower residual thrombus burden associated with use of the nipple-balloon catheter suggests that the device may have the potential to be an effective delivery system for selective thrombolysis in veins.

Animals↗