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At least 1,333 records · Page 74Linked to original sources
PubMed1997

[Biopsy of thoracic space-occupying lesions--from computerized tomography to ultrasound-controlled puncture].

PURPOSE: Having practised CT-controlled biopsies only, we introduced sonographically guided punctures since 1993 for pulmonary diagnoses. The effects are studied. METHOD: In a retrospective study 166 CT-guided biopsies from 1/89 to 12/95 and 50 sonographically guided biopsies from 7/93 to 12/95 were analysed. RESULTS: By CT, 67% intrapulmonary, 22% peripheral pulmonary and 11% pleuropulmonary, pleural and chest wall lesions were punctured. In 66% a diagnosis could be made. 13% of the patients experienced complications, most of them pneumothorax. Half of the patients subjected to sonographic biopsy showed peripheral pulmonary lesions, the other half tumours of the pleura, pleura and lung, mediastinum and chest wall. In 92% a positive result was obtained, whereas pneumothorax occurred in 2%. Leaving aside the intrapulmonary lesions, which would not have been visible by ultrasound, diagnosis with CT could be achieved in only 56% of the cases. CONCLUSION: In diagnosis of pleural, peripheral pulmonary and chest wall lesions, ultrasound guided biopsy is a safe, cost-effective, convenient and accurate method without exposure to x-rays.

Adolescent↗
PubMed1996

[Doppler ultrasound in cases of Rhesus incompatibility. Effect of intravascular punctures with or without transfusion on feto-placental Doppler blood flow velocity curves].

OBJECTIVE: To investigate the influence of cordocentesis with or without blood transfusion on umbilical and fetal blood flow characteristics. METHODS: Of 42 pregnant women suffering from Rh. incompatibility 15 had a puncture of the umbilical cord for diagnostic reasons only. In 27 cases a total of 86 punctures was done for blood transfusion. Fetal heart rate, umbilical artery A/B Ratio and Pulsatility Index (PI) in the fetal aorta were measured before and after cordocentesis in all cases having or having not a transfusion. RESULTS: Diagnostic and therapeutic cordocentesis resulted in a slight decrease of peripheral resistance. Significant differences were only observed in cases with a haematocrit < 20% compared to cases with values > 40% or if the final haematocrit after transfusion resulted in a value of < 30%. CONCLUSION: The decrease peripheral resistance in cases of therapeutic cordocentesis can be attributed to the increase in blood volume and sufficient oxygenation of blood improving fetal perfusion. Doppler sonography is not helpful in the clinical management of red blood cell immunisation.

Adult↗
PubMed1985

[Ultrasound guided puncture of wall fixed intrathoracic processes].

To improve differentiation of intrathoracic lesions in the vicinity of the chest wall, 167 patients were investigated via sonography. In the case of an indication the lesions were punctured, assisted by sonography. Sonography proved helpful in differentiating between liquid and solid masses and in localising the spot for puncture resulting in the successful removal of material for cytologic analysis in all our cases without any complications. The results of the study are presented, and the sonographic morphology is shown.

Biopsy, Needle↗
PubMed1990

[Comparison of ultrasound-controlled fine needle and coarse needle puncture of defined lesions in the abdomen].

Within a 2-year period 677 diagnostic fine needle (DFP) and coarse needle punctures (DGP) were performed in 536 patients. In 34 patients (14 women; 20 men; 54 +/- 17.6 years) the abdominal tumour mass was punctured with the fine needle (22 g) as well as with the coarse (18 g) needle. Sensitivity of DGP accounted for 72%, sensitivity of DFP was 82.6%. Specificity was 100%, respectively. Complications could not be observed, neither with the coarse needle nor with the fine needle. Due to the high sensitivity of DFP this method should be employed first in the diagnostic work up of abdominal tumours.

Abdominal Neoplasms↗
PubMed1986

[Diagnostic and therapeutic puncture sonography of the prostate].

Endosonography of the prostate in combination with ultrasonically guided biopsy is indicated to detect subclinical cancer and to determine local tumour extent. It is easy to puncture any area of interest in the prostate under accurate ultrasound guidance. The percutaneous, transperineal and ultrasonically guided 125iodine implantation enables, as an alternative procedure to radical surgery, good local tumour control in prostatic carcinoma. Ultrasonically guided puncture technique and implantation procedure are described and preliminary clinical results are presented.

Abscess↗
PubMed1983

[Ultrasound-assisted percutaneous blind puncture of the liver].

Since 1975 we performed 1221 percutaneous liver biopsies in outpatients. From 1978 onwards an upper abdominal ultrasound examination has been carried out in 731 patients before performing the puncture. In 203 consecutive punctures in the years 1981/82 another ultrasound examination two hours after the biopsy was performed. No complications have been observed. Hence, we recommend ultrasound examination in outpatients before biopsy for diagnostic and topographic reasons, but not afterwards, as the procedure seems reasonably safe.

Biopsy, Needle↗
PubMed1997

[Computer-assisted control of CT-guided caudo-cranial puncture access route using the triangulation method].

PURPOSE: To control the position of a puncture needle on an access route, which is not parallel to the CT-scan, using control scans not showing start and target points. METHODS: A software tool has been developed. After CT for biopsy planning x/y coordinates and table position of start and target points have to be determined on CT-scans. The software calculates x/y coordinates of the access route for every table position, which must be marked interactively on control scans. The accuracy of the programme was proven experimentally and the method was used in five patients. RESULTS: There was no difference between the calculated and measured access route in the experiment. Four of five patients were punctured successfully using our method. CONCLUSION: Our method is a promising procedure to control a CT-guided caudo-cranial biopsy access route.

Biopsy, Needle↗
PubMedDate not supplied

[Ultrasonically-guided percutaneous puncture and drainage of a splenic abscess caused by Salmonella heidelberg in a child].

In a boy aged 9 years and 11 months pain developed in the left upper abdomen following Salmonella enteritis infection. Purulent splenitis was diagnosed by sonography. Ultrasonically guided percutaneous puncture and drainage, and appropriate chemotherapy led to a marked improvement in the clinical picture and finally to complication-free remission. In a review of the literature the problems associated with purulent splenitis and the possibility of treating it by percutaneous puncture are pointed out. Purulent splenitis should be considered in all patients with temperatures and unexplained abdominal pain.

Abdominal Pain↗
PubMed1986

[Puncture biopsy of the lung. A retrospective evaluation of 127 observations].

On the grounds of a suspected localised tumorous lesion of the lung core biopsy (Tru-cut-needle) was performed in 127 patients to obtain a histologic diagnosis. This was successful on an average in 71.6% of the cases. The smaller lung lesions (less than 2.5 cm) showed a lower accuracy (65.2%) than the larger tumours (73.1%). Correct judgement of tumour status was effected in 88.2%. But in these cases also correct assessment of tumour status was less successful with the smaller tumours (69.6%) than with the larger ones (92.3%). In our case material core biopsy had a high complication rate: pneumothorax resulted in 54.3%, requiring special treatment in 9.4%. Haemoptisis was observed in 22.9% of which 2.4% had a severe and life-threatening clinical course. A correlation between these complications and the patient's age, the depth of the tumour in the lung and the frequency of the punctures was established. Pleural fluid was seen in 16.5% but in all cases it was negligible and no treatment was required. The pleural reaction showed no correlation to the age, to the tumorous lesion and to the frequency of puncture. The diagnostic advantage and the high accuracy of the core biopsy are evident. Nevertheless, we gave up this method in routine application in our lung tumour patients in favour of needle biopsy techniques. Core biopsy is still being used in examining special problems only.

Adult↗
PubMed1995

[Color Doppler-guided compression of pseudoaneurysms after arterial puncture. Early and late results].

Sixteen pseudoaneurysms occurred after 1796 femoral arterial punctures for diagnostic coronary angiography and/or angioplasty, performed between 1. 1. 1993 and 25. 3. 1994. One additional patient with pseudoaneurysm had undergone a femoral arterial puncture at another hospital. Primary colour Doppler-directed compression of the pseudoaneurysm (15-minute compression followed by 10-minute compressions, as needed) was successful in 16 patients. There was one recurrence, after five days, which was successfully and lastingly treated by another compression. Primary thrombosing by compression of the pseudoaneurysm failed in only one patient, but after spontaneous thrombosis achieved by a compression bandage no flow was demonstrable on the following day. Clinical examination and/or colour Doppler sonography was performed on all patients a mean of 84 days (5 days to 6 months) after successful treatment: no recurrence was recorded. There were no significant early or late complications. These data indicate that colour Doppler-monitored compression of femoral-artery pseudoaneurysm can be considered the treatment of choice, with few exceptions, for this not rare complication of arterial catheterization.

Aneurysm, False↗
PubMed1982

[Ultrasound controlled puncture of renal cysts: biochemical and radiological findings (author's transl)].

Ultrasonographically-guided renal cyst puncture was done in 128 patients on outpatient basis. Cortical renal cysts were seen in both male and female patients in an equal ratio. Mean age was 59.6 years. Complication rate of percutaneous puncture was low. Only twice transient haematuria was observed, needing no treatment. Aspirated fluids were examined cytologically and biochemically. None of the aspirated specimens showed malignant cells. Biochemically lactate dehydrogenase activity and concentrations of total protein, cholesterol, triglycerides, potassium and creatinine were determined. Potassium and creatinine determination were found to be valuable in distinguishing between cystic-like lesions containing secondary urine (like caliceal cysts, hydronephrosis, urinoma) and those containing primary urine (like cortical renal cysts). Thus measurement of potassium and creatinine in aspirated fluids may be helpful in determining the need for open exploratory surgery. In cases where cystic lesions produce urographically visible defects of the pelvic system, a dilatation of this area after evacuation of the cyst can be demonstrated via intravenous urography.

Adolescent↗
PubMed1981

[Ultrasound and guided aspiration puncture in delayed bleeding of splenic rupture (author's transl)].

We report on ultrasonic findings on 6 patients who suffered from subcapsular or delayed traumatic bleeding of the spleen. All patients had been hospitalized in our department of internal medicine because of a misinterpretation of their clinical symptoms. In 4 patients we secured the intraperitoneal bleeding with ultrasonically guided fine needle aspiration puncture. In case of a suspected ruptured spleen we suggest ultrasonic tomography with guided aspiration puncture at the beginning of diagnostic measures before invasive procedures (peritoneal lavage, angiography) and during follow-up.

Adult↗
PubMed1985

[Errors and hazards: fatalities through sternal puncture].

Iatrogenic cardiac injury due to diagnostic sternal puncture occurred in 5 patients, 2 women and 3 men, aged 14 to 37 years. Four cases ended fataly but 1 patient survived after immediate thoracotomy and suture of the damaged heart. Perforation of the anterior wall of the right ventricle resulting in pericardial tamponade was present in all patients. All fatalities resulted in conviction, under criminal law, of the clinician who carried out the puncture (Paragraph 222 StGB--causing death through negligence).

Adolescent↗
PubMed1993

A prospective study of the clinical outcome of femoral pseudoaneurysms and arteriovenous fistulas induced by arterial puncture.

PURPOSE: Although spontaneous thrombosis of femoral false aneurysms (FAs) and arteriovenous fistulas (AVFs) has been reported, the frequency of this occurrence is unknown. This prospective study was designed to establish the natural history of FA and AVF and to evaluate factors that might predict eventual thrombosis of these lesions. METHODS: Twenty-two patients with either femoral FAs (n = 16) or AVFs (n = 6) induced by percutaneous arterial punctures were evaluated prospectively. After an initial duplex scan, all patients were monitored with serial scans, either in hospital or weekly as outpatients, depending on the stability of the process. Operative repair was performed for the following indications: (1) a greater than 100% increase in size of a FA by duplex scan, (2) the development of symptoms, or (3) continued patency of the lesion after 2 months of observation. RESULTS: Nine of 16 FAs and four of six AVFs closed spontaneously; FAs greater than 6 cm3 (1.8 cm in diameter) required repair more often (p = 0.065). However, size was not an absolute predictor of the need for repair because two small aneurysms (1.6 and 0.7 cm3) remained patent, although both patients were discharged safely from the hospital, and two large aneurysms (13.2 and 10.7 cm3) thrombosed spontaneously. Three of seven patients whose aneurysms required repair received anticoagulation continuously from the time of catheterization until repair became necessary. None of the patients whose FAs closed spontaneously were receiving anticoagulants at the time of thrombosis (p = 0.02). Neither length of the FA neck, velocity in the FA cavity, size of original arterial puncture, nor velocity in the AVF correlated with thrombosis. CONCLUSIONS: We conclude that (1) all FAs do not thrombose spontaneously and at least one third require surgical repair, (2) patients receiving continuous anticoagulation should undergo aneurysm repair, (3) discharge of patients with FAs less than 6 cm3 is safe (the majority of these FAs will eventually thrombose spontaneously), and (4) many AVFs close spontaneously and repair is not required unless symptoms or signs of progressive enlargement develop.

Aneurysm, False↗
PubMed1987

Recommendation for collection of skin puncture blood from children, with special reference to production of reference values.

Reliable reference values need to be collected under standardized conditions. In order to enable comparison of values observed on patients with reference values, it is also desirable to use the same standardized conditions on patients. The present recommendation was produced as a joint effort of representatives of the clinical chemists and paediatricians of Scandinavia and describes the following details. Preparation of the child before specimen collection (food intake, time of day, physical activity, posture, environment), preparation of skin puncture site (warming, disinfection, ointment), instruments for blood collection (lancet, blood collection vessel), site of puncture (plantar surface of foot, finger, ear lobe), collection of emerging blood and handling and storage of the specimen.

Adolescent↗
PubMed1991

Efficacy of glove combinations in reducing cell culture infection after glove puncture with needles contaminated with human immunodeficiency virus type 1.

OBJECTIVE: To study the effect of various latex and treated glove combinations in reducing the frequency of human immunodeficiency virus (HIV) infection of tissue culture cells after puncture by surgical needles contaminated with infectious human immunodeficiency virus type 1 (HIV-1). DESIGN: One, two, or three layers of sterile latex glove material, or two latex layers with intermediate cotton or Kevlar (with or without the virucidal compound nonoxynol-9) were used to cover 24-well cell culture dishes containing MT2 cells in cell culture medium. Surgical needles wet with cell culture medium containing HIV-1 (HTLV IIIA strain) were passed through the glove materials into the culture medium in the wells of the culture dishes. The culture medium in each well was then assayed biweekly for HIV-1 p24 antigen as a test for infection of cells in the well. RESULTS: The rate of HIV-1 infection of cell cultures after glove puncture was greater than 90% with a single latex surgical glove barrier, 23% to 60% with double or triple layers of latex gloves, less than 8% with an intermediate cotton glove impregnated with 4% nonoxynol-9, 6% with an intermediate Kevlar glove, and 0% with an intermediate Kevlar glove impregnated with nonoxynol-9. CONCLUSIONS: An intermediate glove of Kevlar or of Kevlar or cotton impregnated with virucidal compound nonoxynol-9 between standard latex gloves may improve surgical glove safety, compared with latex gloves alone with respect to needlestick transmission of HIV-1. The experimental model used may permit rapid investigation of other glove systems as barriers to the transfer of infectious agents through gloves by needlestick.

Gloves, Surgical↗
PubMed1993

Puncture injuries due to needles removed from intravenous lines: should the source patient routinely be tested for bloodborne infections?

OBJECTIVE: To better assess the risk of exposure to bloodborne pathogens following puncture injuries due to needles removed from intravenous (IV) lines. SETTING: Tertiary care community medical center. PATIENTS: A convenience sample of hospitalized patients requiring IV piggy-back medications. METHODS: Examination of 501 IV ports of peripheral lines, heparin-locks, and central venous lines for visible blood and testing the residual fluid in the needles removed from these ports for the presence of occult blood by using guaiac-impregnated paper. RESULTS: The proximal ports of central venous lines and heparin-locks were statistically more likely to contain visible blood than proximal and distal ports of peripheral lines (17% and 20% versus 1% and 3% respectively, P < 0.05). Similarly, needles removed from proximal ports of central venous lines and heparin-locks were statistically more likely to contain occult blood than those from peripheral lines (11% and 14% versus 2%, respectively, P < 0.05). Only two needles removed from IV lines without visible blood contained occult blood: one from the proximal port of a central line and another from a heparin-lock. None of the needles from peripheral lines without visible blood contained occult blood. Estimation of the risk of transmission of hepatitis B and C and human immunodeficiency virus (HIV) following injury by needles from various IV lines revealed that injury due to needles removed from peripheral IV lines and distal ports of central lines without visible blood was associated with "near zero" risk of transmission of these bloodborne infections at our medical center. CONCLUSIONS: Routine serological testing of source patients involving injury due to needles removed from peripheral IV lines and distal ports of central lines without visible blood is not necessary at our medical center. Conversely, due to the relatively high rate of occult blood in the needles removed from proximal ports of central venous lines and heparin-locks, puncture injuries due to these needles are considered significant and managed accordingly.

Catheterization↗
PubMed1993

Visualization of extradural blood patch for post lumbar puncture headache by magnetic resonance imaging.

We describe a case of post lumbar puncture headache treated by extradural blood patch. Magnetic resonance imaging (MRI) demonstrated a large extradural haematoma extending over four spinal segments and extending out through the neural outlet foramina. There was significant compression of the thecal sac, supporting the theory that extradural blood patch causes tamponade at the site of dural puncture. The spread of clot was predominantly upwards from the injection site and subarachnoid extension of blood was also demonstrated.

Adult↗