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PubMed1992

Microscopic observations on tracheal aspirates from ventilated neonates. II. The onset of bronchopulmonary dysplasia and other changes.

A total of 450 undiluted and unprocessed tracheal aspirates from 120 intubated infants were examined microscopically for evidence of bronchopulmonary dysplasia and other changes. In 19 infants desquamated sheets of dysplastic epithelium in the fresh aspirate provided an early indication of developing bronchopulmonary dysplasia. Examination of unstained tracheal aspirates can provide, within minutes, information not only about the onset and development of bronchopulmonary dysplasia, but also provide evidence for milk or formula aspiration and for gastro-oesophageal reflux.

Bile Pigments↗
PubMed1996

Early timed follicular aspiration prevents severe ovarian hyperstimulation syndrome.

PURPOSE: Early timed follicular aspiration (ETFA) of one ovary 10-12 hr after administration of chorionic gonadotropin (hCG) is an attempt to prevent severe ovarian hyperstimulation syndrome (OHSS). After the introduction of early timed follicular aspiration ETFA of one ovary in IVF/ET cycles at high risk for severe OHSS, no cases of severe OHSS were registered in the Ljubljana IVF/ET program. In the period before preventive ETFA (1984-1992) there were 16 cases of severe OHSS of 4798 IVF/ET cycles followed by 577 clinical pregnancies. After the introduction of ETFA (1992-1993) there were no cases of severe OHSS of 2289 IVF/ET cycles followed by 364 clinical pregnancies. METHODS: We attempted to evaluate the significance of this observation by comparing two groups of female infertility IVF/ET cycles at high risk for severe OHSS. The occurrence of severe OHSS and clinical parameters in the two groups of IVF/ET cycles at high risk for severe OHSS were compared. RESULTS: In the group of 106 IVF/ET female infertility cycles at high risk of severe OHSS with preventive ETFA, there were no cases of severe OHSS. In the control group of 92 IVF/ET female infertility cycles at high risk for severe OHSS with normally timed follicular aspiration (NTFA) of both ovaries, severe OHSS occurred in 16 cases. The difference in the occurrence of severe OHSS between the two groups is highly significant (P < 0.005), both in hMG/hCG- and in GnRHa/hMG/hCG-induced IVF/ET cycles. No difference in live birth rate (16 vs. 16%) between the two groups was noted. CONCLUSIONS: Considering these results we conclude that ETFA is another successful option to decrease the incidence of severe OHSS in assisted reproduction. The preventive effect of follicular aspiration seems to depend on its timing.

Embryo Transfer↗
PubMed1993

Stable microbubble test for predicting the risk of respiratory distress syndrome: II. Prospective evaluation of the test on amniotic fluid and gastric aspirate.

We determined prospectively if the stable microbubble (SM) test on gastric aspirate obtained at birth was as useful as that on amniotic fluid in predicting respiratory distress syndrome (RDS). One hundred and five paired samples of amniotic fluid obtained at delivery from 105 consecutive women with gestation of 35 weeks or less and gastric aspirates from their neonates obtained within 30 min of birth were studied. The SM test with the predefined cut-off value of less than 5 bubbles/mm2 for amniotic fluid and less than 10 bubbles/mm2 for gastric aspirate signified the risk of RDS with the positive predictive value of 100% and 96% and with the negative predictive value of 91% and 84%, respectively. We conclude that the SM test on both amniotic fluid and gastric aspirate obtained at birth is a rapid (< 10 min), simple and reliable procedure for predicting neonates who will develop RDS. It may be used as a bedside test to define a population of neonates with surfactant deficiency in clinical trials of prophylactic surfactant therapy.

Amniotic Fluid↗
PubMed1995

Ultrasound-guided aspiration in suspected sepsis of resection arthroplasty of the hip joint.

The authors described 17 patients who had had resection arthroplasty of the hip and who were suspected of having an infection. The resection arthroplasties had been performed for previous infection. All the patients were studied by ultrasonography to detect effusion in the pseudoarticular space. Thirteen of the 17 patients were found to have an effusion by ultrasonography. Fluid was obtained in 9 of the 13 patients by ultrasonographic-guided aspiration. The mean aspirated volume was 3 ml (range 1-25 ml). Five of the 9 aspirates proved to be septic. The echopattern in all but one of those five with sepsis was nonechofree. Of four other patients in whom it was not possible to aspirate fluid lavage of the pseudoarticular space one yielded a positive culture. The role of ultrasonography in the diagnosis and management of patients who have undergone resection arthroplasty of the hip and who are suspected of having an infected pseudoarticular space is discussed.

Aged↗
PubMed1977

Percutaneous fine needle aspiration biopsy of pancreatic carcinoma.

Carcinoma of the pancreas was diagnosed in 13 patients by percutaneous fine needle aspiration. The tumor was localized by angiography in eight, ultrasound in five, and endoscopic retrograde pancreatography in three patients. In four patients aspiration was performed using two of the three localizing techniques. Cytological diagnosis of carcinoma of the pancreas can be made accurately by percutaneous fine needle aspiration of the tumor and operative intervention avoided in those patients who do not require operative bypass procedures. Percutaneous fine needle aspiration can be used with equal facility with arteriography, ultrasound, or endoscopic retrograde pancreatography. There have not been complications due to fine needle biopsy, and one can expect a 77-86% positive diagnostic yield.

Angiography↗
PubMed1991

Liposuction: more curettage than aspiration.

After infiltration with epinephrine solution in each adipose area, an 8- or 10-mm cannula, without the suction tube connected, was introduced. With a curettage maneuver and by directing the cannula upward, the fat began to come out spontaneously. After obtaining a considerable amount of fat, the suction tube was connected and the remaining fat tissue aspirated at low suction power (250 mm Hg). With this curettage maneuver adiposity of the abdomen, knees, and trochanteric areas can be reduced. However, in the back, buttocks, or thighs, where adiposity is more fibrous, aspiration is needed from the start in almost every case, but always at low-power suction. This procedure is indicated in particular for the face and neck and for secondary liposuction. The fact that fat comes out easily through the cannula (without suction) demonstrates that the curettage maneuver is more important than the aspiration. Only with curettage can a considerable amount of fat be removed. No fat is removed when aspiration of 1 atm without a curettage maneuver is used. Suction only helps to remove fat already mobilized and free in the cannula. Our experience includes 34 patients.

Abdomen↗
PubMed1995

Transrectal needle aspiration versus transperineal needle biopsy in diagnosis of prostatic carcinoma.

Fine-needle aspiration of the prostate was compared to transperineal biopsy in 86 patients with suspected prostatic carcinoma. Aspiration was found to have a sensitivity of 98.6% while no complications were seen. Initial core needle biopsy compared to the final histological diagnosis in this study showed a sensitivity of 84.5%. Fine-needle aspiration of the prostate is a safe, inexpensive and accurate diagnostic method in prostatic carcinoma. Our findings suggest that prostatic aspiration should be used more widely as an initial diagnostic procedure for suspected prostatic cancer.

Biopsy, Needle↗
PubMedDate not supplied

Oscillating probe aspiration thrombectomy: comparative in vitro evaluation of two concepts.

Aspiration thrombectomy supported by an oscillating metal probe within the catheter allows continuous aspiration of large thrombi without catheter obstruction. Thrombus aspiration assisted by an ultrasound-driven probe (frequency 26 kHz) and by an electric motor-driven probe (frequency 40 Hz) was compared in two different in vitro models: aspiration of large clots from a Petri dish and recanalization of thrombotic occlusions in a flow model. Comparable results were found for a 1 mm ultrasound-driven probe and a 0.5 mm motor-driven probe. The motor-driven device, however, seems to be more appealing for in vivo application because of its simplicity, probe flexibility, absence of thermal effects, and low cost.

Animals↗
PubMed1997

A simplified technique for embryo biopsy: use of the same micropipette for zona drilling and blastomere aspiration.

PURPOSE: Using different micropipettes for zona drilling and blastomere aspiration for embryo biopsy is prevalent at centers of preimplantation genetic diagnosis. The purpose of our study was to simplify the technique by using only one micropipette. METHODS: In this animal model, ICR mouse embryos at the four-cell stage (n = 446) were randomly allocated into two groups; a biopsied group (n = 224) for blastomere aspiration and a control group (n = 222) without micromanipulation. We used a drilling/biopsy micropipette to drill a hole in the zona by expulsion of acidified Tyrode's solution and to aspirate the blastomere by gentle suction with the same micropipette and pull it out of the zona. One blastomere was biopsied from each embryo. RESULTS: In all, 222 (99.1%) intact blastomeres were successfully biopsied from 224 embryos. Only two blastomeres were damaged during aspiration. The capacity for blastocyst development (92.4 vs 93.7%) was not different between the two groups, but the percentages of embryos hatching (51.8 vs 18.0%) and hatched (29.9 vs 8.1%) were significantly higher in the biopsied group than in the control group. CONCLUSIONS: This simplified technique of embryo biopsy is safe and highly efficient for obtaining blastomeres for preimplantation genetic diagnosis and may also facilitate hatching of the blastocysts.

Animals↗
PubMed1993

Fine needle aspiration cytology of thyroid nodules: review of 36 months experience.

Studies suggest that fine needle aspiration of thyroid nodules is a sensitive and specific tool for the detection of thyroid cancers thus preventing unnecessary operations. This technique was introduced in our institution in 1987 and performed where indicated under strictly defined criteria. We reviewed the aspirates performed over a 36 month period to critically evaluate the role of this procedure. Review was limited to F.N.A.s of nodules considered to be potentially malignant by conventional criteria and hence all the following criteria needed to be fulfilled: (1) solitary or dominant nodules in a multinodular goitre, (2) cold on isotope scanning, (3) solid or complex cystic nodule on ultrasonography. During the period May 1987 to May 1990 88 aspiration procedures were performed on 77 patients. 93% of the 77 patients had adequate aspirates and of these approximately 30% were considered suspicious or malignant. The overall resection rate was 23.4% which is approximately one third of the rate expected should suspicion have been based solely on conventional imaging criteria. The yield of neoplasia (adenoma and carcinoma) at resection was 89%. We found FNA to be a very useful adjunct in the management of nodular thyroid disease when used in conjunction with clinical laboratory and radiological evaluation. It is safe, inexpensive and provides useful additional information towards making appropriate decisions in an area beset with uncertainty.

Biopsy, Needle↗
PubMed1996

Flow Cytometric Assay of c-erbB-2 Protein in Fine Needle Aspirates of Fresh and Frozen Human Breast Cancer Tissues.

Using FCM (flow cytometry), we analyzed the ErbB-2 (c-erbB-2 protein) status of 61 breast cancer tissue samples obtained by FNAB (fine-needle aspiration biopsy). The number of cancer cells collected by FNAB from fresh samples was 1.7+/-0.7 x10&sup5;, 2.5 +/-0.6 x10&sup5;, and 4.0+/- 0.8x10 &sup5;, by single, double and triple aspirations, respectively. A mean of 3.0+/-0.6 x10&sup5;cells was collected on three aspirations from frozen samples. The number of cells collected on three aspirations was sufficient for the measurement of ErbB-2. Cells with higher ErbB-2 levels than those of normal human lymphocytes were designated ErbB-2 positive cells. The mean overall for ErbB-2 positive cell rates was 20.5 +/- 27.9 % (mean+/-SD). The rates were 27.9 +/- 31.6 % in patients with recurrence and 15.9 +/- 24.4% in patients without recurrence. When the cut-off value was set at 20% of the positive cell rate (P =0.008, generalized Wilcoxon test), patients with ErbB-2 negative tumors showed highly significantly longer survival without recurrence (P=0.008, generalized Wilcoxontest) and better overall survival rates (P=0.013) than patients with ErbB-2 positive tumors. Among 61 specimens, 16 (26.2%) scored positive for ErbB-2 by FCM. These finding indicated that the analysis of ErbB-2 status using FCM of samples obtained by FNAB should be useful for preoperatively evaluating the prognosis of patients with breast cancer.

Journal Article↗
PubMed1998

Tracheotomy tube occlusion status and aspiration in early postsurgical head and neck cancer patients.

The purpose of the present study was to investigate tracheotomy tube occlusion status and prevalence of aspiration utilizing videofluoroscopy. A prospective study was done of 16 consecutive, early, postsurgical head and neck cancer patients with tracheotomy. Selection criteria included the ability to tolerate tracheotomy tube occlusion prior to and during the modified barium swallow procedure, oral and/or pharyngeal surgical resection, no history of neurological disease or stroke, and medical clearance to begin oral feeding. There was 100% agreement among the independent reviewers on ratings of the presence or absence of aspiration. It was found that occlusion status of the tracheotomy tube did not influence the prevalence of aspiration in the immediate postoperative period. No trends were observed when comparing bolus consistency, type of tracheotomy tube, or presence/absence of a nasogastric tube and the ratings of aspiration.

Adult↗
PubMed1999

Laryngeal penetration: a predictor of aspiration in infants?

BACKGROUND: We routinely observed "isolated" laryngeal penetration (ILP) on upper GI studies in infants with no risk for aspiration. OBJECTIVE: To determine whether "isolated" LP (LP during the pharyngeal phase of swallowing) is a benign process in infants and therefore not a predictor of aspiration as it is known to be in adults. PATIENTS AND METHODS: Two radiologists retrospectively reviewed videotaped upper GI studies done over a 2-year period on patients less than 2 years of age. A total of 110 studies was reviewed, which produced a study group of 34 patients who had no history or clinical suspicion for swallowing dysfunction. RESULTS: Of the 34 patients in the group, 33 demonstrated ILP without radiographic or clinical evidence of aspiration. CONCLUSION: ILP is a benign, normal process in infants likely due to immaturity of the swallowing mechanism. It is not a reliable predictor of aspiration as it is in adults.

Deglutition↗
PubMed2001

Sonographic detection, evaluation and aspiration of infected acromioclavicular joints.

OBJECTIVE: To describe the sonographic findings of septic arthritis of the acromioclavicular joint. DESIGN AND PATIENTS: A retrospective study of five male patients was carried out. Four of the patients were referred because of signs and symptoms suggestive of glenohumeral joint septic arthritis, one for signs and symptoms suggestive of septic arthritis of the acromioclavicular joint. All the acromioclavicular joints were evaluated with ultrasound, aspirated and the aspirate cultured. RESULTS: All patients had normal ultrasound findings of their glenohumeral joints and distended acromioclavicular joints as determined by ultrasound. Ultrasound examination elicited focal tenderness over the acromioclavicular joint. Aspirates of each acromioclavicular joint grew pyogenic organisms. CONCLUSION: Infection in the acromioclavicular joint is uncommon, but is seen in increased frequency in immune-compromised patients and intravenous drug users. A normal glenohumeral joint on ultrasound in a patient suspected of having a septic shoulder should prompt careful review of the acromioclavicular joint. Aspiration of the acromioclavicular joint is easily performed under ultrasound guidance.

Acromioclavicular Joint↗
PubMedDate not supplied

Disseminated mycobacterial infection in AIDS patients: abdominal US features and value of fine-needle aspiration biopsy of lymph nodes and spleen.

BACKGROUND: We evaluated the efficacy of abdominal ultrasound (US) and fine-needle aspiration biopsy (FNAB) in the diagnosis of disseminated mycobacteriosis (DM) in acquired immunodeficiency syndrome (AIDS). METHODS: Twelve AIDS patients (nine male, three female; age range, 22-43 years) with DM underwent abdominal US within 2 days after admission with 3.5- to 5-MHz convex probes and a 7.5-MHz linear probe. All patients underwent FNAB of one or two enlarged abdominal lymph nodes. Eight patients underwent FNAB of the spleen. The aspirated specimens were stained with acid fast for quick examination and cultured for isolation of mycobacteria. RESULTS: Abdominal US showed enlarged, hypoechoic, round or oval, abdominal lymph nodes (diameter, 10-35 mm; mean, 18 mm) in all patients; splenomegaly (spleen diameter, 14-22 cm; mean, 16.8 mm) in all patients; numerous splenic abscesses (diameter, 3-20 mm) in nine patients; hepatomegaly (right hepatic lobe thickness, 14.5-17 cm) in all patients; small intestinal wall thickening in five patients (maximum bowel wall thickness, 7-15 mm); mild to moderate ascites in six patients; pleural effusion in four patients; bilateral enlargement of the kidneys with hyperechogenicity of the cortex in three patients; and a retroperitoneal tubercular abscess in one patient. No complication occurred after FNAB of lymph nodes and spleens. Fast-acid stain of spleen and/or lymph node FNAB specimens allowed early diagnosis of mycobacteriosis in 12 of 12 cases (100%). Cultures of lymph node aspirates grew mycobacteria in six of 12 patients (50%). Spleen aspirates grew mycobacteria in nine of nine patients (100%). Blood cultures were positive in four of 12 patients (33%). Mycobacterium tuberculosis was diagnosed in six patients and M. avium in five. CONCLUSION: Abdominal US features can suggest DM in AIDS patients. Spleen and/or lymph node FNAB indicated the specific diagnosis in 100% of patients.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Percutaneous CT-guided biopsy of the lung: comparison between aspiration and automated cutting needles using a coaxial technique.

PURPOSE: To compare the accuracy and complication rate of two different CT-guided transthoracic needle biopsy techniques: fine needle aspiration and an automated biopsy device. METHODS: Two consecutive series of respectively 125 (group A) and 98 (group B) biopsies performed using 20-22 gauge coaxial fine needle aspiration (group A) and an automated 19.5 gauge coaxial biopsy device (group B) were compared in terms of their accuracy and complication rate. RESULTS: Groups A and B included respectively 100 (80%) and 77 (79%) malignant lesions and 25 (20%) and 18 (21%) benign lesions. No significant difference was found between the two series concerning patients, lesions, and procedural variables. For a diagnosis of malignancy, a statistically significant difference in sensitivity was found (82.7% vs 97.4%) between results obtained with the automated biopsy device and fine needle aspiration respectively. For a diagnosis of malignancy, the false negative rate of the biopsy result was significantly higher (p <0.005) in group A (17%) than in group B (2.6%). For a specific diagnosis of benignity, no statistically significant difference was found between the two groups (44% vs 26%) but the automated biopsy device provided fewer indeterminate cases. There was no difference between the two groups concerning the pneumothorax rate, which was 20% in group A and 15% in group B, or the hemoptysis rate, which was 2.4% in group A and 4% in group B. CONCLUSION: For a diagnosis of malignancy when a cytopathologist is not available on-site, automated biopsy devices provide a lower rate of false negative results and a similar complication rate to fine needle aspiration.

Adult↗
PubMed2006

Nasal NO measurement by direct sampling from the nose during breathhold: Aspiration flow, nasal resistance and reproducibility.

The objective of this study was assessment of the effect of aspiration flow, the nasal cycle, and time on nasal nitric oxide (nNO) concentrations in air sampled from one nostril during breathhold. nNO was measured in 45 healthy subjects (19 males, aged 18-45 years) from one nostril during breathholding. We compared nNO values and time to plateau in both nostrils with 3 aspiration flows (280, 700, 1,200 ml/min) and assessed the short-term and long-term reproducibility. Mean nNO values at flows of 280, 700 and 1,200 ml/min differed significantly (P < 0.01): 854, 474, 380 ppb, respectively. The (median) plateau was reached after 6, 4 and 3 s for the different flows. The within-subject coefficient of variability was always < 5%. We found no difference in nNO between left-, right-, largest or smallest nostril (P > 0.10). nNO values after 6, 24 h and 7 days were not significantly different from baseline (P > 0.10) and showed fair reproducibility. The highest aspiration flow was experienced as unpleasant. nNO can be measured in either nostril and shows no diurnal variation. The measurement is quick, reproducible, feasible and best accepted with an aspiration flow of 700 ml/min during breathhold for 10 s.

Adolescent↗
PubMed2000

Combined clear cornea phacoemulsification and trabecular aspiration in the treatment of pseudoexfoliative glaucoma associated with cataract.

BACKGROUND: In the present prospective randomized study the effectiveness and safety of trabecular aspiration combined with clear cornea phacoemulsification (phaco) was compared to clear cornea phaco alone in patients with pseudoexfoliation (PEX) glaucoma and visually disabling cataract. METHODS: Twenty-seven patients suffering from visually significant cataract (visual acuity < 5 Snellen lines) and PEX glaucoma were randomly assigned to either phaco combined with trabecular aspiration (14 eyes of 14 patients) or phaco alone (13 eyes of 13 patients). Inclusion criteria for glaucoma were IOP < or = 22 mmHg under treatment with up to two antiglaucomatous agents, excluding pilocarpine 4%, and no previous surgery or laser trabeculoplasty treatment. Clear cornea phaco with foldable acrylic intraocular lens (IOL) implantation was carried out in all patients uneventfully. Trabecular aspiration was performed using a special probe in the inferior 180 deg of the angle after IOL implantation. RESULTS: Follow-up duration ranged from 12 to 18 months. In the combined procedure group there was a statistically significant decrease in postoperative IOP during the whole follow-up period (P < 0.01), while in 9 of the 14 patients the IOP was controlled without medications at the last examination. In the phaco alone group a statistically significant decrease in postoperative IOP was recorded at 9 and 12 months after surgery (P < 0.05), while in 4 of the 13 patients the IOP was controlled without medications at the last examination. Comparing the two groups, a statistically significantly lower number of medications was being used in the combined procedure group at the last recorded examination (P < 0.05). CONCLUSIONS: It seems that the combined clear cornea phaco and trabecular aspiration procedure in cases of PEX glaucoma associated with cataract is a safe and effective method. This technique controls IOP more effectively and with fewer postoperative medications than clear cornea phaco alone.

Aged↗