Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “NIPPLE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed1995

Early results with split-cuff nipple ureteral reimplants in urinary diversion.

PURPOSE: A split-cuff nipple technique was developed for ureteral reimplantation in urinary diversion. MATERIALS AND METHODS: Ureteroenteric anastomosis was performed with a uniform split-cuff nipple technique in 46 ureters of 24 adult patients undergoing various forms of conduit or continent urinary diversion. The outcome of 42 reimplants in 22 patients (mean followup 22.5 months, minimum 10) was analyzed. The technique is described in detail. RESULTS: Reflux was prevented in 97.6% and 95% of cases at initial and 2-year followup, respectively. Neither anastomotic leakage nor obstruction occurred. There were 2 episodes of pyelonephritis in the early postoperative period. Results are compared with those in the literature of ureteroenteric anastomoses in general and of various split-cuff nipple techniques. CONCLUSIONS: The technique is easy to perform. Favorable early results warrant continued use of the procedure. Long-term followup in a larger number of patients is indicated.

Adult↗
PubMed1995

Interposed jejunal segment with nipple valve to prevent reflux in biliary reconstruction.

BACKGROUND: Resection is the accepted management of a choledochal cyst. However, the debate continues regarding the optimal method of biliary reconstruction. The Roux-en-Y limb is used most frequently, but concerns have been raised about this method due to associated peptic ulcer disease, cholangitis, and poor growth. A method of reconstruction using an interposed segment of jejunum with a nipple valve placed between the common bile duct and the duodenum has been proposed. STUDY DESIGN: We have reviewed a series of 12 children requiring biliary reconstruction for choledochal cyst (11 children) and biliary stricture (one child). All had reconstruction with a nipple valve, and ten had an interposed segment of jejunum. RESULTS: All of the children are alive and have had follow-up evaluation from six months to 8.5 years (median of three years). Sequential examinations with ultrasound and biliary excretion scans have shown no evidence of obstruction, and liver function tests have remained normal. Three children have had cholangitis. One child had a brief episode in the perioperative period. The second child had cholangitis 16 months postoperatively, and the third child had multiple episodes of cholangitis. These latter two children were unique. One had Alonso-Lej type IV choledochal cyst with intrahepatic dilatation, which persisted after reconstruction. The other had a prior diversion with a Roux-en-Y limb from the gallbladder after resection of a choledochal cyst and had multiple episodes of cholangitis before reconstruction. These episodes are now controlled with chronic antibiotic suppression. Postoperative complications were limited to two episodes of obstruction of the small bowel requiring lysis of adhesions. No child has had peptic ulcer disease. These children have grown well after reconstruction, except for three with multiple anomalies or chronic pancreatitis. CONCLUSIONS: Biliary reconstruction with a jejunal interposition containing a nipple valve can be performed safely with a low incidence of complications. It offers a more physiologic method of reconstruction and a low incidence of postoperative cholangitis.

Adolescent↗
PubMed1996

Antireflux nipples or afferent tubular segments in 70 patients with ileal low pressure bladder substitutes: long-term results of a prospective randomized trial.

PURPOSE: Intestinal low pressure orthotopic bladder substitutes have no major coordinated contractions during micturition. Therefore, the importance and type of reflux prevention were assessed in a prospective randomized study. MATERIALS AND METHODS: A total of 70 patients with an ileal low pressure bladder substitute was randomized to receive a nipple valve or an isoperistaltic afferent ileal tubular segment for reflux prevention. RESULTS: After median observation times of 57 and 45 months, respectively, the results regarding functional reservoir capacity, incidence of infected urine, urinary continence, voiding habits and serum electrolytes, urea and creatinine were similar in both groups. Severe upper tract dilatation due to ureteroileal or nipple stenosis occurred in 9 of 67 evaluable reno-ureteral units (13.5%) in patients with antireflux nipples and in 2 of 69 (3%) in patients with an afferent tubular segment. This difference in favor of the latter cases is significant (Fisher's exact test p < 0.03). Video urodynamics did not show reflux of contrast medium during voiding in either group. A simultaneous intravesical, intra-abdominal and intrapelvic pressure increase was noted during the Valsalva maneuver. CONCLUSIONS: While long-term upper tract preservation by an afferent tubular ileal segment must be confirmed in larger patient series with longer followup, our results indicate that reflux prevention in patients with orthotopic low pressure bladder substitutes is not a major concern and does not justify the use of antireflux mechanisms with a high complication rate.

Adult↗
PubMed2001

Hyperkeratosis of the nipple and areola: report of 3 cases.

BACKGROUND: To date, approximately 43 cases of hyperkeratosis of the nipple and areola have been reported, most of which have been sporadic. OBSERVATION: We describe 3 patients with this dermatosis who were encountered in the outpatient clinic of the Department of Dermatology at the American University of Beirut Medical Center, Beirut, Lebanon, within a 1-year period. CONCLUSION: Hyperkeratosis of the nipple and/or areola may be more common than what has been reported in the literature. We propose a revised classification for the condition.

Adult↗
PubMed1988

Imaging evaluation of the human nipple during breast-feeding.

A new real-time ultrasound technique was employed to document in vivo the anatomic characteristics of the human nipple during breast-feeding. The study quantifies human nipple deformation and provides a description of the mechanics of normal sucking derived from 16 normal infants aged 60 to 120 days. This in vivo imaging technique has great potential value in the study of feeding dysfunction.

Adult↗
PubMed1989

A new surgical localization technique for biopsy in patients with nipple discharge.

In a series of 12 patients with bloody nipple discharge, a new technique of mammary ductal localization was used to identify the duct responsible for the discharge and assure its complete removal for pathological diagnosis. This procedure utilizes a 30-gauge anterior chamber needle that is gently advanced into the offending duct, and methylene blue dye is injected to outline the involved duct for easy dissection though a circumareolar incision. This provides the pathologist with an intact specimen and avoids the problems associated with specimen roentgenography or loss of a ductal probe during the procedure. Because we feel that all patients with a bloody nipple discharge warrant a biopsy, this procedure provides a safe, rapid, effective method and allows the biopsy to be done on an outpatient basis.

Biopsy, Needle↗
PubMed1997

Scrape cytology of pemphigus vulgaris of the nipple, a mimicker of Paget's disease.

A case of histologically and immunocytochemically confirmed pemphigus vulgaris of the nipple examined by scrape cytology is reported. The scrape cytology showed isolated and somewhat loosely clustered cells with basophilic cytoplasm and vesicular hyperchromatic nuclei dysplaying prominent nucleoli, suggesting Paget's disease of the nipple. However, histological examination of the resected tissue together with the direct immunofluorescence technique for demonstration of in vivo-bound immunoglobulin to epithelium confirmed the diagnosis of pemphigus vulgaris. The use of an immunoperoxidase stain for IgG on the Papaniolaou-destained smear also gave a positive reaction on the cell membranes and provided a precise cellular diagnosis of the lesions. Cytodiagnostic pitfalls of these rare breast lesions are discussed, as well as the diagnostic value of immunocytochemistry.

Aged↗
PubMed1984

Paget's disease of the nipple. Alternative management in cases without or with minimal extent of underlying breast carcinoma.

Six cases of Paget's disease of the nipple without clinical or mammographic evidence of a breast mass are described, two without underlying carcinoma of duct origin, and four with very limited duct carcinoma in situ of the most distal lactiferous ducts. Ultrastructural and immunohistochemical studies on these cases demonstrate that Paget cells arise in situ and invalidate the prevalent "epidermotropic" theory of histogenesis. Paget's disease of the nipple is considered to be an independent in situ carcinoma and part of the general phenomenon of multicentricity in breast cancer. A therapeutic option of conservative surgical intervention and follow-up is described for five of these select patients, all of whom are presently without evidence of disease with an average follow-up of 50 months (range, 30-69 months).

Adult↗
PubMed1994

Management of ductal carcinoma in situ with nipple discharge. Intraductal spreading of carcinoma is an unfavorable pathologic factor for breast-conserving surgery.

BACKGROUND: Surgical management of ductal carcinoma in situ (DCIS) has been a controversial issue in the selection of breast-conserving surgery as a method of treatment. The definition of intraductal spreading of carcinoma becomes an important factor in the decision making process, but little is known about how much intraductal extension influences the spreading of tumor in the whole breast. To define any unfavorable pathologic factors existing in limited surgery for patients with DCIS, the authors investigated histopathologic characteristics using a sequential slicing of tissues. METHODS: Duct-lobular segmentectomy, a limited surgery, was performed on 110 patients with a bloody nipple discharge. Six patients with invasive carcinoma and 17 patients with DCIS subsequently received a total mastectomy. The specimens obtained by segmentectomy and mastectomy were histopathologically examined. Using subserial sections, the authors examined the relationship between intraductal spreading of carcinoma in the segmentectomy specimens and carcinoma residue in the mastectomy specimens. RESULTS: Among 16 mastectomy specimens, the authors found residual DCIS in 6, and atypical ductal hyperplasia in 4. Intraductal spreading of carcinoma was detected in 8 of 16 segmentectomy specimens. Six of eight patients with intraductal spreading had residual DCIS. The other two patients had atypical hyperplasia in breasts. No residual DCIS was detected in the other eight patients without intraductal spreading. Among 12 patients under observation who did not have a mastectomy, invasive carcinoma subsequently developed in 3. Two of three patients had intraductal spreading in segmentectomy specimens. Only 1 of 10 patients without intraductal spreading, however, developed carcinoma. CONCLUSIONS: Intraductal spreading of carcinoma is an unfavorable pathologic factor in breast-conserving surgery for patients with ductal carcinoma in situ with nipple discharge.

Adolescent↗
PubMed1979

Melanoma of the nipple and areola.

Fourteen primary melanomas arising in the nipple and areola of the breast were treated by mastectomy and axillary dissection. Four patients had axillary lymph node metastases and all were dead within 3 years of their operation, while the 10 patients with no axillary node involvement were free from recurrent disease 5 years after their operation. On the basis of clinical and anatomical studies, it is suggested that a wide local excision without mastectomy is adequate for the treatment of nipple and areola melanomas.

Adult↗
PubMed1990

Preoperative cytology and mammography in patients with single-duct nipple discharge treated by surgery.

Microdochectomy has been the routine management for single-duct nipple discharge. Our review of 176 consecutive patients surgically treated between 1975 and 1988 revealed eight patients with in situ carcinomas and seven with infiltrative carcinomas. Seventeen patients had multiple papillomas, two had atypical hyperplasia and two had atypical epitheliosis. Case selection for surgery has recently been advocated. In our study, nipple discharge cytology was helpful in 67 per cent of cases with underlying malignant pathology. Mammography was found to be unreliable, alerting suspicion in only two of 15 cases.

Adolescent↗
PubMed2005

Breast-conserving surgery with resection of the nipple-areola complex for subareolar breast carcinoma.

INTRODUCTION: Breast-conserving therapy for centrally located tumours has in the past been viewed with reservation, but is now an accepted treatment. There is little published evidence, however, to show that it is safe and cosmetically acceptable. METHODS: In a prospective investigation carried out between 1996 and 2002, 44 women had surgery for 45 breast carcinomas with suspected nipple involvement. The breast was conserved and the nipple-areola complex removed. Secondary mastectomy was performed in three women because the tumour was found to reach the resection margin. Forty-one women underwent further observation. The mean tumour size at the time of operation was 18 (range 4-50) mm. Six women received preoperative chemotherapy. RESULTS: Histologically, there were seven preinvasive and 35 invasive cancers. No local failure had occurred at a median follow-up of 51 months. Six women developed distant metastasis, of whom five died. The mean score for cosmetic results (evaluated on a scale of 1-5 where a score of 1 was excellent) was 1.5 for patients and 1.7 for physicians. CONCLUSION: Breast-conserving therapy is a safe and cosmetically acceptable alternative to mastectomy for subareolar breast cancer.

Adult↗
PubMed2003

Detection of chromosomal aneusomy by fluorescence in situ hybridization for patients with nipple discharge.

BACKGROUND: Breast carcinoma and precancer are believed to start in the lining of the milk duct or lobule. Ductography and fiberoptic ductoscopy (FDS) are used to identify abnormal intraductal lesions, although it is difficult to distinguish malignant from benign cases. Therefore, we studied the clinical usefulness of fluorescence in situ hybridization (FISH) analysis of a numerical aberration of chromosomes (aneusomy) using ductal lavage from patients with nipple discharge. METHODS: We applied ductography and FDS to 90 women who had nipple discharge. Ductal lavages obtained from patients with positive ductography and/or FDS findings were subjected to cytology and FISH analysis using centromere probes for chromosomes 1, 11, and 17. Patients with samples that showed aneusomy in at least one of the three chromosomes were diagnosed as positive. RESULTS: Histologic evaluation revealed 54 benign lesions and six malignancies. The sensitivity, specificity, and diagnostic accuracy were 33.3%, 88.9%, and 83.3%, respectively, for cytology and 100%, 100%, and 100%, respectively, for FISH. CONCLUSION: The results demonstrated that FISH has a diagnostic accuracy comparable to cytology. This technique has 100% specificity is making a definitive diagnosis of malignancy in patients with indeterminate cytologic results, suggesting that FISH diagnosis can be a good adjunct to cytology.

Adult↗
PubMed2001

Cytodiagnosis of nipple discharge: a study of 602 samples from 484 cases.

To find out the gross and microscopic differentiating features between nipple discharges (ND) due to various breast lesions, smears of 602 ND samples from 484 cases were reviewed by one of the investigators (D.K.D.). The reviewed cytodiagnoses were as follows: benign nipple discharge (59.1%), inflammatory ND (6.5%), ?papillary lesions (2.5%), papillary lesions (20.6%), papillary lesions with atypia (3.8%), duct cells with atypia (0.2%), suspicious for malignancy (0.5%), malignant ND (1.2%), and inadequate (5.6%). Following review, samples with epithelial abnormalities (?papillary lesion, papillary lesion with and without atypia, duct cells with atypia, suspicious for malignancy, and malignancy) increased from 16.6% to 30.4% of adequate samples (P < 0.0001). 37.9% unilateral ND samples showed epithelial abnormalities, as opposed to 18.9% of bilateral ND samples (P < 0.0001). Bloodstained ND showed epithelial abnormalities in 41.5% samples, as compared to 22.1% of ND with other specified gross characteristics (P < 0.0001). The samples with epithelial abnormalities differed significantly from benign and inflammatory ND in respect of frequency of benign duct cells, duct cells with atypia, papillary clusters with or without atypia, malignant cells, columnar cells, red blood cells, inflammatory cells, and background lipid vacuoles (P < 0.01 to < 0.0001). The ND samples with suspicious and malignant cytology, besides the presence of malignant cells (P < 0.0001), differed significantly from rest of the lesions in respect of foam cells (P < 0.0001), red blood cells (P < 0.01), and inflammatory cells (P < 0.05). When compared with histopathological diagnosis in 20 cases, the benign or malignant nature of the lesion was correctly identified in ND in 80% cases. The ND cytologies in 7 histologically proved malignant cases were malignancy (3 cases), suspicious for malignancy (1 case), papillary lesion with atypia (1 case), papillary lesion (1 case), and benign ND (1 case).

Breast Diseases↗
PubMed1990

Cytology of papillary adenoma of the nipple: a case diagnosed on fine-needle aspiration.

A 45-yr-old woman being treated for carcinoma of the uterine cervix was found to have a right nipple nodule. Fine-needle aspiration of the nodule showed a very cellular smear with clusters of ductal cells and many scattered naked nuclei. Papillary clusters with and without a vascular core also were present and enabled a cytological diagnosis of papillary adenoma. Excision of the lesion demonstrated the histopathologic features of a papillary adenoma of the nipple.

Biopsy, Needle↗
PubMed1982

Differential effects of upper gastrointestinal fill on milk ingestion and nipple attachment in the suckling rat.

Milk intake and nipple attachment behaviors were studied in the natural suckling situation after gastrointestinal preloading. Rat pups, deprived of their dam for 9 hr at 1, 10, or 20 days of age, were preloaded by gavage with volumes ranging from 2 to 16% of their body weight and returned to suckle. Preloads of artificial bitch's milk decreased the intake of mother's milk in a volume-related manner at all ages. At 1 and 10 days 4% preloads decreased milk intake without affecting attachment behaviors; larger preloads of 8 and 16% decreased intake and reduced the incidence of attachment. At 20 days of age small and large preloads decreased both incidence of attachment and milk intake. Preloads up to 8% of body weight had no effect on latency to attach at any age. Complete subdiaphragmatic bilateral vagotomy increased milk intake of 7-9 day-old pups fed automatically through an anterior mouth cannula in a nonsuckling situation. Vagotomy combined with spinal cordotomy (T2-T3) resulted in a synergistic hyperphagia and massive distension of the upper GI tract. The results indicate that suckling rats can control their intake of mother's milk while remaining attached to a nipple as early as 1 day of age. The suppression of ingestion in response to GI filling appears to be mediated by visceral afferent activity. Conversely, attachment behaviors are less affected by GI fill. This suggests that ingestive behaviors and attachment behaviors have different controls during the 1st 10 days of postnatal development.

Age Factors↗
PubMed2005

Proteomic analysis of nipple aspirate fluid using SELDI-TOF-MS.

Proteomic analysis of body fluids, including breast nipple aspirate fluid (NAF), holds promise to aid in early cancer detection. We conducted a prospective trial that collected NAF from women scheduled for diagnostic breast surgery to determine 1) the consistency of proteomic results, 2) protein masses associated with breast cancer, 3) subsets of women with a unique proteomic profile and 4) a breast cancer predictive model. NAF was collected preoperatively in 114 women and analyzed by SELDI-TOF mass spectrometry over a 3-50 kDa range using H4, NP and SAX ProteinChips. For all 3 chips, the same protein peaks were detected over 90% of the time in duplicate samples. The overall coefficient of variation was < or = 0.17% for each chip for the internal standard and < or = 0.29% for the unknown proteins. Seven candidate protein ion masses frequently expressed in NAF were identified. Three (5,200-H4, p=.04, 11,880-H4, p=.07 and 13,880 Da-SAX, p=.03) were differentially expressed in women with/without breast cancer. Protein expression differed between women with/without pathologic nipple discharge (PND), but the 5,200, 11,880 and 13,880 proteins remained associated with breast cancer even if PND samples were excluded. Subset analysis identified differences in expression between benign disease and DCIS and between DCIS and invasive cancer for the 5,200 and 33,400 Da proteins. The best cancer detection model included age, parity and the 11,880 Da protein, and excluded women with PND. 1) NAF proteomic analysis using SELDI-TOF is reproducible with the same sample set across different platforms, 2) differential proteomic expression exists between women/without breast cancer and 3) combining proteomic and clinical information that are available before surgery optimizes the prediction of which women have breast cancer.

Adult↗
PubMed1990

S100 protein in human mammary tissue--immunoreactivity in breast carcinoma, including Paget's disease of the nipple, and value as a marker of myoepithelial cells.

The expression of S100 protein, as assessed by immunohistochemistry, has been evaluated in 101 mammary carcinomas of various histological types, including Paget's disease of the nipple. S100 immunoreactivity was seen in 44 of 101 primary carcinomas, including in situ lesions. It was present in all histological types, with the exception of mucoid carcinoma. In the 33 cases with associated Paget's disease of the nipple, S100 expression was seen in the Paget's cells in six cases. S100 immunoreactivity has been suggested as a marker of myoepithelial cells, but in our hands staining of these cells is less consistent using the S100 antibody than with antibodies to actin. Furthermore, S100 protein is also expressed by some luminal epithelial cells. Therefore, in contrast to actin immunoreactivity, S100 immunoreactivity is not a reliable means of differentiating between luminal epithelial and myoepithelial cells. The possibility that staining with antibody to S100 protein may be affected by methods of fixation and immunohistochemical technique is discussed.

Biomarkers, Tumor↗