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PubMed1987

Nipple attachment and survival in neonatal olfactory bulbectomized rats.

Seven-day-old rat pups were olfactory bulbectomized, cortical lesioned, or sham lesioned, tested for nipple attachment 24 hr after surgery, then housed with their dam and weighed daily for the next 7 days. On the basis of histological findings the bulbectomized animals were divided into two subgroups: Those with removal of all olfactory bulb tissue (n = 9) and those in which some cellular elements remained in the lesioned area (n = 7). There were no differences between sham and cortical lesioned groups for nipple attachment behavior or weight gain. The completely bulbectomized pups did not show nipple attachment, lost weight each day, became moribund and had to be sacrificed by the fifth postoperative day. Deficits in incompletely bulbectomized pups were somewhat less severe and each of these survived and maintained or gained weight in the latter part of the test period. These results suggest that suckling may be critically dependent upon olfaction in 8 day or older pups and that significant savings in this behavior may be mediated by small remnants of olfactory bulb tissue.

Animals↗
PubMedDate not supplied

Delta-9-tetrahydrocannabinol during pregnancy in the rat: II. Effects on ontogeny of locomotor activity and nipple attachment in the offspring.

Either 15 or 50 mg/kg delta-9-tetrahydrocannabinol (THC) in sesame oil was administered by gastric intubation to gravid rats during the last two weeks of gestation. A pair-fed control group was administered the vehicle alone and allowed to eat and drink only the amount consumed by the 50 mg/kg group on the same gestation days. A nontreated control group was left undisturbed during pregnancy. All treated and control litters were fostered at birth to untreated dams. Intact litters from the two THC treated and the two control groups were tested at 3-day intervals from birth to 32 days of age for differences in locomotor activity. In addition, pups were tested for nipple attachment on days 2, 5, 8, 11, and 14 of age. There were no differences in locomotor activity among any of the groups although activity level varied during development. Pups from dams exposed to 50 mg/kg of THC, as well as the pair-fed controls, displayed significantly longer latencies to attach to a nipple. These results suggest that the impaired nipple attachment observed among the high-dose offspring was not a primary effect of THC, but rather was secondary to the significant reduction of food and water intake among the dams. The behavioral findings are discussed with respect to other animal and clinical reports of prenatal cannabinoid exposure.

Animals↗
PubMed1998

Further experience with split-cuff nipple ureteral reimplantation in urinary diversion.

PURPOSE: The intermediate followup results with split-cuff nipple ureteral reimplantation in larger numbers of urinary diversion patients are reviewed. MATERIALS AND METHODS: Split-cuff nipple ureteroenteric anastomosis was performed in 98 ureters of 51 adult patients. Mean duration of followup was 23 months (range 3 to 62). Two minor variations in technique compared to the original report are presented. RESULTS: Urinary reflux was prevented in 97.6 and 96.8% of cases at 1 and 2-year followup, respectively. Ureteroenteric anastomotic obstruction occurred in 3.1% of ureters by 3 months postoperatively. No cases of anastomotic leak or later obstruction occurred. Four episodes of acute pyelonephritis occurred in the early postoperative period. CONCLUSIONS: The split-cuff nipple ureteral reimplant technique in urinary diversion continues to provide excellent results with low rates of reflux or obstruction. The 2 described minor technical modifications further simplify the procedure.

Adult↗
PubMed1996

The everting suture: A new technical aid for ureteral nipple construction.

PURPOSE: A new technique using an everting suture to construct a ureteral nipple is described. MATERIALS AND METHODS: The method was used to create 28 ureteral nipples. A 2-zero silk suture is passed through the ureteral wall, transfixing the lumen, and is tied 5 cm. away from the ureteral wall. The ends are cut 10 cm. long. The suture is grasped within the ureteral lumen and with traction the ureter is everted in 1 step without trauma. RESULTS: The suture in smooth 1-step atraumatic eversion of the ureter in all cases. CONCLUSIONS: With this technique a well formed nipple of the desired length can be constructed.

Humans↗
PubMed1992

Ileal nipple for continence in cloacal exstrophy.

Since 1985, 7 children 2 to 17 years old with urinary incontinence from cloacal exstrophy underwent bladder augmentation and creation of a small bowel nipple at the bladder outlet. There were 3 genetic female and 4 genetic male patients being reared in the female role. In 3 early cases augmentation was done with small bowel, while gastric augmentation was used in 3 later cases and 1 had both types. Six patients became completely dry and they empty by intermittent self-catheterization. In the youngest patient the operation failed because the nipple became infarcted and disappeared. Reoperation will be performed after at least 1 year has passed. In cloacal exstrophy if there is insufficient local tissue to create a bladder neck and urethra, a reversed, catheterizable bowel nipple may be an option to consider.

Abnormalities, Multiple↗
PubMed1992

Urethral controlled bladder substitution: a comparison between the intussuscepted nipple valve and the technique of Le Duc as antireflux procedures.

A urethral controlled bladder substitute was constructed from a detubularized, double folded ileal segment in 40 male patients following cystoprostatectomy for bladder cancer. For reflux prevention patients were prospectively randomized to receive either an intussuscepted nipple valve or the ureters were implanted by the Le Duc mucosal trough technique. All patients had normal upper tracts preoperatively. Mean patient age, performance status and stage of cancer were comparable in both groups. Patients were evaluated 6 to 18 months postoperatively. In addition to history taking, assessment included excretory urography, ascending cystography and voiding cystourethrography. During the observation period all patients with nipple valves had normal radiographic appearance of the upper tracts without evidence of reflux. On the other hand, following the Le Duc procedure 12 of 38 renal units (31%) showed evidence of radiographic dilatation. Of the 12 units 11 had stenotic ureters and 1 had reflux. We conclude that nipple valves are more effective in reflux prevention and protection of the upper urinary tract in patients for whom an ileal neobladder is indicated.

Humans↗
PubMed1990

Mucosal ultrastructure of continent cecal reservoir for urine and its ileal nipple valve 2-9 years after construction.

Biopsy specimens from continent cecal reservoir for urine and from its ileal nipple valve were studied with electron microscopy after two to nine years of function in ten patients. In the colonic mucosa from the reservoir there was shortening of microvilli, in some cases with random orientation and numerical reduction-changes unrelated to the time from reservoir construction. Filamentous core rootlets were also randomly oriented and numerically diminished. Glycocalyceal bodies were present in most cases. Mucosal edema and reduced numbers of goblet cells were found in six cases and increased amount of collagen in two. In the ileal nipple valve mucosa there were no microvillous changes, but metaplastic formation of glycocalyceal bodies was interpreted as adaptation to physiologic conditions comparable with those in the reservoir's colonic mucosa. Collagen increase was found in two of the nipple valves. Neurogenic processes, enterochromaffin cells and Paneth cells were always well preserved in normal amounts in the cecal as well as the ileal mucosa.

Biopsy↗
PubMed2002

A modified intussuscepted nipple in the Kock pouch urinary diversion: assessment of perioperative complications and functional results.

OBJECTIVE: To assess the complications and continence of a modified intussuscepted nipple in Kock pouch urinary diversions. PATIENTS AND METHODS: From February 1992 to December 2000, 40 patients (mean age 55.8 years, range 21-74) with bladder cancer (24), gynaecological tumours (eight) or previous lower tract reconstructive surgery (eight) underwent cystectomy and cutaneous continent urinary diversion using the Kock pouch procedure. The first 23 procedures (group I) used Henriet's technique, whereas a modified fixation of the intussuscepted efferent limb was applied in the last 17 (group II). Complications and functional results (focused on continence and the upper urinary tract) were reviewed. RESULTS: The median (range) follow-up was 47.6 (10-124) months; one patient died 4 weeks after surgery. Early complications occurred in 11 (28%) and re-operation was required in two (5%). Of the late complications reported (38%), extussusception (8%) and efferent nipple prolapse (3%) only occurred in group I and required surgical revision. Late complications were minor (15%) including two asymptomatic refluxes and four with stoma sclerosis. The continence rate at 6 months in groups I and II were 78% and 94%, respectively (P = 0.13). CONCLUSION: Efferent limb prolapse and extussusception of the Kock pouch were the main complications requiring surgical revision. Applying the modified nipple fixation the complications can be reduced and reservoir continence improved.

Adult↗
PubMed2000

Nipple valve anastomosis for preventing recurrence of Crohn disease in the neoterminal ileum after ileocolic resection. A prospective pilot study.

BACKGROUND: Crohn disease may recur within months in the neoterminal ileum after ileocolic resection. Coloileal reflux may be a factor contributing to recurrence. This study tests the effect of a nipple valve anastomosis in preventing symptomatic and endoscopic neoileal recurrence. METHODS: Between January 1993 and April 1997, 25 patients with Crohn disease were resected and anastomosed with an ileocolic nipple valve. Postoperatively, the patients were given 5-aminosalicylic acid, 0.75-3 g/daily. Regular follow-up included the Harvey-Bradshaw index, ileocolonoscopy, and hydrocolonic sonography. RESULTS: After 1 year 2 of 25 patients (8%) had a symptomatic and 3 of 23 patients (13%) an endoscopic recurrence. There was no symptomatic neoileal recurrence between 1 and 5 years. After 3 years 6 of 13 patients (46%) had an endoscopic recurrence. After 5 years 4 of 11 patients (36%) had a symptomatic recurrence. CONCLUSIONS: These results may suggest that a nipple valve anstomosis delays and perhaps prevents symptomatic recurrence of Crohn disease in the neoterminal ileum.

Adult↗
PubMed2000

Establishment of an immunocompetent nipple valve anastomosis to prevent faecal reflux after ileocolic resection in dogs.

OBJECTIVE: To construct an immunocompetent nipple valve anastomosis (NVA) to exclude faecal reflux and compare it with an end-to-end anastomosis to see if it would prevent recurrent inflammation caused by intraluminal bacterial antigens in Crohn's disease. DESIGN: Laboratory study. SETTING: Teaching hospital, Germany. ANIMALS: Two groups of six beagle dogs each of which had NVA or end-to-end anastomosis. INTERVENTIONS: Construction of a NVA by stapling the telescoped nipple, and replacing the ileal mucosa on the valve by colonic mucosa; end-to-end anastomosis. MAIN OUTCOME MEASURES: Radiological, bacteriological, angiographic, and morphometric results. RESULTS: Absolute retrograde pressure-competence and free orthograde permeability of the NVA resulted in significantly lower intestinal bacterial counts compared with the end-to-end anastomosis (p < 0.05). Transposition of colonic mucosa was successful as demonstrated by revascularisation from the ileal nipple and looked normal on morphometry. CONCLUSION: If NVA were constructed in patients with Crohn's disease, recurrences should be prevented, which would verify the immunopathogenetic hypothesis of new inflammation.

Anastomosis, Surgical↗
PubMed2000

Method for intraoperative positioning of the nipple-areola complex in vertical scar reduction mammaplasty.

The desired shape and position of the nipple-areola complex may be difficult to achieve in vertical scar reduction mammaplasty when using the standard technique of preoperative marking of the so-called mosque-shaped areolar pattern of excision. We describe our modified approach of intraoperative final positioning of the nipple-areola complex by hiding the nipple-areola complex behind the closed vertical incision. Individual positioning at the final part of the operation allows for more predictable results and also for a calculated lower positioning, which enables balance of the potential bottoming-out of the breast, particularly in previously large ptotic breasts. We believe that this modification helps to further improve the results of vertical scar reduction mammaplasty by adding more possibilities for shaping and "last-minute" modifications intraoperatively.

Adult↗
PubMed1979

Subcutaneous mastectomy using an inferior nipple pedicle.

A technique for subcutaneous mastectomy is described which permits a reduction mammoplasty or mastopexy to be performed at the same time. The nipple is based on an inferior dermal pedicle. This appears to provide a safe blood supply to the nipple and safe cover for the prosthesis. The dermal pedicle for the nipple reinforces the submammary suture line and lessens the chance of extrusion of the prosthesis.

Breast↗
PubMed1994

Nipple feeding premature infants in the neonatal intensive-care unit: factors and decisions.

OBJECTIVE: To rank factors considered important by neonatal intensive-care unit (NICU) nurses in identifying hunger in infants weighing 1,800 g or less, to rank factors considered important in making decisions about nipple feeding such infants, to determine whether the two rankings varied among hospitals, and to identify the caregiver with the greatest influence over feeding decisions. DESIGN: Descriptive comparative survey. SETTING: NICUs of three metropolitan hospitals. PARTICIPANTS: Forty-seven NICU nurses in those hospitals. MAIN OUTCOME MEASURES: Nurses ranked factors indicating hunger in preterm infants and factors contributing to feeding decisions for such infants. RESULTS: Vigorous sucking, rooting, and crying were ranked as hunger cues. Nonnutritive sucking and a gestational age of 34 weeks or more were considered indicators of readiness to begin nipple feeding. The centrality of the nurse's role in feeding decisions was confirmed. CONCLUSIONS: Additional research is needed to determine whether nonnutritive sucking predicts nutritive sucking performance and to study the nurses' responses to infants who suck poorly or refuse to nipple feed.

Adult↗
PubMed2001

Effects of warmth on newborn rats' motor activity and oral responsiveness to an artificial nipple.

Temperature is a powerful regulator of the behavior and physiology of newborn altricial animals. The effects of warmth on newborn rats' oral responsiveness to suckling stimuli and spontaneous motor activity in a thermoneutral environment were investigated. Newborn rat pups' oral grasp responses to an artificial nipple and overall motor activity were recorded for 18 min. Near-term pups were delivered by cesarean section so that their 1st experiences with suckling stimuli could be observed. Experimental pups were warmed for 15 s every 2 min; control pups were not warmed. Warmed pups grasped the nipple fewer times than the not-warmed pups. However, oral grasp durations became longer for the warmed pups but not for the not-warmed pups. Warmth increased pups' motor activity but only while the heat was applied. Warmth in a thermoneutral environment may promote longer nipple attachment during newborns' early feeding experiences.

Animals↗
PubMed1991

[Tumor markers. Personal experience--screening of breast cancer by determining CEA in nipple discharge].

Secondary prevention, detection and treatment at an early stage, may be the only means of controlling breast cancer. This is rational behind screening for breast cancer. We have previously reported that CEA measurement in nipple discharge is a useful adjunct in the diagnosis of nonpalpable breast cancer. As an extension, a dot-immunobinding assay was developed to screen a large number of patients with nipple discharge for nonpalpable breast cancer. This article is a review of the current status of CEA assay in nipple discharge for mass screening of breast cancer. False positive and negative cases will be also described.

Adult↗
PubMed1989

Methysergide-induced nipple attachment depends on suckling experience in juvenile rats.

These studies were designed to investigate the links between pharmacological and behavioral procedures that facilitate suckling in weanling rats by assessing the effects of methysergide on nipple attachment behavior following experiential manipulations known to either promote or attenuate suckling. In the first experiment, methysergide failed to stimulate suckling in 25-day-old rats separated from their dam on Day 20, although it facilitated suckling in rats kept with the dam until either Day 24 or Day 25. In the second experiment, methysergide did not facilitate suckling in 35-day-old rats separated on Day 25, although rats separated on Day 30 or 34 were induced to suckle. In the third experiment, rats were housed with preweanling litters until Day 35 and then separated, housed with 25-day-old litters, or housed with preweanling litters for another 10 days. Rats in a fourth group remained with their dams until Day 35 and were then separated for 10 days. When tested at Day 45, nipple attachment was facilitated by methysergide only in the three groups that had received extended suckling experience. These results demonstrate that serotonergic inhibitory mechanisms modulate nipple attachment only when suckling experience is recent or extensive.

Animals↗
PubMed1988

[Evaluation of the free nipple method in cutaneous ureterostomy].

Cutaneous ureterostomies, in which urostomas were made by a free nipple method, were performed on 14 ureters of 10 patients. The free nipple method was evaluated from the standing point of stoma care. Catheterless cutaneous ureterostomy was applied in 8 of the 10 patients. Six patients had to have catheters, and the catheter was not needed in 2 patients. The reasons for reindwelling the catheter in 6 patients were: 1) the urostoma had come to be at skin level by disturbance of blood supply for the ureter, and 2) urine puddled just on the urostoma and oozed out between the skin and Varicare flange. It may be concluded that the free nipple method is not satisfactory as urostoma in cutaneous ureterostomy for advancing the quality of life of the ostomate. A further study is in progress.

Aged↗
PubMed1984

Volatile N-nitrosamines in baby bottle rubber nipples and pacifiers. Analysis, occurrence and migration.

A simple direct extraction method has been developed for rapid determination of volatile N-nitrosamines in rubber nipples and pacifiers. It consists of overnight extraction of the sample with dichloromethane in the presence of ascorbyl palmitate for N-nitrosation inhibition, filtration of the extract and rinsing of the samples with dichloromethane, concentration of the extract using a Kuderna-Danish concentrator, and final analysis by gas-liquid chromatography-Thermal Energy Analyser. The method gave excellent (80-100%) recoveries of various volatile N-nitrosamines that had been added to cut nipples or pacifiers at 20-80 micrograms/kg levels, and gave comparable or lower values than those obtained with another published method. The method is recommended for rapid screening purposes. A survey of 30 samples of various nipples and pacifiers indicated the presence of the following N-nitrosamines: N-nitrosodimethylamine (up to 70 micrograms/kg), N-nitrosodiethylamine (up to 88 micrograms/kg), N-nitrosodi-n-butylamine (up to 2796 micrograms/kg), N-nitrosopiperidine (up to 180 micrograms/kg), and N-nitrosomorpholine (up to 86 micrograms/kg). A more recent study, however, indicated a general decline in the levels of various volatile N-nitrosamines in these products. These N-nitrosamines were shown to migrate easily from the rubber products to liquid infant formula, orange juice and simulated human saliva.

Humans↗