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At least 1,315 records · Page 73Linked to original sources
PubMed2006

Diagnosing amyloid goitre with thyroid aspiration biopsy.

OBJECTIVE: The aim of the study was to evaluate the value of fine needle aspiration biopsy of the thyroid as a tool for diagnosing amyloid goitre and assess how amyloidosis affects thyroid tissue and thyroid function. METHODS: Clinical and laboratory evaluation of 50 patients with secondary systemic amyloidosis was done, and goitre was found in 38 of them. All 38 patients underwent thyroid aspiration biopsy. Tissue samples were stained with haematoxylin and eosin, May-Grünwald-Giemsa, crystal violet and Congo red. RESULTS: Of the 38 cases of amyloid goitre, 10 showed euthyroid sick syndrome, two showed primary hyperthyroidism, two showed hypothyroidism and one showed subacute thyroiditis. The serum levels of thyroid hormones and thyroid-stimulating hormone were normal in the remaining patients. Thirty-five of the 38 patients (92%) showed amyloidosis after thyroid aspiration. One of these patients had papillary carcinoma in addition to amyloid goitre. Ten patients underwent subtotal thyroidectomy, and one patient underwent total thyroidectomy after aspiration. Microscopic evaluation revealed that the thyroid parenchyma in all patients was largely replaced with amyloid and adipose tissue. CONCLUSION: Fine needle aspiration of the thyroid is a valuable and sensitive method for diagnosing amyloid goitre, especially because it is a safe and easily performed procedure. Further, amyloid goitre has no significant influence on thyroid function even when it causes extensive parenchyma replacement.

Adult↗
PubMed1995

Career aspirations, job satisfaction and gender identity in female student nurses.

This study examines the gender-role orientation, gender-role conflict, job commitment and work motivation of female student nurses in the Republic of Ireland. Career aspirations, year of nurse training and geographical area of upbringing were examined as potential concomitants of these dependent measures. Subjects completed self-report measures of job involvement, work motivation, gender-role orientation and gender-role conflict. Results obtained showed that aspiring towards a traditionally female career area of nursing was associated with higher levels of work motivation and lower levels of gender-role conflict. Higher levels of job commitment amongst final year students were also significantly related to traditionally female career aspirations. Year of training had a significant and negative influence on work motivation and job commitment. Finally, nurses from rural areas aspiring towards a traditionally female area of nursing had significantly more feminine gender-role orientations than either their urban counterparts or rural colleagues with non-traditional career aspirations. The theoretical and practical implications of these results are discussed.

Analysis of Variance↗
PubMed1996

Ultrasound-guided parathyroid aspiration to diagnose parathyroid adenomas.

AIM: To ascertain the accuracy of ultrasound-guided fine needle aspiration and parathyroid hormone assay in the identification of parathyroid adenomas. DESIGN: Case study. SETTING: Tertiary referral clinic. PATIENTS: 12 subjects, consisting of 10 female and two male patients, with documented primary hyperaparathyroidism. INTERVENTION: Ultrasonography of the parathyroid glands was performed using an Acuson XP 128 machine with a linear array 7.5 MHz multihertz probe. Following accurate localization of the parathyroid lesion, fine needle aspiration was performed using a 23 gauge needle, and parathyroid hormone assay was performed on the aspirate. Preoperative localization was compared with intra-operative findings. RESULTS: Ultrasound examination detected 10 out of a possible 12 parathyroid adenomas (83% sensitivity), while ultrasound-guided fine needle aspiration only confirmed nine out of the 12 adenomas (75% sensitivity). CONCLUSIONS: While ultrasound-guided fine needle aspiration may be simple and with minimal morbidity, it does not appear to provide any advantage over ultrasound examination alone for the localization of parathyroid adenomas. It has a potential role in defining the nature of ultrasonically localized nodules.

Adenoma↗
PubMed2004

Occult bronchial foreign body aspiration in adults: analysis of four cases.

Occult tracheobronchial foreign body aspirations are infrequently seen in adults because there is usually a high index of suspicion. Occult foreign bodies can remain undetected for months to years and often are misdiagnosed. The aim of this paper is to report the cases of four adult patients with occult bronchial foreign body aspiration. None of the patients had a previous history of aspiration. One patient had been misdiagnosed as having asthma. One was thought to have tuberculosis, while unresolved pneumonia was present in another. A CXR showed the presence of a foreign body in only one patient because it was metallic. The foreign bodies included a stone, a tooth fragment, a bone fragment, and a needle. The foreign bodies were removed using a rigid bronchoscope in two patients and via a surgical procedure in the other two. In conclusion, tracheobronchial foreign body aspiration should always be taken into consideration in the differential diagnosis of radiographic lesions or chronic respiratory symptoms that are poorly explained, even in the absence of a previous history of aspiration.

Adult↗
PubMed1982

Aspiration of breast cysts.

One hundred and sixty nine women with 220 breast cysts were treated by needle aspiration between 1950 and 1980. Mean follow up was seven years. One hundred and twenty two (72%) patients were aged from 40 to 49 years. The majority (61%) of cysts occurred in the left breast. In 147 patients 174 (79%) of 220 cysts were aspirated once and did not recur at that site. One hundred and eleven (66%) patients presented with a single cyst and had no recurrence in either breast after aspiration. Two patients developed carcinoma of the opposite breast at 8 and 12 years after cyst aspiration. Needle aspiration of the breast is regarded as a safe, simple and economic diagnostic and therapeutic modality in women presenting with single breast lumps.

Adenocarcinoma, Scirrhous↗
PubMed1987

The complementary role of fine needle aspiration cytology and Tru-cut needle biopsy in the management of breast masses.

Fine needle aspiration cytology (FNA) and Tru-cut needle biopsy (TNB) have been used for the pre-operative diagnosis of cancer in breast masses as alternatives to open breast biopsy. The accuracy of clinical examination, fine needle aspiration biopsy and Tru-cut needle biopsy was assessed in 230 patients with palpable breast masses and the value of using both biopsy methods in the management was prospectively evaluated. Clinical diagnosis had a sensitivity of 89.2% and specificity of 78.4% (32.7% false positive, 6.5% false negative). Aspiration cytology was diagnostic in 78.4% of cancers and 71.6% of benign lesions [excluding non-diagnostic samples (27.4%), sensitivity was 96.6% and specificity was 100%]. Tru-cut needle biopsy identified 82.9% of cancers and 61.7% of benign lesions [excluding non-diagnostic samples (33.3%), sensitivity was 96.7% and specificity was 100%]. There were no false positive errors with either aspiration cytology or needle biopsy. Statistical comparison showed that there was no significant difference between aspiration cytology and needle biopsy. The combined result of both biopsies was superior to clinical examination when non-diagnostic samples were excluded. With the routine use of both biopsy techniques, frozen section was avoided in 73% of all cancers and unnecessary operations were avoided in 33.5% of patients which included breast cysts, benign mammary dysplasia and inflammatory lesions.

Adult↗
PubMed2005

Safe and effective sedation and analgesia for bone marrow aspiration procedures in children with alfentanil, remifentanil and combinations with midazolam.

BACKGROUND: Invasive procedures such as bone marrow aspiration in children may be painful and cause anxiety. We investigated the efficacy and safety of remifentanil (R) alfentanil (A), remifentanil-midazolam (RM), and alfentanil-midazolam (AM) combinations in providing analgesia and sedation for bone marrow aspiration. METHODS: Eighty children undergoing a diagnostic bone marrow aspiration whose ages ranged from 5-16 years (mean 9.20 +/- 3.00 years) were enrolled in this study. The patients were randomly assigned to one of 4 treatment groups. Vital signs, sedation and pain scores, somatic responses (sweating and tears) were recorded before, during bone marrow aspiration and after 5 and 15 min of the procedure. RESULTS: There were no statistical differences between sedation and the CHEOPS scores of the four groups during and after the procedures. The VAS scores were significantly higher for group A compared with groups R and RM during the procedure (P < 0.008). There were no differences between the VAS scores in group AM compared with groups R and RM (P > 0.008). There were also no statistical differences among the VAS scores of four groups after the procedure (P > 0.008). All patients had adequate sedation and analgesia. None of the patients in the study had deep sedation, hypotension, bradycardia, hypoxemia, or respiratory depression. CONCLUSIONS: Remifentanil, alfentanil, remifentanil-midazolam, and alfentanil-midazolam combinations are effective in children and can be used safely in bone marrow aspiration which is a brief but painful procedure performed in the pediatric patient group.

Adolescent↗
PubMed1987

Menstrual regulation by intramuscular injections of 16-phenoxy-tetranor PGE2 methyl sulfonylamide or vacuum aspiration. A randomized multicentre study. World Health Organization Task Force on Post-ovulatory Methods for Fertility Regulation.

A multicentre trial was conducted to compare the efficacy and side-effects of an intramuscularly administered PGE2 analogue and vacuum aspiration in women with a delay of up to 21 days in the expected onset of menses. A total of 473 such women were randomly allocated to treatment with either 16-phenoxy-W-17, 18, 19, 20-tetranor PGE2 methyl sulfonylamide (three intramuscular injections of 0.5 mg at 3-h intervals) or vacuum aspiration, and the outcome of therapy assessed 1, 2 and 6-8 weeks later. Retrospective analysis of hCG levels indicated that 419 (88.6%) women had been pregnant at the time of treatment. With few exceptions, administration of the PGE2 analogue induced vaginal bleeding in both pregnant and non-pregnant women but the duration and subjectively perceived amount of bleeding were greater than after vacuum aspiration. Both treatments were equally effective. In pregnant women the overall frequency of complete abortion was 91% for prostaglandin treatment and 94% for vacuum aspirations. If non-pregnant women were included, the respective success rates (i.e. percentages of women not pregnant 2 weeks after treatment) were 92% and 95%. Gastrointestinal side-effects and lower abdominal pain requiring intramuscular analgesia were more common after prostaglandin therapy than following vacuum aspiration in both pregnant and non-pregnant women.

Abortifacient Agents↗
PubMed1983

Effects of jejunal reinfusion of aspirated duodenal fluid on biliary and pancreatic secretion in man.

The standard duodenal perfusion technique was used to measure biliary and pancreatic secretion in normal subjects, with and without jejunal reinfusion of aspirated duodenal fluid. In studies carried out without reinfusion of the duodenal aspirate, and where a continuous background stimulation of caerulein and secretin was given throughout the studies to eliminate extrahepatic biliary storage, a gradual fall in bile salt and bilirubin secretion was observed. In contrast, when the experiments were carried out in these same individuals, and under exactly the same experimental conditions except that the duodenal aspirate, rich in bile and pancreatic juice, was in every successive collection period reinfused into the jejunum, the bile salt secretion remained stable and the bilirubin secretion increased. In neither series of studies were there any definite changes in the secretory output of trypsin. The total secretory output of bicarbonate was, however, marginally greater in studies carried out with jejunal reinfusion of the aspirate than in the studies where the aspirate was discarded. Carried out under basal conditions, a gradual fall in both biliary and pancreatic secretion was observed in both series of studies. These results indicate that partial diversion of bile and pancreatic juice from the jejunum in man may affect hepato-biliary secretion of bile salts and bilirubin and the secretion of bicarbonate.

Adult↗
PubMed1998

Hodgkin's disease diagnosed by endoscopic ultrasound-guided fine needle aspiration of a periduodenal lymph node.

Hodgkin's disease rarely presents as obstructive jaundice. We report a case of Hodgkin's disease arising in periduodenallymph nodes, presenting with biliary obstruction, definitively diagnosed on cytologic material obtained by endosonographically-guided real-time fine needle aspiration biopsy and confirmed at laparotomy. The medical literature pertaining to the use of endosonography and fine needle aspiration biopsy for pancreatic lesions and abdominal lymphoma is reviewed. Currently available data support the use of fine needle aspiration biopsy in establishing the diagnosis of lymphoma. This case highlights the utility of endoscopic ultrasonography with endosonographically guided real-time fine needle aspiration biopsy in diagnosing and managing patients with extrahepatic biliary obstruction or suspected abdominal lymphoma. Pairing endosonographically guided real-time fine needle aspiration biopsy with on-site cytologic assessment and immediate specimen triage can lead to definitive diagnosis of abdominal lymphoma, avoiding surgical intervention in many cases.

Adult↗
PubMed2005

Gallbladder aspiration for acute cholecystitis in average-surgical-risk patients.

We conducted a retrospective case note review to assess whether or not gallbladder aspiration can be applied as a temporary measure for the treatment of acute cholecystitis in average-surgical-risk patients. Gallbladder aspiration was performed in 79 consecutive average-surgical-risk patients with acute cholecystitis, who had no indications of emergent surgery and who complained of severe colicky pain. Elective surgery became possible in 92% of patients by gallbladder aspiration. The percentage reached 97 when percutaneous cholecystostomy was added (four patients). Emergent surgery was needed in one patient suffering bile leakage following gallbladder aspiration. Colicky pain was controlled soon after the procedure in most cases. Neither major complications nor mortalities were observed in the following surgical therapies. It is suggested that gallbladder aspiration might be applied as a temporary measure for acute cholecystitis in average-surgical-risk patients, although early surgery should remain the primary choice of therapy in such patients.

Aged↗
PubMed1985

Fine-needle aspiration biopsy in diagnosis of soft tissue infections.

This study explores the efficacy of fine-needle tissue aspiration biopsy in the diagnosis of soft tissue infections that cannot be sampled satisfactorily by regular microbiological techniques. Aspiration biopsy was performed on 50 patients with presumptive soft tissue infections. The conditions investigated were decubitus, diabetic, ischemic, venous, and traumatic ulcers (2, 6, 1, 2, and 7 patients, respectively), cellulitis (23 patients), chronic osteomyelitis (5 patients), and infected surgical wounds (4 patients). Where possible, comparison with superficial cultures was made. All of the cultures obtained from aspirate samples taken from ulcers, chronic osteomyelitis, and infected surgical wounds were positive. In cellulitis, cultures from aspirates were positive in 30 and 81% of the cases, respectively, depending on the presence or absence of concomitant antimicrobial therapy. These results suggest that fine-needle deep tissue aspiration biopsy is reliable and clinically applicable for deep tissue sample collection. The procedure is simple, brief, and does not cause significant discomfort to the patient. It also plays an important role in providing a guideline for antimicrobial therapy.

Adult↗
PubMed2006

Nasopharyngeal aspiration for diagnosis of pulmonary tuberculosis.

BACKGROUND: Confirmation of pulmonary tuberculosis (PTB) in young children is difficult as they seldom expectorate sputum. AIM: To compare sputa obtained by nasopharyngeal aspiration and by sputum induction for staining and culture of Mycobacterium tuberculosis. PATIENTS AND METHODS: Patients from Mulago Hospital, Kampala with symptoms suggestive of PTB were considered for inclusion in the study. Those with a positive tuberculin test and/or a chest radiograph compatible with tuberculosis were recruited. Infection with human immunodeficiency virus (HIV) was confirmed by duplicate enzyme-labelled immunosorbent assay or in children <15 months by polymerase chain reaction (PCR). Direct PCR was undertaken on 82 nasopharyngeal aspirates. RESULTS: Of 438 patients referred, 94 were recruited over a period of 5 months. Median (range) age was 48 (4-144) months. Of 63 patients tested, 69.8% were infected with HIV. Paired and uncontaminated culture results were available for 88 patients and smear results for 94 patients. Nasopharyngeal aspirates were smear-positive in 8.5% and culture-positive in 23.9%. Induced sputa were smear-positive in 9.6% and culture positive in 21.6%. Overall, 10.6% were smear-positive, 25.5% were culture-positive and 26.6% had smear and/or culture confirmed tuberculosis. Direct PCR on nasopharyngeal aspirates had a sensitivity of 62% and specificity of 98% for confirmation of culture-positive tuberculosis. CONCLUSIONS: Nasopharyngeal aspiration is a useful, safe and low-technology method for confirmation of PTB and, like sputum induction, can be undertaken in outpatient clinics.

Child↗
PubMed1995

How do the clinical findings in patients with pericardial effusions influence the success of aspiration?

OBJECTIVE: To identify features associated with success or failure of aspiration of pericardial effusion. METHOD: A retrospective analysis of 36 drainage procedures in 30 patients with pericardial effusion was performed using patient records and echocardiograms. RESULTS: Unsuccessful aspiration was associated with pericardial loculation but not with the seniority of the operator or the size and position of the effusion. Pericardiocentesis relieved symptoms of breathlessness in 21 of 26 patients who had a pericardial effusion suspected of causing dyspnoea. These 21 patients had few clinical or echocardiographic signs of classic tamponade. CONCLUSION: The paucity of abnormal physical or echocardiographic signs of tamponade in breathless patients with pericardial effusion does not exclude symptomatic benefit being derived from pericardiocentesis. Pericardial aspiration is safe in appropriate hands, although aspiration of loculated effusions may not be as successful as aspiration of non-loculated effusions.

Adolescent↗
PubMed1974

Comparison of the diagnostic value of bone marrow biopsy and bone marrow aspiration in neoplastic disease.

The Jamshidi-Swaim biopsy needle was utilized to perform 205 bone marrow biopsies, accompanied by simultaneous bone marrow aspirates, on patients with lymphoma, leukaemia, and a variety of solid tumours. There was no significant morbidity. There were 67 positive findings with biopsy and 42 with aspiration. The two techniques were complementary in Hodgkin's disease, non-Hodgkin's lymphoma, breast carcinoma, bronchogenic carcinoma, malignant melanoma, and in leukaemia. We have examined the bone marrow biopsies and aspirates with respect to the adequacy of the bone marrow biopsy specimen, the number of positive biopsies in the various categories of neoplasia, and the disparity of biopsy and aspirate, finding that 28 of the 67 positive biopsies (41.8%) had negative aspirates. These data and specimens obtained compared quite favourably with other series in which a modification of the Vim-Silverman needle was used.

Biopsy, Needle↗
PubMed1989

Rapid reporting on fine needle aspiration of breast lumps in outpatients.

A retrospective analysis of the performance and value of fine needle aspiration of symptomatic breast masses in a special outpatient "breast clinic" within a district general hospital was carried out. All but a few aspirations were performed by a group of histopathologists, with, immediate cytological reporting. Fine needle aspiration was more sensitive for detecting malignancy than clinical assessment alone, the sensitivity increasing with the experience of the aspirator. The results compared favourably with those in reported series from specialist centres in the United Kingdom. The value of fine needle aspiration extends to the overall management of patients with breast masses but the results must be assessed in conjunction with the clinical context in view of the possibility of false negative or, more rarely, false positive cytological diagnoses.

Adult↗
PubMed1995

Demonstration of CD44 gene expression in cells from fine needle aspirates of breast lesions by the polymerase chain reaction.

Aim-To demonstrate the feasibility of studying specific gene expression in fine needle aspirates from clinical lesions. The reverse transcription/polymerase chain reaction (RT-PCR) technique was used to demonstrate CD44 gene expression in cells from diagnostic fine needle aspirates taken from patients attending the outpatient clinic for breast diseases.Methods-Polyadenylated RNA was extracted from the cells remaining in the syringe barrel after fine needle aspirate cytological diagnosis of 41 patients with breast lesions. Analysis of CD44 gene expression was performed by RT-PCR using primers flanking the site for insertion of the variant exons. The resulting products were separated on 1.2% agarose gels, transferred to nylon membranes using Southern blotting and hybridised with specific probes for standard (constitutive) and variant exons of this gene.Results-On hybridisation with the CD44 standard exon probe, the expected amplified product of approximately 482 base pairs was visualised in 22 of 41 samples examined. Further hybridisation with the "variant" exon probes (exons 7 (v2), 8 (v3), 9b (v4), 12 (v7), and 15 (v10)) on 12 of these samples showed the presence of large molecular variants in all of these samples. However, the expression pattern detected with the probes for exons 7 (v2), 8 (v3) and 9b (v4) differed among the patients.Conclusions-Expression of the standard and variant regions of the CD44 gene in cells remaining in the syringe after fine needle aspiration was demonstrated using RT-PCR. The 5' variant exon probes seemed to show different patterns of expression among the patients. Further studies are currently being conducted to determine whether there is any correlation between expression of the various components of this gene and cytological diagnosis. Using this method, it would be possible to study the expression of other candidate marker genes in breast cancer using fine needle aspirates.

Journal Article↗
PubMed1998

A simple combined microdissection and aspiration device for the rapid procurement of single cells from clinical peripheral blood smears.

Molecular analysis of cells from cytology specimens can help to establish a diagnosis in ambiguous cases. However, mutations in heterogeneous samples might not be detected because of the diluting effect of DNA from normal background cells. Even if a mutation were detected, it could not be traced back to a specific cell type. Molecular analysis of single cells circumvents this problem. Both mechanical and laser assisted methods have been described for the selective procurement of cells from histology slides; however, they have the drawback of either being technically demanding or expensive. Furthermore, it is nuclear whether they can be applied to cytology specimens. Finally, few of these techniques are able to procure single cells. Therefore, we developed a simplified combined microdissection and aspiration device for the rapid procurement of single cells from clinical cytology specimens. The principle of this device, called the cytopicker, is the combination of the microdissection tool, a steel cannula, with the aspiration tool, a glass capillary connected to a vacuum, into one device. Steel cannulae are optimal for microdissection of cells from the hard matrix of cytology specimens but aspirate poorly. On the other hand, glass capillaries are suboptimal for dissecting but aspirate very well. Combining both tools into one by inserting the capillary into the cannula allows optimal dissection using the cannula (with the glass capillary with-drawn and thus protected), followed by optimal aspiration using the capillary (after being advanced through the cannula). All movements of the device are controlled by just one micromanipulator, making the cytopicker inexpensive to manufacture. The cytopicker can rapidly and simply procure single cells, such as lymphoblasts, from cytology specimens, such as peripheral blood smears. DNA from these cells can be amplified by PCR. However, precautions have to be taken to avoid contamination. Once improved further, the cytopicker might facilitate molecular analysis in the routine cytology laboratory.

Blood Specimen Collection↗