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At least 685 records · Page 38Linked to original sources
PubMed2002

Stereotactic biopsy of the breast using an upright unit, a vacuum-suction needle, and a lateral arm-support system.

OBJECTIVE: This study evaluated the vacuum-suction needle (8- to 11-gauge) on an upright stereotactic machine with a lateral arm-support system. SUBJECTS AND METHODS: From July 1999 to August 2000, 185 core biopsies of the breast in 179 consecutive patients were planned in four institutions using 8- 11-gauge vacuum-suction probes on an upright stereotactic unit. Needles were stabilized and attached to the x, y, and z coordinates of the machines via a lateral arm-support system. Needle entry was made in the x-axis. RESULTS: Five patients were canceled, and 180 biopsies were performed in 174 patients while the patients were in seated (n = 171) and lateral decubitus (n = 9) positions. An average of 9.5 cores were taken (range, 5-26 cores). Targeting was successful in 176 (98%) of 180 cores. Lesions were missed because of movement associated with Parkinson's disease (n = 1), or because the mass was obscured (n = 1) or calcifications were not in the core specimen (n = 2). Findings in 152 (84%) of the biopsies were benign and 28 (16%) were malignant. Forty-one lesions underwent surgical excision and 106 underwent mammographic follow-up. Discordance was 4% (6/147). Complications included vasovagal reactions (n = 10, 5.6%), bleeding (n = 5, 3%), hematomas (n = 3, 1.7%), vomiting (n = 1, 0.6%), and technical failure (n = 1, 0.6%). CONCLUSION: Vacuum-suction needle core biopsies can be successfully performed on an upright stereotactic machine with a lateral arm attachment. Thinly compressed breasts and lesions located near the chest wall are well sampled. The vasovagal rate is higher than that on a prone table but is acceptable.

Adult↗
PubMedDate not supplied

Suction curettage for removal of retained intrathoracic blood clots and pleural lesions.

OBJECTIVE: To develop a thoracoscopic technique for correcting and/or removing an intrathoracic disease process using our existing operating room equipment and without a "small thoracotomy." METHODS AND PROCEDURES: Fifty-eight patients from October 1994 to April 1998 were prospectively studied. All were undergoing procedures involving the removal of a suspected benign (or infectious) pleural process or a retained blood clot. Three or four thoracic ports were used in all cases. Straight and curved suction curettage cannulae (with finger valve attachment) ranging from 8 to 16 French were available for use. Intermittent variable suction (between zero and 60 mm Hg) was used in all cases. Dependent upon the size and adherence of the lesion to be removed, the pressure was determined by the surgeon and regulated by the circulating nurse in the room. In each case, a trap system was used for retrieval of the specimen. One lung ventilation was used in every case, and when suction was used one of the ports was kept "open" to allow room air to enter the chest cavity. RESULTS: All patients in our series had their procedures completed without the need for any kind of open thoracotomy. Pre and postoperative diagnosis concurred in all 10 patients, and no complications occurred (specifically, no injury to the lung tissue or chest wall structures). Operative time ranged from 45 minutes to 180 minutes with a mean of 75 minutes. In all cases of a hemothorax, a cell saver system was used for an average of one unit of blood autotransfused per case. CONCLUSIONS: New techniques do not always require the purchase of new equipment. Tight hospital budgets are forcing surgeons to rely on redefining uses of instrumentation already available in solving surgical problems. We believe that the use of this instrumentation will provide another avenue for surgeons to successfully complete a procedure thoracoscopically without the need for a thoracotomy. It is through multidisciplinary conferences such as the Society of Laparoendoscopic Surgeons that ideas such as this are propagated.

Adolescent↗
PubMed1975

Suction drainage as an alternative to prophylactic antibiotics for hysterectomy.

A technic is described for suction drainage of the retroperitoneal space. Its use is evaluated in 150 private patients undergoing vaginal or abdominal hysterectomy and compared with 150 private control patients. This technic resulted in an average of 40 cc of fluid (range, 10-200 cc) being suctioned from the retroperitoneal space. With this technic febrile morbidity decreased from 26 to 11% for abdominal hysterectomies and from 32 to 8% for vaginal hysterectomies. Information is offered to explain the physiology of posthysterectomy infections, the effectiveness of prophylactic antibiotics, and the paradox of a febrile morbidity higher for vaginal than for abdominal hysterectomies. The risks in using prophylactic antibiotics routinely are stated, and suction drainage is suggested as a preferable alternative.

Adult↗
PubMed1975

A simplified neck suction device for activation of carotid baroreceptors.

Application of negative neck pressure is a valuable research technique for activation of carotid baroreceptors in man, but its use has been limited because a simple, effective, comfortable neck suction chamber has not been available. We have developed a new neck suction device which may have significant advantages over earlier models. Construction details are illustrated for this chamber which has the following attributes: (1) it is simple and inexpensive to construct, (2) one model fits most adults in relative comfort, and (3) the design of the chamber permits rapid initiation of neck suction to preselected levels leading to stimulus-related cardiac slowing and arterial hypotension.

Blood Pressure↗
PubMed1998

Use of the PumpVac Plus Suction Irrigation System at Gynecologic Endoscopy.

At both laparoscopy and hysteroscopy, controlled movement of fluids is necessary. In addition, at laparoscopy, suctioning of accumulated smoke from lasers or electrosurgery is an essential venting technique to enhance visibility. This chapter will describe and discuss a unique, simple, cost-effective system that can be used for both hysteroscopy and laparoscopy to accomplish movement of fluids and management of smoke. Aquadissection or hydrodissection has been used for many years as an adjuvant to operative laparoscopy.' It has been found useful for operative laparoscopic treatment of conditions such as endometriosis, pelvic adhesions, and tubal obstructron. Most current systems are cumbersome, wastefully use large volumes of fluid, and often require a mechanical pump for pressurizing the fluid suction and irrigation systems. Usually, during combined laparoscopy and hysteroscopy, a separate system is used for accomplishing uterine distention when fluids are used for the hysteroscopic portion of surgery. The Pump Vac Plus can be used for both hysteroscopic distention and laparoscopic suction and irrigation. This article will describe our techniques for using the Pump Vac for both of these endoscopic approaches.

Journal Article↗
PubMed1992

Large-volume suction lipectomy: an analysis of 108 patients.

Suction lipectomy was initially advocated for the treatment of localized collections of fat and for the removal of less than 1500 ml of material. However, many patients wished to have multiple areas treated or had diffuse collections of fat. In such instances, the removal of over 1500 ml of material and circumferential lipectomy are necessary to provide optimal aesthetic results. However, when over 1500 ml of material is removed, anesthetic requirements, fluid replacement, and treatment of blood loss become important if the operation is to be performed safely. We have treated 108 patients who had over 1500 ml of material removed. Eight-eight percent of the patients were female; 12 percent were male. Using the body-mass index, 3 percent of patients were underweight, 70 percent were normal weight, and 27 percent were overweight. Fifty-five patients (51 percent) had 1500 to 2499 ml of material removed, 26 patients (24 percent) had 2500 to 3499 ml removed, 16 patients (15 percent) had 3500 to 4499 ml removed, and 11 patients (10 percent) had over 4500 ml removed. All patients were treated in the hospital; 44 percent were admitted after surgery. A total of 227 units of autologous and 2 units of homologous blood were transfused. As measured by a computerized monitor, the average amount of blood in the material removed from thighs was 30 percent; from abdomens, the blood loss was 45 percent. The aesthetic results were generally excellent. No complications were encountered. A few patients developed undesired sequelae, the most common of which was seroma formation, which occurred in 19 percent of those who had suction of abdominal-wall fat. We believe that large-volume suction lipectomy is safe and efficacious, provided attention is directed to such important aspects of patient care as anesthesia, fluid replacement, and blood loss.

Adolescent↗
PubMed1992

A double-blind comparison of adhesive bandages with the use of uniform suction blister wounds.

BACKGROUND AND DESIGN: The assessment of cutaneous wound healing in humans has been hampered by the inability to evaluate multiple wounds with identical origins, treatment histories, and sizes. There have been no double-blind wound healing studies in humans that compared one wound dressing with another. The purpose of this study was to determine if identical suction blister wounds could serve as a model to evaluate and compare wound healing and overall cosmetic appearance of wounds treated with commercially available adhesive bandages. In a double-blind study, we compared superficial skin wounds of identical depth and diameter, created on the forearms of five human subjects by means of a suction blister device. The wounds were covered by two common, commercially available adhesive bandages or a copolymer of polyurethane membrane type of wound dressing. We compared the degree of reepithelialization, erythema, skin depression, and overall cosmetic appearance of wounds with respect to the specific adhesive bandages used. RESULTS: The wounds covered with the copolymer of polyurethane membrane were judged to have better overall appearance and advanced reepithelialization compared with identical wounds covered by the other wound dressings. With the use of x5 magnification for viewing the wounds on the final day of evaluation (between days 18 and 22), the wounds treated with the copolymer of polyurethane membrane were judged to be the least depressed wounds in fields of identical wounds in the three subjects studied. Concordance between the evaluators' "blinded" assessments was uniform, and no discrepancy between the evaluators' assessments occurred at any of the time points. CONCLUSION: Identical wounds created with a suction blistering device can be used reliably to detect differences between the performances of wound dressings in healing superficial wounds. Superficial cutaneous wounds covered with a copolymer of polyurethane dressing demonstrated a superior rate of reepithelialization, less depression, and a better overall cosmetic appearance than wounds covered with two commercially available adhesive bandages.

Adhesives↗
PubMed1992

Suction-drain injury in a public wading pool--North Carolina, 1991.

On June 16, 1991, a 3-year-old girl playing in a public wading pool sat on the pool's uncapped suction drain. The child appeared to be stuck on the drain, and the pool attendant quickly turned off the pool's suction pump. As a consequence of sitting on the drain, the child sustained severe internal injuries requiring surgical repair. This report summarizes the investigation of this incident by the North Carolina Department of Environment, Health, and Natural Resources (DEHNR) and describes safety measures to prevent injuries among children caused by pool suction drains.

Child, Preschool↗
PubMed1991

Calcium channel blockers and the CVS reflex responses during lower body suction.

Nine normal men (mean age 27.6 yr) were exposed to continuous lower-body suction pressure (LBSP) of -20 to -50 mmHg (for 5 min at each level) on four different occasions after having consumed a single oral therapeutic dose of either diltiazem, nifedipine, verapamil, or a placebo, randomly, in a single blind manner. The suction was applied at 12.30 pm in all experiments, while the medications were administered in such a manner so that their expected peak plasma levels would have been achieved at the time of suction application. The cardiovascular reflex effects commenced at a pressure of -30 mmHg, and peaked at -50 mmHg. The increases in the heart rate for all treatments at -50 mmHg was statistically similar (about 16-20 beats/min). The systolic BP fell by about 9 mmHg for the placebo experiments, and this change was not different from the changes produced by the 3 Calcium channel blocker treatments. The diastolic BP increase was about 3 mmHg. The Cardiac index did not vary significantly. Our results suggest that the commonly used Ca++ channel blockers do not adversely affect orthostatic tolerance.

Adult↗
PubMed1991

Suction lipoplasty: a report on complications, undesired results, and patient satisfaction based on 3511 procedures.

Suction lipoplasty comprising 3511 procedures in 2009 patients was followed up prospectively for 6 to 12 months over a 5-year period. Eighty-eight percent of the procedures led to patient satisfaction and 3.4 percent led to dissatisfaction. Males were more dissatisfied than females. No mortality, deep thrombosis, pulmonary embolism, hypotension, or respiratory distress (fat emboli syndrome) was registered. Excessive bleeding and complications from anesthesia were the most common general complications. No hematoma, skin slough, or damage to adjacent organs occurred. Hypertrophic scarring and skin problems caused by external factors were the most common local complications. Only one clinical bacterial infection occurred. Three hundred and seventy-nine undesired results were registered by the 6-month follow-up, and 213 revisions because of asymmetry, underresection, or skin problems were performed. A total of 121 procedures unexpectedly required secondary suction, skin excision, or fat grafting. Forty-five sequelae were not corrected by revisions. Medial thigh, buttock, ankle, and facial suction emerged as the most difficult locations with regard to the results and complication rate. The age group 20 to 49 years emerged as the least troublesome.

Adult↗
PubMed1991

Suction curettage with a tissue trap compared with sharp curettage for tissue sampling.

Recent reports have shown that various endometrial sampling techniques are comparable to each other. This study showed that suction curettage utilizing tissue traps is superior to sharp curettage in terms of adequacy of sampling. The results show that adequate tissue was obtained in all 114 cases, regardless of which type of curettage was utilized first. However, when sharp curettage was the second procedure, only 43 of 57 procedures yielded adequate tissue, whereas when suction curettage was the second procedure, 56 of 57 procedures yielded adequate tissue. Suction curettage utilizing tissue traps was more thorough than sharp curettage.

Curettage↗
PubMed1989

Suction lipoplasty: biohazardous aerosols and exhaust mist--the clouded issue.

With the increased popularity of suction lipoplasty procedures, attention has been focused on their safety. One significant concern involves the rotary vane aspirators used to provide the suction required for the procedure. A series of experiments was carried out to determine whether aerosols are produced during the use of a rotary vane aspirator, since aerosols are known to be hazardous under appropriate conditions. Using a viable strain of Pseudomonas aeruginosa, we challenged the system through the suction port, and the exhaust from the aspirator was then cultured in a particle sampler. Results indicate that viable pathogens are released from the exhaust in physiologically significant particles capable of penetrating to the level of the alveolus in the normal human lung. These infectious particles were produced for 3 hours after the initial challenge. When an appropriate filtration device was attached to the aspirator outflow, the aspirator pump and environment were protected. In the absence of an appropriate filtration device, the aerosolized particles may constitute a hazard to patients or medical workers in the vicinity of the aspirator.

Aerosols↗
PubMed1989

[The development and disappearance of electrical current in frog heart injuries induced by suction electrodes].

Origin and extinction of current due to damage caused by suction electrode on frog heart was studied. By means of epicardial and intracellular leads it was found out that this demarcation current manifests itself only in a very limited space around the place of suction and does not differ from the current due to damage caused by restraint in the coronary bloodstream in hearts of warm-blooded or in myocardial infarction in man. Membrane depolarization degree is diminishing from the place of suction with all accompanying manifestations also in intracellular recordings. The main cause of these changes is the local raised concentration of extracellular potassium ions and the participation of sodium and calcium ions is also being considered. It was proved that this simple biological model of current due to damage is suitable for the study of some changes in electrical heart area and in this way depolarizing and repolarizing parts of the electrocardiogram also in the ischemic heart disease in man.

Animals↗
PubMed1989

Transcervical uterine cultures with a new endometrial suction curette: a comparison of three sampling methods in postpartum endometritis.

The potential for cervicovaginal contamination has precluded direct sampling of the endometrial cavity and has led to the development of multi-lumen protected catheter systems, among other techniques. The extent of this presumed contamination was examined using three different techniques in 55 postpartum women with the diagnosis of endometritis. Each woman had the endometrium sampled with an unprotected cotton-tipped swab, a double-lumen catheter with brush, and a flexible endometrial suction curette. A statistically larger number of bacterial species was recovered with the cotton swab (2.4) than with the double-lumen catheter (1.3) or the suction curette (1.7) (P less than .001). A difference was also noted between the double-lumen catheter and the suction curette (P = .006); however, this represented less than one-third of a single bacterial species. The larger number of bacterial species recovered by the unprotected methods was found to result not from cervicovaginal contamination, as suspected, but from a significant increase in the recovery of bacteria commonly regarded as potential pathogens, such as Bacteroides bivius, Streptococcus faecalis, Proteus mirabilis, and Bacteroides melaninogenicus.

Dilatation and Curettage↗
PubMed1975

Suction blister transplantation for leg ulcers.

Application of suction blister transplants to leg ulcers is an alternative symptomatic treatment to split-skin grafting, i.e. "pinch-grafting". Blisters are produced by the suction device Dermovac at a suction pressure of 250-300 mmHg for 1-2 hours. The blister-roofs are cut off at the periphery and placed on the granulation tissue of the ulcer. The healing time for leg ulcers was 10-14 days. Excellent epithelialization was seen in 10 out of 12 ulcers. The advantages of the method are, that it is easy to perform, no scarring is produced, and the procedure is painless.

Blister↗
PubMed1982

Significant hemorrhage as a complication of hydraulic suction biopsy of the esophagus.

An histological diagnosis of gastroesophageal reflux disease is more accurately made with biopsies obtained by the hydraulic suction method than by endoscopic biopsy forceps. We report significant hemorrhage as a complication of biopsying the esophagus by hydraulic suction. This bleed was explained by an aberrantly large vessel in the lamina propria of an otherwise histologically normal esophagus. This risk of hemorrhage in our extensive experience is less than 0.1%, and hydraulic suction biopsy can be regarded as a safe technique and the optimal method of obtaining histological information in the esophagus.

Adult↗
PubMed1994

[Intrabullar suction-adhesion in a case of giant bulla of the lung with steroid--department intractable bronchial asthma].

We successfully reduced a giant bulla using an intrabullar suction-adhesion method in a case of steroid-dependent intractable bronchial asthma. A 53-year-old woman was hospitalized with an asthma attack, and suffered pneumonia in the area surrounding a giant bulla after remission of two episodes of asthma. After the pneumonia, we found that the giant bulla had increased in volume. It was readily apparent that the bulla should be reduced. At that time a right side pneumothorax occurred by accident, which improved the chest drainage. Immediately after that, we inserted a chest drainage tube directly into the bulla and instilled fibrin glue through the tube into the bulla. Intrabullar suction and bronchial embolization via bronchofiberscopy has been used to patients with inoperable giant bullae of the lung. If intrabullar suction with fibrin glue alone can reduce giant bulla, it would offer another option to patients with inoperable giant bullae without the risk of a surgical procedure.

Asthma↗
PubMed1994

[Effect of change in refraction by increasing intraocular pressure with the suction cup method on pattern reversal VECP].

When IOP is increased by the suction cup method, refraction changes will occur, depending on the shape of the cup and the height of the IOP increase. Similar refraction changes were simulated in six healthy volunteers by employing spherical and cylindrical glasses during pattern-reversal visual evoked cortical potential (VECP) with various check sizes and amount of contrast. While the pattern-reversal VECP latencies were not influenced, the amplitudes were reduced considerably. By using contact lenses and a suitably shaped suction cup, refraction changes could be compensated for. In 22 healthy volunteers pattern-reversal VECPs were derived with and without the application of contact lenses with artificially raised IOP. A comparison showed that the amplitudes differed significantly. Without contact lenses a negative pressure of more than 40 mmHg resulted in a drop in the amplitudes with a plateau formed between 80 and 120 mmHg. With compensation by contact lenses the amplitudes are found to be unaltered or even slightly increased until a negative pressure of 120 mmHg is reached in the suction cup, after which they drop. Plotting the pattern-reversal VECP amplitudes (obtained with refraction changes being compensated for by contact lenses) against ciliary perfusion pressure, one finds the characteristic curve described by Ulrich et al., suggesting an autoregulative capacity between 15 and 20 mmHg in healthy persons. The latencies, which remain uninfluenced by refraction changes, are also not altered within an IOP increase of 15-20 mmHg.

Adult↗