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PubMed2004

Repetitive exposures to a surrogate nipple providing nutritive and non-nutritive fluids: effects on suckling behavior of the newborn rat.

Responsiveness to a surrogate nipple providing water, 0.1% saccharin, 10% sucrose, pedialyte, or milk was tested in naïve-to-suckling newborn rats during six 10-min exposures, one every 1.5 h over a 7.5 h period. Across a succession of exposures, newborn rats repeatedly attached to and ingested milk from a surrogate nipple, yielding significant body weight gain and increased concentration of blood plasma glucose. Initially, pups ingested considerable amounts of saccharin and sucrose, but then dramatically decreased their consumption of these fluids across the experimental sessions. Intake of milk was significantly higher than that of all other substances. Blood glucose concentration in pups treated with water, saccharin, sucrose, and pedialyte did not differ significantly from that of non-treated pups. The present data suggest a potential contribution of a fluid's palatability and nutritive value in the persistence and efficacy of diet intake for neonatal rats in the context of suckling behavior.

Animals↗
PubMed1987

N-nitrosamines and nitrosatable amines, potential precursors of N-nitramines, in children's pacifiers and baby-bottle nipples.

Sixteen types of children's pacifiers and baby-bottle nipples, bought in shops in Israel but produced both there and elsewhere in the world, were analyzed for their contents of N-nitrosamines, which have been shown to be potent carcinogens in animals, and of nitrosatable amines. Two methods were used: one, originating in the United States, involved dichloromethane extraction of total volatile N-nitrosamines from the nipples and pacifiers, and the other, from the Federal Republic of Germany, consisted of analysis of N-nitrosamines and their amine precursors that migrated into artificial saliva. N-Nitrosodibutylamine (NDBA). N-nitrosodiethylamine (NDEA), N-nitrosodimethylamine (NDMA). N-nitrosopiperidine (NPIP), and N-nitrosopyrrolidine (NPYR) were detected by the first method, at individual levels as high as 369 ppb. Using the second method, NDBA, NDEA, NDMA, and N-nitrosomorpholine (NMOR) were detected at concentrations up to 41 ppb, in addition to the three nitrosatable amines dibutylamine, diethylamine, and dimethylamine. Upon nitrosation in the artificial saliva, these amines produced not only the related N-nitrosamines but also relatively high levels of the corresponding N-nitramines (N-nitrodibutylamine, N-nitrodiethylamine, and N-nitrodimethylamine), probably formed by oxidation of the N-nitrosamines by peroxides used for vulcanization of elastomers. Thus, if N-nitramines are not measured in addition to N-nitrosamines after nitrosation, the second method may underestimate the quantities of nitrosatable amines present in artificial saliva extracts. Whether N-nitramines, some of which have been shown to be both mutagenic and carcinogenic, also occur in the saliva of babies exposed to these products remains to be confirmed. Of the samples tested, 50% failed to meet both the U.S. and the FRG regulations. A larger percentage, 60%, would not conform to the new standard suggested in the United States, and more than 80% failed to comply with the even stricter Dutch standard.

Amines↗
PubMed1992

Tapering of intussuscepted ileal nipple valve or ileocecal valve to correct secondary incontinence in patients with urinary reservoir.

Malfunction of the outlet mechanism, that is leakage of urine or difficulty in catheterization, has been the main problem in the evolution of continent urinary reservoirs. Urinary leakage in 3 patients with a right colonic reservoir (2 with an intussuscepted ileal nipple valve and 1 with a plicated ileal segment as a continence mechanism) was managed with tapered narrowing of the nipple valve and the ileocecal valve, respectively, using stapling techniques. Continence was thereby reestablished without impeding catheterization. Tapering is easy to perform and, when applicable, can obviate the need for a major surgical procedure.

Adult↗
PubMed1995

Promotion of preterm infant nipple feeding with nonnutritive sucking.

Transition of preterm infants from enteral to nipple feeding is a necessary milestone for hospital discharge. This study tested the efficacy of one potential intervention to facilitate the transition process. Ten minutes of nonnutritive sucking (NNS) and a control condition were administered randomly before first nipple feedings. The sample consisted of 20 preterm infants (gestational ages 27-33 weeks, M = 31.6, SD = 1.7; birth weights 931-2, 140 g, M = 1,649, SD = 373) who served as their own controls. NNS resulted in fewer behavioral state changes during feedings and produced quiet, awake states more frequently during feedings. Heart rates did not differ between feedings following NNS compared with those in the control condition.

Clinical Nursing Research↗
PubMed1999

Is mastectomy overtreatment for Paget's disease of the nipple?

The standard local management for Paget's disease of the nipple is currently mastectomy although this may well represent overtreatment. The place of breast conserving surgery is somewhat uncertain. We have reviewed the casenotes of 146 patients with Paget's disease of the nipple, and compared the mortality and recurrence rates between 74 women who had undergone mastectomy and 31 women who had breast conserving surgery. There was no significant difference in either local or overall treatment failure rates between these two treatment groups. We conclude that breast conserving treatment maybe an appropriate alternative to mastectomy for the management of Paget's disease, where clear margins of excision can be achieved. However, a randomized prospective study is needed to confirm this.

Journal Article↗
PubMed1999

Nipple aspirate fluid in relation to breast cancer.

Samples of breast ductal fluid can be obtained by nipple aspiration. Such samples may contain a variety of exfoliated or shed cells and display a distinctive biochemical profile reflecting the microenvironment of the ductal-alveolar system of the breast. Study of nipple aspirates may, therefore, shed light on the biology of breast cancer. This review summarizes the more important aspects of published data and explores potential avenues for future study with particular regard to molecular-biological approaches.

Journal Article↗
PubMed2002

Bilateral nipple necrosis in a breastfeeding woman with Behçet's disease.

Behçet's disease is a chronic, multisystem disorder. A 23-year-old female patient diagnosed with Behçet's disease 3 years earlier was admitted with deep ulcers on both areolae caused by detachment of the nipples following breastfeeding since spontaneous delivery of her baby. Physical examination revealed a necrotic ulcer crater 2 cm in diameter on each breast, with the lactiferous ducts draining into these. Incisional biopsy sample from the areola ulcer border on the left breast showed leukocytoclastic vasculitis. Breastfeeding was stopped, and local wound care and systemic corticosteroid therapy were started. After 4 weeks, epithelialization tissue filled the ulcers, leveling the crater base with the areola. Bilateral nipple necrosis in a breastfeeding woman is a rare entity. It is thought that in the present case minor trauma caused by breastfeeding accompanied by neutrophilic infiltration resulting from amplified inflammatory response and leukocytoclastic vasculitis attributable to Behçet's disease was responsible for the necrosis.

Journal Article↗
PubMed1992

Breast cancer incidence in women with abnormal cytology in nipple aspirates of breast fluid.

This is a prospective study of breast cancer risk in relation to nipple aspirate fluid cytology in 2,701 volunteer white women from the San Francisco Bay Area first enrolled between 1973 and 1980. The women were not pregnant or lactating and were free of breast cancer within 6 months of entry into the study. The breast cancer status of this cohort was determined between June 1988 and April 1991. Follow-up was complete for 87% (n = 2,343) of the cohort, representing 29,961 person-years and an average of 12.7 years of follow-up. The overall breast cancer incidence was 4.4% (104 of 2,343) and rose with fluid cytology findings as follows: no fluid obtained, 2.6% (9 of 352); unsatisfactory specimen, 4.8% (15 of 315); normal cytology, 4.3% (56 of 1,291); epithelial hyperplasia, 5.5% (18 of 327); and atypical hyperplasia, 10.3% (6 of 58). Relative risks for breast cancer and their 95% confidence intervals were estimated by Cox regression, adjusting for age and year of entry. Compared with the relative risk for women who yielded no fluid, relative risks were: unsatisfactory specimen, relative risk (RR) = 1.4 (95% confidence interval (CI) 0.6-3.3); normal cytology, RR = 1.8 (95% CI 0.9-3.6); epithelial hyperplasia, RR = 2.5 (95% CI 1.1-5.5); and atypical hyperplasia, RR = 4.9 (95% CI 1.7-13.9). These findings were strongest for and were mainly confined to women aged 25-54 years. Women with atypical hyperplasia and a first-degree family history of breast cancer were six times more likely to develop breast cancer than were women with atypical hyperplasia but without a family history of breast cancer (95% CI 1.0-30.2). These findings provide strong support for our hypothesis that hyperplasia and atypical hyperplasia diagnosed in nipple aspirates of breast fluid are associated with an increased risk of breast cancer.

Adolescent↗
PubMed2004

Surgical management of hidradenitis suppurativa of the nipple-areolar complex.

Involvement of the nipple-areolar complex is an infrequent area of distribution of hidradenitis suppurativa. The difficulty of this particular distribution has been encountered in the past and resulted in bilateral mastectomies. The authors describe successful treatment of a patient with hidradenitis suppurativa of the breasts and nipple-areolar complexes using breast-conserving measures. Normal breast contour was preserved and overall cosmetic result was good.

Adult↗
PubMed2006

Ruminal drinkers: endocrine and metabolic status and effects of suckling from a nipple instead of drinking from a bucket.

In ruminal drinkers (RD) ingested milk is transported into the rumen and not into the abomasum. Because this is followed by changes in digestibility and absorption, we have tested whether this is associated with postprandial metabolic and endocrine changes. Unweaned, bucket-fed calves (one RD, two controls) were studied on seven farms. On d 1, after metabolic and endocrine 12-h profiles were studied, RD and one control calf were fed for 10 d by nipple, whereas the other control calf was fed by bucket. On d 11, metabolic and endocrine 12-h profiles were again studied. On d 1, mean plasma concentrations of glucose, triglycerides, urea, insulin, insulin-like growth factor-1 (IGF-1), 3,5,3'-triiodothyronine (T3), thyroxine (T4) and leptin were significantly different between RD and controls, whereas mean concentrations of non-esterified fatty acids (NEFA), total protein, albumin, and glucagon did not differ significantly among groups. In RD concentrations of glucose, NEFA, insulin, growth hormone, IGF-1, and T4 were higher, and of urea were lower on d 11 than on d 1. Glucose and insulin concentrations increased postprandially in healthy calves on d 1, but barely in RD and remained lower than in controls, and there was no rise of NEFA and triglyceride concentrations on d 1 after the initial postprandial decrease in RD, in contrast to controls. But on d 11 postprandial responses of these four traits were similar in RD and controls and urea and T4 concentrations on d 11 became normalized. However, glucose and T3 concentrations in RD on d 11 were still lower than in one or both control groups. In conclusion, various metabolic and endocrine traits in RD differed from healthy controls. Drinking by floating nipple instead of drinking from bucket for 10 d normalized several metabolic and endocrine traits in RD.

Animal Husbandry↗
PubMed1988

Construction of ileal nipples as anti-reflux valve technique.

When an ileal loop is used to replace the ureter or to create a urinary pouch, an adequate anti-reflux mechanism is essential. Intussusception of the ileal wall can be used but a proper technique must be chosen to prevent necrosis of the nipple. Good knowledge of the vascularization of the ileal wall is necessary. Leaving a 1-cm strip of mesenterium when stripping it from the ileal wall provides adequate circulation. Nipples of 3 cm or longer are enough to create an anti-reflux mechanism.

Animals↗
PubMed1985

The "aortic nipple" as a sign of impending superior vena caval syndrome.

The development of dilatation of the left superior intercostal vein ("aortic nipple") on chest radiographic studies can be used as a clue to impending superior vena caval syndrome. Two cases are described in which detection of an "aortic nipple" on chest roentgenograms predated the clinical syndrome by seven to ten weeks. Since superior vena caval syndrome is a medical emergency, recognition of signs such as this which may significantly predate the "full-blown" syndrome have far-reaching implications in the care of patients.

Adult↗
PubMed1999

Nipple feeding preterm infants: an individualized, developmentally supportive approach.

Many NICU infants present with complex issues that affect the transition to full nipple feeding. At a time when length of stay is critical, this transition can be facilitated by an individualized, developmentally supportive approach. The approach described in this article involves (1) observing the infant for behavioral cues of stability or stress during nippling, as reflected in change in color, state of alertness, breathing, and swallowing; (2) individualizing intervention to help the infant regain and maintain coordination; and (3) facilitating parents' competence and confidence in feeding their infant. Contingent interventions are used to promote physiologic homeostasis and self-regulation.

Adult↗
PubMed1992

Effects of two nipple drinker types with different flow rates on the productive performance of broiler chickens during summerlike growing conditions.

Three trials were conducted to study the effects of a high flow volume (2.3 mL/s) nipple waterer (HFN) versus a low flow volume (.4 mL/s) nipple waterer (LFN) on the productive performance of broiler chickens as measured by average body weight (kilograms), average feed conversion (kilograms:kilogram), and percentage mortality rate. Equal numbers of male and female birds were used during Trial 1; only male birds were used during Trials 2 and 3. All trials were conducted during the summer months. An attempt was made during Trial 2 to expose the birds to artificial heat stress. No differences were seen during any of the trials in feed conversion between the two treatments. In Trial 1 the only significant difference (P less than or equal to .05) exhibited was in average male body weight (1.87 kg HFN; 1.84 kg LFN). A highly significant difference (P less than or equal to .01) was seen in average body weight (1.75 kg HFN; 1.64 kg LFN) during Trial 2. Average body weight difference during Trial 3 was highly significant at 42 days of age but not at Day 49. Mortality rate figures during Trial 2 indicate a highly significant difference during the 38-day period prior to heat stress (2.2% LFN; .4% HFN), and significant difference during the heat stress period (38 to 44 days; 2.9% LFN; 1.5% HFN). During Trial 3 mortality rate differences were significant by 49 days (20.6% LFN; 11.4% HFN) although there was no difference at 42 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Husbandry↗
PubMed1995

The antral nipple sign of pyloric mucosal prolapse: endoscopic correlation of a new sonographic observation in patients with pyloric stenosis.

This study describes the antral nipple sign of pyloric mucosal prolapse, a newly delineated sonographic observation in patients with pyloric stenosis, correlates the endoscopic findings, and examines its prevalence and significance in 31 consecutive patients with pyloric stenosis. Fifty patients who did not have pyloric stenosis served as the control population. The antral nipple sign consists of visualization of prolapsed, hypertrophied pyloric mucosa protruding into the gastric antrum. Using the Wilcoxon scores (rank sums), there was no significant difference among the patients in age, weight, or pyloric muscle dimensions. Although the diagnosis of pyloric stenosis is made on the basis of muscle thickness, we have documented that the pyloric mucosa becomes redundant in infants with pyloric stenosis, permitting a fuller understanding of the anatomic correlate underlying the sonographic images.

Endoscopy, Gastrointestinal↗
PubMed2000

Rapid and robust olfactory conditioning with milk before suckling experience: promotion of nipple attachment in the newborn rat.

An olfactory conditioning paradigm tested the hypothesis that newborn rats are able to learn about events associated with their first experience with milk as early as 3-5 hr after birth. Exposure to lemon odor (conditioned stimulus, [CS]) paired with intraoral milk infusions (unconditioned stimulus, [US]) resulted in strong conditioning: In the presence of the CS, sustained attachment occurred to an empty nipple as if it provided milk, whereas pups in control conditions showed little attachment. A single CS-US pairing was sufficient for strong conditioning, which was evident with a trace interval as long as 60 s. Conditioning was robust enough to promote attachment to a nipple providing saline, which is aversive to the newborn rat, and comparably strong conditioning occurred with sucrose or saccharin as the US. These findings suggest that olfactory conditioning has the potential to modify suckling behavior.

Animals↗
PubMed2000

[Uretero-intestinal anastomosis using the ureteral nipple technique with personal modification in continent urinary diversion].

BACKGROUND: This report presents the follow-up data for the incidence of stenosis and reflux in 143 split cuff nipple ureteral intestinal anastomoses in continent urinary diversions. METHODS: 74 ureteral implants (1990-1995) were performed using the original technique, whereas a technical modification was adopted after 1996. This was used in 69 implants and consisted of the removal of a button of bowel tract in order to obtain a linear implant to the reservoir, instead of using a simple enterotomy at the level of the anastomosis. RESULTS: The rate of clinically significant refluxes was 2.2%, whereas the incidence of stenosis fell from 6.8% in the group using the original technique to 2.9% in those using the modified technique. CONCLUSIONS: Anastomosis using the split cuff ureteral nipple technique is simple to perform and is indicated in peristaltic and non-dilatated ureters. Moreover, this technical modification improves the overall results.

Anastomosis, Surgical↗
PubMed2003

Paget's disease of the nipple: a copy number of the genes ERBB2 and CCND1 versus expression of the proteins ERBB-2 and cyclin D1.

Paget's disease of the nipple (PDN) is characterized by Paget's cells infiltrating from an underlying breast carcinoma into the epidermis of the nipple. The tumor cells were reported to overexpress ERBB-2 protein. There is no evidence, whether the overexpression is caused by amplification of the ERBB2 gene (as is the case of invasive duct carcinomas) or by other causes. Because the Paget's cells proliferate vividly we were interested also in cyclin D1 expression and in its relation to the number of CCND1 gene copies. To address these issues, we performed a study using fluorescence in situ hybridization on interphasic nuclei (I-FISH) on formalin fixed / paraffin embedded tissue sections from twelve women with PDN. We compared immunohistochemical (IHC) expression of the ERBB-2 protein and cyclin D1 with the copy number of the gene ERBB2 and CCND1, respectively (I-FISH). In all cases of our series we found overexpression of the ERBB-2 protein (3+), and in all of them there was a strong amplification of the ERBB2 gene (more than 10 signals per a nucleus, usually about 20). Keratinocytes of the epidermis had two signals of the gene. IHC and I-FISH revealed comparable findings in successive biopsies in two patients. Cyclin D1 was positive in seven cases. We found a moderate amplification of the CCND1 gene (up to 10 signals per a nucleus) in three patients only. Any correlation between the cyclin D1 overexpression anda copy number of the CCND1 gene was observed. Combined numerical changes of chromosome 17 and of chromosome 11 were found in seven women. It is concluded that in PDN, the ERBB-2 protein overexpression is caused by amplification of the ERBB2 gene. A specific immuno-therapy with trastuzumab (Herceptin) used in patients with invasive duct carcinoma may be also effective in patients with PDN.

Adult↗