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PubMed1999

Ultrasound-guided follicle aspiration: effect of the frequency of a linear transvaginal probe on the collection of bovine oocytes.

The effect of the frequency of an ultrasonic linear transvaginal probe on the collection of bovine oocytes by transvaginal ultrasound-guided follicle aspiration was investigated. Probes with different frequencies (7.5 or 5.0 MHz) were applied to examine the clarity of follicles on the monitor using ovaries of slaughtered cows in Experiment 1. The follicles were visualized on the monitor and divided into small (3- to 5-mm diameter) and large (6- to 10-mm) groups. They were also divided into 2 groups according to the clarity of their outline (clear or obscure). The number of small follicles visualized with a clear outline was greater (P < 0.01) with the 7.5 MHz probe than with the 5.0 MHz probe (9.0 vs 3.2). Oocyte aspiration from live cows was performed using the 7.5 or 5.0 MHz probe in Experiments 2 and 3. The recovered oocytes were divided into 3 categories: cumulus-oocyte-complexes (COCs), denuded oocytes and all others. In Experiment 2, the number of oocytes collected per donor cow was assessed, and in Experiment 3 the number of oocytes per aspirated follicle was examined by aspirating a constant number of follicles per aspiration session. The numbers of oocytes and COCs per donor cow obtained with the 7.5 MHz probe (11.2 and 9.0, respectively) were greater (P < 0.01) than those obtained with the 5.0 MHz probe (4.3 and 3.5). This difference between probes was due to the greater clarity of the follicle images obtained with the 7.5 MHz probe.

Animals↗
PubMed1999

Plasma estradiol FSH and LH concentration after dominant follicle aspiration in the cow.

This work investigates the estrogenic role of the dominant follicle with regard to regulation of plasma FSH and LH concentration. Eight Holstein-Friesian cows were used for aspiration of the dominant follicle using ultrasound guidance during the early, mid and late stages of the luteal phase. Blood samples were collected at 15-min intervals from 4 h before until 7 h after aspiration. Plasma progesterone concentration increased from 0.7 to 7.2 ng mL-1 from early to mid luteal phase and then fell slightly to 5.9 ng mL-1 in the late luteal phase, but remained unaffected by follicle puncture. The follicular aspirate contained a thousandfold higher estradiol, than plasma concentration but its estradiol:progesterone ratio remained at around 2 at each stage of the luteal phase. Aspiration caused plasma estradiol concentration to fall from 1.4 to 0.7, 1.8 to 1.0 and 1.7 to 0.8 pg mL-1 in the early, mid and late stages of the luteal phase, respectively (P < 0.05). At the same time, mean plasma FSH concentration was increased from 1.1 to 1.8, 1.7 to 2.9 and 0.8 to 1.9 ng mL-1 (P < 0.05), respectively. The results suggest that estradiol secreted from dominant follicles selectively regulates gonadotropin secretion, since aspiration of the dominant follicle at any stage of the cycle affected circulating FSH but did not appear to influence the mean LH concentration.

Animals↗
PubMed2003

Vitreous aspiration needle tap in the diagnosis of intraocular inflammation.

PURPOSE: To determine the safety of vitreous aspiration needle tap as a clinical procedure and its usefulness in helping to distinguish between infective, inflammatory, and malignant causes of uveitis. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Data were collected for 53 patients who had undergone vitreous aspiration needle tap as an outpatient in the clinic. METHODS: These patients underwent vitreous aspiration needle tap using a needle and syringe for the following indications: (1) when masquerade syndrome or infective retinitis was the primary diagnosis; and (2) to diagnose or exclude infective or malignant entities in patients not responding to treatment. The result of the analysis of the biopsy specimen and any complications that arose from the procedure were determined. RESULTS: In this series, vitreous aspiration needle tap generated an adequate sample for the relevant investigations in 92% of cases. The initial diagnosis of intraocular malignancy or infection was confirmed in 40% of patients. The remaining patients were treated with immunosuppressives for the ocular inflammation and showed clinical improvement over the follow-up period. Multiple procedures were required in two patients to make the diagnosis of B-cell intraocular lymphoma and in two patients with acute retinal necrosis who were treated for the presenting clinical features. CONCLUSIONS: Vitreous aspiration needle tap would seem to be a safe clinical procedure, which has a high success rate in differentiating between infectious, inflammatory, and malignant causes of uveitis. It is a quick procedure that can be carried out at the first outpatient visit.

Adult↗
PubMed2000

Endoscopically guided sinonasal cultures: a direct comparison with maxillary sinus aspirate cultures.

Sinusitis is a common medical problem that can at times be challenging to treat. Although most cases respond to empiric therapy, success is not achieved universally. If empiric therapy fails, it is important to identify the causative bacterial pathogen. Antral puncture is the traditional diagnostic method to recover and identify pathogens in sinusitis; however, it remains a painful, invasive test with potential complications. In contrast, rigid sinonasal endoscopy permits recovery of mucopus emanating from the sinus ostia with little pain and few possible complications. Endoscopy also affords important visual information that can confirm or refute a historical/clinical diagnosis of sinusitis. Although previous studies have shown poor correlation between nasal cavity swab cultures and maxillary sinus aspiration cultures, few investigations have compared endoscopically guided middle meatal cultures with cultures obtained from maxillary sinus aspiration. Thirteen patients with maxillary sinusitis in one or both sinuses underwent endoscopically guided culture of the middle meatus and maxillary sinus puncture with aspiration and culture (16 total study samples). Results from the microbiologic analysis were compared. Endoscopically guided middle meatal cultures accurately identified the predominant bacterial pathogen and correlated with the cultures from maxillary sinus aspiration in more than 90% of infections. These preliminary results suggest that endoscopically guided sinonasal cultures hold promise as a viable alternative to maxillary sinus aspiration. Endoscopically guided cultures appear to be an effective, noninvasive diagnostic tool for otolaryngologists managing sinusitis.

Adult↗
PubMed1998

An experimental study on the aspirating reliability of different types of injection syringes with regard to the formation of punch cylinders.

Aspiration before local anaesthesia is essential to avoid an incorrectly placed needle. We tested 142 types of cannula in mucobuccal preparations from 29 cadavers. The cannulas were obtained from 23 different firms and the formation of punch cylinders caused by injection was studied at angles of penetration of 70 degrees and 90 degrees. The force of puncture was measured by a computer-controlled apparatus. In a second series of tests the aspirating ability of 121 cannulas with self-aspirating and actively aspirating syringes was tested in vitro. The results show that false negative aspirations are caused by: using a cannula that is too small (<= 27 Gauge); the cannula lumen becoming clogged with tissue punch cylinders; using a Carpule needle end that is too short to perforate the rubber of the ampoule; containing rubber fragments in the back of the Carpule needle end; and using an injection syringe with too small a viewport when the injection syringe was positioned at a 90 degrees. We recommend the construction of a system in which the distance between the cone and viewport is reduced.

Aged↗
PubMed1997

Conservative management of wrist ganglia. Aspiration versus steroid infiltration.

Wrist ganglia were randomly allocated for conservative treatment by either aspiration or aspiration and injection of steroid. Both treatment methods had 33% success rates. Almost all ganglia which recurred after one aspiration did not resolve with further aspirations. After aspiration and explanation of the benign nature of ganglia, only a quarter of patients requested surgical treatment.

Anti-Inflammatory Agents↗
PubMed1979

Collection of cytological specimens with a cell aspirator with reference to the wooden spatula method. II. Comparative quantitative and qualitative studies.

This article describes the results of comparative quantitative and qualitative examinations of specimens obtained by testing 65 individuals by means of a cell aspirator and a wooden spatula. The studies were performed on a clinically normal mucosa as well as on different mucosal lesions. A statistical analysis of the cells obtained showed that the cell aspirator quantitatively produced significantly better results both with regard to the total number of cells obtained and to the number of epithelial cells in the different stages of maturity. The number of cells obtained turned out to be dependent on surface structure and the size of the lesion, however. Qualitatively the cell aspirator collected epithelial cells which were better preserved morphologically, but also a larger number of compact cell clusters. The number of erythrocytes was low. The structure of these blood cells was well preserved, indicating bleeding arising in connection with the taking of the specimens. The number of leucocytes was larger in the aspirated material. The degrees of fixation and staining were similar. The authors make recommendations for using the cell aspirator in such a manner as to obtain the best qualitative results.

Cytodiagnosis↗
PubMed2003

Unilateral follicular aspiration and in-vitro maturation before contralateral oocyte retrieval: a method to prevent ovarian hyperstimulation syndrome.

BACKGROUND: Five women undergoing intracytoplasmatic sperm injection (ICSI) considered to be at high risk of developing an ovarian hyperstimulation syndrome (OHSS) from March to July 2002 underwent unilateral follicular aspiration. METHODS: When >/=15 follicles of 12-15 mm diameter in each ovary and a serum estrodial level >/=2500 pg/ml was present, follicular aspiration was performed unilaterally without hCG administration. Ovarian stimulation was continued for 1-3 days in four women before human chorionic gonadotrophin (hCG) was given. In one woman hCG injection was administered at the evening after unilateral follicular aspiration. The oocyte retrieval from the contralateral ovary was performed 36 h after hCG injection. By unilateral follicular aspiration two to six germinal vesicle (GV) oocytes could be retrieved. After in-vitro maturation of those oocytes ICSI was performed. RESULTS: In four women one to two oocytes were fertilized and cryopreserved. In one case only one triploid pronucleus (3PN) was observed. At the contralateral ovum-pick up after hCG injection a median of 10 could be retrieved. After transfer of a median of 3 embryos, no pregnancy was achieved. Four of five patients developed a severe OHSS and were hospitalized for a median of 3 days. CONCLUSION: Unilateral follicular aspiration and continuation of stimulation therefore can not be recommended for the prevention of OHSS.

Chorionic Gonadotropin↗
PubMed1985

Primary tracheoesophageal shunt operation for postlaryngectomy voice restoration--a sphincter mechanism against aspiration.

Out of a total of 113 consecutive tracheoesophageal (TE) shunt operations for postlaryngectomy voice restoration in the past 8 years performed at the Department of Otorhinolaryngology, 92 patients (81%) succeeded in the postoperative TE speech. The essential part of this surgery consists of the construction of the TE shunt using the membraneous part of the trachea obtained at surgery. In the course of 8 years, important changes have been employed for the prevention of aspiration. We attempted to combine primary cancer surgery with the creation of intelligible voice, but without aspiration. For the above purpose, we have employed the bilateral esophageal muscle flaps (BEMF) against aspiration in combination with the TE shunt construction for phonation. Sixteen of 18 patients thus operated on complained of no aspiration even with a drop of saliva and dietary fluids. As far as the mechanism against aspiration is concerned, both dilatation and elevation of the cervical esophagus during deglutition, together with the BEMF, seem to approximate the sphincter mechanism against tracheal reflux. A proper case selection may achieve high success rates for preserving normal deglutition and restoring speech after total laryngectomy.

Adult↗
PubMed2004

The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess.

INTRODUCTION: Prostatic abscess (PA) is a very uncommon disorder. The value of transrectal ultrasound (TRUS) guided aspiration in the treatment of PA has not been clearly defined. We present our experience with six such patients. MATERIALS AND METHODS: Between July 1997 and December 2002, six patients with PA were diagnosed by TRUS and treated by TRUS guided needle aspiration in our department. PA was defined as hypoechoic, inhomogeneous, thick walled fluid collection. TRUS guided needle aspiration of the abscess was performed transrectally in all patients with a 20-cm long 18 gauge Chiba needle. Successful treatment criteria were defined as clinical improvement in symptoms and decrease of more than half of the estimated abscess volume on follow up TRUS control. Patients with continuing clinical symptoms were defined as treatment failures. RESULTS: The most common TRUS finding was detection of a hypoechoic area with inhomogeneous structures, which was determined in all patients (100%). In some patients irregular contour and heterogeneous areas were additionally described. TRUS guided needle aspiration treatment of PA was successful in five of six patients (83.3%). In one patient treatment failed and the abscess recurred 3 weeks after the procedure. As this patient had additionally a bladder outflow obstruction, transurethral resection of the prostate was performed instead of a repeat procedure. There were no complications associated with the procedure. CONCLUSIONS: In conclusion, TRUS has an important value in diagnosis and treatment of PA. TRUS guided aspiration is an effective and minimally invasive treatment modality for PA which causes no serious complications.

Abscess↗
PubMed1996

Aspiration as a guide to sepsis in revision total hip arthroplasty.

One hundred sixty-five patients underwent 171 preoperative aspiration arthrograms to evaluate a painful total hip arthroplasty. Intraoperative cultures and histologic specimens were obtained in all cases. Of the 166 aspirations where fluid was obtained, there were 140 true negative, 5 true positive, 18 false positive, and 3 false negative cultures. Sensitivity of hip aspiration to identify periprosthetic sepsis correctly was 50%; specificity was 88%. Hip aspiration with a 50% sensitivity rate lacks the ability to consistently predict those patients with occult periprosthetic sepsis. The routine use of aspiration in evaluation of a painful total hip is probably not indicated. Selective use in patients with a history of wound healing problems, radiographic changes, and elevated laboratory values should be considered.

Arthrography↗
PubMed1996

Aspiration arthrography of the hip joint. Its uses and limitations in revision hip surgery.

Seventy-one patients undergoing revision hip surgery over a 5-year period from 1988 to 1993 had aspiration arthrography of the hip as a preoperative investigation. Sixteen hips were found to be infected at operation. Preoperative aspiration yielded positive cultures in 11 of these 16 hips. There was identical correlation between the organisms isolated on aspiration and during surgery. There were 5 false positive cultures from the aspirates of the remaining 55 noninfected hips. All of the hips from which a true positive culture was obtained had either clinical or radiologic evidence suggestive of infection. Aspiration arthrography does not have a major role to play as a routine investigation prior to all revision hip surgery. It is recommended that its use be reserved for those hips in which there is either clinical, hematologic, or radiologic evidence of infection.

Adult↗
PubMed1991

Irrigation, aspiration, and polishing cannula.

Aspiration of the lens cortex and capsule polishing are two important aspects of modern extracapsular cataract surgery. In this report we describe simple but useful modifications to the widely used Simcoe irrigation/aspiration cannula. The modifications consist of enlarging the aspiration port diameter from 0.3 mm to 0.4 mm and altering the terminal segment of the cannula to a sandblasted capsule polisher. The 0.4 mm diameter aspiration port reduces the incidence of capsular entrapment and allows a more efficient aspiration of cortex of varying textures. The modifications eliminate the need for a separate capsule polishing instrument and allow simultaneous lens material aspiration and capsular cleanup. These modifications can be used for any irrigation/aspiration cannula whether manually or machine operated.

Cataract Extraction↗
PubMed2001

US-guided needle aspiration and catheter drainage as an alternative to open surgical drainage for uniloculated neck abscesses.

PURPOSE: To prospectively evaluate the effectiveness of ultrasound (US)-guided needle aspiration and catheter drainage as an alternative to open surgical drainage of uniloculated neck abscesses. MATERIALS AND METHODS: Fifteen consecutive patients (11 female, four male; age range from 18 days to 78 years, mean 42.5 y +/- 22.4) diagnosed with deep neck infections associated with uniloculated neck abscesses were treated. The patients were originally scheduled for surgical incision and drainage after a period of unsuccessful treatment with antibiotics. US-guided needle aspiration (in 10 patients) and US-guided catheter drainage (in five patients) were performed under local anesthesia. Open surgical drainage was performed when US-guided drainage procedures failed. RESULTS: Surgical open drainage was avoided in 13 of the 15 patients (87%). An average of 6 mL of pus was obtained in patients in the needle aspiration group and 140 mL of pus was drained by catheter. One patient had a recurrent pyogenic lymphadenitis at the same location and was treated successfully by repeated needle aspiration. No complications occurred in this study. CONCLUSION: In a selected group of patients without imminent airway obstruction, most uniloculated neck abscesses may be managed initially by US-guided needle aspiration and catheter drainage before resorting to open surgical drainage.

Abscess↗
PubMed1998

Fine-needle aspiration of breast masses. A review of its role in diagnosis and management in adolescent patients.

PURPOSE: To assess the role of fine-needle aspiration biopsy (FNA) in the evaluation and management of breast masses in adolescents. METHODS: All FNAs performed on organ masses over a 15-year period on patients age 21 years and younger were evaluated. Cases were collected from four large university-affiliated teaching hospitals and clinics. Pathology records from the laboratory information systems were reviewed. Data included clinical information, anatomic site, and cytologic diagnoses. Surgical follow-up was included when available. RESULTS: Three hundred and twenty-five FNAs from 302 patients were reviewed. Of 325 aspirates, 59 were breast FNAs (in 51 patients: 4 males and 47 females). Among all organs, the breast was the most common one aspirated in females. Of the breast aspirates in females, 49% were diagnosed as fibroadenomas. No cases of malignant breast disease or phyllodes tumors were encountered. Surgical biopsy follow-up was available in 23.7% of the patients. Of those masses which were subsequently surgically biopsied, most were diagnosed as either fibroadenoma (11) or juvenile fibroadenoma (two). One other case biopsied showed ductal hyperplasia and adenosis. The majority of the remaining cases were followed up clinically, since the clinical nature and cytologic features of the lesions were those of fibrocystic changes or benign cysts. CONCLUSIONS: In the series of FNAs we examined, breast masses were the most frequent lesions aspirated in adolescent females, with fibroadenomas being the most common lesion encountered. FNA proved to be a useful and reliable tool in the evaluation and management of masses involving the adolescent breast. The majority of breast masses in adolescents are benign, and lesions can be managed conservatively in this age group. The use of noninvasive diagnostic procedures such as FNA and ultrasound can reduce the need for open surgery during breast development.

Adolescent↗
PubMed1998

Diagnosis of malignant epithelial thyroid lesions: fine needle aspiration and histopathologic correlation.

Fine needle aspiration is a diagnostic tool useful as a guide to patient management. We believe that its role in solving the diagnostic dilemmas presented by thyroid nodules is still underappreciated. Current fiscal constraints in health care might bring about a wider use of this simple technique to select patients for surgery. Care in sampling a mass is essential to obtain aspirates that are representative of the lesion and adequate in quantity for interpretation. Several aspirates are needed from all but the smallest masses. Most thyroid carcinomas are well-differentiated with a low grade of malignancy. The majority of these are papillary carcinomas, which are easily diagnosed in good cytologic smears. With fine needle aspirates the goal is to diagnose a follicular neoplasm and to separate it from the adenomatoid nodule. The follicular neoplasm then can be classified as adenoma or carcinoma with the histologic sections. The minimally invasive carcinoma still can be challenging to recognize. We hope that the cytologic criteria and histopathologic correlations presented here will help general pathologists who interpret aspirates. We believe that in the near future additional immunohistochemical methods and genetic markers will be used increasingly to discriminate among the neoplasms and to provide prognostic information.

Adenocarcinoma, Follicular↗
PubMed2002

Contribution of digit joint aspiration to the diagnosis of rheumatic diseases.

OBJECTIVES: To assess the diagnostic usefulness of digit joint aspiration in patients with involvement of one or more digit joints. PATIENTS AND METHODS: All patients who underwent digit joint aspiration during a rheumatology outpatient visit between 1994 and 1998 were included. Fine needles (25 or 28 G) were used, and the aspirate was immediately examined under the microscope to determine the leukocyte count and to look for crystals under polarized light. RESULTS: Digit aspiration yielded a diagnosis of crystal deposition arthropathy in 20 (29%) of the 71 patients (gout, N = 14; calcium pyrophosphate dihydrate crystal deposition disease, N = 6). In 28 patients, the amount of fluid was too small to allow analysis. The leukocyte count indicated inflammatory disease in eight of the remaining 23 patients and mechanical disease in 15. CONCLUSION: Fine-needle aspiration of symptomatic digit joints provided the diagnosis in two-thirds of patients.

Adult↗
PubMed2005

[Transbronchial needle aspiration of diseased mediastinal lymph nodes: predictors of positive findings].

OBJECTIVE: To assess the factors that may determine the effectiveness of transbronchial needle aspiration through a flexible bronchoscope in the diagnosis of diseased mediastinal lymph nodes in patients with lung or extrapulmonary tumors. METHODS: Prospective study carried out at 2 hospitals between 1998 and 2004 that included all transbronchial needle aspirations performed on patients who had diseased mediastinal lymph nodes larger than 10 mm and nonlymphoid neoplasms. Univariate and multivariate analysis of the diagnostic results of transbronchial needle aspiration were performed according to the type and location of the primary neoplasm and the lymph node station biopsied, the diameter of the affected node, endoscopic findings, and the results of other bronchoscopic techniques. RESULTS: The study evaluated the transbronchial needle aspiration of 230 lymph node stations in 207 patients. Histologic examination revealed 151 cases (72.9%) of non-small cell lung cancer, 42 cases (20.3%) of small cell lung cancer, and 14 cases (6.8%) of extrapulmonary cancer. The best predictors of obtaining a diagnostic sample were a diameter of the diseased node greater than 20 mm in diameter (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.2-4.7; P=.01) and a histologic diagnosis of small cell lung cancer (OR, 2.7; 95% CI, 0.9-8.2; P=.07). CONCLUSIONS: The size of the diseased node and the tumor type are the best predictors of obtaining a diagnostic sample with transbronchial needle aspiration of diseased mediastinal lymph nodes in patients with lung or extrapulmonary tumors.

Aged↗