Transbronchial needle aspiration with a new electromagnetically-tracked TBNA needle

NASA Astrophysics Data System (ADS)

Choi, Jae; Popa, Teo; Gruionu, Lucian

2009-02-01

Transbronchial needle aspiration (TBNA) is a common method used to collect tissue for diagnosis of different chest diseases and for staging lung cancer, but the procedure has technical limitations. These limitations are mostly related to the difficulty of accurately placing the biopsy needles into the target mass. Currently, pulmonologists plan TBNA by examining a number of Computed Tomography (CT) scan slices before the operation. Then, they manipulate the bronchoscope down the respiratory track and blindly direct the biopsy. Thus, the biopsy success rate is low. The diagnostic yield of TBNA is approximately 70 percent. To enhance the accuracy of TBNA, we developed a TBNA needle with a tip position that can be electromagnetically tracked. The needle was used to estimate the bronchoscope's tip position and enable the creation of corresponding virtual bronchoscopic images from a preoperative CT scan. The TBNA needle was made with a flexible catheter embedding Wang Transbronchial Histology Needle and a sensor tracked by electromagnetic field generator. We used Aurora system for electromagnetic tracking. We also constructed an image-guided research prototype system incorporating the needle and providing a user-friendly interface to assist the pulmonologist in targeting lesions. To test the feasibility of the accuracy of the newly developed electromagnetically-tracked needle, a phantom study was conducted in the interventional suite at Georgetown University Hospital. Five TBNA simulations with a custom-made phantom with a bronchial tree were performed. The experimental results show that our device has potential to enhance the accuracy of TBNA.

Does a child's fear of needles decrease through a learning event with needles?

PubMed

Kajikawa, Natsuki; Maeno, Takami; Maeno, Tetsuhiro

2014-09-01

Most children have a fear of needles. Suitable preparation can decrease the pain and fear of needles in hospitals; however, few have examined how such preparation affects healthy children. This study examined whether learning with needles decreases fear of needles and changes motivation to get vaccinations in school-age children and the possible association between fear of needles and motivation toward vaccinations. This study included children participating in the "Let's Be Doctors" event, which was held in 4 child centers in Tsukuba city, Ibaraki, Japan. In this event, children learned about injections and how a vaccine works, and injected a vaccine (water) into skin (sponge) using a real syringe and imitation needle. Data were collected just before and after the event by anonymous self-assessment questionnaires that used a 4-point Likert scale to assess fear of needles, motivation to get vaccinations, recommendation of vaccinations, and fear toward doctors among the children. Answers were divided into two categories for statistical analysis. In total, 194 children participated in the event and 191 children answered the questionnaire (response rate 98.5%). We analyzed 180 subjects, comprising 79 boys (43.9%) and 94 girls (52.2%), mean age of 8.1 ± 1.0 years. The number of children reporting a fear of needles decreased from 69 (38.3%) before the event to 51 (28.3%) after the event, and those unwilling to get vaccinations decreased from 48 (26.7%) to 27 (15.0%). Children who reported fear of needles before the event were more unwilling to get vaccinations than those with no fear of needles (36 [52.2%] vs. 12 [10.8%]), while after the event the number of needle-fearing children unwilling to get vaccinations decreased to 19 (27.5%). Children's fear of needles and unwillingness to get vaccinations were decreased after experiencing a learning event with needles. The fear of needles is associated with a negative motivation to get vaccinations in children.

Teleoperated master-slave needle insertion.

PubMed

Abolhassani, Niki; Patel, Rajni V

2009-12-01

Accuracy of needle tip placement and needle tracking in soft tissue are of particular importance in many medical procedures. In recent years, developing autonomous and teleoperated systems for needle insertion has become an active area of research. In this study, needle insertion was performed using a master-slave set-up with multi-degrees of freedom. The effect of force feedback on the accuracy of needle insertion was investigated. In addition, this study compared autonomous, teleoperated and semi-autonomous needle insertion. The results of this study show that incorporation of force feedback can improve teleoperated needle insertion. However, autonomous and semi-autonomous needle insertions, which use feedback from a deflection model, provide significantly better performance. Development of a haptic master-slave needle insertion system, which is capable of performing some autonomous tasks based on feedback from tissue deformation and needle deflection models, can improve the performance of autonomous robotics-based insertions as well as non-autonomous teleoperated manual insertions. Copyright (c) 2009 John Wiley & Sons, Ltd.

Effect and Safety of Deep Needling and Shallow Needling for Functional Constipation

PubMed Central

Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

2014-01-01

Abstract Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study. SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P < 0.01, all). The changes in the mean weekly SBMs over week 1 to 4 were 2 (1.75) in the deep needling group, 2 (1.75) in the shallow needling group, and 2 (2) in the lactulose group (P > 0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (P < 0.05, all compared with the lactulose group). No significant difference

Effect of Needle Size in Ultrasound-guided Core Needle Breast Biopsy: Comparison of 14-, 16-, and 18-Gauge Needles.

PubMed

Giuliani, Michela; Rinaldi, Pierluigi; Rella, Rossella; Fabrizi, Gina; Petta, Federica; Carlino, Giorgio; Di Leone, Alba; Mulè, Antonino; Bufi, Enida; Romani, Maurizio; Belli, Paolo; Bonomo, Lorenzo

2017-11-01

The aim of the present study was to assess the diagnostic accuracy of ultrasound-guided core needle biopsy (US-CNB) of breast lesions, comparing smaller needles (16- and 18-gauge) with the 14-gauge needle, and to analyze the lesion characteristics influencing US-CNB diagnostic performance. All the patients provided informed consent before the biopsy procedure. The data from breast lesions that had undergone US-CNB in our institution from January 2011 to January 2015 were retrospectively reviewed. The inclusion criterion was the surgical histopathologic examination findings of the entire lesion or radiologic follow-up data for ≥ 24 months. The exclusion criterion was the use of preoperative neoadjuvant therapy. The US-CNB results were compared with the surgical pathologic results or with the follow-up findings in the 3 needle size groups (14-, 16-, and 18-gauge). The needle size- and lesion characteristic-specific diagnostic accuracy parameters were evaluated. Statistical analysis was performed using a dedicated software program, and P ≤ .01 was considered significant. A total of 1118 US-CNB cases (1042 patients) were included. Of the 1118 cases, 630 (56.3%) were in the 14-gauge group, 136 (12.2%) in the 16-gauge, and 352 (31.5%) in the 18-gauge needle group. Surgery was performed on 800 lesions (71.6%). Of these, 619 were malignant, 77 were high risk, and 104 were benign. The remaining 318 lesions (28.4%) underwent follow-up imaging studies. All the lesions were stable and, therefore, were considered benign. No differences were observed in the diagnostic accuracy parameters among the 3 needle size groups (P > .01). The false-negative rate was greater for lesions < 10 mm (7.2%) (P < .01) but without statistically significant differences among the 3 gauges (P > .01). US-CNB performed with small needles (16 and 18 gauge) had the same diagnostic accuracy as that performed with 14-gauge needles, regardless of the lesion characteristics. Copyright © 2017

Paraesthesia during the needle-through-needle and the double segment technique for combined spinal epidural anaesthesia.

PubMed

Ahn, H J; Choi, D H; Kim, C S

2006-07-01

Paraesthesia during regional anaesthesia is an unpleasant sensation for patients and, more importantly, in some cases it is related to neurological injury. Relatively few studies have been conducted on the frequency of paraesthesia during combined spinal epidural anaesthesia. We compared two combined spinal epidural anaesthesia techniques: the needle-through-needle technique and the double segment technique in this respect. We randomly allocated 116 parturients undergoing elective Caesarean section to receive anaesthesia using one of these techniques. Both techniques were performed using a 27G pencil point needle, an 18G Tuohy needle, and a 20G multiport epidural catheter from the same manufacturer. The overall frequency of paraesthesia was higher in the needle-through-needle technique group (56.9% vs. 31.6%, p = 0.011). The frequency of paraesthesia at spinal needle insertion was 20.7% in the needle-through-needle technique group and 8.8% in the double segment technique group; whereas the frequency of paraesthesia at epidural catheter insertion was 46.6% in the needle-through-needle technique group and 24.6% in the double segment technique group.

Physical Properties Of Acupuncture Needles: Do Disposable Acupuncture Needles Break With Normal Use

DTIC Science & Technology

2016-06-01

Lamb shank, which has complexity of tendon, fascia, and bone, was used to mimic human tissue. The needles (n=10) were stressed in the tissue substitute...needles were re-imaged after stressing and visually assessed. RESULTS: Only one manufacturing scuff mark was noted out of 90 needles before stress ...testing. Needles buckled but did not break when they were stressed beyond normal clinical use. No cracks or fractures were noted after stress

Does Needle Rotation Improve Lesion Targeting?

PubMed Central

Badaan, Shadi; Petrisor, Doru; Kim, Chunwoo; Mozer, Pierre; Mazilu, Dumitru; Gruionu, Lucian; Patriciu, Alex; Cleary, Kevin; Stoianovici, Dan

2011-01-01

Background Image-guided robots are manipulators that operate based on medical images. Perhaps the most common class of image-guided robots are robots for needle interventions. Typically, these robots actively position and/or orient a needle guide, but needle insertion is still done by the physician. While this arrangement may have safety advantages and keep the physician in control of needle insertion, actuated needle drivers can incorporate other useful features. Methods We first present a new needle driver that can actively insert and rotate a needle. With this device we investigate the use of needle rotation in controlled in-vitro experiments performed with a specially developed revolving needle driver. Results These experiments show that needle rotation can improve targeting and may reduce errors by as much as 70%. Conclusion The new needle driver provides a unique kinematic architecture that enables insertion with a compact mechanism. Perhaps the most interesting conclusion of the study is that lesions of soft tissue organs may not be perfectly targeted with a needle without using special techniques, either manually or with a robotic device. The results of this study show that needle rotation may be an effective method of reducing targeting errors. PMID:21360796

A novel adaptive needle insertion sequencing for robotic, single needle MR-guided high-dose-rate prostate brachytherapy

NASA Astrophysics Data System (ADS)

Borot de Battisti, M.; de Senneville, B. Denis; Hautvast, G.; Binnekamp, D.; Lagendijk, J. J. W.; Maenhout, M.; Moerland, M. A.

2017-05-01

MR-guided high-dose-rate (HDR) brachytherapy has gained increasing interest as a treatment for patients with localized prostate cancer because of the superior value of MRI for tumor and surrounding tissues localization. To enable needle insertion into the prostate with the patient in the MR bore, a single needle MR-compatible robotic system involving needle-by-needle dose delivery has been developed at our institution. Throughout the intervention, dose delivery may be impaired by: (1) sub-optimal needle positioning caused by e.g. needle bending, (2) intra-operative internal organ motion such as prostate rotations or swelling, or intra-procedural rectum or bladder filling. This may result in failure to reach clinical constraints. To assess the first aforementioned challenge, a recent study from our research group demonstrated that the deposited dose may be greatly improved by real-time adaptive planning with feedback on the actual needle positioning. However, the needle insertion sequence is left to the doctor and therefore, this may result in sub-optimal dose delivery. In this manuscript, a new method is proposed to determine and update automatically the needle insertion sequence. This strategy is based on the determination of the most sensitive needle track. The sensitivity of a needle track is defined as its impact on the dose distribution in case of sub-optimal positioning. A stochastic criterion is thus presented to determine each needle track sensitivity based on needle insertion simulations. To assess the proposed sequencing strategy, HDR prostate brachytherapy was simulated on 11 patients with varying number of needle insertions. Sub-optimal needle positioning was simulated at each insertion (modeled by typical random angulation errors). In 91% of the scenarios, the dose distribution improved when the needle was inserted into the most compared to the least sensitive needle track. The computation time for sequencing was less than 6 s per needle track. The

Dynamics of translational friction in needle-tissue interaction during needle insertion.

PubMed

Asadian, Ali; Patel, Rajni V; Kermani, Mehrdad R

2014-01-01

In this study, a distributed approach to account for dynamic friction during needle insertion in soft tissue is presented. As is well known, friction is a complex nonlinear phenomenon. It appears that classical or static models are unable to capture some of the observations made in systems subjected to significant frictional effects. In needle insertion, translational friction would be a matter of importance when the needle is very flexible, or a stop-and-rotate motion profile at low insertion velocities is implemented, and thus, the system is repeatedly transitioned from a pre-sliding to a sliding mode and vice versa. In order to characterize friction components, a distributed version of the LuGre model in the state-space representation is adopted. This method also facilitates estimating cutting force in an intra-operative manner. To evaluate the performance of the proposed family of friction models, experiments were conducted on homogeneous artificial phantoms and animal tissue. The results illustrate that our approach enables us to represent the main features of friction which is a major force component in needle-tissue interaction during needle-based interventions.

Needle phobia during pregnancy.

PubMed

Searing, Kimberly; Baukus, Mary; Stark, Mary Ann; Morin, Karen H; Rudell, Barb

2006-01-01

The objective of this study was to understand the experience of a pregnant woman with needle phobia and examine its impact on her antepartum, intrapartum, and postpartum experience. A case study format was employed. A 21-year-old primiparous woman with diagnosed needle phobia was interviewed, and her prenatal and delivery records were reviewed. Three tasks during pregnancy were identified: seeking trusting relationships with health care providers; establishing and maintaining control and understanding; and coping with fear of needles, pain, and invasion. As frequent caregivers during childbearing, nurses with an understanding of needle phobia can help to establish trusting relationships with women with this phobia and support them and their families during childbearing and their encounters with needles. (c) 2006, AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses

Needle bar for warp knitting machines

DOEpatents

Hagel, Adolf; Thumling, Manfred

1979-01-01

Needle bar for warp knitting machines with a number of needles individually set into slits of the bar and having shafts cranked to such an extent that the head section of each needle is in alignment with the shaft section accommodated by the slit. Slackening of the needles will thus not influence the needle spacing.

Histological observation for needle-tissue interactions.

PubMed

Nakagawa, Yoshiyuki; Koseki, Yoshihiko

2013-01-01

We histologically investigated tissue fractures and deformations caused by ex vivo needle insertions. The tissue was formalin-fixed while the needle remained in the tissue. Following removal of the needle, the tissue was microtomed, stained, and observed microscopically. This method enabled observations of cellular and tissular conditions where deformations caused by needle insertions were approximately preserved. For this study, our novel method presents preliminary findings related with tissue fractures and the orientation of needle blade relative to muscle fibers. When the needle blade was perpendicular to the muscle fiber, transfiber fractures and relatively large longitudinal deformations occurred. When the needle blade was parallel to the muscle fiber, interfiber fractures and relatively small longitudinal deformations occurred. This made a significant difference in the resistance force of the needle insertions.

Comparison of 21-Gauge and 22-Gauge Aspiration Needle in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

PubMed Central

Akulian, Jason; Lechtzin, Noah; Yasin, Faiza; Kamdar, Biren; Ernst, Armin; Ost, David E.; Ray, Cynthia; Greenhill, Sarah R.; Jimenez, Carlos A.; Filner, Joshua; Feller-Kopman, David

2013-01-01

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure originally performed using a 22-gauge (22G) needle. A recently introduced 21-gauge (21G) needle may improve the diagnostic yield and sample adequacy of EBUS-TBNA, but prior smaller studies have shown conflicting results. To our knowledge, this is the largest study undertaken to date to determine whether the 21G needle adds diagnostic benefit. Methods: We retrospectively evaluated the results of 1,299 patients from the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation (AQuIRE) Diagnostic Registry who underwent EBUS-TBNA between February 2009 and September 2010 at six centers throughout the United States. Data collection included patient demographics, sample adequacy, and diagnostic yield. Analysis consisted of univariate and multivariate hierarchical logistic regression comparing diagnostic yield and sample adequacy of EBUS-TBNA specimens by needle gauge. Results: A total of 1,235 patients met inclusion criteria. Sample adequacy was obtained in 94.9% of the 22G needle group and in 94.6% of the 21G needle group (P = .81). A diagnosis was made in 51.4% of the 22G and 51.3% of the 21G groups (P = .98). Multivariate hierarchical logistic regression showed no statistical difference in sample adequacy or diagnostic yield between the two groups. The presence of rapid onsite cytologic evaluation was associated with significantly fewer needle passes per procedure when using the 21G needle (P < .001). Conclusions: There is no difference in specimen adequacy or diagnostic yield between the 21G and 22G needle groups. EBUS-TBNA in conjunction with rapid onsite cytologic evaluation and a 21G needle is associated with fewer needle passes compared with a 22G needle. PMID:23632441

[Deep needling and shallow needling at three acupoints around ear for subjective tinnitus: a randomized controlled trial].

PubMed

Yin, Tao; Ni, Jinxia; Zhu, Wenzeng

2015-10-01

To compare the effective differences between deep needling and shallow needling at three acupoints around ear for subjective tinnitus. Fifty patients with subjective tinnitus were randomized divided into a deep needling group and a shallow needling group, 25 cases in each group. Twenty-two patients in the deep needling group and 20 patients in the shallow needling group were brought into statistic in the end. In the two groups, the three acupoints around ear and distal acupoints were both selected. The acupoints of the affected side such as Yifeng (TE 17), Tinghui (GB 2), Ermen (TE 21), Zhigou (TE 6), Zhongzhu (TE 3) and Hegu (LI 4) were adopted. Yifeng (TE 17), Tinghui (GB 2) and Ermen (TE 21) were acupunctured 30-38 mm in the deep needling group and 15-20 mm in the shallow needling group. The other acupoints were conventionally acupunctured in the two groups. The needles were retained for 30 min,once a day and five times a week for all patients. The treatment was continuously for 4 weeks in the two groups. Tinnitus handicap inventory (THI) scores, tinnitus grades and visual analogue scale (VAS) for tinnitus sound levels were observed before and after treatment, and the effects of the two groups were compared. The total effective rate in the deep needling group was 59.1% (13/22), and it was better than 20.0% (4/20) in the shallow needling group (P < 0.05). In the deep needling, group, the THI score, tinnitus grade and the VAS score were improved than those before treatment (all P < 0.05). In the shallow needling group, the three above indices before and after treatment were not different in statistical significance (all P > 0.05). After treatment, all the three indices in the deep needling group were superior to those in the shallow needling group (all P < 0.05). Acupuncture at the three acupoints around ear deeply could apparently improve tinnitus, and reduce tinnitus sound levels for subjective tinnitus. The effect is better than that by shallow needling at the

Using insulin pen needles up to five times does not affect needle tip shape nor increase pain intensity.

PubMed

Puder, Jardena J; Atar, Michael; Muller, Beat; Pavan, Marco; Keller, Ulrich

2005-02-01

Reusing insulin pen needles could help to reduce the increasing economic burden of diabetes. We tested the hypothesis that reusing insulin pen needles leads to needle tip deformity and increased pain. Three blinded reviewers assessed 123 electron microscope pictures analyzing needle tip deformity of insulin pen needles used up to four times by diabetic subjects and up to five times by blinded non-diabetic volunteers. The estimated frequency of needle use was correlated to the actual number of needle use. Pain intensity and unpleasantness of each injection were measured by a visual analogue scale and their differences analyzed by Kruskal-Wallis analysis of variance. Unused needles could be differentiated visually from used needles. However, there was no correlation between the actual and guessed number of times a needle was used (r = 0.07, P = 0.2). Evaluating all 270 injections, neither pain intensity nor unpleasantness increased with repeated injections of the same needles in people with diabetes (P = 0.1 and 0.96) and in the volunteers (P = 0.63 and 0.92). Using pen needles four to five times does not lead to progressive needle tip deformity and does not increase pain intensity or unpleasantness, but could increase convenience and lead to substantial financial savings in Europe of around EUR 100 million/year.

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Using 19-G Needle for Sarcoidosis.

PubMed

Balwan, Akshu

2018-05-16

Flexible bronchoscopy with endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is increasingly being used to obtain pathology specimens for diagnosis of sarcoidosis. There is wide variation in reported diagnostic yield in literature. New TBNA needles are available in the market but data are lacking about their diagnostic yield especially for sarcoidosis. This study reports the diagnostic yield of bronchoscopy with EBUS-TBNA using ViziShot FLEX 19-G needle in a series of patients with suspected sarcoidosis. This is a retrospective chart review for diagnostic yield of the 19-G EBUS-TBNA needle for suspected sarcoidosis. Eighty-six EBUS bronchoscopies were performed, 15 were done with clinical suspicion of sarcoidosis. The 19-G needle was used for all cases of suspected sarcoidosis. The procedure was diagnostic of sarcoidosis in 14 (93.3%) patients by TBNA with 1 nondiagnostic bronchoscopy. Procedural diagnostic yield was 93.3%. Eighty-five percent (28/33) of sampled lymph nodes were positive for noncaseating granulomas. The yield of transbronchial lung biopsy (TBLB) and endobronchial lung biopsy was 38% (5/13) and 43% (6/14), respectively. TBLB and endobronchial lung biopsy did not add to the diagnostic yield of the procedure. No significant adverse events were noted. This series reports a higher diagnostic yield than most other published studies and opens platform for direct comparison of each available needle. It also adds to the safety data for this larger needle. In addition, it raises doubt into utility of TBLB for diagnosis of sarcoidosis, which can increase the procedural complications.

Needle tract implantation of hepatoblastoma after percutaneous needle biopsy: report of a case.

PubMed

Sumiyoshi, Tatsuaki; Shima, Yasuo; Nishiuchi, Ritsuo; Sasaki, Kiyoshi; Kouzuki, Akihito; Noda, Yoshihiro; Hata, Yasuhiro; Uka, Kiminobu

2014-06-01

A 13-year-old boy was referred to us for investigation of a giant liver mass, approximately 16 cm in diameter. Sonographically guided percutaneous needle biopsy was performed and histological examination revealed a fetal-type hepatoblastoma. After four courses of chemotherapy, we performed a left hepatic trisegmentectomy. Follow-up computed tomography, 55 months after the surgery, showed a 1-cm tumor on the route of the preoperative needle biopsy. A second laparotomy revealed a peritonealised tumor, which was excised. The histology of this tumor was identical to that of the primary hepatoblastoma. To our knowledge, this is only the second report of needle tract implantation of hepatoblastoma after percutaneous needle biopsy.

Endoscopic ultrasound-guided fine-needle aspiration needles: which one and in what situation?

PubMed

Karadsheh, Zeid; Al-Haddad, Mohammad

2014-01-01

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is increasingly used as a diagnostic and therapeutic tool for pancreatic and other gastrointestinal disorders. Several factors affect the outcome of EUS-FNA, one of which is needle size. The decision to use a specific needle depends on factors including location, consistency, and type of the lesion; presence of onsite cytopathologist; and need for additional tissue procurement for histology. This review provides a balanced perspective on the use of different needle sizes available, highlighting the differences among them and potential niche applications of each to maximize diagnostic yield of EUS-FNA. Copyright © 2014 Elsevier Inc. All rights reserved.

Investigations of needle-free jet injections.

PubMed

Schramm-Baxter, J R; Mitragotri, S

2004-01-01

Jet injection is a needle-free drug delivery method in which a high-speed stream of fluid impacts the skin and delivers drugs. Although a number of jet injectors are commercially available, especially for insulin delivery, they have a low market share compared to needles possibly due to occasional pain associated with jet injection. Jets employed by the traditional jet injectors penetrate deep into the dermal and sub-dermal regions where the nerve endings are abundantly located. To eliminate the pain associated with jet injections, we propose to utilize microjets that penetrate only into the superficial region of the skin. However, the choice of appropriate jet parameters for this purpose is challenging owing to the multiplicity of factors that determine the penetration depth. Here, we describe the dependence of jet injections into human skin on the power of the jet. Dermal delivery of liquid jets was quantified using two measurements, penetration of a radiolabeled solute, mannitol, into skin and the shape of jet dispersion in the skin which was visualized using sulforhodamine B. The dependence of the amount of liquid delivered in the skin and the geometric measurements of jet dispersion on nozzle diameter and jet velocity was captured by a single parameter, jet power.

Detecting stages of needle penetration into tissues through force estimation at needle tip using fiber Bragg grating sensors

NASA Astrophysics Data System (ADS)

Kumar, Saurabh; Shrikanth, Venkoba; Amrutur, Bharadwaj; Asokan, Sundarrajan; Bobji, Musuvathi S.

2016-12-01

Several medical procedures involve the use of needles. The advent of robotic and robot assisted procedures requires dynamic estimation of the needle tip location during insertion for use in both assistive systems as well as for automatic control. Most prior studies have focused on the maneuvering of solid flexible needles using external force measurements at the base of the needle holder. However, hollow needles are used in several procedures and measurements of forces in proximity of such needles can eliminate the need for estimating frictional forces that have high variations. These measurements are also significant for endoscopic procedures in which measurement of forces at the needle holder base is difficult. Fiber Bragg grating sensors, due to their small size, inert nature, and multiplexing capability, provide a good option for this purpose. Force measurements have been undertaken during needle insertion into tissue mimicking phantoms made of polydimethylsiloxane as well as chicken tissue using an 18-G needle instrumented with FBG sensors. The results obtained show that it is possible to estimate the different stages of needle penetration including partial rupture, which is significant for procedures in which precise estimation of needle tip position inside the organ or tissue is required.

21 CFR 880.5580 - Acupuncture needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Acupuncture needle. 880.5580 Section 880.5580 Food... § 880.5580 Acupuncture needle. (a) Identification. An acupuncture needle is a device intended to pierce the skin in the practice of acupuncture. The device consists of a solid, stainless steel needle. The...

Needle tip visibility in 3D ultrasound images

NASA Astrophysics Data System (ADS)

Arif, Muhammad; Moelker, Adriaan; van Walsum, Theo

2017-03-01

Needle visibility is of crucial importance for ultrasound guided interventional procedures. However, several factors, such as shadowing by bone or gas and tissue echogenic properties similar to needles, may compromise needle visibility. Additionally, small angle between the ultrasound beam and the needle, as well as small gauged needles may reduce visibility. Variety in needle tips design may also affect needle visibility. Whereas several studies have investigated needle visibility in 2D ultrasound imaging, no data is available for 3D ultrasound imaging, a modality that has great potential for image guidance interventions1. In this study, we evaluated needle visibility using a 3D ultrasound transducer. We examined different needles in a tissue mimicking liver phantom at three angles (200, 550 and 900) and quantify their visibility. The liver phantom was made by 5% polyvinyl alcohol solution containing 1% Silica gel particles to act as ultrasound scattering particles. We used four needles; two biopsy needles (Quick core 14G and 18G), one Ablation needle (Radiofrequency Ablation 17G), and Initial puncture needle (IP needle 17G). The needle visibility was quantified by calculating contrast to noise ratio. The results showed that the visibility for all needles were almost similar at large angles. However the difference in visibility at lower angles is more prominent. Furthermore, the visibility increases with the increase in angle of ultrasound beam with needles.

Arterial puncture using insulin needle is less painful than with standard needle: a randomized crossover study.

PubMed

Ibrahim, Irwani; Yau, Ying Wei; Ong, Lizhen; Chan, Yiong Huak; Kuan, Win Sen

2015-03-01

Arterial punctures are important procedures performed by emergency physicians in the assessment of ill patients. However, arterial punctures are painful and can create anxiety and needle phobia in patients. The pain score of radial arterial punctures were compared between the insulin needle and the standard 23-gauge hypodermic needle. In a randomized controlled crossover design, healthy volunteers were recruited to undergo bilateral radial arterial punctures. They were assigned to receive either the insulin or the standard needle as the first puncture, using blocked randomization. The primary outcome was the pain score measured on a 100-mm visual analogue scale (VAS) for pain, and secondary outcomes were rate of hemolysis, mean potassium values, and procedural complications immediately and 24 hours postprocedure. Fifty healthy volunteers were included in the study. The mean (±standard deviation) VAS score in punctures with the insulin needle was lower than the standard needle (23 ± 22 mm vs. 39 ± 24 mm; mean difference = -15 mm; 95% confidence interval = -22 mm to -7 mm; p < 0.001). The rates of hemolysis and mean potassium value were greater in samples obtained using the insulin needle compared to the standard needle (31.3% vs. 11.6%, p = 0.035; and 4.6 ±0.7 mmol/L vs. 4.2 ±0.5 mmol/L, p = 0.002). Procedural complications were lower in punctures with the insulin needle both immediately postprocedure (0% vs. 24%; p < 0.001) and at 24 hours postprocedure (5.4% vs. 34.2%; p = 0.007). Arterial punctures using insulin needles cause less pain and fewer procedural complications compared to standard needles. However, due to the higher rate of hemolysis, its use should be limited to conditions that do not require a concurrent potassium value in the same blood sample. © 2015 by the Society for Academic Emergency Medicine.

Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

PubMed

Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

2017-07-01

To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P < 0.001). For ultrasound guided-fine needle aspiration, gender, age, size, presence of vascularity, and suspicious US features were not associated with post-biopsy hematoma according to experience level. Post-biopsy hematoma occurred significantly more with ultrasound guided-core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P < 0.001) in experienced performers and ultrasound guided-core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P < 0.001). Post-biopsy hematoma occurred significantly more in ultrasound guided-core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

Veres needle in the pleural space.

PubMed

Jenkins, D W; McKinney, M K; Szpak, M W; Booker, J L

1983-11-01

The Veres needle is designed to allow entry into body cavities without trauma to underlying organs. Its major use has been in the induction of a pneumoperitoneum for peritoneoscopy. An initial successful evaluation of its use was in the pleural space of dogs. A subsequent analysis of complications in 69 thoracenteses using the Veres needle and 152 thoracenteses using a conventional needle favored the Veres needle (P = .05). We believe that the Veres needle is a safe and technically superior instrument for thoracentesis and that it deserves further application and study.

[Design and application of silver needle-knife].

PubMed

Sun, Guodong; Shi, Bin; Zhang, Benwu; Xu, Haidong

2015-04-01

A silver needle-knife which has the dual function of silver needle and needle-knife is designed. The main components of this silver needle-knife are approximately 50% silver and approximately 50% nichrome. The silver needle-knife is composed of five parts, including needle-knife tail, spiral handle; steering handle, needle-knife body and needle-knife edge. It converges the advantages of needle-knife and silver needle, which can cut loose of diseased tissue and peel adhesion of lesions, but also be heated with moxa cone and thermal therapeutic instrument, and connect with electroacupuncture apparatus. It has the function of warming channel and removing coldness, dispelling wind and eliminating dampness, resolving spasm and relieving pain, dredging the channel and so on. Due to the spiral handle and the steering handle, the operation is easier, which reduces the blindness of cutting and increase the safety. It is mainly used for soft tissue injury, rheumatism and rheumatoid arthritis, as well as degenerative diseases of spine and joint, and it has obvious efficacy on some internal medical diseases.

[Effects of slow twisting needle insertion and tubing needle insertion at Neiguan (PC 6) on cardiovascular function: a comparative study].

PubMed

Ning, Shaoli; Zhao, Lihua; Xu, Lingjun; Huang, Yu; Pang, Yong; Huang, Dingjian

2016-01-01

To compare the effects between slow twisting needle insertion and tubing needle insertion. With cross-over design, 100 healthy young subjects (half male and half female) aged from 19 to 23 years were randomly divided into two groups by random digital table, 50 cases in each one. At the first stage, subjects in the group A were treated with slow twisting needle insertion while, subjects in,the group B were treated with tubing needle insertion. One week later, the procedure of second stage was performed alternately. The needle was inserted into Neiguan (PC 6) with two methods by one acupuncturist. The needle was retained for 5 min before removal. Five min before needle insertion as well as needle withdrawal and 30 min after needle withdrawal, ZXG-E automatic cardiovascular diagnostic apparatus was used to test cardiovascular function. At the tim of needle withdrawal, slow twisting needle insertion could improve effect work of kinetics (EWK), effective blood volume (BV) and reduce elastic expansion coefficient of blood vessel (FEK) and left ventricular spray blood impedance (VER), which was significantly different from tubing needle insertion (all P < 0.05). Thirty min after needle withdrawal, the differences of the indices of cardiovascular function between the two groups were not significant (all P > 0.05). The slow twisting needle insertion is significantly superior to tubing needle insertion on lowering vascular tension and VER, improving EWK and BV.

Premature Needle Loss of Spruce

Treesearch

Jennifer Juzwik; Joseph G. O Brien

1990-01-01

Premature needle loss on white, black and Norway spruce has been observed in forest plantations in Wisconsin and Minnesota during the past six years. Symptoms vary by species but usually appear first in 2-4-year old needles on lower branches. Infected needles are dropped, resulting in branch mortality that progresses upward through the crown, sometimes killing even...

Drug preparation, injection, and sharing practices in Tajikistan: a qualitative study in Kulob and Khorog.

PubMed

Otiashvili, David; Latypov, Alisher; Kirtadze, Irma; Ibragimov, Umedjon; Zule, William

2016-06-02

Sharing injection equipment remains an important rout of transmission of HIV and HCV infections in the region of Eastern Europe and Central Asia. Tajikistan is one of the most affected countries with high rates of injection drug use and related epidemics.The aim of this qualitative study was to describe drug use practices and related behaviors in two Tajik cities - Kulob and Khorog. Twelve focus group discussions (6 per city) with 100 people who inject drugs recruited through needle and syringe program (NSP) outreach in May 2014. Topics covered included specific drugs injected, drug prices and purity, access to sterile equipment, safe injection practices and types of syringes and needles used. Qualitative thematic analysis was performed using NVivo 10 software. All participants were male and ranged in age from 20 to 78 years. Thematic analysis showed that cheap Afghan heroin, often adulterated by dealers with other admixtures, was the only drug injected. Drug injectors often added Dimedrol (Diphenhydramine) to increase the potency of "low quality" heroin. NSPs were a major source of sterile equipment. Very few participants report direct sharing of needles and syringes. Conversely, many participants reported preparing drugs jointly and sharing injection paraphernalia. Using drugs in an outdoor setting and experiencing withdrawal were major contributors to sharing equipment, using non-sterile water, not boiling and not filtering the drug solution. Qualitative research can provide insights into risk behaviors that may be missed in quantitative studies. These finding have important implications for planning risk reduction interventions in Tajikistan. Prevention should specifically focus on indirect sharing practices.

[Stiletto needle and needle-knife for influence of gravity index in treating knee osteoarthritis].

PubMed

Gu, Li-Jun; Zhang, Bin; Li, Wen-Hua; Tang, Yan; Dong, Fu-Hui

2017-12-25

To explore stiletto needle and needle-knife for influence of double sufficient weight in treating knee osteoarthritis patients. One hundred and thirteen early and medium term knee osteoarthritis patients were randomly divided into three groups, including stiletto needle group(38 cases), needle-knife group (38 cases) and voltaren group (37 cases). In stiletto needle group, there were 13 males and 25 females with an average of(55.87±7.72) years old, treated by stiletto needle once a week, and 2 weeks were a course; there were 11 males and 27 females in needle-knife group with an average of(57.11±7.07) years old, treated by acupotome once a week, and 2 weeks were a course; there were 12 males and 25 females in voltaren group with an average age of(57.62±8.08) years old, treated by votalin emulsion smearing 3 to 5 cm on painful area of knee joint, three times a day for 2 weeks; 36 patients in normal group, including 11 males and 25 females with a mean age of (55.28±7.55) years old, treated with nothing. Gravitational four lattice used to measure bipedal back and forth load before and after treatment in further observe weight-bearing situation among three groups, d value, which was the distance from center of gravity to original point, was measured as a obvervational index, JOA score was used to evaluate clinical effect. Five patients were fall out, including 2 patients in stiletto needle group, 2 patients in needle-knife group and 1 patient in voltaren group. Other 108 patients were followed-up from 28 to 35 d with an average of 30 d, and without untoward effect. There was significant difference in d value between treatment group and control group at 1 month after treatment( P <0.05); there was significant difference in d value among treatment group at 1 month after treatment( P >0.05), and d value was decreased before treatment than that of after treatment. There was no significant difference in JOA score among treatment group after treatment at 1 month( P <0

Properties of southern pine needles

Treesearch

E.T. Howard

1973-01-01

To investigate properties that might be related to utilization, needles were sampled on one tree of each of the four major species. Tensile strength was measured on loblolly needles only; it ranged from 4,630 to 6,980 psi. Maximum load averaged 4.1 pounds per needle, with a modulus of elasticity of 220,000 psi. Specific gravity (ovendry weight, green volume of...

Secure Container For Discarded Hypodermic Needles

NASA Technical Reports Server (NTRS)

Lee, Angelene M.

1992-01-01

Container designed for safe retention of discarded blood-collecting hypodermic needles and similar sharp objects used in life-science experiments aboard spacecraft. Needles inserted through self-closing lid and retained magnetically. They are inserted, sharp end first, through spring-loaded flap. Long needles and needles on syringes cannot turn around in container. Can be emptied, cleaned, and reused. Used on Earth to provide unusually secure containment of sharp objects.

Health Outcomes for Clients of Needle and Syringe Programs in Prisons.

PubMed

Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Hetherington, Kristina L; Bromberg, Daniel J; Ocampo, Denise; Graf, Niels; Dichtl, Anna; Stöver, Heino; Wolff, Hans

2018-04-12

High levels of drug dependence have been observed in the prison population globally, and the sharing of injecting drug equipment in prisons has contributed to higher prevalence of bloodborne diseases in prisoners than in the general population. Few prison needle and syringe programs (PNSPs) exist. We conducted a systematic review to assess evidence regarding health outcomes of PNSPs. We searched peer-reviewed databases for data relating to needle and syringe programs in prisons. The search methodology was conducted in accordance with accepted guidelines. Five studies met review inclusion criteria, and all presented evidence associating PNSPs with one or more health benefits, but the strength of the evidence was low. The outcomes for which the studies collectively demonstrated the strongest evidence were prevention of human immunodeficiency virus and viral hepatitis. Few negative consequences from PNSPs were observed, consistent with previous evidence assessments. More research is needed on PNSP effectiveness, and innovative study designs are needed to overcome methodological limitations of previous research. Until stronger evidence becomes available, policymakers are urged to recognize that not implementing PNSPs has the potential to cause considerable harm, in light of what is currently known about the risks and benefits of needle and syringe programs and PNSPs and about the high prevalence of human immunodeficiency virus and viral hepatitis in prisons.

[Needling technique of Professor Li Yan-Fang].

PubMed

Li, Li-Jun

2014-01-01

Experiences of needling techniques of Professor LI Ya- fang is introduced in this article. Gentle and superficial insertion is adopted by Professor LI in clinic. Emphases are put on the qi regulation function, needling sensation to the affected region and insertion with both hands, especially the function of the left hand as pressing hand. The gentle and superficial insertion should be done as the follows: hold the needle with the right hand, press gently along the running course of meridians with the left hand to promote qi circulation, hard pressing should be applied at acupoints to disperse the local qi and blood, insert the needle gently and quickly into the subcutaneous region with the right hand, and stop the insertion when patient has the needling sensation. While the fast needling is characterized with shallow insertion and swift manipulation: the left hand of the manipulator should press first along the running course of the meridian, and fix the local skin, hold the needle with the right hand and insert the needle quickly into the acupoint. Withdrawal of the needle should be done immediately after the reinforcing and reducing manipulations. Professor LI is accomplished in qi regulation. It is held by him that regulating qi circulation is essence of acupuncture, letting the patient get the needling sensation is the most important task of needling. Lifting, thrusting and rotation manipulations should be applied to do reinforcing or reducing. The tissue around the tip of the needle should not be too contracted or too relaxed, and the resistance should not be too strong or too weak. The feeling of the insertion hand of the practitioner should not be too smooth or too hesitant. Needle should be inserted into the skin quickly at the moment of hard pressing by the left hand. And then, slow rotation and gentle lifting and thrusting can be applied to promote the needling sensation like electric current pass through and to reach the affected region along the

Radiofrequency Cauterization with Biopsy Introducer Needle

PubMed Central

Pritchard, William F.; Wray-Cahen, Diane; Karanian, John W.; Hilbert, Stephen; Wood, Bradford J.

2014-01-01

PURPOSE The principal risks of needle biopsy are hemorrhage and implantation of tumor cells in the needle tract. This study compared hemorrhage after liver and kidney biopsy with and without radiofrequency (RF) ablation of the needle tract. MATERIALS AND METHODS Biopsies of liver and kidney were performed in swine through introducer needles modified to allow RF ablation with the distal 2 cm of the needle. After each biopsy, randomization determined whether the site was to undergo RF ablation during withdrawal of the introducer needle. Temperature was measured with a thermistor stylet near the needle tip, with a target temperature of 70°C–100°C with RF ablation. Blood loss was measured as grams of blood absorbed in gauze at the puncture site for 2 minutes after needle withdrawal. Selected specimens were cut for gross examination. RESULTS RF ablation reduced bleeding compared with absence of RF ablation in liver and kidney (P < .01), with mean blood loss reduced 63% and 97%, respectively. Mean amounts of blood loss (±SD) in the liver in the RF and no-RF groups were 2.03 g ± 4.03 (CI, 0.53–3.54 g) and 5.50 g ± 5.58 (CI, 3.33–7.66 g), respectively. Mean amounts of blood loss in the kidney in the RF and no-RF groups were 0.26 g ± 0.32 (CI, −0.01 to 0.53 g) and 8.79 g ± 7.72 (CI, 2.34–15.24 g), respectively. With RF ablation, thermal coagulation of the tissue surrounding the needle tract was observed. CONCLUSION RF ablation of needle biopsy tracts reduced hemorrhage after biopsy in the liver and kidney and may reduce complications of hemorrhage as well as implantation of tumor cells in the tract. PMID:14963187

A new posterior iliac puncture/aspiration needle.

PubMed

Islam, Anwarul

2016-03-25

The needles that are currently used for obtaining bone marrow aspirate samples from the posterior ilium are typically those of 1930s vintage (eg, Klima, Salah or similar needles), which were specifically designed for sternal aspiration. These needles are not designed to obtain bone marrow aspirate samples from the posterior ilium and as a result they are unsatisfactory particularly if the patient is large or obese. A new posterior iliac puncture/aspiration needle has therefore been designed, which is particularly suited for bone marrow aspiration from the posterior ilium. The needle was tested on five cadavers and on five patients. The design and construction of the needle was found to be satisfactory and a marked improvement over the conventional sternal puncture needles particularly when large or obese patients were concerned. The new posterior iliac bone marrow aspiration needle has advantages that overcome the limitations of using a conventional sternal puncture needle to obtain marrow aspirates from the posterior ilium. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia - randomized clinical trial.

PubMed

Dau, M; Buttchereit, I; Ganz, C; Frerich, B; Anisimova, E N; Daubländer, M; Kämmerer, P W

2017-11-01

The aims of this in vivo study were to evaluate the impact of needle bevel design on patients' pain perception and the mechanical deformation of the needle tip after the injection. In a prospective single-blinded trial, 150 patients received conventional infiltration anaesthesia for dental treatment by one examiner. Patients were randomized for one out of three different needle bevel types (scalpel-designed bevel needle (SB), n=50; triple bevel needle (TB), n=50; regular bevel needle (RB), n=50). Subjects' self-reported injection pain perception was evaluated using a numeric rating scale (NRS). For each needle tip, deformations after single use were measured using SEM. A significant lower injection pain level was found in SB (mean 2.1±1.2) than in TB (mean 3.5±1.6;) and RB (mean 3.4±1.0; all P<0.001). A needle deformation was detected in about 97.3% of all needles (SB 50/50, TB 50/50, and RB: 46/50). A higher number of barbs were found in SB (29/50) versus TB (17/50) and RB (19/50). For dental local infiltration anaesthesia, injection needles with a scalpel-designed bevel demonstrated significantly less injection pain. Needle tip deflections after anaesthetic agent infiltration, especially barbed hooks on the non-cutting edge may result in greater soft tissue trauma. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A novel prototype 3/5 laparoscopic needle driver: A validation study with conventional laparoscopic needle driver.

PubMed

Ganpule, Arvind P; Deshmukh, Chaitanya S; Joshi, Tanmay

2018-01-01

The challenges in laparoscopic suturing include need to expertise to suture. Laparoscopic needle holder is a" key" instrument to accomplish this arduous task. The objective of this new invention was to develop a laparoscopic needle holder which would be adapted to avoid any wobble (with a shaft diameter same as a 5mm port), ensure accurate and dexterous suturing not just in adult patients but pediatric patients alike (with a short shaft diameter) and finally ensure seamless throw of knots with a narrow tip configuration. We did an initial evaluation to evaluate the validity of the prototype needle holder and its impact on laparoscopic suturing skills by experienced laparoscopic surgeons and novice laparoscopic Surgeons. Both the groups of surgeons performed two tasks. The first task was to grasp the needle and position it in an angle deemed ideal for suturing. The second task was to pass suture through two fixed points and make a single square knot. At the end of the tasks each participant was asked to complete a 5- point Likert's scale questionnaire (8 items; 4 items of handling and 4 items of suturing) rating each needle holder. In expert group, the mean time to complete task 1 was shorter with prototype 3/5 laparoscopic needle holder (11.8 sec Vs 20.8 sec). The mean time to complete task 2 was also shorter with prototype 3/5 laparoscopic needle holder (103.2 sec Vs 153.2 sec). In novice group, mean time to complete both the task was shorter with prototype 3/5 laparoscopic needle holder. The expert laparoscopic surgeons as well as novice laparoscopic surgeons performed laparoscopic suturing faster and with more ease while using the prototype 3/5 laparoscopic needle holder.

A novel prototype 3/5 laparoscopic needle driver: A validation study with conventional laparoscopic needle driver

PubMed Central

Ganpule, Arvind P.; Deshmukh, Chaitanya S.; Joshi, Tanmay

2018-01-01

Introduction: The challenges in laparoscopic suturing include need to expertise to suture. Laparoscopic needle holder is a ”key” instrument to accomplish this arduous task. Instrument: The objective of this new invention was to develop a laparoscopic needle holder which would be adapted to avoid any wobble (with a shaft diameter same as a 5mm port), ensure accurate and dexterous suturing not just in adult patients but pediatric patients alike (with a short shaft diameter) and finally ensure seamless throw of knots with a narrow tip configuration. Validation: We did an initial evaluation to evaluate the validity of the prototype needle holder and its impact on laparoscopic suturing skills by experienced laparoscopic surgeons and novice laparoscopic Surgeons. Both the groups of surgeons performed two tasks. The first task was to grasp the needle and position it in an angle deemed ideal for suturing. The second task was to pass suture through two fixed points and make a single square knot. At the end of the tasks each participant was asked to complete a 5- point Likert's scale questionnaire (8 items; 4 items of handling and 4 items of suturing) rating each needle holder. In expert group, the mean time to complete task 1 was shorter with prototype 3/5 laparoscopic needle holder (11.8 sec Vs 20.8 sec). The mean time to complete task 2 was also shorter with prototype 3/5 laparoscopic needle holder (103.2 sec Vs 153.2 sec). In novice group, mean time to complete both the task was shorter with prototype 3/5 laparoscopic needle holder. Conclusion: The expert laparoscopic surgeons as well as novice laparoscopic surgeons performed laparoscopic suturing faster and with more ease while using the prototype 3/5 laparoscopic needle holder. PMID:28782740

Comparative cyto-histological study of needle tip aspirates and entry sites after intravitreal injection using different needle types

PubMed Central

Lytvynchuk, Lyubomyr; Sergienko, Andrij; Savytska, Iryna; Albert, Réka; Glittenberg, Carl; Binder, Susanne; Petrovski, Goran

2017-01-01

A comparison of the cellular content of needle tip aspirates and entry sites after transconjunctival intravitreal injection (IVI) using different needle types was performed. White outbred rats and human cadaver eyes were used for IVI by hypodermic 27 gauge (G) and 30G needles, and spinal anesthesia Pencan 27G needles. Aspiration of vitreous for quantitative morphological and cell cultivation analysis, as well as cyto-histological analysis of aspirates and entry sites were carried out. The most common cells in the aspirates from all needle types were conjunctival epithelial-, ciliary body non-pigmented epithelial- and sclerocyte-like cells and granular proteins. Crystallized vitreous specimens were present in each aspirate. The entry sites of hypodermic needles showed marked trauma in all wall layers of rat and human eyes accompanied by cellular destruction and hemorrhages. Pencan 27G needle caused less tissue trauma with partial reposition of sclerocytes. Transconjunctival IVIs with hypodermic 27G and 30G, and Pencan 27G needles result in trauma of all layers of the eyeball. The possible consequences of cellular content being cut and injected into the eye, as well as the entry site wound shape deserve future consideration and improvements. PMID:28692684

Modeling and Control of Needles with Torsional Friction

PubMed Central

Reed, Kyle B.; Okamura, Allison M.; Cowan, Noah J.

2010-01-01

A flexible needle can be accurately steered by robotically controlling the bevel tip orientation as the needle is inserted into tissue. Friction between the long, flexible needle shaft and the tissue can cause a significant discrepancy between the orientation of the needle tip and the orientation of the base where the needle angle is controlled. Our experiments show that several common phantom tissues used in needle steering experiments impart substantial friction forces to the needle shaft, resulting in a lag of over 45° for a 10 cm insertion depth in some phantoms; clinical studies report torques large enough to cause similar errors during needle insertions. Such angle discrepancies will result in poor performance or failure of path planners and image-guided controllers, since the needles used in percutaneous procedures are too small for state-of-the-art imaging to accurately measure the tip angle. To compensate for the angle discrepancy, we develop an estimator using a mechanics-based model of the rotational dynamics of a needle being inserted into tissue. Compared to controllers that assume a rigid needle in a frictionless environment, our estimator-based controller improves the tip angle convergence time by nearly 50% and reduces the path deviation of the needle by 70%. PMID:19695979

Analysis of the NovoTwist Pen Needle in Comparison with Conventional Screw-Thread Needles

PubMed Central

Aye, Tandy

2011-01-01

Administration of insulin via a pen device may be advantageous over a vial and syringe system. Hofman and colleagues introduce a new insulin pen needle, the NovoTwist, to simplify injections to a small group of children and adolescents. Their overall preferences and evaluation of the handling of the needle are reported in the study. This new needle has the potential to ease administration of insulin via a pen device that may increase both the use of a pen device and adherence to insulin therapy. PMID:22226270

Effect and safety of deep needling and shallow needling for functional constipation: a multicenter, randomized controlled trial.

PubMed

Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

2014-12-01

Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study.SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P<0.01, all). The changes in the mean weekly SBMs over week 1 to 4 were 2 (1.75) in the deep needling group, 2 (1.75) in the shallow needling group, and 2 (2) in the lactulose group (P>0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (P<0.05, all compared with the lactulose group). No significant difference was observed among the 3

Clogging in staked-in needle pre-filled syringes (SIN-PFS): Influence of water vapor transmission through the needle shield.

PubMed

De Bardi, M; Müller, R; Grünzweig, C; Mannes, D; Rigollet, M; Bamberg, F; Jung, T A; Yang, K

2018-06-01

Staked-in needle pre-fillable syringes (SIN-PFS) are a convenient delivery system widely established in the growing pharmaceutical market. Under specific storage conditions, the needle of PFS containing high concentration drug product (DP) solution is prone to clogging, which prevents administration of the liquid. The purpose of this study is to clarify the clogging phenomenon of SIN-PFS and to elucidate the role of water vapor transmission via the needle shield. The presence of liquid within needles is a prerequisite condition for clogging and was investigated non-invasively by neutron imaging (NI) to confirm that liquid can migrate into the needle under certain processing conditions. The water vapor transmission rate (WVTR) of different needle shields was measured and the impact of temperature and relative humidity (rH) on the WVTR was investigated on sheets with the same composition as used in commercial needle shields. Our study clearly showed that the partial vapor pressure difference (ΔPP) across the needle shield is the dominant driving factor for water vapor transmission. A linear correlation between ΔPP and WVTR was found and a model to predict the water vapor transmission for PFS under specific storage conditions was developed. The impact of the WVTR on needle clogging was confirmed by clogging tests performed on SIN-PFS stored under different conditions. Thereby, we clearly show that high water loss induced by higher WVTR can be correlated to an increased occurrence of needle clogging. In conclusion, the WVTR of the needle shield plays a key role in needle clogging and the established WVTR model can be employed to assess the clogging risk for product development. Copyright © 2018 Elsevier B.V. All rights reserved.

Influence of Needle Tip Distance on Barrier Discharge and Ozone Generation for Multiple Needles-Plane Electrode Configuration

NASA Astrophysics Data System (ADS)

Ueno, Hideki; Kawahara, Shintaro; Nakayama, Hiroshi

Relationship between barrier discharge characteristics and ozone generation under ac voltage application on triple needles-plane configuration has been investigated for various distances among triple needle-tips (d=0 ∼ 7.0mm) at constant distance between needle tip and plane (g=3.0mm) in dry air. Characteristics of barrier discharge and ozone generation depend on the needle-tips distance. It is considered that the influence is caused by space charge and accumulated charge suggested from discharge image by still camera and CCD camera. And ozone generation efficiency is also estimated by power consumption and ozone concentration. As a result, when the distance among triple needle-tips is narrow, the above-mentioned influence is strengthened. And in this case, ozone generation efficiency is improved.

Analysis of the NovoTwist pen needle in comparison with conventional screw-thread needles.

PubMed

Aye, Tandy

2011-11-01

Administration of insulin via a pen device may be advantageous over a vial and syringe system. Hofman and colleagues introduce a new insulin pen needle, the NovoTwist, to simplify injections to a small group of children and adolescents. Their overall preferences and evaluation of the handling of the needle are reported in the study. This new needle has the potential to ease administration of insulin via a pen device that may increase both the use of a pen device and adherence to insulin therapy. © 2011 Diabetes Technology Society.

Development of Repulsive Barrier Discharge from Twin Needles

NASA Astrophysics Data System (ADS)

Ueno, Hideki; Hata, Koji; Nakayama, Hiroshi

2007-03-01

Barrier discharge characteristics have been investigated for a twin needles-to-plane electrode configuration in dry air. The characteristics of barrier discharge under ac voltage application have been investigated for various distances between two needle tips (d=1.0--4.0 mm). We have found that corona discharge behavior strongly depends on needle-tip distance. In the case of a twin-needles configuration with a long needle-tip distance (d=4.0 mm), discharges from the two needle tips develop into a dielectric barrier with almost a straight path. On the contrary, the development of repulsive discharges from two needle tips in the gap between needles and a barrier was obtained for the shortest needle-tip distance investigated here (d=1.0 mm) and it was enhanced by increasing the peak voltage. From detailed time-resolved observations, development of repulsive discharge was observed only during positive polarity upon ac voltage application. Moreover, the degree of repulsion increased with increasing applied voltage of positive polarity. The observed unique discharge behavior can be interpreted as the effect of field relaxation induced not only by charge accumulation on the barrier surface, which is markedly enhanced at a short needle-tip distance, but also by space charge by coronas between two needles.

Intra-operative navigation of a 3-dimensional needle localization system for precision of irreversible electroporation needles in locally advanced pancreatic cancer.

PubMed

Bond, L; Schulz, B; VanMeter, T; Martin, R C G

2017-02-01

Irreversible electroporation (IRE) uses multiple needles and a series of electrical pulses to create pores in cell membranes and cause cell apoptosis. One of the demands of IRE is the precise needle spacing required. Two-dimensional intraoperative ultrasound (2-D iUS) is currently used to measure inter-needle distances but requires significant expertise. This study evaluates the potential of three-dimensional (3-D) image guidance for placing IRE needles and calculating needle spacing. A prospective clinical evaluation of a 3-D needle localization system (Explorer™) was evaluated in consecutive patients from April 2012 through June 2013 for unresectable pancreatic adenocarcinoma. 3-D reconstructions of patients' anatomy were generated from preoperative CT images, which were aligned to the intraoperative space. Thirty consecutive patients with locally advanced pancreatic cancer were treated with IRE. The needle localization system setup added an average of 6.5 min to each procedure. The 3-D needle localization system increased surgeon confidence and ultimately reduced needle placement time. IRE treatment efficacy is highly dependent on accurate needle spacing. The needle localization system evaluated in this study aims to mitigate these issues by providing the surgeon with additional visualization and data in 3-D. The Explorer™ system provides valuable guidance information and inter-needle distance calculations. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

[Infraoccipital needle-knife for cervical vertigo].

PubMed

Li, Shaofang; Huang, Manhua; Lin, Zhuopeng; Chen, Xinze; Lin, Dongna; Lu, Peng; Lu, Qu

2017-03-12

To observe the clinical effect differences between infraoccipital needle-knife and massage for cervical vertigo. A total of 366 patients with cervical vertigo were randomly assigned into a needle-knife group (186 cases) and a massage group (180 cases). With cases dropping excluded, 183 cases in the needle-knife group and 176 cases in the massage group were included. Needle-knife was used at Fengchi (GB 20), infraoccipital ashi point, etc. in the needle-knife group. The treatment was given for one course, once three days, 5 times as one course. The traditional massage was applied in the massage group for one course, including systematic stroking, kneading, and the application of pressure and plucking, etc., once every two days and 7 times as one course. The dizziness handicap inventory (DHI) score was observed before and after treatment, as well as 3, 6, and 12 months after treatment. The effects were also evaluated. The total effective rate was 92.3% (169/183) in the needle-knife group, which was better than 85.2% (150/176) in the massage group ( P <0.05). Compared with those before treatment, the DHI scores at all the observation time points after treatment were improved in the two groups (all P <0.05), with better improvements after treatment as well as 3 and 6 months after treatment in the needle-knife group (all P <0.05). There was no significant difference in the improvement of DHI scores between the two groups 12 months after treatment ( P >0.05). The recurrence rate was 10.3% (12/117) in the needle-knife group, and it was 10.7% (11/103) in the massage group 12 months after treatment ( P >0.05). Infraoccipital needle-knife achieves apparent effect for cervical vertigo, which is superior to massage in short period.

Design and Production of an Articulating Needle Guide for Ultrasound-Guided Needle Block Manufactured With a Three-Dimensional Printer: Technical Communication.

PubMed

Bigeleisen, Paul E

2017-05-15

Needle guides may allow the practitioner to align the needle with the probe when ultrasound-guided nerve block is performed. The author's goal was to design and fabricate an inexpensive ($1.90), disposable, needle guide that could articulate over a range from 85 degrees to 0 degrees with a three-dimension printer. Three-dimensional representations of an L50, L25, and C 60 ultrasound probe (Sono Site, Bothell, WA) were created using a laser scanner. Computer-aided design software (Solid Works, Waltham, MA) was used to design a needle bracket and needle guide to attach to these probes. A three-dimensional printer was used to fabricate the needle bracket and guide with acrylonitrile polybutadiene polystyrene. An echogenic needle was held in plane with the needle guide. The author performed a supraclavicular block in a morbidly obese patient. The needle was easily visualized. Similar guides that are commercially available cost as much as $400. A knowledge of computer-aided design is necessary for this work.

Laser Generated Leaky Acoustic Waves for Needle Visualization.

PubMed

Wu, Kai-Wen; Wang, Yi-An; Li, Pai-Chi

2018-04-01

Ultrasound (US)-guided needle operation is usually used to visualize both tissue and needle position such as tissue biopsy and localized drug delivery. However, the transducer-needle orientation is limited due to reflection of the acoustic waves. We proposed a leaky acoustic wave method to visualize the needle position and orientation. Laser pulses are emitted on top of the needle to generate acoustic waves; then, these acoustic waves propagate along the needle surface. Leaky wave signals are detected by the US array transducer. The needle position can be calculated by phase velocities of two different wave modes and their corresponding emission angles. In our experiments, a series of needles was inserted into a tissue mimicking phantom and porcine tissue to evaluate the accuracy of the proposed method. The results show that the detection depth is up to 51 mm and the insertion angle is up to 40° with needles of different diameters. It is demonstrated that the proposed approach outperforms the conventional B-mode US-guided needle operation in terms of the detection range while achieving similar accuracy. The proposed method reveals the potentials for further clinical applications.

Comparison of two different size needles in endoscopic ultrasound-guided fine-needle aspiration for diagnosing solid pancreatic lesions

PubMed Central

Xu, Mei-Mei; Jia, Hong-Yu; Yan, Li-Li; Li, Shan-Shan; Zheng, Yue

2017-01-01

Abstract Background: This meta-analysis aimed to provide a pooled analysis of prospective controlled trials comparing the diagnostic accuracy of 22-G and 25-G needles on endoscopic ultrasonography (EUS-FNA) of the solid pancreatic mass. Methods: We established a rigorous study protocol according to Cochrane Collaboration recommendations. We systematically searched the PubMed and Embase databases to identify articles to include in the meta-analysis. Sensitivity, specificity, and corresponding 95% confidence intervals were calculated for 22-G and 25-G needles of individual studies from the contingency tables. Results: Eleven prospective controlled trials included a total of 837 patients (412 with 22-G vs 425 with 25-G). Our outcomes revealed that 25-G needles (92% [95% CI, 89%–95%]) have higher sensitivity than 22-G needles (88% [95% CI, 84%–91%]) on solid pancreatic mass EUS-FNA (P = 0.046). However, there were no significant differences between the 2 groups in overall diagnostic specificity (P = 0.842). The pooled positive and negative likelihood ratio of the 22-G needle were 12.61 (95% CI, 5.65–28.14) and 0.16 (95% CI, 0.12–0.21), respectively. The pooled positive likelihood ratio was 12.61 (95% CI, 5.65–28.14), and the negative likelihood ratio was 0.16 (95% CI, 0.12–0.21) for the 22-G needle. The pooled positive likelihood ratio was 8.44 (95% CI, 3.87–18.42), and the negative likelihood ratio was 0.13 (95% CI, 0.09–0.18) for the 25-G needle. The area under the summary receiver operating characteristic curve was 0.97 for the 22-G needle and 0.96 for the 25-G needle. Conclusion: Compared to the study of 22-G EUS-FNA needles, our study showed that 25-G needles have superior sensitivity in the evaluation of solid pancreatic lesions by EUS–FNA. PMID:28151856

[Needle breakage during mandibular block anaesthesia: prevention and retrieval].

PubMed

Baart, J A; van Amerongen, W E; de Jong, K J M; Allard, R H B

2006-12-01

Disposable needles for dental local anaesthesia do not break easily. Still, needle breakage does occur, and is mainly caused by unexpected movements of the patient or pre-use bending of the needle by the dentist. If a dental needle breaks while administering local anaesthesia, the dentist should prevent panic. If the patient opens his mouth wide the needle might still be visible. If so, the needle is removed. If the needle is no longer visible, the site where the needle has penetrated the mucosa should be marked with a permanent marker. The dentist will contact a maxillofacial surgeon for immediate consultation. The maxillofacial surgeon will try to retrieve the broken dental needle under general anaesthesia.

The effects of needle deformation during lumbar puncture

PubMed Central

Özdemir, Hasan Hüseyin; Demir, Caner F.; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

2015-01-01

Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH. PMID:25883480

The effects of needle deformation during lumbar puncture.

PubMed

Özdemir, Hasan Hüseyin; Demir, Caner F; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

2015-01-01

The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

A comparison of 25 gauge Quincke spinal needle with 26 gauge Eldor spinal needle for the elective Caesarian sections: insertion characteristics and complications.

PubMed

Tabedar, S; Maharjan, S K; Shrestha, B R; Shrestha, B M

2003-01-01

The study was designed to compare the insertion characteristics and incidence of PDPH between 25 gauge Quincke needle and 26 gauge Eldor needle for spinal anaesthesia in elective c/s. 60 pregnant women (aged 19-35 yrs and weighing 58 -67 kg) undergoing elective caesarean section were randomized into group A (Quincke spinal needle group) or group B (Eldor spinal needle group). Spinal anaesthesia was performed with 2.9 ml 0.5% heavy bupivacaine using 25 gauge Quincke spinal needle in group A and 26 Gauge Eldor spinal needle in group B. Onset, time of first identification of backflow of CSF, number of attempts, level of sensory and motor blockade, failure of anaesthesia, inadequate anaesthesia and incidence of PDPH were recorded. Quincke spinal needle was found easy at insertion, first attempt was successful in 90% of cases, whereas Eldor spinal needle was successful at first attempt in only 60% of cases. Early identification of CSF was seen in Eldor spinal needle group in 3.5 seconds vs. 5.2 seconds in Quincke spinal needle group. Blood mixed CSF was seen in 8 Quincke spinal needle group vs. none in Eldor spinal needle group. Onset was similar between both groups i.e. in 6 minutes. Failure of anaesthesia was none in Eldor spinal needle group vs. 2 in quincke spinal needle group. Height of sensory block achieved was T4 level in 26 parturients,T6 in 1 ,T8 in 1 and no anaesthesia at all in another 2 parturient as compared to T4 level in 29 and T3 in 1 parturient in Eldor spinal needle group. The degree of motor block with the use of Bromage criteria showed a motor score of 1 or 2 in 26 parturients in Quincke spinal needle group vs. same in all cases in Eldor spinal needle group. The total incidence of PDPH was 8.3 % (5 out of 60 parturient) which occurred all in Quincke spinal needle group. 2 parturient who developed severe PDPH required epidural blood patch. 26 gauge Eldor spinal needle was found to be better than 25 gauge Quincke spinal needle for caesarian sections

The effectiveness and safety of syringe vending machines as a component of needle syringe programmes in community settings.

PubMed

Islam, Mofizul; Wodak, Alex; Conigrave, Katherine M

2008-12-01

Syringe vending machines (SVMs) have been introduced in Europe and Australasia as part of the effort to increase the availability of sterile needles and syringes to injecting drug users (IDUs). This qualitative review of 14 published and grey literature studies examines whether community-based SVMs as a component of a comprehensive needle syringe programme (NSP) assist to reduce the spread of HIV and other blood-borne viruses amongst IDUs. The available evidence suggests that SVMs increase access to sterile injecting equipment, reduce needle and syringe sharing, and are likely to be cost efficient. SVMs also complement other modes of NSP delivery as they are used by IDUs who are less likely to attend staffed NSPs or pharmacies. If installed and properly maintained in a well-chosen location and with the local community well prepared, SVMs can enhance the temporal and geographical availability of sterile injecting equipment.

Electromyographic comparison of forearm muscle movements for fine skin suturing between an enlarged pen needle holder and a webster needle holder.

PubMed

Ohata, Erika; Matsuo, Kiyoshi; Ban, Ryokuya; Shiba, Masato; Yasunaga, Yoshichika

2013-01-01

For surgical suturing, a Webster needle holder uses wrist supinating with supinator and extrinsic muscles, whereas a pen needle holder uses finger twisting with intrinsic and extrinsic muscles. Because the latter is better suited to microsurgery, which requires fine suturing with less forearm muscle movement, we have recently adopted an enlarged pen needle holder scaled from a micro needle holder for fine skin suturing. In this study, we assessed whether the enlarged pen needle holder reduced forearm muscle movement during fine skin suturing as compared with the Webster needle holder. A fine skin-suturing task was performed using pen holding with the enlarged micro needle holder or scissor holding with the Webster needle holder by 9 experienced and 6 inexperienced microsurgeons. The task lasted for 60 seconds and was randomly performed 3 times for each method. Forearm flexor and extensor muscular activities were evaluated by surface electromyography. The enlarged pen needle holder method required significantly less forearm muscle movement for experienced microsurgeons despite it being their first time using the instrument. There was no significant difference between 2 methods for inexperienced microsurgeons. Experienced microsurgeons conserved forearm muscle movement by finger twisting in fine skin suturing with the enlarged pen needle holder. Inexperienced microsurgeons may benefit from the enlarged pen needle holder, even for fine skin suturing, to develop their internal acquisition model of the dynamics of finger twisting.

The research of knitting needle status monitoring setup

NASA Astrophysics Data System (ADS)

Liu, Lu; Liao, Xiao-qing; Zhu, Yong-kang; Yang, Wei; Zhang, Pei; Zhao, Yong-kai; Huang, Hui-jie

2013-09-01

In textile production, quality control and testing is the key to ensure the process and improve the efficiency. Defect of the knitting needles is the main factor affecting the quality of the appearance of textiles. Defect detection method based on machine vision and image processing technology is universal. This approach does not effectively identify the defect generated by damaged knitting needles and raise the alarm. We developed a knitting needle status monitoring setup using optical imaging, photoelectric detection and weak signal processing technology to achieve real-time monitoring of weaving needles' position. Depending on the shape of the knitting needle, we designed a kind of Glass Optical Fiber (GOF) light guides with a rectangular port used for transmission of the signal light. To be able to capture the signal of knitting needles accurately, we adopt a optical 4F system which has better imaging quality and simple structure and there is a rectangle image on the focal plane after the system. When a knitting needle passes through position of the rectangle image, the reflected light from needle surface will back to the GOF light guides along the same optical system. According to the intensity of signals, the computer control unit distinguish that the knitting needle is broken or curving. The experimental results show that this system can accurately detect the broken needles and the curving needles on the knitting machine in operating condition.

Ozone production of hollow-needle-to-mesh negative corona discharge enhanced by dielectric tube on the needle electrode

NASA Astrophysics Data System (ADS)

Pekárek, Stanislav

2014-12-01

For the hollow-needle-to-mesh negative corona discharge in air, we studied the effect of placing the dielectric tube on the needle electrode and the effect of various positions of the end of this tube with respect to the tip of the needle electrode on the concentration of ozone produced by the discharge, the ozone production yield and the discharge V-A characteristics. We found that the placement of the dielectric tube on the needle electrode with a suitable position of this tube end with respect to the tip of the needle electrode for a particular discharge power led to a more than fourfold increase in the concentration of ozone produced by the discharge and also, for a constant airflow, the ozone production yield.

Difficulties in spinal needle use. Insertion characteristics and failure rates associated with 25-, 27- and 29-gauge Quincke-type spinal needles.

PubMed

Tarkkila, P; Huhtala, J; Salminen, U

1994-08-01

The effect of different size (25-, 27- and 29-gauge) Quincke-type spinal needles on the incidence of insertion difficulties and failure rates was investigated in a randomised, prospective study with 300 patients. The needle size was randomised but the insertion procedure was standardised. The time to achieve dural puncture was significantly longer with the 29-gauge spinal needle compared with the larger bore needles and was due to the greater flexibility of the thin needle. However, the difference was less than 1 min and cannot be considered clinically significant. There were no significant differences between groups in the number of insertion attempts or failures and the same sensory level of analgesia was reached with all the needle sizes studied. Postoperatively, no postdural puncture headaches occurred in the 29-gauge spinal needle group, whilst in the 25- and 27-gauge needle groups, the postdural puncture headache rates were 7.4% and 2.1% respectively. The incidence of backache was similar in all study groups. We conclude that dural puncture with a 29-gauge spinal needle is clinically as easy as with larger bore needles and its use is indicated in patients who have a high risk of postdural puncture headache.

Pinyon Needle Scale (FIDL)

Treesearch

William F. McCambridge

1994-01-01

The pinyon needle scale (Matsucoccus acalyptus Herbert) is a native sap-sucking insect found in the Southwest. Feeding by scales weakens trees by killing needles older than 1 year. Sometimes small trees are killed by repeated feeding and large trees weakened to such an extent that they fall victims to attack by the bark beetle Ips confusus (LeConte). Scale infestations...

Reducing infectious complications after transrectal prostate needle biopsy using a disposable needle guide: is it possible?

PubMed

Gurbuz, Cenk; Canat, Lutfi; Atis, Gokhan; Caskurlu, Turhan

2011-01-01

To investigate whether the use of a disposable needle guide results in a decreased incidence of infectious complication after transrectal prostate needle biopsy (TPNB). Fifty five patients who underwent 10-core TPNB were randomized into two groups. A pre-biopsy blood and urine examination was performed in both groups. Group 1 (25 patients) underwent biopsy with disposable biopsy needle guide and Group 2 (30 patients) underwent biopsy with reusable biopsy needle guide. All patients had a blood and negative urine culture before the procedure. The patients received ciprofloxacin 500 mg twice a day beginning the day before the biopsy and continued for 3 days after. Serum C-reactive protein levels and urine and blood specimens were obtained 48 h after the biopsy. Primary endpoint of the study was to determine the effect of needle guide on the bacteriologic urinary tract infection (UTI) rate and secondary end point was to determine symptomatic UTI. The mean age of the patients was 63.46 (range 55 to 68) years. There were no significant differences regarding the prostate-specific antigen level, prostate size, existence of comorbidity in two groups before the procedure. Bacteriologic and symptomatic UTI was detected in 4% vs. 6.6% and 4% vs. 3.9% in Group 1 and 2 relatively (P > 0.05). The use of a disposable needle guide does not appear to minimize infection risk after TPNB. Large scale and randomized studies are necessary to determine the effect of disposable needle guide on infection rate after TPNB.

Needle thoracostomy in the treatment of a tension pneumothorax in trauma patients: what size needle?

PubMed

Zengerink, Imme; Brink, Peter R; Laupland, Kevin B; Raber, Earl L; Zygun, Dave; Kortbeek, John B

2008-01-01

A tension pneumothorax requires immediate decompression using a needle thoracostomy. According to advanced trauma life support guidelines this procedure is performed in the second intercostal space (ICS) in the midclavicular line (MCL), using a 4.5-cm (2-inch) catheter (5-cm needle). Previous studies have shown a failure rate of up to 40% using this technique. Case reports have suggested that this high failure rate could be because of insufficient length of the needle. To analyze the average chest wall thickness (CWT) at the second ICS in the MCL in a trauma population and to evaluate the length of the needle used in needle thoracostomy for emergency decompression of tension pneumothoraces. Retrospective review of major trauma admissions (Injury Severity Score >12) at the Foothills Medical Centre in Calgary, Canada, who underwent a computed tomography chest scan admitted in the period from October 2001 until March 2004. Subgroup analysis on men and women, <40 years of age and >/=40 years of age was defined a priori. CWT was measured to the nearest 0.01 cm at the second ICS in the MCL. The mean CWT in the 604 male patients and 170 female patients studied averaged 3.50 cm at the left second ICS MCL and 3.51 cm on the right. The mean CWT was significantly higher for women than men (p < 0.0001). About 9.9% to 19.3% of the men had a CWT >4.5 cm and 24.1% to 35.4% of the women studied. A catheter length of 4.5 cm may not penetrate the chest wall of a substantial amount (9.9%-35.4%) of the population, depending on age and gender. This study demonstrates the need for a variable needle length for relief of a tension pneumothorax in certain population groups to improve effectiveness of needle thoracostomy.

Simulation and experimental studies in needle-tissue interactions.

PubMed

Konh, Bardia; Honarvar, Mohammad; Darvish, Kurosh; Hutapea, Parsaoran

2017-08-01

This work aims to introduce a new needle insertion simulation to predict the deflection of a bevel-tip needle inside soft tissue. The development of such a model, which predicts the steering behavior of the needle during needle-tissue interactions, could improve the performance of many percutaneous needle-based procedures such as brachytherapy and thermal ablation, by means of the virtual path planning and training systems of the needle toward the target and thus reducing possible incidents of complications in clinical practices. The Arbitrary-Lagrangian-Eulerian (ALE) formulation in LS-DYNA software was used to model the solid-fluid interactions between the needle and tissue. Since both large deformation and fracture of the continuum need to be considered in this model, applying ALE method for fluid analysis was considered a suitable approach. A 150 mm long needle was used to bend within the tissue due to the interacting forces on its asymmetric bevel tip. Three experimental cases of needle steering in a soft phantom were performed to validate the simulation. An error measurement of less than 10 % was found between the predicted deflection by the simulations and the one observed in experiments, validating our approach with reasonable accuracy. The effect of the needle diameter and its bevel tip angle on the final shape of the needle was investigated using this model. To maneuver around the anatomical obstacles of the human body and reach the target location, thin sharp needles are recommended, as they would create a smaller radius of curvature. The insertion model presented in this work is intended to be used as a base structure for path planning and training purposes for future studies.

Dry needling — peripheral and central considerations

PubMed Central

Dommerholt, Jan

2011-01-01

Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive input leading to peripheral and central sensitization. Dry needling cannot only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points. Trigger point dry needling should be based on a thorough understanding of the scientific background of trigger points, the differences and similarities between active and latent trigger points, motor adaptation, and central sensitize application. Several outcome studies are included, as well as comments on dry needling and acupuncture. PMID:23115475

Electromyographic Comparison of Forearm Muscle Movements for Fine Skin Suturing Between an Enlarged Pen Needle Holder and a Webster Needle Holder

PubMed Central

Ohata, Erika; Matsuo, Kiyoshi; Ban, Ryokuya; Shiba, Masato; Yasunaga, Yoshichika

2013-01-01

Background: For surgical suturing, a Webster needle holder uses wrist supinating with supinator and extrinsic muscles, whereas a pen needle holder uses finger twisting with intrinsic and extrinsic muscles. Because the latter is better suited to microsurgery, which requires fine suturing with less forearm muscle movement, we have recently adopted an enlarged pen needle holder scaled from a micro needle holder for fine skin suturing. In this study, we assessed whether the enlarged pen needle holder reduced forearm muscle movement during fine skin suturing as compared with the Webster needle holder. Methods: A fine skin-suturing task was performed using pen holding with the enlarged micro needle holder or scissor holding with the Webster needle holder by 9 experienced and 6 inexperienced microsurgeons. The task lasted for 60 seconds and was randomly performed 3 times for each method. Forearm flexor and extensor muscular activities were evaluated by surface electromyography. Results: The enlarged pen needle holder method required significantly less forearm muscle movement for experienced microsurgeons despite it being their first time using the instrument. There was no significant difference between 2 methods for inexperienced microsurgeons. Conclusions: Experienced microsurgeons conserved forearm muscle movement by finger twisting in fine skin suturing with the enlarged pen needle holder. Inexperienced microsurgeons may benefit from the enlarged pen needle holder, even for fine skin suturing, to develop their internal acquisition model of the dynamics of finger twisting. PMID:23691259

[Academic origin of round magnetic needle and standardization operation].

PubMed

Cheng, Yan-Ting; Zhang, Tian-Sheng; Meng, Li-Qiang; Shi, Rui-Qi; Ji, Lai-Xi

2014-07-01

The origin and development of round magnetic needle was explored, and the structure of round magnetic needle was introduced in detail, including the handle, the body and the tip of the needle. The clinical opera tion of round magnetic needle were standardized from the aspects of the methods of holding needle, manipulation skill, tapping position, strength of manipulation, application scope and matters needing attention, which laid foundation for the popularization and application of round magnetic needle.

Dimensions of stabident intraosseous perforators and needles.

PubMed

Ramlee, R A; Whitworth, J

2001-09-01

Problems can be encountered inserting intraosseous injection needles through perforation sites. This in vitro study examined the variability and size compatibility of Stabident intraosseous injection components. The diameters of 40 needles and perforators from a single Stabident kit were measured in triplicate with a toolmakers microscope. One-way ANOVA revealed that mean needle diameter (0.411 mm) was significantly narrower than mean perforator diameter (0.427 mm) (p < 0.001). A frequency distribution plot revealed that needle diameter followed a normal distribution, indicating tight quality control during manufacture. The diameter of perforators was haphazardly distributed, with a clustering of 15% at the lower limit of the size range. However on no occasion was the diameter of a perforator smaller than that of an injection needle. We conclude that components of the Stabident intraosseous anaesthetic system are size-compatible, but there is greater and more haphazard variability in the diameter of perforators than injection needles.

Needle Thoracostomy: Does Changing Needle Length and Location Change Patient Outcome?

PubMed

Weichenthal, Lori A; Owen, Scott; Stroh, Geoffory; Ramos, John

2018-06-01

Needle thoracostomy (NT) is a common prehospital intervention for patients in extremis or cardiac arrest due to trauma. The purpose of this study is to compare outcomes, efficacy, and complications after a change in policy related to NT in a four-county Emergency Medical Services (EMS) system with a catchment area of greater than 1.6 million people. This is a before and after observational study of all patients who had NT performed in the Central California (USA) EMS system. The before, anterior midclavicular line (MCL) group consisted of all patients who underwent NT from May 7, 2007 through February 28, 2013. The after, midaxillary line (MAL) axillary group consisted of all patients who underwent NT from March 1, 2013 through January 30, 2016, after policy revisions changed the timing, needle size, and placement location for NT. All prehospital and hospital records where NT was performed were queried for demographics, mechanism of injury, initial status and post-NT clinical change, reported complications, and final outcome. The trauma registry was accessed to obtain Injury Severity Scores (ISS). Information was manually abstracted by study investigators and examined utilizing univariate and multivariate analyses. Three-hundred and five trauma patients treated with NT were included in this study, of which, 169 patients (the MCL group) were treated with a 14-guage intravenous (IV) catheter at least 5.0-cm long at the second intercostal space (ICS), MCL after being placed in the ambulance; and 136 patients (the MAL group) were treated with a 10-guage IV catheter at least 9.5-cm long at the fifth ICS, MAL on scene. The mean ISS was lower in the MAL cohort (64.5 versus 69.2; P=.007). The mortality rate was 79% in both groups. The multivariate model with regard to survival supported that a lower ISS (P<.001) and reported clinical change after NT (P=.003) were significant indicators of survival. No complications from NT were reported. Changing the timing, length of

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Anesthesia conduction needle. 868.5150 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a) Identification. An anesthesia conduction needle is a device used to inject local anesthetics into a patient to...

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction needle. 868.5150 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a) Identification. An anesthesia conduction needle is a device used to inject local anesthetics into a patient to...

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Anesthesia conduction needle. 868.5150 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a) Identification. An anesthesia conduction needle is a device used to inject local anesthetics into a patient to...

Comparison of Spinal Needle Deflection in a Ballistic Gel Model.

PubMed

Rand, Ethan; Christolias, George; Visco, Christopher; R Singh, Jaspal

2016-10-01

Percutaneous diagnostic and therapeutic procedures are commonly used in the treatment of spinal pain. The success of these procedures depends on the accuracy of needle placement, which is influenced by needle size and shape. The purpose of this study is to examine and quantify the deviation of commonly used spinal needles based on needle tip design and gauge, using a ballistic gel tissue simulant. Six needles commonly used in spinal procedures (Quincke, Short Bevel, Chiba, Tuohy, Hustead, Whitacre) were selected for use in this study. Ballistic gel samples were made in molds of two depths, 40mm and 80 mm. Each needle was mounted in a drill press to ensure an accurate needle trajectory. Distance of deflection was recorded for each needle. In comparing the mean deflection of 22 gauge needles of all types at 80 mm of depth, deflection was greatest among beveled needles [Short Bevel (9.96 ± 0.77 mm), Quincke (8.89 ± 0.17 mm), Chiba (7.71 ± 1.16 mm)], moderate among epidural needles [Tuohy (7.64 ± 0.16 mm) and least among the pencil-point needles [Whitacre (0.73 ± 0.34 mm)]. Increased gauge (25 g) led to a significant increase in deflection among beveled needles. The direction of deflection was away from the bevel with Quincke, Chiba and Short Beveled needles and toward the bevel of the Tuohy and Hustead needles. Deflection of the Whitacre pencil-point needle was minimal. There is clinical utility in knowing the relative deflection of various needle tips. When a procedure requires a needle to be steered around obstacles, or along non-collinear targets, the predictable and large amount of deflection obtained through use of a beveled spinal needle may prove beneficial.

Comparison of Spinal Needle Deflection in a Ballistic Gel Model

PubMed Central

Rand, Ethan; Christolias, George; Visco, Christopher; R. Singh, Jaspal

2016-01-01

Background Percutaneous diagnostic and therapeutic procedures are commonly used in the treatment of spinal pain. The success of these procedures depends on the accuracy of needle placement, which is influenced by needle size and shape. Objectives The purpose of this study is to examine and quantify the deviation of commonly used spinal needles based on needle tip design and gauge, using a ballistic gel tissue simulant. Materials and Methods Six needles commonly used in spinal procedures (Quincke, Short Bevel, Chiba, Tuohy, Hustead, Whitacre) were selected for use in this study. Ballistic gel samples were made in molds of two depths, 40mm and 80 mm. Each needle was mounted in a drill press to ensure an accurate needle trajectory. Distance of deflection was recorded for each needle. Results In comparing the mean deflection of 22 gauge needles of all types at 80 mm of depth, deflection was greatest among beveled needles [Short Bevel (9.96 ± 0.77 mm), Quincke (8.89 ± 0.17 mm), Chiba (7.71 ± 1.16 mm)], moderate among epidural needles [Tuohy (7.64 ± 0.16 mm) and least among the pencil-point needles [Whitacre (0.73 ± 0.34 mm)]. Increased gauge (25 g) led to a significant increase in deflection among beveled needles. The direction of deflection was away from the bevel with Quincke, Chiba and Short Beveled needles and toward the bevel of the Tuohy and Hustead needles. Deflection of the Whitacre pencil-point needle was minimal. Conclusions There is clinical utility in knowing the relative deflection of various needle tips. When a procedure requires a needle to be steered around obstacles, or along non-collinear targets, the predictable and large amount of deflection obtained through use of a beveled spinal needle may prove beneficial. PMID:27847693

[Professor WU Zhongchao's experience of penetration needling].

PubMed

Zhang, Ning; Wang, Bing; Zhou, Yu

2016-08-12

Professor WU Zhongchao has unique application of penetration needling in clinical treatment. Professor WU applies penetration needling along meridians, and the methods of penetration needling include self-meridian penetration, exterior-interior meridian penetration, identical-name meridian penetration, different meridian penetration. The meridian differentiation is performed according to different TCM syndromes, locations and natures of diseases and acupoint nature, so as to make a comprehensive assessment. The qi movement during acupuncture is focused. In addition, attention is paid on anatomy and long-needle penetration; the sequence and direction of acupuncture is essential, and the reinforcing and reducing methods have great originality, presented with holding, waiting, pressing and vibrating. Based on classical acupoint, the acupoint of penetration needling is flexible, forming unique combination of acupoints.

A new needle on the block: EchoTip ProCore endobronchial ultrasound needle

PubMed Central

Dincer, H Erhan; Andrade, Rafael; Zamora, Felix; Podgaetz, Eitan

2016-01-01

Endobronchial ultrasound has become the first choice standard of care procedure to diagnose benign or malignant lesions involving mediastinum and lung parenchyma adjacent to the airways owing to its characteristics of being real-time and minimally invasive. Although the incidence of lung cancer has been decreasing, it is and will be the leading cause of cancer-related mortality in the next few decades. When compared to other cancers, lung cancer kills more females than breast and colon cancers combined and more males than colon and prostate cancers combined. The type of lung cancer has changed in recent decades and adenocarcinoma has become the most frequent cell type. Prognosis of lung cancer depends upon the cell type and the staging at the time of diagnosis. The cell type and molecular characteristics of adenocarcinoma may allow individualized targeted treatment. Other malignant conditions in the mediastinum and lung (eg, metastatic lung cancers and lymphoma) can be biopsied using endobronchial ultrasound needles. Endobronchial ultrasound needle biopsies provides mostly cytology specimens due to its small sizes of needles (22 gauge or larger) which may not give enough tissue to make a definitive diagnosis in malignant (eg, lymphoma) or benign conditions (eg, sarcoidosis). EchoTip ProCore endobronchial needle released in early 2014 provides histologic biopsy material. Larger tissue biopsies may potentially provide a higher diagnostic yield and it eliminates mediastinoscopy or other surgical interventions. Here we aim to review bronchoscopic approach in the diagnosis of mediastinal lesions with emphasis of EchoTip ProCore needles. PMID:27099535

The incidence of coring with blunt versus sharp needles.

PubMed

Wani, Tariq; Wadhwa, Anupama; Tobias, Joseph D

2014-03-01

With the advent of safety needles to prevent inadvertent needle sticks in the operating room (OR), a potentially new issue has arisen. These needles may result in coring, or the shaving off of fragments of the rubber stopper, when the needle is pierced through the rubber stopper of the medication vial. These fragments may be left in the vial and then drawn up with the medication and possibly injected into patients. The current study prospectively evaluated the incidence of coring when blunt and sharp needles were used to pierce rubber topped vials. We also evaluated the incidence of coring in empty medication vials with rubber tops. The rubber caps were then pierced with either an18-gauge sharp hypodermic needle or a blunt plastic (safety) needle. Coring occurred in 102 of 250 (40.8%) vials when a blunt needle was used versus 9 of 215 (4.2%) vials with a sharp needle (P < 0.0001). A significant incidence of coring was demonstrated when a blunt plastic safety needle was used. This situation is potentially a patient safety hazard and methods to eliminate this problem are needed. Copyright © 2014 Elsevier Inc. All rights reserved.

Method to Reduce Target Motion Through Needle-Tissue Interactions.

PubMed

Oldfield, Matthew J; Leibinger, Alexander; Seah, Tian En Timothy; Rodriguez Y Baena, Ferdinando

2015-11-01

During minimally invasive surgical procedures, it is often important to deliver needles to particular tissue volumes. Needles, when interacting with a substrate, cause deformation and target motion. To reduce reliance on compensatory intra-operative imaging, a needle design and novel delivery mechanism is proposed. Three-dimensional finite element simulations of a multi-segment needle inserted into a pre-existing crack are presented. The motion profiles of the needle segments are varied to identify methods that reduce target motion. Experiments are then performed by inserting a needle into a gelatine tissue phantom and measuring the internal target motion using digital image correlation. Simulations indicate that target motion is reduced when needle segments are stroked cyclically and utilise a small amount of retraction instead of being held stationary. Results are confirmed experimentally by statistically significant target motion reductions of more than 8% during cyclic strokes and 29% when also incorporating retraction, with the same net insertion speed. By using a multi-segment needle and taking advantage of frictional interactions on the needle surface, it is demonstrated that target motion ahead of an advancing needle can be substantially reduced.

[Our experience using "Huber Plus" needles in our infusion center].

PubMed

Tazumi, Keiko; Kouji, Keiko; Matsumura, Natsuko; Nabetani, Yoshiko; Kondo, Motoi; Tomono, Kazunori; Mizuki, Masao

2008-01-01

We conducted a pilot trial to compare the operability and safety of two huber needles in the infusion center. In the present study, we used huber needles without the safety cover and one huber needle with the safety cover (Huber Plus(R)). Both huber needles were used nine times. The successful puncture rate of the first time puncture and the incidence of needle accidents with both huber needles were 100% and 0%, respectively. The evaluation of pain and uneasiness by VAS (Visual Analogue scale)revealed the superiority of the safety needle over the than non-safety needle(pain: 3.8 vs 2.6, uneasiness: 3.7 vs 0.5). To our knowledge, this is the first report of the safety of the huber needle in Japan. This system may be recommended in Japan to avoid needle stick injuries, patient pain and uneasiness.

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental injecting needle. 872.4730 Section 872.4730...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4730 Dental injecting needle. (a) Identification. A dental injecting needle is a slender, hollow metal device with a sharp point intended to be attached to a...

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental injecting needle. 872.4730 Section 872.4730...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4730 Dental injecting needle. (a) Identification. A dental injecting needle is a slender, hollow metal device with a sharp point intended to be attached to a...

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Dental injecting needle. 872.4730 Section 872.4730...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4730 Dental injecting needle. (a) Identification. A dental injecting needle is a slender, hollow metal device with a sharp point intended to be attached to a...

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Dental injecting needle. 872.4730 Section 872.4730...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4730 Dental injecting needle. (a) Identification. A dental injecting needle is a slender, hollow metal device with a sharp point intended to be attached to a...

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental injecting needle. 872.4730 Section 872.4730...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4730 Dental injecting needle. (a) Identification. A dental injecting needle is a slender, hollow metal device with a sharp point intended to be attached to a...

How Placebo Needles Differ From Placebo Pills?

PubMed Central

Chae, Younbyoung; Lee, Ye-Seul; Enck, Paul

2018-01-01

Because acupuncture treatment is defined by the process of needles penetrating the body, placebo needles were originally developed with non-penetrating mechanisms. However, whether placebo needles are valid controls in acupuncture research is subject of an ongoing debate. The present review provides an overview of the characteristics of placebo needles and how they differ from placebo pills in two aspects: (1) physiological response and (2) blinding efficacy. We argue that placebo needles elicit physiological responses similar to real acupuncture and therefore provide similar clinical efficacy. We also demonstrate that this efficacy is further supported by ineffective blinding (even in acupuncture-naïve patients) which may lead to opposite guesses that will further enhances efficacy, as compared to no-treatment, e.g., with waiting list controls. Additionally, the manner in which placebo needles can exhibit therapeutic effects relative to placebo pills include enhanced touch sensations, direct stimulation of the somatosensory system and activation of multiple brain systems. We finally discuss alternative control strategies for the placebo effects in acupuncture therapy.

EUS Needle Identification Comparison and Evaluation study (with videos).

PubMed

Tang, Shou-Jiang; Vilmann, Andreas S; Saftoiu, Adrian; Wang, Wanmei; Streba, Costin Teodor; Fink, Peter P; Griswold, Michael; Wu, Ruonan; Dietrich, Christoph F; Jenssen, Christian; Hocke, Michael; Kantowski, Marcus; Pohl, Jürgen; Fockens, Paul; Annema, Jouke T; van der Heijden, Erik H F M; Havre, Roald Flesland; Pham, Khanh Do-Cong; Kunda, Rastislav; Deprez, Pierre H; Mariana, Jinga; Vazquez-Sequeiros, Enrique; Larghi, Alberto; Buscarini, Elisabetta; Fusaroli, Pietro; Lahav, Maor; Puri, Rajesh; Garg, Pramod Kumar; Sharma, Malay; Maluf-Filho, Fauze; Sahai, Anand; Brugge, William R; Lee, Linda S; Aslanian, Harry R; Wang, Andrew Y; Shami, Vanessa M; Markowitz, Arnold; Siddiqui, Ali A; Mishra, Girish; Scheiman, James M; Isenberg, Gerard; Siddiqui, Uzma D; Shah, Raj J; Buxbaum, James; Watson, Rabindra R; Willingham, Field F; Bhutani, Manoop S; Levy, Michael J; Harris, Cynthia; Wallace, Michael B; Nolsøe, Christian Pállson; Lorentzen, Torben; Bang, Niels; Sørensen, Sten Mellerup; Gilja, Odd Helge; D'Onofrio, Mirko; Piscaglia, Fabio; Gritzmann, Norbert; Radzina, Maija; Sparchez, Zeno Adrian; Sidhu, Paul S; Freeman, Simon; McCowan, Timothy C; de Araujo, Cyrillo Rodrigues; Patel, Akash; Ali, Mohammad Adel; Campbell, Garth; Chen, Edward; Vilmann, Peter

2016-09-01

EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development. Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices. There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001). All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity. Copyright © 2016 American Society for Gastrointestinal Endoscopy. All rights reserved.

Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors.

PubMed

Eom, H-J; Lee, J H; Ko, M-S; Choi, Y J; Yoon, R G; Cho, K J; Nam, S Y; Baek, J H

2015-06-01

Diagnostic test accuracy studies for ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy have shown inconclusive results due to their heterogenous study designs. Our aim was to compare the diagnostic accuracy of ultrasonography-guided fine-needle aspiration versus ultrasonography-guided core needle biopsy for detecting malignant tumors of the salivary gland and for the tissue-specific diagnosis of salivary gland tumors in a single tertiary hospital. This retrospective study was approved by our institutional review board and informed consent was waived. Four hundred twelve patients who underwent ultrasonography-guided fine-needle aspiration (n = 155) or ultrasonography-guided core needle biopsy (n = 257) with subsequent surgical confirmation or clinical follow-up were enrolled. We compared the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy regarding malignant salivary gland tumors and the correct tissue-specific diagnosis of benign and malignant tumors. We also tested the difference between these procedures according to the operator's experience and lesion characteristics. The inconclusive rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 19% and 4%, respectively (P < .001). The overall accuracy of ultrasonography-guided core needle biopsy for diagnosing malignant tumors was significantly higher than that of ultrasonography-guided fine-needle aspiration (P = .024). The correct tissue-specific diagnosis rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 95% versus 97% for benign tumors (P = .648) and 67% versus 80% for malignant tumors (P = .310). Trainees showed significantly lower accuracy with ultrasonography-guided fine-needle aspiration than with ultrasonography-guided core needle biopsy for diagnosing malignant tumors (P = .021). There was no

Pine needle abortion biomarker detected in bovine fetal fluids

USDA-ARS?s Scientific Manuscript database

Pine needle abortion is a naturally occurring condition in free-range cattle caused by the consumption of pine needles from select species of cypress, juniper, pine, and spruce trees. Confirmatory diagnosis of pine needle abortion has previously relied on a combined case history of pine needle cons...

Coaxial needle insertion assistant with enhanced force feedback.

PubMed

De Lorenzo, Danilo; Koseki, Yoshihiko; De Momi, Elena; Chinzei, Kiyoyuki; Okamura, Allison M

2013-02-01

Many medical procedures involving needle insertion into soft tissues, such as anesthesia, biopsy, brachytherapy, and placement of electrodes, are performed without image guidance. In such procedures, haptic detection of changing tissue properties at different depths during needle insertion is important for needle localization and detection of subsurface structures. However, changes in tissue mechanical properties deep inside the tissue are difficult for human operators to sense, because the relatively large friction force between the needle shaft and the surrounding tissue masks the smaller tip forces. A novel robotic coaxial needle insertion assistant, which enhances operator force perception, is presented. This one-degree-of-freedom cable-driven robot provides to the operator a scaled version of the force applied by the needle tip to the tissue, using a novel design and sensors that separate the needle tip force from the shaft friction force. The ability of human operators to use the robot to detect membranes embedded in artificial soft tissue was tested under the conditions of 1) tip force and shaft force feedback, and 2) tip force only feedback. The ratio of successful to unsuccessful membrane detections was significantly higher (up to 50%) when only the needle tip force was provided to the user.

Hyper- and viscoelastic modeling of needle and brain tissue interaction.

PubMed

Lehocky, Craig A; Yixing Shi; Riviere, Cameron N

2014-01-01

Deep needle insertion into brain is important for both diagnostic and therapeutic clinical interventions. We have developed an automated system for robotically steering flexible needles within the brain to improve targeting accuracy. In this work, we have developed a finite element needle-tissue interaction model that allows for the investigation of safe parameters for needle steering. The tissue model implemented contains both hyperelastic and viscoelastic properties to simulate the instantaneous and time-dependent responses of brain tissue. Several needle models were developed with varying parameters to study the effects of the parameters on tissue stress, strain and strain rate during needle insertion and rotation. The parameters varied include needle radius, bevel angle, bevel tip fillet radius, insertion speed, and rotation speed. The results will guide the design of safe needle tips and control systems for intracerebral needle steering.

Transillumination for needle localization in the larynx.

PubMed

Hoffman, Henry T; Dailey, Seth H; Bock, Jonathan M; Thibeault, Susan L; McCulloch, Timothy M

2015-10-01

Transillumination through laryngeal soft tissue may be used to direct percutaneous transcricothyroid membrane subepithelial needle placement in the larynx. Cadaver simulation (canine and human). Lighted devices, including sialendoscopes and fiberoptic cables, were tested as transilluminating obturators in trocars and needles through multiple studies to identify appropriate illumination, monitoring, and equipment for successful localization of needle/trocar tips placed within laryngeal tissue. Lighted 250-micron fiberoptic cables within 23-gauge needles were successfully placed percutaneously through the cricothyroid membrane and maneuvered submucosally into Reinke's space, the midlateral vocal fold, and through the thyroarytenoid gap with monitoring via flexible transnasal laryngoscopy. Technical adaptations in the course of study permitted successful simulation of clinical use in full cadaver study for accurate injection laryngoplasty, confirmed by laryngeal dissection following collagen injection. Small caliber fiberoptic cables are useful as transilluminating obturators to accurately direct needle position within laryngeal tissue. Clinical application of this new technique is anticipated to improve the accuracy of percutaneous needle localization in the larynx, as well as to assist in directed instrumentation of the larynx from an external approach. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

DIY guide-needle-assisted conjunctivodacryocystorhinostomy (CDCR).

PubMed

Paik, Ji-Sun; Kim, Su-Ah; Doh, Sang-Hee

2013-01-01

In this study, we introduce DIY guide-needle-assisted conjunctivodacryocystorhinostomy (CDCR), in which a guide needle helps in measuring the initial Jones tube length for insertion and reduces unnecessary handling for tube changes. Three CDCR procedures were conducted in which the length of the Jones tube was calculated using a 22-gauge DIY guide needle, and a prospective study of tube position change and migration, (a major cause of CDCR failure) was done. Wound healing was almost complete within 4 weeks postoperatively in the osteotomy site, but in cases of partial middle turbinectomy, a little more time was necessary. There was a slight change in Jones tube position in the nasal cavity compared with the expected position of original tube tip, but no tube migration from the caruncle fixation position had occurred by the final follow-up time. This guide-needle-assisted CDCR has multiple advantages, such as easy measurement of the proper initial tube size, utilization of the initial needle path, and easy replacement of tubes. Finally, this approach to CDCR can be readily applied because it uses materials ordinarily found in hospitals to create the devices needed for the procedure, so there is no additional cost.

Do safety engineered devices reduce needle-stick injuries?

PubMed

Schuurmans, J; Lutgens, S P; Groen, L; Schneeberger, P M

2018-05-05

Needle stick injuries (NSIs) are one of the most common health hazards facing health care workers (HCWs) across the globe. Needles with safety engineered devices (SEDs) have been developed to minimize the risk of exposure to blood-borne infections such as Hepatitis B virus (HBV), Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) associated with NSIs. To assess the effect of the introduction of SEDs in preventing NSIs among HCWs in the Jeroen Bosch Hospital (JBH), the Netherlands. We compared the incidence of reported NSIs before and after the introduction of SEDs. All HCWs who reported a NSI with a SED were interviewed in order to understand the underlying causes of the NSIs. Despite the introduction of SEDs the incidence of NSIs increased from 1.9/100 HCWs before the introduction of SEDs to 2.2/100 HCWs after the introduction of SEDs. The registration of reported SED related NSIs showed a significant decrease in the number of NSIs related to injection needles and blood sugar needles, while an unexpected significant increase in NSIs with nadroparin calcium needles and infusion needles was found. The most common causes reported for NSIs were unsafe disposal of the needles and problems with the safety feature. The application of SEDs has not led to a reduction of NSIs. The majority of NSIs caused by a needle with a SED can be prevented by stimulation of safe needle disposal, proper use of SEDs and provision of feedback to manufacturers to keep improving product design. Copyright © 2018. Published by Elsevier Ltd.

Needle Steering in 3-D Via Rapid Replanning

PubMed Central

Patil, Sachin; Burgner, Jessica; Webster, Robert J.; Alterovitz, Ron

2014-01-01

Steerable needles have the potential to improve the effectiveness of needle-based clinical procedures such as biopsy and drug delivery by improving targeting accuracy and reaching previously inaccessible targets that are behind sensitive or impenetrable anatomical regions. We present a new needle steering system capable of automatically reaching targets in 3-D environments while avoiding obstacles and compensating for real-world uncertainties. Given a specification of anatomical obstacles and a clinical target (e.g., from preoperative medical images), our system plans and controls needle motion in a closed-loop fashion under sensory feedback to optimize a clinical metric. We unify planning and control using a new fast algorithm that continuously replans the needle motion. Our rapid replanning approach is enabled by an efficient sampling-based rapidly exploring random tree (RRT) planner that achieves orders-of-magnitude reduction in computation time compared with prior 3-D approaches by incorporating variable curvature kinematics and a novel distance metric for planning. Our system uses an electromagnetic tracking system to sense the state of the needle tip during the procedure. We experimentally evaluate our needle steering system using tissue phantoms and animal tissue ex vivo. We demonstrate that our rapid replanning strategy successfully guides the needle around obstacles to desired 3-D targets with an average error of less than 3 mm. PMID:25435829

Spinal anaesthesia for caesarean section: comparison of 22-gauge and 25-gauge Whitacre needles with 26-gauge Quincke needles.

PubMed

Shutt, L E; Valentine, S J; Wee, M Y; Page, R J; Prosser, A; Thomas, T A

1992-12-01

We have studied 150 women undergoing elective Caesarean section under spinal anaesthesia. They were allocated randomly to have a 22-gauge Whitacre, a 25-gauge Whitacre or a 26-gauge Quincke needle inserted into the lumbar subarachnoid space. The groups were compared for ease of insertion, number of attempted needle insertions before identification of cerebrospinal fluid, quality of subsequent analgesia and incidence of postoperative complications. There were differences between groups, but they did not reach statistical significance. Postdural puncture headache (PDPH) was experienced by one mother in the 22-gauge Whitacre group, none in the 25-gauge Whitacre group and five in the 26-gauge Quincke group. Five of the six PDPH occurred after a single successful needle insertion. Seven of the 15 mothers in whom more than two needle insertions were made experienced backache, compared with 12 of the 129 receiving two or less (P < 0.001). We conclude that the use of 22- and 25-gauge Whitacre needles in elective Caesarean section patients is associated with a low incidence of PDPH and that postoperative backache is more likely when more than two attempts are made to insert a spinal needle.

Effect of vibration frequency on biopsy needle insertion force.

PubMed

Tan, Lei; Qin, Xuemei; Zhang, Qinhe; Zhang, Hongcai; Dong, Hongjian; Guo, Tuodang; Liu, Guowei

2017-05-01

Needle insertion is critical in many clinical medicine procedures, such as biopsy, brachytherapy, and injection therapy. A platform with two degrees of freedom was set up to study the effect of vibration frequency on needle insertion force. The gel phantom deformation at the needle cutting edge and the Voigt model are utilized to develop a dynamic model to explain the relationship between the insertion force and needle-tip velocity. The accuracy of this model was verified by performing needle insertions into phantom gel. The effect of vibration on insertion force can be explained as the vibration increasing the needle-tip velocity and subsequently increasing the insertion force. In a series of needle insertion experiments with different vibration frequencies, the peak forces were selected for comparison to explore the effect of vibration frequency on needle insertion force. The experimental results indicate that the insertion force at 500Hz increases up to 17.9% compared with the force at 50Hz. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

The biopolitics of needle exchange in the United States

PubMed Central

McLean, Katherine

2012-01-01

Needle exchange began in the United States as a fragmented and illegal practice initiated by actors at the grassroots level; since the late 1980s, needle exchange has achieved increasing yet variable levels of institutional support across the country, receiving official sanction and funding from state and municipal governments. In turn, the practice(s) and discourse(s) of needle exchange have shifted significantly in many locales, becoming the purview of professional administration that advocates needle exchange as a necessary public health measure. This article is interested in the ways in which needle exchange has become implicated in and appropriated by networks of power seeking to discipline and regulate injection drug use. Drawing theoretically on Michel Foucault’s writings concerning biopower and governmentality, it will examine the proliferation of discourses, knowledges, and rules surrounding needle exchange in the United States. At the same time, this article will avoid a characterization of needle exchange that envisions the unilateral control of drug users by governmental power, illuminating instead both its negative and productive effects for drug users. Namely, it will explore how needle exchange creates both subjects of interest and subjects of resistance among drug users – that is to say, the governmentalization of needle exchange and its ‘clients’. PMID:22389572

Effect of needle size and type, reuse of needles, insertion speed, and removal of hair on contamination of joints with tissue debris and hair after arthrocentesis.

PubMed

Adams, Stephen B; Moore, George E; Elrashidy, Mohammed; Mohamed, Ahmed; Snyder, Paul W

2010-08-01

To assess joint contamination with tissue and hair after arthrocentesis of equine fetlock joints. Experimental. Limb specimens from 8 equine cadavers. Soft tissues including the joint capsule were harvested from the dorsal aspect of the fetlock joints and mounted on a wooden frame. Needles inserted through the joint tissue preparation were flushed into tissue culture plates that were examined for tissue and hair debris. Variables evaluated were gauge and type of needle (16, 18, 20, and 22 G sharp disposable needles and 20 G disposable spinal needles with stylet), number of times each needle was used (1, 2, 3, 4), length of hair (unclipped, clipped, shaved with razor), and needle insertion speed (fast, slow). Descriptive and statistical evaluations were performed. Tissue contamination was identified in 1145 of 1260 wells and hair contamination was identified in 384 of 1260 wells. Twenty gauge needles inserted through unclipped hair resulted in the least amount of hair contamination. Compared with 20 G needles with fast insertion 1 time through unclipped hair the odds ratios for contamination with hair were significantly greater for 16 G sharp disposable needles, 20 G spinal needles, clipped hair, shaved hair, and reuse of the needles. Spinal needles inserted through unclipped hair transferred many long hairs into the joint space. Reuse of needles for arthrocentesis should be avoided. Removal of hair is not indicated for arthrocentesis with sharp injection needles but is recommended when using spinal needles with stylets. Joint contamination with hair and tissue debris will be decreased by specific needle insertion techniques. Decreased contamination of joints may reduce the frequency of joint infections after arthrocentesis.

Fusion of electromagnetic trackers to improve needle deflection estimation: simulation study.

PubMed

Sadjadi, Hossein; Hashtrudi-Zaad, Keyvan; Fichtinger, Gabor

2013-10-01

We present a needle deflection estimation method to anticipate needle bending during insertion into deformable tissue. Using limited additional sensory information, our approach reduces the estimation error caused by uncertainties inherent in the conventional needle deflection estimation methods. We use Kalman filters to combine a kinematic needle deflection model with the position measurements of the base and the tip of the needle taken by electromagnetic (EM) trackers. One EM tracker is installed on the needle base and estimates the needle tip position indirectly using the kinematic needle deflection model. Another EM tracker is installed on the needle tip and estimates the needle tip position through direct, but noisy measurements. Kalman filters are then employed to fuse these two estimates in real time and provide a reliable estimate of the needle tip position, with reduced variance in the estimation error. We implemented this method to compensate for needle deflection during simulated needle insertions and performed sensitivity analysis for various conditions. At an insertion depth of 150 mm, we observed needle tip estimation error reductions in the range of 28% (from 1.8 to 1.3 mm) to 74% (from 4.8 to 1.2 mm), which demonstrates the effectiveness of our method, offering a clinically practical solution.

[Brief introduction of acupuncture needling and teaching keypoint].

PubMed

Hou, Shu-wei; Guo, Li; Kong, Su-ping

2014-09-01

We summarized our accumulated clinical and teaching experiences and explored the regularity of acupuncture needling and teaching. It is of great importance in pressing hand during inserting needle. Stroking and pressing are two crucial parts which deserve more attention, and seldom useage of pressing hand should be abolished. Operating hand needs practice before inserting needle, while it should fully relaxed during inserting. Blending "touching", "stretch" "gathering" "erupting" and "advancing" in single moment, applying appropriate dynamic mode of inserting needle such as "join 3 forces as one" "3 points in a line" expertly and naturally. In addition, enough attention should be paid on "altering direction" and "shifting point". Inserting deftly and powerfully, no/slight sensation, deqi when inserting needle are the highest reflection as an acupuncturist.

[Try to discuss manipulation of the "Feijing Zouqi" needling technique].

PubMed

Zhou, Dan; Gao, Ying; Wang, Fu-chun

2008-03-01

Based on description of "Feijing Zouqi" needling methods in Jin Zhen Fu (Rhyme Prose of Golden Needle) written by Xu Feng, and explain and analyze the descriptions of "Feijing Zouqi" needling method in Zhenjiu Juying (A Collection of Gems in Acu-Moxibustion) written by Gao Wu, Zhenjiu Wendui written by Wang Ji, Zhenjiu Dacheng (Great Compendium on Acu-Moxibustion) written by Yang Ji-zhou, Yixue Rumen (Elementary Medicine) written by LI Chan and many other works, summarize the technique characteristics of all the "Feijing Zouqi" needling methods. The characteristic of "Qinglong Baiwei" needling method is " first toward the left, then toward the right, slowly move or adjust with the hand"; and "Baihu Yaotou" needling method emphasizes "Tuifang Jinyuan" and "Yaozhen "; key point of "Canggui Tanxue" needling method is "Zuanti Sifang"; Chifeng Yingyuan" needling method emphasizes "Siwei Feixuan".

Mixed mode fuel injector with individually moveable needle valve members

DOEpatents

Stewart, Chris; Chockley, Scott A.; Ibrahim, Daniel R.; Lawrence, Keith; Tomaseki, Jay; Azam, Junru H.; Tian, Steven Ye; Shafer, Scott F.

2004-08-03

A fuel injector includes a homogenous charge nozzle outlet set and a conventional nozzle outlet set controlled respectively, by first and second needle valve members. One of the needle valve members moves to an open position while the other needle valve member remains stationary for a homogeneous charge injection event. The former needle valve member stays stationary while the other needle valve member moves to an open position for a conventional injection event. One of the needle valve members is at least partially positioned in the other needle valve member. Thus, the injector can perform homogeneous charge injection events, conventional injection events, or even a mixed mode having both types of injection events in a single engine cycle.

Self-chaperoning of the type III secretion system needle tip proteins IpaD and BipD.

PubMed

Johnson, Steven; Roversi, Pietro; Espina, Marianela; Olive, Andrew; Deane, Janet E; Birket, Susan; Field, Terry; Picking, William D; Blocker, Ariel J; Galyov, Edouard E; Picking, Wendy L; Lea, Susan M

2007-02-09

Bacteria expressing type III secretion systems (T3SS) have been responsible for the deaths of millions worldwide, acting as key virulence elements in diseases ranging from plague to typhoid fever. The T3SS is composed of a basal body, which traverses both bacterial membranes, and an external needle through which effector proteins are secreted. We report multiple crystal structures of two proteins that sit at the tip of the needle and are essential for virulence: IpaD from Shigella flexneri and BipD from Burkholderia pseudomallei. The structures reveal that the N-terminal domains of the molecules are intramolecular chaperones that prevent premature oligomerization, as well as sharing structural homology with proteins involved in eukaryotic actin rearrangement. Crystal packing has allowed us to construct a model for the tip complex that is supported by mutations designed using the structure.

A Multicenter comparative trial of a novel EUS-guided core biopsy needle (SharkCore™) with the 22-gauge needle in patients with solid pancreatic mass lesions

PubMed Central

Naveed, Mariam; Siddiqui, Ali A.; Kowalski, Thomas E.; Loren, David E.; Khalid, Ammara; Soomro, Ayesha; Mazhar, Syed M.; Yoo, Joseph; Hasan, Raza; Yalamanchili, Silpa; Tarangelo, Nicholas; Taylor, Linda J.; Adler, Douglas G.

2018-01-01

Background and Objectives: The ability to obtain adequate tissue of solid pancreatic lesions by EUS-guided remains a challenge. The aim of this study was to compare the performance characteristics and safety of EUS-FNA for evaluating solid pancreatic lesions using the standard 22-gauge needle versus a novel EUS biopsy needle. Methods: This was a multicenter retrospective study of EUS-guided sampling of solid pancreatic lesions between 2009 and 2015. Patients underwent EUS-guided sampling with a 22-gauge SharkCore (SC) needle or a standard 22-gauge FNA needle. Technical success, performance characteristics of EUS-FNA, the number of needle passes required to obtain a diagnosis, diagnostic accuracy, and complications were compared. Results: A total of 1088 patients (mean age = 66 years; 49% female) with pancreatic masses underwent EUS-guided sampling with a 22-gauge SC needle (n = 115) or a standard 22-gauge FNA needle (n = 973). Technical success was 100%. The frequency of obtaining an adequate cytology by EUS-FNA was similar when using the SC and the standard needle (94.1% vs. 92.7%, respectively). The sensitivity, specificity, and diagnostic accuracy of EUS-FNA for tissue diagnosis were not significantly different between two needles. Adequate sample collection leading to a definite diagnosis was achieved by the 1st, 2nd, and 3rd pass in 73%, 92%, and 98% of procedures using the SC needle and 20%, 37%, and 94% procedures using the standard needle (P < 0.001), respectively. The median number of passes to obtain a tissue diagnosis using the SC needle was significantly less as compared to the standard needle (1 and 3, respectively; P < 0.001). Conclusions: The EUS SC biopsy needle is safe and technically feasible for EUS-FNA of solid pancreatic mass lesions. Preliminary results suggest that the SC needle has a diagnostic yield similar to the standard EUS needle and significantly reduces the number of needle passes required to obtain a tissue diagnosis. PMID:29451167

21 CFR 882.1350 - Needle electrode.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Needle electrode. 882.1350 Section 882.1350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1350 Needle electrode. (a...

21 CFR 882.1350 - Needle electrode.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Needle electrode. 882.1350 Section 882.1350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1350 Needle electrode. (a...

Needle Steering in Biological Tissue using Ultrasound-based Online Curvature Estimation

PubMed Central

Moreira, Pedro; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2014-01-01

Percutaneous needle insertions are commonly performed for diagnostic and therapeutic purposes. Accurate placement of the needle tip is important to the success of many needle procedures. The current needle steering systems depend on needle-tissue-specific data, such as maximum curvature, that is unavailable prior to an interventional procedure. In this paper, we present a novel three-dimensional adaptive steering method for flexible bevel-tipped needles that is capable of performing accurate tip placement without previous knowledge about needle curvature. The method steers the needle by integrating duty-cycled needle steering, online curvature estimation, ultrasound-based needle tracking, and sampling-based motion planning. The needle curvature estimation is performed online and used to adapt the path and duty cycling. We evaluated the method using experiments in a homogenous gelatin phantom, a two-layer gelatin phantom, and a biological tissue phantom composed of a gelatin layer and in vitro chicken tissue. In all experiments, virtual obstacles and targets move in order to represent the disturbances that might occur due to tissue deformation and physiological processes. The average targeting error using our new adaptive method is 40% lower than using the conventional non-adaptive duty-cycled needle steering method. PMID:26229729

Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

MedlinePlus

... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid ... Needle Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? ...

High-pressure needle interface for thermoplastic microfluidics.

PubMed

Chen, C F; Liu, J; Hromada, L P; Tsao, C W; Chang, C C; DeVoe, D L

2009-01-07

A robust and low dead volume world-to-chip interface for thermoplastic microfluidics has been developed. The high pressure fluidic port employs a stainless steel needle inserted into a mating hole aligned to an embedded microchannel, with an interference fit used to increase pressure resistance. Alternately, a self-tapping threaded needle screwed into a mating hole is also demonstrated. In both cases, the flat bottom needle ports seat directly against the microchannel substrate, ensuring low interfacial dead volumes. Low dispersion is observed for dye bands passing the interfaces. The needle ports offer sufficient pull-out forces for applications such as liquid chromatography that require high internal fluid pressures, with the epoxy-free interfaces compatible with internal microchannel pressures above 40 MPa.

A clinical guide to needle desensitization for the paediatric patient.

PubMed

Taylor, Greig D; Campbell, Caroline

2015-05-01

Needle phobia is a common problem encountered by dental practitioners and it can pose a challenge, especially in the paediatric patient. Needle desensitization can be used for patients who have needle fear or phobia and help them overcome this by repeated, non-threatening and controlled contacts. This paper will describe an accepted technique of needle desensitization and work through the steps required to achieve a successful outcome of local anaesthesia being delivered in a calm, safe and controlled manner. Clinical Relevance: Needle desensitization is an effective technique which can be used to enable a needle phobic patient to receive a dental injection.

Sugar export limits size of conifer needles

NASA Astrophysics Data System (ADS)

Rademaker, Hanna; Zwieniecki, Maciej A.; Bohr, Tomas; Jensen, Kaare H.

2017-04-01

Plant leaf size varies by more than three orders of magnitude, from a few millimeters to over one meter. Conifer leaves, however, are relatively short and the majority of needles are no longer than 6 cm. The reason for the strong confinement of the trait-space is unknown. We show that sugars produced near the tip of long needles cannot be exported efficiently, because the pressure required to drive vascular flow would exceed the greatest available pressure (the osmotic pressure). This basic constraint leads to the formation of an inactive region of stagnant fluid near the needle tip, which does not contribute to sugar flow. Remarkably, we find that the size of the active part does not scale with needle length. We predict a single maximum needle size of 5 cm, in accord with data from 519 conifer species. This could help rationalize the recent observation that conifers have significantly smaller leaves than angiosperms, and provide a biophysical explanation for this intriguing difference between the two largest groups of plants.

A GIS-based methodology for improving needle exchange service delivery

PubMed Central

Davidson, Peter J.; Scholar, Shoshanna; Howe, Mary

2010-01-01

Background A variety of legal, social and logistical factors can prevent individuals from accessing formal needle exchange programs. One common solution to this problem is satellite exchange, which involves collaborating with people who already use an exchange to deliver needles and other supplies to those unable to access the exchange. While this approach can be very successful, one potential problem is that those most willing to deliver needles to their peers are often members of social networks that are already well connected with the needle exchange, leading to duplication of effort. In this paper we describe a simple and novel method for identifying groups of people who are demonstrably in need of improved access to needles, and for re-targeting efforts to meet the needs of those people. The method described was piloted at the Homeless Youth Alliance, San Francisco, USA, and further refined at Clean Needles Now, Los Angeles, USA. Methods People accessing needle exchange sites were asked to participate in a survey with two questions: “where were you and what time was it last time someone borrowed a needle from you?” and “where were you and what time was it last time you had to borrow a needle from someone else?” Responses were geocoded, and maps produced showing ‘hotspots’ where people were frequently finding themselves without needles. Results Satellite needle exchange was refined from an ad-hoc activity into one which focused on delivering needles to those with empirically demonstrable need. Maps produced in the process also proved valuable in discussions with local officials and other agencies about funding, as well as needle provision policy and practices. Conclusion We describe a method for rapidly assessing, describing, and responding to unmet and under-met need among injecting drug users. The method is particularly well-suited to organizations with extremely limited resources. PMID:21112757

Free thyroxine in needle washout after fine needle aspiration biopsy of toxic thyroid nodules.

PubMed

Raikov, Nikolai; Nonchev, Boyan; Chaushev, Borislav; Vjagova, Diyana; Todorov, Svetoslav; Bocheva, Yana; Malceva, Daniela; Vicheva, Snejinka; Raikova, Asyia; Argatska, Antoaneta; Raikov, Miroslav

2016-01-01

The main diagnostic tool for toxic adenomas (TA) is radionuclide imaging indicated in patients with evidence of thyroid nodules in combination with thyrotoxic syndrome. Thyroid ultrasound and fine-needle aspiration biopsy (FNAB) are widely used for the valuation of thyroid masses. There is no literature data concerning the utility of FNAB and related tests for the diagnosis of hyperfunctioning thyroid nodules. The purpose of this study is to determine the levels of free thyroxine (FT4) in the needle washout after FNAB of hot thyroid nodules. The results of our study show that the FT4 levels in needle washout from TA were significantly higher than the surrounding parenchyma and correlated with the hormonal changes in patients with thyroid hyperfunctioning nodules. Further studies on a large number of patients are needed to refine the diagnostic value of this method and evaluate its importance in quantitative risk assessment of thyroid autonomy.

Fine-needle aspiration by vacuum tubes.

PubMed

Holmquist, N D

1989-07-01

Fine-needle aspiration of subcutaneous masses, accepted in many parts of Europe and the Americas as a routine diagnostic technique, employs a syringe holder to facilitate the creation of a vacuum to withdraw cells. This investigation demonstrates that a vacuum tube used in venipuncture can be used to supply the negative pressure to suck cells into the needle. This apparatus is more readily available than a syringe holder in hospitals and clinics, and particularly provides the operator with a more dexterous approach to the mass because the fingers holding the needle can be much closer to the mass being immobilized by the other hand.

21 CFR 880.5580 - Acupuncture needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Acupuncture needle. 880.5580 Section 880.5580 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... the skin in the practice of acupuncture. The device consists of a solid, stainless steel needle. The...

Image-based tracking of the suturing needle during laparoscopic interventions

NASA Astrophysics Data System (ADS)

Speidel, S.; Kroehnert, A.; Bodenstedt, S.; Kenngott, H.; Müller-Stich, B.; Dillmann, R.

2015-03-01

One of the most complex and difficult tasks for surgeons during minimally invasive interventions is suturing. A prerequisite to assist the suturing process is the tracking of the needle. The endoscopic images provide a rich source of information which can be used for needle tracking. In this paper, we present an image-based method for markerless needle tracking. The method uses a color-based and geometry-based segmentation to detect the needle. Once an initial needle detection is obtained, a region of interest enclosing the extracted needle contour is passed on to a reduced segmentation. It is evaluated with in vivo images from da Vinci interventions.

The effect of SO2 pollution on pine needle structure

Treesearch

E. A. Zhitkova; L. L. Novitskaya

2000-01-01

Fall and winter needles from pines growing near the Kostomuksha oredressing mill (KODM) were collected and studied by light microscopy. Fall needles showed symptoms of SO2 influence and no specific seasonal changes in mesophyll. The injury rates of needle surface and mesophyll showed that pollutants penetrate into the needles through stomata and...

Preparation (pulling) of needles for gene delivery by microinjection.

PubMed

Dean, David A

2006-12-01

INTRODUCTIONThis protocol contains methods for pulling microinjection needles using two different models of pipette pullers. The advantage of pulling needles in the laboratory is that a variety of different needle types can be pulled, depending on the samples and cells being injected. An added advantage is cost; once a pipette puller has been purchased, boxes of glass capillaries are inexpensive compared to premade microinjection needles. The advantages to buying preformed and sterilized needles include increased uniformity of needles from one to another, ease of use, high quality, and not having to invest in a pipette puller. The pipette puller models described in this article are the Flaming/Brown Pipette Puller Model P-97 (Sutter) and the PUL-1 Micropipette Puller (World Precision Instruments). The PUL-1 instrument is the less expensive of the two, but it requires more user input, and it cannot be used to pull Femtotip-like microinjection pipettes.

Behavior of Tip-Steerable Needles in ex vivo and in vivo Tissue

PubMed Central

Majewicz, Ann; Marra, Steven P.; van Vledder, Mark G.; Lin, MingDe; Choti, Michael A.; Song, Danny Y.; Okamura, Allison M.

2012-01-01

Robotic needle steering is a promising technique to improve the effectiveness of needle-based clinical procedures, such as biopsies and ablation, by computer-controlled, curved insertions of needles within solid organs. In this paper, we explore the capabilities, challenges, and clinical relevance of asymmetric-tip needle steering though experiments in ex vivo and in vivo tissue. We evaluate the repeatability of needle insertion in inhomogeneous biological tissue and compare ex vivo and in vivo needle curvature and insertion forces. Steerable needles curved more in kidney than in liver and prostate, likely due to differences in tissue properties. Pre-bent needles produced higher insertion forces in liver and more curvature in vivo than ex vivo. When compared to straight stainless steel needles, steerable needles did not cause a measurable increase in tissue damage and did not exert more force during insertion. The minimum radius of curvature achieved by pre-bent needles was 5.23 cm in ex vivo tissue, and 10.4 cm in in vivo tissue. The curvatures achieved by bevel tip needles were negligible for in vivo tissue. The minimum radius of curvature for bevel tip needles in ex vivo tissue was 16.4 cm; however, about half of the bevel tip needles had negligible curvatures. We also demonstrate a potential clinical application of needle steering by targeting and ablating overlapping regions of cadaveric canine liver. PMID:22711767

Habitat conditions and phenological tree traits overrule the influence of tree genotype in the needle mycobiome-Picea glauca system at an arctic treeline ecotone.

PubMed

Eusemann, Pascal; Schnittler, Martin; Nilsson, R Henrik; Jumpponen, Ari; Dahl, Mathilde B; Würth, David G; Buras, Allan; Wilmking, Martin; Unterseher, Martin

2016-09-01

Plant-associated mycobiomes in extreme habitats are understudied and poorly understood. We analysed Illumina-generated ITS1 sequences from the needle mycobiome of white spruce (Picea glauca) at the northern treeline in Alaska (USA). Sequences were obtained from the same DNA that was used for tree genotyping. In the present study, fungal metabarcoding and tree microsatellite data were compared for the first time. In general, neighbouring trees shared more fungal taxa with each other than trees growing in further distance. Mycobiomes correlated strongly with phenological host traits and local habitat characteristics contrasting a dense forest stand with an open treeline site. Genetic similarity between trees did not influence fungal composition and no significant correlation existed between needle mycobiome and tree genotype. Our results suggest the pronounced influence of local habitat conditions and phenotypic tree traits on needle-inhabiting fungi. By contrast, the tree genetic identity cannot be benchmarked as a dominant driver for needle-inhabiting mycobiomes, at least not for white spruce in this extreme environment. © 2016 The Authors. New Phytologist © 2016 New Phytologist Trust.

Master-slave robotic system for needle indentation and insertion.

PubMed

Shin, Jaehyun; Zhong, Yongmin; Gu, Chengfan

2017-12-01

Bilateral control of a master-slave robotic system is a challenging issue in robotic-assisted minimally invasive surgery. It requires the knowledge on contact interaction between a surgical (slave) robot and soft tissues. This paper presents a master-slave robotic system for needle indentation and insertion. This master-slave robotic system is able to characterize the contact interaction between the robotic needle and soft tissues. A bilateral controller is implemented using a linear motor for robotic needle indentation and insertion. A new nonlinear state observer is developed to online monitor the contact interaction with soft tissues. Experimental results demonstrate the efficacy of the proposed master-slave robotic system for robotic needle indentation and needle insertion.

Self-Chaperoning of the Type III Secretion System needle tip proteins IpaD and BipD

PubMed Central

Johnson, Steven; Roversi, Pietro; Espina, Marianela; Olive, Andrew; Deane, Janet E.; Birket, Susan; Field, Terry; Picking, William D.; Blocker, Ariel; Galyov, Edouard E.; Picking, Wendy L.; Lea, Susan M.

2007-01-01

Bacteria expressing type III secretion systems (T3SS) have been responsible for the deaths of millions worldwide, acting as key virulence elements in diseases ranging from plague to typhoid fever. The T3SS is composed of a basal body, which traverses both bacterial membranes, and an external needle through which effector proteins are secreted. We report multiple crystal structures of two proteins that sit at the tip of the needle and are essential for virulence; IpaD from Shigella flexneri and BipD from Burkholderia pseudomallei. The structures reveal that the N-terminal domains of the molecules are intra-molecular chaperones that prevent premature oligomerization, as well as sharing structural homology with proteins involved in eukaryotic actin rearrangement. Crystal packing has allowed us to construct a model for the tip complex that is supported by mutations designed using the structure. PMID:17077085

[Observation on therapeutic effect of three needling method on piriformis injury syndrome].

PubMed

Yang, Jun-xiong; Zhu, Xiao-yi

2008-03-01

To search for an effective needling method for treatment of piriformis injury syndrome. Eighty-two cases were randomly divided into a three needling group and a routine needling group, 41 cases in each group. The three needling group were treated by acupuncture at Huantiao (GB 30), Yanglingquan (GB 34) and Shenmai (BL 62), with needling shallow, middle and deep layers for Huantiao, Yanglingquan, and after acupuncture massage was given at the Foot-Taiyang Channel and the Foot-Shaoyang Channel on lumbosacral region and the affected foot. The routine needling group were treated by routine needling at Huantiao (GB 30), Juliao (GB 29), Chengfu (BL 36), Yanglingquan (GB 34), massage was given also. Their therapeutic effects were compared. The cured rate was 87.8% in the three needling group and 63.4% in the routine needling group, with a significant difference between the two groups (P < 0.05). The therapeutic effect of three needling method on piriformis injury syndrome is better than that of routine needling.

Torsional Dynamics of Steerable Needles: Modeling and Fluoroscopic Guidance

PubMed Central

Swensen, John P.; Lin, MingDe; Okamura, Allison M.; Cowan, Noah J.

2017-01-01

Needle insertions underlie a diversity of medical interventions. Steerable needles provide a means by which to enhance existing needle-based interventions and facilitate new ones. Tip-steerable needles follow a curved path and can be steered by twisting the needle base during insertion, but this twisting excites torsional dynamics that introduce a discrepancy between the base and tip twist angles. Here, we model the torsional dynamics of a flexible rod—such as a tip-steerable needle—during subsurface insertion and develop a new controller based on the model. The torsional model incorporates time-varying mode shapes to capture the changing boundary conditions inherent during insertion. Numerical simulations and physical experiments using two distinct setups—stereo camera feedback in semi-transparent artificial tissue and feedback control with real-time X-ray imaging in optically opaque artificial tissue— demonstrate the need to account for torsional dynamics in control of the needle tip. PMID:24860026

Transperineal prostate biopsy under magnetic resonance image guidance: a needle placement accuracy study.

PubMed

Blumenfeld, Philip; Hata, Nobuhiko; DiMaio, Simon; Zou, Kelly; Haker, Steven; Fichtinger, Gabor; Tempany, Clare M C

2007-09-01

To quantify needle placement accuracy of magnetic resonance image (MRI)-guided core needle biopsy of the prostate. A total of 10 biopsies were performed with 18-gauge (G) core biopsy needle via a percutaneous transperineal approach. Needle placement error was assessed by comparing the coordinates of preplanned targets with the needle tip measured from the intraprocedural coherent gradient echo images. The source of these errors was subsequently investigated by measuring displacement caused by needle deflection and needle susceptibility artifact shift in controlled phantom studies. Needle placement error due to misalignment of the needle template guide was also evaluated. The mean and standard deviation (SD) of errors in targeted biopsies was 6.5 +/- 3.5 mm. Phantom experiments showed significant placement error due to needle deflection with a needle with an asymmetrically beveled tip (3.2-8.7 mm depending on tissue type) but significantly smaller error with a symmetrical bevel (0.6-1.1 mm). Needle susceptibility artifacts observed a shift of 1.6 +/- 0.4 mm from the true needle axis. Misalignment of the needle template guide contributed an error of 1.5 +/- 0.3 mm. Needle placement error was clinically significant in MRI-guided biopsy for diagnosis of prostate cancer. Needle placement error due to needle deflection was the most significant cause of error, especially for needles with an asymmetrical bevel. (c) 2007 Wiley-Liss, Inc.

Dual mode fuel injector with one piece needle valve member

DOEpatents

Lawrence, Keith E.; Hinrichsen, Michael H.; Buckman, Colby

2005-01-18

A fuel injector includes a homogenous charge nozzle outlet set and a conventional nozzle outlet set controlled respectively by inner and outer needle value members. The homogenous charged nozzle outlet set is defined by an outer needle value member that is moveably positioned in an injector body, which defines the conventional nozzle outlet set. The inner needle valve member is positioned in the outer needle valve member. The outer needle valve member is a piece component that includes at least one external guide surface, an external value surface and an internal valve seat.

Robust path planning for flexible needle insertion using Markov decision processes.

PubMed

Tan, Xiaoyu; Yu, Pengqian; Lim, Kah-Bin; Chui, Chee-Kong

2018-05-11

Flexible needle has the potential to accurately navigate to a treatment region in the least invasive manner. We propose a new planning method using Markov decision processes (MDPs) for flexible needle navigation that can perform robust path planning and steering under the circumstance of complex tissue-needle interactions. This method enhances the robustness of flexible needle steering from three different perspectives. First, the method considers the problem caused by soft tissue deformation. The method then resolves the common needle penetration failure caused by patterns of targets, while the last solution addresses the uncertainty issues in flexible needle motion due to complex and unpredictable tissue-needle interaction. Computer simulation and phantom experimental results show that the proposed method can perform robust planning and generate a secure control policy for flexible needle steering. Compared with a traditional method using MDPs, the proposed method achieves higher accuracy and probability of success in avoiding obstacles under complicated and uncertain tissue-needle interactions. Future work will involve experiment with biological tissue in vivo. The proposed robust path planning method can securely steer flexible needle within soft phantom tissues and achieve high adaptability in computer simulation.

Scaling of phloem structure and optimality of sugar transport in conifer needles

NASA Astrophysics Data System (ADS)

Jensen, Kaare H.; Ronellenfitsch, Henrik; Liesche, Johannes; Holbrook, N. Michele; Schulz, Alexander; Katifori, Eleni

2015-11-01

The phloem vascular system facilitates transport of energy-rich sugar and signalling molecules in plants, thus permitting long-range communication within the organism and growth of non-photosynthesizing organs such as roots and fruits. The flow is driven by osmotic pressure, generated by differences in sugar concentration between distal parts of the plant. The phloem is an intricate distribution system, and many questions about its regulation and structural diversity remain unanswered. Here, we investigate the phloem structure in the simplest possible geometry: a linear leaf, found, for example, in the needles of conifer trees. We measure the phloem structure in four tree species representing a diverse set of habitats and needle sizes, from 1 cm (Picea omorika) to 35 cm (Pinus palustris). We show that the phloem shares common traits across these four species and find that the size of its conductive elements obeys a power law. We present a minimal model that accounts for these common traits and takes into account the transport strategy and natural constraints. This minimal model predicts a power law phloem distribution consistent with transport energy minimization, suggesting that energetics are more important than translocation speed at the leaf level.

Needle Decompression of Tension Pneumothorax with Colorimetric Capnography.

PubMed

Naik, Nimesh D; Hernandez, Matthew C; Anderson, Jeff R; Ross, Erika K; Zielinski, Martin D; Aho, Johnathon M

2017-11-01

The success of needle decompression for tension pneumothorax is variable, and there are no objective measures assessing effective decompression. Colorimetric capnography, which detects carbon dioxide present within the pleural space, may serve as a simple test to assess effective needle decompression. Three swine underwent traumatically induced tension pneumothorax (standard of care, n = 15; standard of care with needle capnography, n = 15). Needle thoracostomy was performed with an 8-cm angiocatheter. Similarly, decompression was performed with the addition of colorimetric capnography. Subjective operator assessment of decompression was recorded and compared with true decompression, using thoracoscopic visualization for both techniques. Areas under receiver operating curves were calculated and pairwise comparison was performed to assess statistical significance (P < .05). The detection of decompression by needle colorimetric capnography was found to be 100% accurate (15 of 15 attempts), when compared with thoracoscopic assessment (true decompression). Furthermore, it accurately detected the lack of tension pneumothorax, that is, the absence of any pathologic/space-occupying lesion, in 100% of cases (10 of 10 attempts). Standard of care needle decompression was detected by operators in 9 of 15 attempts (60%) and was detected in 3 of 10 attempts when tension pneumothorax was not present (30%). True decompression, under direct visualization with thoracoscopy, occurred 15 of 15 times (100%) with capnography, and 12 of 15 times (80%) without capnography. Areas under receiver operating curves were 0.65 for standard of care and 1.0 for needle capnography (P = .002). Needle decompression with colorimetric capnography provides a rapid, effective, and highly accurate method for eliminating operator bias for tension pneumothorax decompression. This may be useful for the treatment of this life-threatening condition. Copyright © 2017 American College of Chest Physicians

Experimental analysis of robot-assisted needle insertion into porcine liver.

PubMed

Wang, Wendong; Shi, Yikai; Goldenberg, Andrew A; Yuan, Xiaoqing; Zhang, Peng; He, Lijing; Zou, Yingjie

2015-01-01

How to improve placement accuracy of needle insertion into liver tissue is of paramount interest to physicians. A robot-assisted system was developed to experimentally demonstrate its advantages in needle insertion surgeries. Experiments of needle insertion into porcine liver tissue were performed with conic tip needle (diameter 8 mm) and bevel tip needle (diameter 1.5 mm) in this study. Manual operation was designed to compare the performance of the presented robot-assisted system. The real-time force curves show outstanding advantages of robot-assisted operation in improving the controllability and stability of needle insertion process by comparing manual operation. The statistics of maximum force and average force further demonstrates robot-assisted operation causes less oscillation. The difference of liver deformation created by manual operation and robot-assisted operation is very low, 1 mm for average deformation and 2 mm for maximum deformation. To conclude, the presented robot-assisted system can improve placement accuracy of needle by stably control insertion process.

Diagenesis of conifer needles in a coastal marine environment

NASA Astrophysics Data System (ADS)

Hedges, John I.; Weliky, K.

1989-10-01

Physically intact fir, hemlock and cedar needles were isolated from different horizons of a sediment core from a coastal marine bay (Dabob Bay, Washington State, U.S.A.) and from nearby trees and forest litter. Green fir, hemlock and cedar needles were all characterized by glucose-rich aldose mixtures (~30% of tissue carbon), the production of vanillyl and cinnamyl CuO-derived phenols (~8% of tissue carbon) and the presence of both pinitol and myo-inositol (1-2% of tissue carbon). Needles from forest litter were enriched in lignin phenols and non-glucose aldoses and depleted in glucose and cyclitols. The sediment core contained an average of 10 mg/1 of physically intact fir, hemlock and cedar needles, which occurred in similar relative abundances and accounted for less than 1% of the total nonwoody gymnosperm tissue. Compared to the green and litter counterparts, all sedimentary needles were greatly depleted in cyclitols, glucose and p-coumaric acid and enriched in vanillyl phenol precursors. The degree of elevation of vanillyl phenol yield from the degraded needles was used to estimate minimal carbon losses from the samples, which ranged from near 40% for needle litter to almost 70% for the deepest (~100 years old) sedimentary fir/hemlock samples. Although downcore increases in carbon loss and refractory organic components indicated in situ diagenesis, the bulk of overall degradation occurred either on land or during the first 10-20 years after deposition. Atomic C/N ratios of degraded needles were lower than for green counterparts, but nitrogen was lost overall. These relative changes indicate the following stability series: vanillyl phenols > N > ferulic acid, p-hydroxy phenols, most aldoses and bulk tissue > glucose and p-coumaric acid > cyclitols (near 100% loss). Vanillic acid to vanillin ratios, (Ad/Al)v, of the green fir and hemlock needles were unusually high (0.36-0.38) and decreased downcore. Diagenesis also decreased the cinnamyl/vanillyl phenol ratio

Rooting of needle fascicles from western white pine seedlings

Treesearch

Ramond J. Hoff; Geral I. McDonald

1968-01-01

In one test, 45 out of 318 (14 percent) needle fascicles from 2-year-old seedlings of Pinus monticola Dougl. were rooted. Eight of the needle fascicles produced shoot growth. In another test, 392 out of 742 (53 percent) needle fascicles were rooted, but none of these produced shoot growth.

Endpoint Accuracy in Manual Control of a Steerable Needle.

PubMed

van de Berg, Nick J; Dankelman, Jenny; van den Dobbelsteen, John J

2017-02-01

To study the ability of a human operator to manually correct for errors in the needle insertion path without partial withdrawal of the needle by means of an active, tip-articulated steerable needle. The needle is composed of a 1.32-mm outer-diameter cannula, with a flexure joint near the tip, and a retractable stylet. The bending stiffness of the needle resembles that of a 20-gauge hypodermic needle. The needle functionality was evaluated in manual insertions by steering to predefined targets and a lateral displacement of 20 mm from the straight insertion line. Steering tasks were conducted in 5 directions and 2 tissue simulants under image guidance from a camera. The repeatability in instrument actuations was assessed during 100 mm deep automated insertions with a linear motor. In addition to tip position, tip angles were tracked during the insertions. The targeting error (mean absolute error ± standard deviation) during manual steering to 5 different targets in stiff tissue was 0.5 mm ± 1.1. This variability in manual tip placement (1.1 mm) was less than the variability among automated insertions (1.4 mm) in the same tissue type. An increased tissue stiffness resulted in an increased lateral tip displacement. The tip angle was directly controlled by the user interface, and remained unaffected by the tissue stiffness. This study demonstrates the ability to manually steer needles to predefined target locations under image guidance. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Smart surgical needle actuated by shape memory alloys for percutaneous procedures

NASA Astrophysics Data System (ADS)

Konh, Bardia

Background: Majority of cancer interventions today are performed percutaneously using needle-based procedures, i.e. through the skin and soft tissue. Insufficient accuracy using conventional surgical needles motivated researchers to provide actuation forces to the needle's body for compensating the possible errors of surgeons/physicians. Therefore, active needles were proposed recently where actuation forces provided by shape memory alloys (SMAs) are utilized to assist the maneuverability and accuracy of surgical needles. This work also aims to introduce a novel needle insertion simulation to predict the deflection of a bevel tip needle inside the tissue. Methods: In this work first, the actuation capability of a single SMA wire was studied. The complex response of SMAs was investigated via a MATLAB implementation of the Brinson model and verified via experimental tests. The material characteristics of SMAs were simulated by defining multilinear elastic isothermal stress-strain curves. Rigorous experiments with SMA wires were performed to determine the material properties as well as to show the capability of the code to predict a stabilized SMA transformation behavior with sufficient accuracy. The isothermal stress-strain curves of SMAs were simulated and defined as a material model for the Finite Element Analysis of the active needle. In the second part of this work, a three-dimensional finite element (FE) model of the active steerable needle was developed to demonstrate the feasibility of using SMA wires as actuators to bend the surgical needle. In the FE model, birth and death method of defining boundary conditions, available in ANSYS, was used to achieve the pre-strain condition on SMA wire prior to actuation. This numerical model was validated with needle deflection experiments with developed prototypes of the active needle. The third part of this work describes the design optimization of the active using genetic algorithm aiming for its maximum flexibility

Needle free injection technology: A complete insight

PubMed Central

Ravi, Ansh Dev; Sadhna, D; Nagpaal, D; Chawla, L

2015-01-01

Needle free injection technology (NFIT)is an extremely broad concept which include a wide range of drug delivery systems that drive drugs through the skin using any of the forces as Lorentz, Shock waves, pressure by gas or electrophoresis which propels the drug through the skin, virtually nullifying the use of hypodermic needle. This technology is not only touted to be beneficial for the pharma industry but developing world too find it highly useful in mass immunization programmes, bypassing the chances of needle stick injuries and avoiding other complications including those arising due to multiple use of single needle. The NFIT devices can be classified based on their working, type of load, mechanism of drug delivery and site of delivery. To administer a stable, safe and an effective dose through NFIT, the sterility, shelf life and viscosity of drug are the main components which should be taken care of. Technically superior needle-free injection systems are able to administer highly viscous drug products which cannot be administered by traditional needle and syringe systems, further adding to the usefulness of the technology. NFIT devices can be manufactured in a variety of ways; however the widely employed procedure to manufacture it is by injection molding technique. There are many variants of this technology which are being marketed, such as Bioject® ZetaJetTM, Vitajet 3, Tev-Tropin® and so on. Larger investment has been made in developing this technology with several devices already being available in the market post FDA clearance and a great market worldwide. PMID:26682189

Building a city wide service for exchanging needles and syringes.

PubMed Central

Gruer, L; Cameron, J; Elliott, L

1993-01-01

How best can injecting drug misusers obtain clean injecting equipment in a city where drug injecting is widespread? An exchange service for needles and syringes throughout Glasgow has been established in health centres and clinics in the evening. Over the past four years seven new exchanges have been opened and over 2700 injecting drug misusers have attended. Attendances rose from under 1000 in 1988 to 28,000 in 1992. The exchanges also provide a wide range of other health and social services. Public hostility to the exchanges has abated. During the same period equipment sharing in the city diminished and the observed prevalence of HIV among injecting drug misusers stabilised at around 1%. Images FIG 1 FIG 2 FIG 3 PMID:8518609

Complications after LP related to needle type: pencil-point versus Quincke.

PubMed

Aamodt, A; Vedeler, C

2001-06-01

We studied the incidence of complications after diagnostic lumbar puncture (LP) related to needle type. A 5 months' observational study of routine diagnostic LP in 83 patients was conducted. Significantly more headache was observed after LP using thicker cutting needles (20G Quincke) compared with thinner cutting or non-cutting needles (22G Quincke or pencil-point). No significant difference in complications after LP was found between the 22G Quincke and pencil-point needles. The size of the needle and not the needle shape seems to be the main determinant for post-dural puncture headache (PDPH).

Recovering Infectious HIV from Novel Syringe-Needle Combinations with Low Dead Space Volumes.

PubMed

Abdala, Nadia; Patel, Amisha; Heimer, Robert

This study determines if detachable syringe-needle combinations redesigned to reduce their dead space volume may substantially reduce the burden of exposure to infectious HIV among people who inject drugs. Two novel, low dead space (LDS) syringe-needle designs-one added a piston to the plunger (LDS syringe) and the other added a filler to the needle (LDS needle) to reduce their dead space-were compared to standard detachable needle-syringe combinations and to syringes with fixed needles. LDS and standard syringes attached to LDS and standard needles of 23-, 25-, and 27-gauge size were contaminated with HIV-infected blood in the laboratory. The proportion of syringe-needle combinations containing infectious HIV was analyzed after syringes were (1) stored up to 7 days at 22°C or (2) rinsed with water. Detachable syringes attached to 25-gauge needles yielded comparable proportions of syringes with infectious HIV, whether the needle was standard or LDS. Among needles of greater diameter (23 gauge), LDS needles tended to reduce recoverable HIV to a greater extent than standard needles. Syringes with fixed needles showed superior results to LDS syringes attached to needles of equivalent diameter and were less likely to get clogged by blood. Detachable LDS syringe-needle designs must be recommended with caution since they still pose potential risk for HIV transmission. Distribution of LDS syringes and needles must be accompanied by recommendations and instructions for their proper rinsing and disinfection in order to reduce viral burden and chances of needle clogging.

A comparison of the Cook single lumen immature ovum IVM needle to the Steiner-Tan pseudo double lumen flushing needle for oocyte retrieval for IVM.

PubMed

Rose, B I; Laky, D

2013-06-01

This study compared the impact of using the Steiner-Tan pseudo double lumen needle for antral follicle oocyte retrieval to using a conventional non-flushing needle. The Steiner-Tan needle has a much smaller dead space than the needles commonly used for IVM oocyte retrievals. This was a retrospective cohort study. The patient population was determined by the time period in which a patient underwent IVM in a single physician's IVF practice. The following data was abstracted from clinical and embryology records: oocytes retrieved, oocytes matured, early maturing oocytes, oocytes fertilized, embryo quality measures, retrieval time, needle punctures, clot formation, and clinical pregnancy rate. The Steiner-Tan needle did not increase the number of oocytes retrieved. It also did not increase the time required for retrieval. However, flushing of antral follicles significantly decreased clot formation in fluid aspirates. Use of the Steiner-Tan needle also significantly decreased the number of vaginal needle punctures during each case. There was a trend toward improved embryo quality, but statistical power was inadequate to show a difference. The primary benefit of the Steiner-Tan needle was on the embryological aspects of IVM. Decreased blood and blood clots in the aspirates made an IVM retrieval more like conventional IVF for the embryologist. The patient also experienced less tissue trauma without increasing anesthesia or surgical time. There was no improvement in the number of oocytes retrieved, but based on the results, we hypothesized that oocytes were more commonly retrieved from slightly large follicles than when using a routine needle.

Limited retention of micro-organisms using commercialized needle filters.

PubMed

Elbaz, W; McCarthy, G; Mawhinney, T; Goldsmith, C E; Moore, J E

2015-03-01

A study was undertaken to compare a commercialized needle filter with a 0.2-μm filtered epidural set and a non-filtered standard needle. No culturable bacteria were detected following filtration through the 0.2-μm filter. Bacterial breakthrough was observed with the filtered needle (pore size 5 μm) and the non-filtered needle. Filtered systems (0.2 μm) should be employed to achieve total bacterial retention. This highlights that filtration systems with different pore sizes will have varying ability to retain bacteria. Healthcare professionals need to know what type/capability of filter is implied on labels used by manufacturers, and to assess whether the specification has the desired functionality to prevent bacterial translocation through needles. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

A novel curvature-controllable steerable needle for percutaneous intervention.

PubMed

Bui, Van Khuyen; Park, Sukho; Park, Jong-Oh; Ko, Seong Young

2016-08-01

Over the last few decades, flexible steerable robotic needles for percutaneous intervention have been the subject of significant interest. However, there still remain issues related to (a) steering the needle's direction with less damage to surrounding tissues and (b) increasing the needle's maximum curvature for better controllability. One widely used approach is to control the fixed-angled bevel-tip needle using a "duty-cycle" algorithm. While this algorithm has shown its applicability, it can potentially damage surrounding tissue, which has prevented the widespread adoption of this technology. This situation has motivated the development of a new steerable flexible needle that can change its curvature without axial rotation, while at the same time producing a larger curvature. In this article, we propose a novel curvature-controllable steerable needle. The proposed robotic needle consists of two parts: a cannula and a stylet with a bevel-tip. The curvature of the needle's path is controlled by a control offset, defined by the offset between the bevel-tip and the cannula. As a result, the necessity of rotating the whole needle's body is decreased. The duty-cycle algorithm is utilized to a limited degree to obtain a larger radius of curvature, which is similar to a straight path. The first prototype of 0.46 mm (outer diameter) was fabricated and tested with both in vitro gelatin phantom and ex vivo cow liver tissue. The maximum curvatures measured 0.008 mm(-1) in 6 wt% gelatin phantom, 0.0139 mm(-1) in 10 wt% gelatin phantom, and 0.0038 mm(-1) in cow liver. The experimental results show a linear relationship between the curvature and the control offset, which can be utilized for future implementation of this control algorithm. © IMechE 2016.

Cadaveric validation of dry needle placement in the lateral pterygoid muscle.

PubMed

Mesa-Jiménez, Juan A; Sánchez-Gutiérrez, Jesús; de-la-Hoz-Aizpurua, José L; Fernández-de-las-Peñas, César

2015-02-01

The aim of this anatomical study was to determine if a needle is able to reach the lateral pterygoid muscle during the application of dry needling technique. A dry needling approach using 2 needles of 50 to 60 mm in length, one inserted over the zygomatic process posterior at the obituary arch (for the superior head) and other inserted below the zygomatic process between the mandibular condyle and the coronoid process (for the inferior head), was proposed. A progressive dissection into 3 stages was conducted into 2 heads of fresh male cadavers. First, dry needling of the lateral pterygoid muscle was applied on the cadaver. Second, a block dissection containing the lateral pterygoid was harvested. Finally, the ramus of the mandible was sectioned by osteotomy to visualize the lateral pterygoid muscle with the needle placements. With the needles inserted into the cadaver, the block dissection revealed that the superior needle reached the superior (sphenoid) head of the lateral pterygoid muscle and the inferior needle reached the inferior (pterygoid) head of the muscle. At the final stage of the dissection, when the ramus of the mandible was sectioned by osteotomy, it was revealed that the superior needle entered into the belly of the superior head of the lateral pterygoid muscle. This anatomical study supports that dry needling technique for the lateral pterygoid muscle can be properly conducted with the proposed approach. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Infrared needle mapping to assist biopsy procedures and training.

PubMed

Shar, Bruce; Leis, John; Coucher, John

2018-04-01

A computed tomography (CT) biopsy is a radiological procedure which involves using a needle to withdraw tissue or a fluid specimen from a lesion of interest inside a patient's body. The needle is progressively advanced into the patient's body, guided by the most recent CT scan. CT guided biopsies invariably expose patients to high dosages of radiation, due to the number of scans required whilst the needle is advanced. This study details the design of a novel method to aid biopsy procedures using infrared cameras. Two cameras are used to image the biopsy needle area, from which the proposed algorithm computes an estimate of the needle endpoint, which is projected onto the CT image space. This estimated position may be used to guide the needle between scans, and results in a reduction in the number of CT scans that need to be performed during the biopsy procedure. The authors formulate a 2D augmentation system which compensates for camera pose, and show that multiple low-cost infrared imaging devices provide a promising approach.

Predictors of Sharing Injection Equipment by HIV-Seropositive Injection Drug Users

PubMed Central

Latkin, Carl A.; Buchanan, Amy S.; Metsch, Lisa R.; Knight, Kelly; Latka, Mary H.; Mizuno, Yuko; Knowlton, Amy R.

2009-01-01

Among HIV-positive injection drug users (IDUs), we examined baseline predictors of lending needles and syringes, and sharing cookers, cotton, and rinse water in the prior 3 months at follow-up. Participants were enrolled in INSPIRE, a secondary prevention intervention for sexually active HIV-positive IDUs in four US cities during 2001–2005. The analyses involved 357 participants who reported injecting drugs in the prior six months at either the 6- or 12-months follow-up visit. About half (49%) reported at least one sharing episode. In adjusted analyses, peer norms supporting safer injection practices, and having primary HIV medical care visits in the prior 6 months were associated with reporting no sharing of injection equipment. Higher levels of psychological distress was associated with a greater likelihood of reporting drug paraphernalia sharing. These findings suggest that intervention approaches for reducing HIV-seropositive IDUs’ transmission of blood-borne infections should include peer-focused interventions to alter norms of drug paraphernalia sharing and promoting primary HIV care and mental health services. PMID:19186356

Predictors of sharing injection equipment by HIV-seropositive injection drug users.

PubMed

Latkin, Carl A; Buchanan, Amy S; Metsch, Lisa R; Knight, Kelly; Latka, Mary H; Mizuno, Yuko; Knowlton, Amy R

2008-12-01

Among HIV-positive injection drug users (IDUs), we examined baseline predictors of lending needles and syringes and sharing cookers, cotton, and rinse water in the prior 3 months at follow-up. Participants were enrolled in Intervention for Seropositive Injectors-Research and Evaluation, a secondary prevention intervention for sexually active HIV-positive IDUs in 4 US cities during 2001-2005. The analyses involved 357 participants who reported injecting drugs in the prior 6 months at either the 6- or 12-month follow-up visit. About half (49%) reported at least 1 sharing episode. In adjusted analyses, peer norms supporting safer injection practices and having primary HIV medical care visits in the prior 6 months were associated with reporting no sharing of injection equipment. Higher levels of psychological distress were associated with a greater likelihood of reporting drug paraphernalia sharing. These findings suggest that intervention approaches for reducing HIV-seropositive IDUs' transmission of blood-borne infections should include peer-focused interventions to alter norms of drug paraphernalia sharing and promoting primary HIV care and mental health services.

21 CFR 882.4650 - Neurosurgical suture needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Neurosurgical suture needle. 882.4650 Section 882.4650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle...

21 CFR 882.4650 - Neurosurgical suture needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neurosurgical suture needle. 882.4650 Section 882.4650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle...

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Emergency airway needle. 868.5090 Section 868.5090 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5090 Emergency airway needle. (a...

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Emergency airway needle. 868.5090 Section 868.5090 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5090 Emergency airway needle. (a...

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Anesthesia conduction needle. 868.5150 Section 868.5150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a...

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Emergency airway needle. 868.5090 Section 868.5090 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5090 Emergency airway needle. (a...

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Anesthesia conduction needle. 868.5150 Section 868.5150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a...

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Emergency airway needle. 868.5090 Section 868.5090 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5090 Emergency airway needle. (a...

Evaluation of heat transfer in acupuncture needles: convection and conduction approaches.

PubMed

Tzou, Chieh-Han John; Yang, Tzyy-Yih; Chung, Ya-Chien

2015-04-01

Originating in ancient China, acupuncture using needles has been developed for thousands of years and has received attention for its reported medical remedies, such as pain relief and chronic disease treatment. Heat transfer through the needles, which might have effects on the biomechanism of acupuncture, providing a stimulus and regulating homeostasis, has never been studied. This article analyzes the significance of heat transfer through needles via convection and conduction, approached by means of computational analysis. The needle is a cylindrical body, and an axis symmetrical steady-state heat-transfer model that viscosity and static pressure was not applied. This article evaluates heat transfer via acupuncture needles by using five metal materials: silver, copper, brass, iron, and stainless steel. A silver needle of the type extensively applied in acupuncture can dissipate more than seven times as much heat as a stainless steel needle of the same type. Heat transfer through such a needle is significant, compared to natural body-energy consumption over a range of ambient temperatures. The mechanism by which heat flows in or out of the body through the needles may be crucial in the remedial efficacy of acupuncture. Copyright © 2015. Published by Elsevier B.V.

Etiological study of the short needle disease of pine

Treesearch

Francis A. Wood; Stanley P. Pennypacker

1976-01-01

The short needle disease of pines consists of dwarfing, crooking, twisting, and excessive elongation of random needles, failure of buds to develop, reduced lateral branch development and the premature casting of needles. The disease was initially associated with a power plant source of air pollution in the eastern United States during 1969; at that time the cause of...

In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle

NASA Astrophysics Data System (ADS)

Li, Yu-Tao; Tang, Li-Na; Ning, Yong; Shu, Qing; Liang, Feng-Xia; Wang, Hua; Zhang, Guo-Jun

2016-06-01

Acupuncture treatment is amazing but controversial. Up to now, the mechanism of treating diseases by acupuncture and moxibustion is still unclear, especially the occurrence of the molecular events in local acupoints. Herein, we report an extremely stable microsensor by modifying carbon nanotube (CNT) to the tip surface of acupuncture needle and applying this CNT-modified acupuncture needle for real time monitoring of serotonin (5-HT) in vivo. To stabilize CNT modification on the needle tip surface, poly(3,4-ethylenedioxythiophene)(PEDOT) was employed as glue water to stick CNT on the needle. The detection limit of the CNT-modified needle was found to be approximately 50 nM and 78 nM in the PBS and the cell medium, respectively. In addition, the needle showed good selectivity to some inflammatory mediators and some electroactive molecules. For the first time, the CNT-modified needle could be directly probed into rat body for real time monitoring of 5-HT in vivo, showing a great potential for better understanding the mechanism of acupuncture treatment.

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Needle-type epilator. 878.5350 Section 878.5350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices § 878.5350 Needle-type epilator...

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Needle-type epilator. 878.5350 Section 878.5350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices § 878.5350 Needle-type epilator...

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Needle-type epilator. 878.5350 Section 878.5350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices § 878.5350 Needle-type epilator...

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Needle-type epilator. 878.5350 Section 878.5350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices § 878.5350 Needle-type epilator...

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Needle-type epilator. 878.5350 Section 878.5350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices § 878.5350 Needle-type epilator...

In-plane ultrasonic needle tracking using a fiber-optic hydrophone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xia, Wenfeng, E-mail: wenfeng.xia@ucl.ac.uk; Desjardins, Adrien E.; Mari, Jean Martial

Purpose: Accurate and efficient guidance of needles to procedural targets is critically important during percutaneous interventional procedures. Ultrasound imaging is widely used for real-time image guidance in a variety of clinical contexts, but with this modality, uncertainties about the location of the needle tip within the image plane lead to significant complications. Whilst several methods have been proposed to improve the visibility of the needle, achieving accuracy and compatibility with current clinical practice is an ongoing challenge. In this paper, the authors present a method for directly visualizing the needle tip using an integrated fiber-optic ultrasound receiver in conjunction withmore » the imaging probe used to acquire B-mode ultrasound images. Methods: Needle visualization and ultrasound imaging were performed with a clinical ultrasound imaging system. A miniature fiber-optic ultrasound hydrophone was integrated into a 20 gauge injection needle tip to receive transmissions from individual transducer elements of the ultrasound imaging probe. The received signals were reconstructed to create an image of the needle tip. Ultrasound B-mode imaging was interleaved with needle tip imaging. A first set of measurements was acquired in water and tissue ex vivo with a wide range of insertion angles (15°–68°) to study the accuracy and sensitivity of the tracking method. A second set was acquired in an in vivo swine model, with needle insertions to the brachial plexus. A third set was acquired in an in vivo ovine model for fetal interventions, with insertions to different locations within the uterine cavity. Two linear ultrasound imaging probes were used: a 14–5 MHz probe for the first and second sets, and a 9–4 MHz probe for the third. Results: During insertions in tissue ex vivo and in vivo, the imaged needle tip had submillimeter axial and lateral dimensions. The signal-to-noise (SNR) of the needle tip was found to depend on the insertion angle

Precision grid and hand motion for accurate needle insertion in brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.

2011-08-15

Purpose: In prostate brachytherapy, a grid is used to guide a needle tip toward a preplanned location within the tissue. During insertion, the needle deflects en route resulting in target misplacement. In this paper, 18-gauge needle insertion experiments into phantom were performed to test effects of three parameters, which include the clearance between the grid hole and needle, the thickness of the grid, and the needle insertion speed. Measurement apparatus that consisted of two datum surfaces and digital depth gauge was developed to quantify needle deflections. Methods: The gauge repeatability and reproducibility (GR and R) test was performed on themore » measurement apparatus, and it proved to be capable of measuring a 2 mm tolerance from the target. Replicated experiments were performed on a 2{sup 3} factorial design (three parameters at two levels) and analysis included averages and standard deviation along with an analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: Results showed that grid with tight clearance hole and slow needle speed increased precision and accuracy of needle insertion. The tight grid was vital to enhance precision and accuracy of needle insertion for both slow and fast insertion speed; additionally, at slow speed the tight, thick grid improved needle precision and accuracy. Conclusions: In summary, the tight grid is important, regardless of speed. The grid design, which shows the capability to reduce the needle deflection in brachytherapy procedures, can potentially be implemented in the brachytherapy procedure.« less

[Research progress of needles with knife-edge for carotid cardiac syndrome].

PubMed

Tan, Lingqiong; Zhao, Yanling

2015-04-01

According to topographic anatomy, pathogenesis and by retrieving, summarizing and analyzing literature regarding needle-knife and needles with knife-edge for carotid cardiac syndrome, it is found out that clinical misdiagnosis rate of carotid cardiac syndrome is considerably high. Needle-knife and needles with knife-edge could significantly improve the clinical symptoms of carotid cardiac syndrome, showing characteristic and advantage in treatment, but it is deficient in technique standard and efficacy criteria that should be united and authoritative. Researches regarding pathogenesis of carotid cardiac syndrome are not systematic. Clinical observation regarding long-term efficacy and relapse of needle-knife and needles with knife-edge treatment is rare. It is believed that the awareness on carotid cardiac syndrome should be increased to reduce misdiagnosis; scientific and standardized technique standard and efficacy criteria should be established; systematic and comprehensive researches regarding mechanism of needle-knife and needles with knife-edge for carotid cardiac syndrome should be launched; besides, clinical discussion regarding its long-term efficacy should start to provide a better clinical guideline.

Endovascular retrieval of dental needle retained in the internal carotid artery.

PubMed

Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel

2017-03-08

Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. 2017 BMJ Publishing Group Ltd.

Discrimination accuracy between real and sham press needles in the hands.

PubMed

Kim, Sungha; Lee, Sanghun; Choi, Sunmi; Park, Jeonghwan; Kim, Sungchul

2015-08-01

To evaluate the blinding effectiveness of a modified blunt sham press needle on the basis of the ability of subjects to discriminate between real and sham acupuncture needles compared with their discrimination ability based on pure guessing, and to define differences between senses (touch and vision) in the rates of correctly identified needles. Sixty-three healthy students and staff members were recruited through convenience sampling. First, real or sham acupuncture was randomly administered to the left LI4 point while subjects could not observe the needle tip. A real or sham needle tip was then shown to the subjects. Finally, a random combination of real or sham acupuncture needles were randomly administered to the left and right LI4 points, this time with the subjects observing the procedure. In all conditions the subjects gave their judgement as Yes or No in response to questions asking them to identify the needle type. The proportion of correct judgements (P(C)) was computed for the last part of the trial in left and right LI4 points, and the rates of correctly identified needles for each trial were obtained. The subjects' accuracy of discrimination between the real and sham acupuncture needles in left and right LI4 points was not significantly different from that based on pure guess (P(C)=0.50 (chance level)), which indicates complete inability to discriminate between needles. The rates of correctly identified needles using touch, vision and a combination of both senses were not significantly different (p=0.807). The findings from this study show that this sham acupuncture device successfully blinded subjects to real and sham press needles, suggesting that it is effective for subject blinding in studies on acupuncture using press needles, and facilitating evaluation of the effects of acupuncture in placebo-controlled trials using a rigorous scientific research methodology. Published by the BMJ Publishing Group Limited. For permission to use (where not already

Drug-related deaths and the sales of needles through pharmacies

PubMed Central

Davidson, Peter J.; Martinez, Alexis; Lutnick, Alexandra; Kral, Alex H.; Bluthenthal, Ricky N.

2014-01-01

Background Providing needles to people who inject drugs is a well-proven public health response to the transmission of HIV and other blood borne viruses. Despite over a quarter of a century of research, new concerns about potential unintended negative consequences of needle distribution continue to emerge. Specifically, a claim was recently made that the introduction of pharmacy sales of needles was followed by an increase in overdoses in pharmacy parking lots. If true, this would have serious implications for the design of needle access programs, particularly those involving pharmacy sales of needles. Methods We examine spatial relationships between drug-related deaths and pharmacies in Los Angeles County (population 9·8 million) before and after the 2007 enactment of a California law allowing pharmacy sales of needles without a prescription. 7,049 drug related deaths occurred in Los Angeles county from 2000-2009 inclusive. 4,275 of these deaths could be geocoded, and were found to be clustered at the census tract level. Results We used three methods to examine spatial relationships between overdose death locations and pharmacy locations for two years on either side of the enactment of the pharmacy sales law, and found no statistically significant changes. Among the 711 geocodable deaths occurring in the two years following the change in law, no death was found to occur within 50 meters of a pharmacy which sold needles. Conclusion These results are consistent with prior studies which suggest pharmacy sales of needles improve access to needles without causing increased harms to the surrounding community. PMID:25499730

Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice.

PubMed

Scholten, H J; Pourtaherian, A; Mihajlovic, N; Korsten, H H M; A Bouwman, R

2017-07-01

Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

A portable integrated system to control an active needle

NASA Astrophysics Data System (ADS)

Konh, Bardia; Motalleb, Mahdi; Ashrafiuon, Hashem

2017-04-01

The primary objective of this work is to introduce an integrated portable system to operate a flexible active surgical needle with actuation capabilities. The smart needle uses the robust actuation capabilities of the shape memory alloy wires to drastically improve the accuracy of in medical procedures such as brachytherapy. This, however, requires an integrated system aimed to control the insertion of the needle via a linear motor and its deflection by the SMA wire in real-time. The integrated system includes a flexible needle prototype, a Raspberry Pi computer, a linear stage motor, an SMA wire actuator, a power supply, electromagnetic tracking system, and various communication supplies. The linear stage motor guides the needle into tissue. The power supply provides appropriate current to the SMA actuator. The tracking system measures tip movement for feedback, The Raspberry Pi is the central tool that receives the tip movement feedback and controls the linear stage motor and the SMA actuator via the power supply. The implemented algorithms required for communication and feedback control are also described. This paper demonstrates that the portable integrated system may be a viable solution for more effective procedures requiring surgical needles.

Short beveled sharp cutting needle is superior to facet tip needle for ultrasound-guided rectus sheath block in children with umbilical hernia: a case series.

PubMed

Alsaeed, A; Thallaj, A; Alzahrani, T; Khalil, N; Aljazaeri, A

2014-10-01

The most common peripheral nerve blocks used in umbilical hernia repair are rectus sheath block and regional block (caudal block). Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. The aim of this study is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery, and to evaluate the easiness of soft tissue puncture and ultrasonic appearance of two different needle types. Twenty two (22) pediatric patients (age range: 1.5-8 years) scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz linear probe. An ultrasound-guided rectus sheath block in the lateral edge of both rectus abdominis muscles (RMs) was performed (total of 44 punctures). A 22 gauge short beveled sharp cutting needle 1.1 x 30 mm needle A (BD Insyte--W, Vialon material. Spain) was used in one side, and a Stimuplex A insulated Needle 22G 50mm (needle B) was used on the other side. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia were evaluated. Ultrasonograghic visualization of the posterior sheath was possible in all patients. Needle A scored 72.7% of excellent needle tip and shaft view (16 out of 22) compared to 63.63% for needle B (14 out of 22). None of the needles scored poor view. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one child who postoperatively requested morphine 0.1 mg/kg intravenously in recovery room. There were no complications. Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia in the lateral edge of the rectus muscle. Use of the sharp short beveled needle of 22 gauge intravenous (IV) cannula stylet provides easy, less traumatic skin and rectus muscle

Design of an Optically Controlled MR-Compatible Active Needle

PubMed Central

Ryu, Seok Chang; Quek, Zhan Fan; Koh, Je-Sung; Renaud, Pierre; Black, Richard J.; Moslehi, Behzad; Daniel, Bruce L.; Cho, Kyu-Jin; Cutkosky, Mark R.

2015-01-01

An active needle is proposed for the development of magnetic resonance imaging (MRI)-guided percutaneous procedures. The needle uses a low-transition-temperature shape memory alloy (LT SMA) wire actuator to produce bending in the distal section of the needle. Actuation is achieved with internal optical heating using laser light transported via optical fibers and side coupled to the LT SMA. A prototype, with a size equivalent to a standard 16-gauge biopsy needle, exhibits significant bending, with a tip deflection of more than 14° in air and 5° in hard tissue. A single-ended optical sensor with a gold-coated tip is developed to measure the curvature independently of temperature. The experimental results in tissue phantoms show that human tissue causes fast heat dissipation from the wire actuator; however, the active needle can compensate for typical targeting errors during prostate biopsy. PMID:26512231

Risk of needle stick injuries in health care workers: bad habits (recapping needles) last long.

PubMed

Rogowska-Szadkowska, Dorota; Stanisławowicz, Małgorzata; Chlabicz, Sławomir

2010-01-01

In order to assess the nurses' knowledge concerning the risk of hepatitis B and C viruses or human immunodeficiency virus infection while performing their professional duties, an anonymous questionnaire developed by the authors was distributed in 2008. Surprisingly 64% respondents occasionally recapping needles after injections, although they know the procedures which are obligatory at the ward. The first step in preventing percutaneous injuries should focus on efforts to eliminate the practice of recapping needles, though education and convenient placement of puncture-resistant containers for the disposal of used sharps.

Effect of spinal needle characteristics on measurement of spinal canal opening pressure.

PubMed

Bellamkonda, Venkatesh R; Wright, Thomas C; Lohse, Christine M; Keaveny, Virginia R; Funk, Eric C; Olson, Michael D; Laack, Torrey A

2017-05-01

A wide variety of spinal needles are used in clinical practice. Little is currently known regarding the impact of needle length, gauge, and tip type on the needle's ability to measure spinal canal opening pressure. This study aimed to investigate the relationship between these factors and the opening-pressure measurement or time to obtain an opening pressure. Thirteen distinct spinal needles, chosen to isolate the effects of length, gauge, and needle-point type, were prospectively tested on a lumbar puncture simulator. The key outcomes were the opening-pressure measurement and the time required to obtain that measure. Pressures were recorded at 10-s intervals until 3 consecutive, identical readings were observed. Time to measure opening pressure increased with increasing spinal needle length, increasing gauge, and the Quincke-type (cutting) point (P<0.001 for all). The time to measurement ranged from 30s to 530s, yet all needle types were able to obtain a consistent opening pressure measure. Although opening pressure estimates are unlikely to vary markedly by needle type, the time required to obtain the measurement increased with increasing needle length and gauge and with Quincke-type needles. Copyright © 2017 Elsevier Inc. All rights reserved.

Hierarchical Micro/Nano-Porous Acupuncture Needles Offering Enhanced Therapeutic Properties

NASA Astrophysics Data System (ADS)

in, Su-Ll; Gwak, Young S.; Kim, Hye Rim; Razzaq, Abdul; Lee, Kyeong-Seok; Kim, Hee Young; Chang, Suchan; Lee, Bong Hyo; Grimes, Craig A.; Yang, Chae Ha

2016-10-01

Acupuncture as a therapeutic intervention has been widely used for treatment of many pathophysiological disorders. For achieving improved therapeutic effects, relatively thick acupuncture needles have been frequently used in clinical practice with, in turn, enhanced stimulation intensity. However due to the discomforting nature of the larger-diameter acupuncture needles there is considerable interest in developing advanced acupuncture therapeutical techniques that provide more comfort with improved efficacy. So motivated, we have developed a new class of acupuncture needles, porous acupuncture needles (PANs) with hierarchical micro/nano-scale conical pores upon the surface, fabricated via a simple and well known electrochemical process, with surface area approximately 20 times greater than conventional acupuncture needles. The performance of these high-surface-area PANs is evaluated by monitoring the electrophysiological and behavioral responses from the in vivo stimulation of Shenmen (HT7) points in Wistar rats, showing PANs to be more effective in controlling electrophysiological and behavioral responses than conventional acupuncture needles. Comparative analysis of cocaine induced locomotor activity using PANs and thick acupuncture needles shows enhanced performance of PANs with significantly less pain sensation. Our work offers a unique pathway for achieving a comfortable and improved acupuncture therapeutic effect.

Hierarchical Micro/Nano-Porous Acupuncture Needles Offering Enhanced Therapeutic Properties

PubMed Central

In, Su-ll; Gwak, Young S.; Kim, Hye Rim; Razzaq, Abdul; Lee, Kyeong-Seok; Kim, Hee Young; Chang, SuChan; Lee, Bong Hyo; Grimes, Craig A.; Yang, Chae Ha

2016-01-01

Acupuncture as a therapeutic intervention has been widely used for treatment of many pathophysiological disorders. For achieving improved therapeutic effects, relatively thick acupuncture needles have been frequently used in clinical practice with, in turn, enhanced stimulation intensity. However due to the discomforting nature of the larger-diameter acupuncture needles there is considerable interest in developing advanced acupuncture therapeutical techniques that provide more comfort with improved efficacy. So motivated, we have developed a new class of acupuncture needles, porous acupuncture needles (PANs) with hierarchical micro/nano-scale conical pores upon the surface, fabricated via a simple and well known electrochemical process, with surface area approximately 20 times greater than conventional acupuncture needles. The performance of these high-surface-area PANs is evaluated by monitoring the electrophysiological and behavioral responses from the in vivo stimulation of Shenmen (HT7) points in Wistar rats, showing PANs to be more effective in controlling electrophysiological and behavioral responses than conventional acupuncture needles. Comparative analysis of cocaine induced locomotor activity using PANs and thick acupuncture needles shows enhanced performance of PANs with significantly less pain sensation. Our work offers a unique pathway for achieving a comfortable and improved acupuncture therapeutic effect. PMID:27713547

Brief reports: regional anesthesia needles can introduce ultrasound gel into tissues.

PubMed

Belavy, David

2010-09-01

Anesthesiologists may insert needles through ultrasound gel when performing ultrasound-guided regional anesthesia. In this study, it was determined whether needles carry gel into tissues. Ultrasound gel dyed blue was applied to pork rashers. Tuohy and short-bevel needles were passed through the gel and pork. The needles were then assessed for the presence of ultrasound gel. All needles, including those with stylets, carried gel and tissue within the lumen. Ultrasound gel may be injected around (and perhaps in) nerves during regional anesthesia procedures. Studies are needed to determine the implications of this practice.

Modeling, Production, and Testing of an Echogenic Needle for Ultrasound-Guided Nerve Blocks.

PubMed

Bigeleisen, Paul E; Hess, Aaron; Zhu, Richard; Krediet, Annelot

2016-06-01

We have designed, produced, and tested an echogenic needle based on a sawtooth pattern where the height of the tooth was 1.25 times the wavelength of the ultrasound transducer. A numeric solution to the time-independent wave equation (Helmholtz equation) was used to create a model of backscattering from a needle. A 21-gauge stainless steel prototype was manufactured and tested in a water bath. Backscattering from the needle was compared to theoretical predications from our model. Based on these results, an 18-gauge prototype needle was fabricated from stainless steel and tested in a pig cadaver. This needle was compared to a commercial 18-gauge echogenic needle (Pajunk Medical Systems, Tucker, GA) by measuring the brightness of the needle relative to the background of sonograms of a needle in a pig cadaver. The backscattering from the 21-gauge prototype needle reproduced the qualitative predictions of our model. At 30° and 45° of insonation, our prototype performed equivalently to the Pajunk needle. At 60°, our prototype was significantly brighter than the Pajunk needle (P = .017). In conclusion, we chose a model for the design of an echogenic needle and modeled it on the basis of a solution to the Helmholtz equation. A prototype needle was tested in a water bath and compared to the model prediction. After verification of our model, we designed an 18-gauge needle, which performed better than an existing echogenic needle (Pajunk) at 60° of insonation. Our needle will require further testing in human trials. © 2016 by the American Institute of Ultrasound in Medicine.

Autonomic Responses to Ultrasound-Guided Percutaneous Needle Electrolysis: Effect of Needle Puncture or Electrical Current?

PubMed

García Bermejo, Paula; De La Cruz Torres, Blanca; Naranjo Orellana, José; Albornoz Cabello, Manuel

2018-01-01

The aim of this study was to establish if the changes in sympathetic and parasympathetic activity (analyzed through heart-rate variability [HRV]) during ultrasound (US)-guided percutaneous needle electrolysis (PNE) is due to the effect of needle puncture only or of the PNE technique per se where the puncture and galvanic current are combined. This was an experimental, case-control study that took place at the University of Seville. Subjects were 36 male footballers who were randomly allocated to three groups: a control group (CG; 12 players), for whom HRV was recorded for 10 min, both at rest and during an exhaustive US examination of the patellar tendon and adjacent structures; a first experimental group (PNE group; 12 players), for whom HRV was recorded for 10 min, both at rest and during application of US-guided PNE in the patellar tendon; and a second experimental group (needle group; 12 players), for whom HRV was recorded for 10 min, both at rest and during application of US-guided PNE without electrical current in the patellar tendon. The outcome measures were the diameters of the Poincaré plot (SD1, SD2), stress score, and sympathetic/parasympathetic ratio. There were no differences between groups in any baseline measurements, nor were there any significant differences between CG measurements (baseline vs. intervention). The PNE group exhibited statistically significant increases in SD1 (p = 0.01) and SD2 (p = 0.004) and statistically significant decreases in SS and S/PS ratio (p = 0.03), indicating increased parasympathetic and decreased sympathetic activity, respectively. The needle group exhibited statistically significant increases in SD2 (p = 0.02) and statistically significant decreases in SS (p = 0.02), indicating decreased sympathetic activity. The application of the US-guided PNE technique caused a measurable increase in parasympathetic activity (detected by HRV), which was due to the combination of needle puncture and

Reductions in HIV/STI Incidence and Sharing of Injection Equipment among Female Sex Workers Who Inject Drugs: Results from a Randomized Controlled Trial

PubMed Central

Strathdee, Steffanie A.; Abramovitz, Daniela; Lozada, Remedios; Martinez, Gustavo; Rangel, Maria Gudelia; Vera, Alicia; Staines, Hugo; Magis-Rodriguez, Carlos; Patterson, Thomas L.

2013-01-01

Background We evaluated brief combination interventions to simultaneously reduce sexual and injection risks among female sex workers who inject drugs (FSW-IDUs) in Tijuana and Ciudad Juarez, Mexico during 2008–2010, when harm reduction coverage was expanding rapidly in Tijuana, but less so in Juarez. Methods FSW-IDUs ≥18 years reporting sharing injection equipment and unprotected sex with clients within the last month participated in a randomized factorial trial comparing four brief, single-session conditions combining either an interactive or didactic version of a sexual risk intervention to promote safer sex in the context of drug use, and an injection risk intervention to reduce sharing of needles/injection paraphernalia. Women underwent quarterly interviews and testing for HIV, syphilis, gonorrhea, Chlamydia and Trichomonas, blinding interviewers and assessors to assignment. Poisson regression with robust variance estimation and repeated measures ordinal logistic regression examined effects on combined HIV/STI incidence and receptive needle sharing frequency. Findings Of 584 initially HIV-negative FSW-IDUs, retention was ≥90%. After 12 months, HIV/STI incidence decreased >50% in the interactive vs. didactic sex intervention (Tijuana:AdjRR:0.38,95% CI:0.16–0.89; Juarez: AdjRR:0.44,95% CI:0.19–0.99). In Juarez, women receiving interactive vs. didactic injection risk interventions decreased receptive needle-sharing by 85% vs. 71%, respectively (p = 0.04); in Tijuana, receptive needle sharing declined by 95%, but was similar in active versus didactic groups. Tijuana women reported significant increases in access to syringes and condoms, but Juarez women did not. Interpretation After 12 months in both cities, the interactive sexual risk intervention significantly reduced HIV/STI incidence. Expanding free access to sterile syringes coupled with brief, didactic education on safer injection was necessary and sufficient for achieving robust, sustained

[Special penetration needling for refractory peripheral facial paralysis].

PubMed

Cao, Rongjuan; Qiu, Xiaohu; Xie, Xiaokun

2018-03-12

To observe the clinical effect difference between special penetration needling and conventional penetration needling for the refractory peripheral facial paralysis. A total of 97 patients with intractable facial paralysis were randomized into an observation group (49 cases and 2 dropping) and a control group (48 cases and 4 dropping). In the observation group, special penetration needling at an angle about 45° between the penetration needle and paralysis muscle bundle was used, Yangbai (GB 14) through Touwei (ST 8), Yangbai (GB 14) through Shangxing (GV 23), Sizhukong (TE 23) through Yuyao (EX-HN 4), Qianzhen (Extra) through Yingxiang (LI 20), mutual penetration between Yingxiang (LI 20) and Jiache (ST 6). Conventional penetration needling was applied in the control group, Yangbai (GB 14) through Yuyao (EX-HN 4), Cuanzhu (BL 2) through Yuyao (EX-HN 4), mutual penetration between Dicang (ST 4) and Jiache (ST 6), Qianzheng (Extra) through Dicang (ST 4), Sibai (ST 2) through Yingxiang (LI 20). Three groups of electroacupuncture (discontinuous wave, 1 Hz) with tolerance were connected respectively in the two groups, Yangbai (GB 14) and Sizhukong (TE 23), Yangbai (GB 14) and Qianzheng (Extra), Yingxiang (LI 20) and Jiache (ST 6) in the observation group, Yangbai (GB 14) and Cuanzhu (BL 2), Dicang (ST 4) and Jiache (ST 6), Qianzheng (Extra) and Sibai (ST 2) in the control group. TDP was applied in the two groups at the affected Yifeng (TE 17), Jiache (ST 6) and Qianzheng (Extra), which were around the ear. Perpendicular insertion was used at Yifeng (TE 17) at the affected side and Hegu (LI 4) at the healthy side and bilateral Zusanli (ST 36). The needles were retained for 30 min. The treatment was given for 3 courses, once a day and 10 days as a course, 5 days at the interval. House-Brackmann (H-B) facial nerve grading score was recorded before and after treatment. The clinical effects were compared. The H-B scores after treatment in the two groups were higher than

Pine needle abortion biomarker detected in bovine fetal fluids.

PubMed

Snider, Douglas B; Gardner, Dale R; Janke, Bruce H; Ensley, Steven M

2015-01-01

Pine needle abortion is a naturally occurring condition in free-range cattle caused by the consumption of pine needles from select species of cypress, juniper, pine, and spruce trees. Confirmatory diagnosis of pine needle abortion has previously relied on a combined case history of pine needle consumption and detection of isocupressic acid in a sample from the dam. Stable metabolites of isocupressic acid include agathic acid, dihydroagathic acid, and tetrahydroagathic acid, which have been shown to be present in the serum of mature animals for a few days following consumption of pine needles. As maternal serum is infrequently submitted for diagnosis of cattle abortions, a diagnostic assay capable of confirming isocupressic acid exposure in other matrices would be desirable. To the authors' knowledge, no previous investigations have indicated whether these stable metabolites of isocupressic acid cross the placenta or are detectable in fetal tissues. Therefore, the presence of agathic acid, dihydroagathic acid, and tetrahydroagathic acid was evaluated using gas chromatography-mass spectroscopy on fetal thoracic fluid and stomach contents collected from 2 aborted bovine fetuses with a recent herd history of pine needle consumption by the dams and a subsequent abortion outbreak in the herd. Only tetrahydroagathic acid was detected in the fetal thoracic fluid and fetal stomach contents. The current study encourages diagnosticians to collect fetal thoracic fluids to permit the detection of tetrahydroagathic acid in cases of suspected pine needle abortion. © 2014 The Author(s).

[Meta-analysis of needle-knife treatment on cervical spondylosis].

PubMed

Kan, Li-Li; Wang, Hai-Dong; Liu, An-Guo

2013-11-01

To assess the efficacy of cervical spondylosis by needle-knife treatment according to the correlated literature of RCT,to compare advantages of needle-knife treatment. Randomized Controlled Trials about needle-knife treatment of cervical spondylosis were indexed from Chinese HowNet (CNKI) and Wanfang (WF) from 2000 to 2012, then were analyzed the efficacy by Review Manager 5.1 software. A total of 13 RCT literatures and 1 419 patients were included. The methods of included studies were poor in quality evaluation because of large sample and multi-center RCT studies was lacked, randomization method was not accurate enough, diagnostic criteria and efficacy evaluation were various, only four studies described long-term efficacy, most of the literature didn't describe the adverse event and fall off,all studies did not use the blind method. The Meta analysis outcome showed overall efficiency of needle-knife therapy was better than acupuncture and traction. Needle-knife therapy compared with Acupuncture, the total RR = 0.19, 95% confidence interval was (0.15, 0.24), P < 0.000.01. Compared with traction therapy the total RR = 1.30, 95% confidence intervalwas (1.18,1.42), P < 0.00001. Compared with acupuncture therapy,the overall effectiveness of needle-knife therapy is higher;compared with traction therapy, although,needle-knife therapy has a high overall effectiveness, but because of the loss of total sample size, the outcome RCT researches to confirm.

Needle lost in minimally invasive surgery: management proposal and literature review.

PubMed

Medina, Luis G; Martin, Oscar; Cacciamani, Giovannni E; Ahmadi, Nariman; Castro, Juan C; Sotelo, Rene

2018-03-19

The reported incidence of intraoperative retained instruments, such as needles, hangs around 0.06-0.11%. Leaving a needle inside the abdominal cavity can have significant medical and legal consequences. In addition, the retrieval can be hampered due to the limited visualization of the scope during minimally invasive surgery. Factors associated with an increased probability for NL have been described. Prevention for this situation includes: having one needle at a time inside the cavity, effective communication between all personnel in the operating room, evaluation of the strength of the suture-needle connection, avoid parking of needles intraoperatively, and a proper needle withdrawal. Notwithstanding, no agreement has been made regarding NL management. Herein, we present a literature review, and a management proposal in which through a series of systematic steps, the surgical team can efficiently locate and retrieve a lost needle such as: examination of the surgical field, trocar visualization, trocar disassembly, and revision of the suction device. Finally, intraoperative or postoperative imaging can be utilized.

Drug-related deaths and the sales of needles through pharmacies.

PubMed

Davidson, Peter J; Martinez, Alexis; Lutnick, Alexandra; Kral, Alex H; Bluthenthal, Ricky N

2015-02-01

Providing needles to people who inject drugs is a well-proven public health response to the transmission of HIV and other blood borne viruses. Despite over a quarter of a century of research, new concerns about potential unintended negative consequences of needle distribution continue to emerge. Specifically, a claim was recently made that the introduction of pharmacy sales of needles was followed by an increase in overdoses in pharmacy parking lots. If true, this would have serious implications for the design of needle access programs, particularly those involving pharmacy sales of needles. We examine spatial relationships between drug-related deaths and pharmacies in Los Angeles County (population 9.8 million) before and after the 2007 enactment of a California law allowing pharmacy sales of needles without a prescription. Seven thousand and forty-nine drugs related deaths occurred in Los Angeles county from 2000 to 2009 inclusive. Four thousand two hundred and seventy-five of these deaths could be geocoded, and were found to be clustered at the census tract level. We used three methods to examine spatial relationships between overdose death locations and pharmacy locations for two years on either side of the enactment of the pharmacy sales law, and found no statistically significant changes. Among the 711 geocodable deaths occurring in the two years following the change in law, no death was found to occur within 50m of a pharmacy which sold needles. These results are consistent with prior studies which suggest pharmacy sales of needles improve access to needles without causing increased harms to the surrounding community. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Guided percutaneous fine-needle aspiration biopsy of the liver

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ho, C.S.; McLoughlin, M.J.; Tao, L.C.

1981-04-01

Forty patients with suspected malignant disease of the liver underwent percutaneous fine-needle aspiration biopsy with radioisotope scintigraphic and fluoroscopic guidance. The needle was aimed at focal defects identified on the liver scan and several passes were made. When the scan was diffusely abnormal, the liver was widely sampled with multiple passes. Thirty patients were eventually considered to have malignant disease and aspiration biopsy was positive in 28 (93%) of these patients, including 25 of 26 with liver metastases (96%). There were two false-positive results and one minor complication. In 24 patients, conventional wide-bore needle biopsy was also performed. In thismore » group, 16 patients had a final diagnosis of hepatic malignancy. Aspiration biopsies were positive in 14 of these (87%) and conventional needle biopsies were positive in four (25%). Guided percutaneous fine-needle aspiration biopsy is recommended for pathologic diagnosis of hepatic malignancy because of its simplicity, high yield, and reasonable safety.« less

Methods for Improving the Curvature of Steerable Needles in Biological Tissue

PubMed Central

Adebar, Troy K.; Greer, Joseph D.; Laeseke, Paul F.; Hwang, Gloria L.; Okamura, Allison M.

2016-01-01

Robotic needle steering systems have the potential to improve percutaneous interventions such as radiofrequency ablation of liver tumors, but steering techniques described to date have not achieved sufficiently small radius of curvature in biological tissue to be relevant to this application. In this work, the impact of tip geometry on steerable needle curvature is examined. Finite-element simulations and experiments with bent-tip needles in ex vivo liver tissue demonstrate that selection of tip length and angle can greatly improve curvature, with radius of curvature below 5 cm in liver tissue possible through judicious selection of these parameters. Motivated by the results of this analysis, a new articulated-tip steerable needle is described, in which a distal section is actively switched by a robotic system between a straight tip (resulting in a straight path) and a bent tip (resulting in a curved path). This approach allows the tip length and angle to be increased, while the straight configuration allows the needle tip to still pass through an introducer sheath and rotate inside the body. Validation testing in liver tissue shows that the new articulated-tip steerable needle achieves smaller radius of curvature compared to bent-tip needles described in previous work. Steerable needles with optimized tip parameters, which can generate tight curves in liver tissue, increase the clinical relevance of needle steering to percutaneous interventions. PMID:26441438

Real-time MRI-guided needle intervention for cryoablation: a phantom study

NASA Astrophysics Data System (ADS)

Gao, Wenpeng; Jiang, Baichuan; Kacher, Dan F.; Fetics, Barry; Nevo, Erez; Lee, Thomas C.; Jayender, Jagadeesan

2017-03-01

MRI-guided needle intervention for cryoablation is a promising way to relieve the pain and treat the cancer. However, the limited size of MRI bore makes it impossible for clinicians to perform the operation in the bore. The patients had to be moved into the bore for scanning to verify the position of the needle's tip and out for adjusting the needle's trajectory. Real-time needle tracking and shown in MR images is of importance for clinicians to perform the operation more efficiently. In this paper, we have instrumented the cryotherapy needle with a MRI-safe electromagnetic (EM) sensor and optical sensor to measure the needle's position and orientation. To overcome the limitation of line-of-sight for optical sensor and the poor dynamic performance of the EM sensor, Kalman filter based data fusion is developed. Further, we developed a navigation system in open-source software, 3D Slicer, to provide accurate visualization of the needle and the surrounding anatomy. Experiment of simulation the needle intervention at the entrance was performed with a realistic spine phantom to quantify the accuracy of the navigation using the retrospective analysis method. Eleven trials of needle insertion were performed independently. The target accuracy with the navigation using only EM sensor, only optical sensor and data fusion are 2.27 +/-1.60 mm, 4.11 +/- 1.77 mm and 1.91 - 1.10 mm, respectively.

Needle tip visualization by bevel-point ultrasound generator and prototype photoacoustic imaging system

NASA Astrophysics Data System (ADS)

Irisawa, Kaku; Murakoshi, Dai; Hashimoto, Atsushi; Yamamoto, Katsuya; Hayakawa, Toshiro

2017-03-01

Visualization of the tip of medical devices like needles or catheters under ultrasound imaging has been a continuous topic since the early 1980's. In this study, a needle tip visualization system utilizing photoacoustic effects is proposed. In order to visualize the needle tip, an optical fiber was inserted into a needle. The optical fiber tip is placed on the needle bevel and affixed with black glue. The pulsed laser light from laser diode was transferred to the optical fiber and converted to ultrasound due to laser light absorption of the black glue and the subsequent photoacoustic effect. The ultrasound is detected by transducer array and reconstructed into photoacoustic images in the ultrasound unit. The photoacoustic image is displayed with a superposed ultrasound B-mode image. As a system evaluation, the needle is punctured into bovine meat and the needle tip is observed with commercialized conventional linear transducers or convex transducers. The needle tip is visualized clearly at 7 and 12 cm depths with linear and convex probes, respectively, even with a steep needle puncture angle of around 90 degrees. Laser and acoustic outputs, and thermal rise at the needle tip, were measured and were well below the limits of the safety standards. Compared with existing needle tip visualization technologies, the photoacoustic needle tip visualization system has potential distinguishable features for clinical procedures related with needle puncture and injection.

Scaling of phloem structure and optimality of photoassimilate transport in conifer needles.

PubMed

Ronellenfitsch, Henrik; Liesche, Johannes; Jensen, Kaare H; Holbrook, N Michele; Schulz, Alexander; Katifori, Eleni

2015-02-22

The phloem vascular system facilitates transport of energy-rich sugar and signalling molecules in plants, thus permitting long-range communication within the organism and growth of non-photosynthesizing organs such as roots and fruits. The flow is driven by osmotic pressure, generated by differences in sugar concentration between distal parts of the plant. The phloem is an intricate distribution system, and many questions about its regulation and structural diversity remain unanswered. Here, we investigate the phloem structure in the simplest possible geometry: a linear leaf, found, for example, in the needles of conifer trees. We measure the phloem structure in four tree species representing a diverse set of habitats and needle sizes, from 1 (Picea omorika) to 35 cm (Pinus palustris). We show that the phloem shares common traits across these four species and find that the size of its conductive elements obeys a power law. We present a minimal model that accounts for these common traits and takes into account the transport strategy and natural constraints. This minimal model predicts a power law phloem distribution consistent with transport energy minimization, suggesting that energetics are more important than translocation speed at the leaf level. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Imaging and Spectroscopy of Natural Fluorophores in Pine Needles

PubMed Central

Williams, Nari

2018-01-01

Many plant tissues fluoresce due to the natural fluorophores present in cell walls or within the cell protoplast or lumen. While lignin and chlorophyll are well-known fluorophores, other components are less well characterized. Confocal fluorescence microscopy of fresh or fixed vibratome-cut sections of radiata pine needles revealed the presence of suberin, lignin, ferulate, and flavonoids associated with cell walls as well as several different extractive components and chlorophyll within tissues. Comparison of needles in different physiological states demonstrated the loss of chlorophyll in both chlorotic and necrotic needles. Necrotic needles showed a dramatic change in the fluorescence of extractives within mesophyll cells from ultraviolet (UV) excited weak blue fluorescence to blue excited strong green fluorescence associated with tissue browning. Comparisons were made among fluorophores in terms of optimal excitation, relative brightness compared to lignin, and the effect of pH of mounting medium. Fluorophores in cell walls and extractives in lumens were associated with blue or green emission, compared to the red emission of chlorophyll. Autofluorescence is, therefore, a useful method for comparing the histology of healthy and diseased needles without the need for multiple staining techniques, potentially aiding visual screening of host resistance and disease progression in needle tissue. PMID:29393922

COMPARISON OF DRY NEEDLING VS. SHAM ON THE PERFORMANCE OF VERTICAL JUMP.

PubMed

Bandy, William D; Nelson, Russell; Beamer, Lisa

2017-10-01

Dry needling has been reported to decrease pain in subjects having myofascial trigger points, as well as pain in muscle and connective tissue. The purpose of the study was to compare the effects on the ability to perform a two-legged vertical jump between a group who received one bout of dry needling and a group who received one bout of a sham treatment. Thirty-five healthy students (19 males, 16 females) were recruited to participate in this study (mean age 22.7+/- 2.4 years). The subjects were randomly divided into two groups- dry needling (n=18) vs sham (n=17). The dry needling group received needling to four sites on bilateral gastrocnemius muscles; two at the medial head and two at the lateral head. The sham group had the four areas of the gastrocnemius muscle pressed with the tube housing the needle, but the needle was never inserted into the skin. Two-legged vertical jump was measured with chalk marks on the wall before and after the dry needling and sham treatments. Analysis with a t-test indicated that the dry needling group significantly increased vertical jump height 1.2 inches over the sham group. One bout of dry needling showed an immediate effect at significantly increasing vertical jump height in healthy, young adults. Future research is needed to determine if dry needling has any long-term effects. 2b.

COMPARISON OF DRY NEEDLING VS. SHAM ON THE PERFORMANCE OF VERTICAL JUMP

PubMed Central

Nelson, Russell; Beamer, Lisa

2017-01-01

Introduction Dry needling has been reported to decrease pain in subjects having myofascial trigger points, as well as pain in muscle and connective tissue. Objective The purpose of the study was to compare the effects on the ability to perform a two-legged vertical jump between a group who received one bout of dry needling and a group who received one bout of a sham treatment. Methods Thirty-five healthy students (19 males, 16 females) were recruited to participate in this study (mean age 22.7+/- 2.4 years). The subjects were randomly divided into two groups- dry needling (n=18) vs sham (n=17). The dry needling group received needling to four sites on bilateral gastrocnemius muscles; two at the medial head and two at the lateral head. The sham group had the four areas of the gastrocnemius muscle pressed with the tube housing the needle, but the needle was never inserted into the skin. Two-legged vertical jump was measured with chalk marks on the wall before and after the dry needling and sham treatments. Results Analysis with a t-test indicated that the dry needling group significantly increased vertical jump height 1.2 inches over the sham group. Conclusion One bout of dry needling showed an immediate effect at significantly increasing vertical jump height in healthy, young adults. Future research is needed to determine if dry needling has any long-term effects. Level of Evidence 2b PMID:29181252

Evaluation of 8.0-cm needle at the fourth anterior axillary line for needle chest decompression of tension pneumothorax.

PubMed

Chang, Samuel J; Ross, Samuel Wade; Kiefer, David J; Anderson, William E; Rogers, Amelia T; Sing, Ronald F; Callaway, David W

2014-04-01

Five-centimeter needles at the second intercostal space midclavicular line (2MCL) have high failure rates for decompression of tension pneumothorax. This study evaluates 8-cm needles directed at the fourth intercostal space anterior axillary line (4AAL). Retrospective radiographic analysis of 100 consecutive trauma patients 18 years or older from January to September 2011. Measurements of chest wall thickness (CWT) and depth to vital structure (DVS) were obtained at 2MCL and 4AAL. 4AAL measurements were taken based on two angles: closest vital structure and perpendicular to the chest wall. Primary outcome measures were radiographic decompression (RD) (defined as CWT < 80 mm) and radiographic noninjury (RNI) (DVS > 80 mm) of 8-cm needles at 4AAL. Secondary outcome measures are effect of angle of entry on RNI at 4AAL, RD and RNI of 8-cm needles at 2MCL, and comparison of 5-cm needles with 8-cm needles at both locations. Eighty-four percent of the patients were male, with mean Injury Severity Score (ISS) of 17.7 (range, 1.0-66.0) and body mass index of 26.8 (16.5-48.4). Mean CWT at 4AAL ranged from 37.6 mm to 39.9 mm, significantly thinner than mean CWT at 2MCL (43.3-46.7 mm). Eight-centimeter needle RD was more than 96% at both 4AAL and 2MCL. Five-centimeter RD ranged from 66% to 81% at all sites. Mean DVS at 4AAL ranged from 91.8 mm to 128.0 mm. RNI at all sites was more than 91% except at left 4AAL, when taken to the closest vital structure (mean DVS, 91.8 mm), with 68% RNI. Perpendicular entry increased DVS to 109.4 mm and subsequent RNI to 91%. Five-centimeter RNI at all sites was more than 99%. CWT at 4AAL is significantly thinner than 2MCL. Based on radiographic measurements, 8-cm catheters have a higher chance of pleural decompression when compared with 5-cm catheters. Steeper angle of entry at 4AAL improves 8-cm noninjury rates to more than 91%. Therapeutic/care management study, level IV.

Whitacre or Quincke needles--does it really matter.

PubMed

Eriksson, A L; Hallén, B; Lagerkranser, M; Persson, E; Sköldefors, E

1998-01-01

Postdural puncture headache (PDPH) and backache are well known complications of spinal anaesthesia. The incidence of PDPH may be significant in young people (< 50 years). The present study was undertaken in order to compare the utility and complication rate of the Whitacre and Ouincke spinal needles. During three years all patients who could comply, and who were to undergo spinal anaesthesia at the Department were asked to join this quality control study. Each one received a questionnaire including questions about discomfort and other possible side effects attributed to spinal anaesthesia. In each case, an extended anaesthetic record was filled out by the anaesthesiologist. About 50 anaesthesiologists at different educational levels were involved. The study includes 2598 cases, of which questionnaires were returned by 66%. Needles of the 25 G gauge size were used in over 90% of the cases. Multiple skin punctures were required more frequently in the Quincke than in the Whitacre group (P < 0.01). The number of insufficient blocks was also higher in the Quincke group (P < 0.01). There was a higher incidence of backache in the Quincke group (P < 0.05). In patients under 50 years, PDPH was more frequent following use of the Quincke needle (P < 0.05), whereas no difference between the needles in this regard was found among those over 50 years (P > 0.05). For routine clinical use the Whitacre needle appears to be associated with better performance and increased reliability. In younger patients the Whitacre needle have the additional advantage of decreasing the risk of postdural puncture headache.

Postmyelography headache rates with Whitacre versus Quincke 22-gauge spinal needles.

PubMed

Peterman, S B

1996-09-01

To compare the postdural puncture headache (PDPH) rates after myelography with use of 22-gauge Whitacre (blunt tip) versus standard 22-gauge Quincke (bevel-tip) spinal needles. At myelography, 340 patients were randomly assigned to one of two groups in which either the Whitacre (167 patients) or the Quincke (173 patients) needle was used. Follow-up was at 48 hours and at 4 days after the procedure. Crude and adjusted Whitacre/PDPH odds ratios and risk ratios were calculated. The crude Whitacre needle PDPH risk was 9.6%, and the crude Quincke needle PDPH risk was 15.6%. The absolute risk difference was 6.0% with a 95% confidence interval of -0.98% and 13.04%. The adjusted Whitacre/PDPH odds ratio was 0.492 with a 95% confidence interval of 0.241 and 1.003. The Whitacre needle group had a statistically significantly lower PDPH severity grade (P = .0151), similar PDPH duration, and more technical difficulty with the needle. The Whitacre needle is associated with an equal or lower PDPH risk; the lack of statistical significance is most likely related to sample size. Further study is necessary to determine whether the decreased PDPH rate justifies the added difficulty associated with use of the Whitacre needle.

Incidence of tissue coring with the 25-gauge Quincke and Whitacre spinal needles.

PubMed

Campbell, D C; Douglas, M J; Taylor, G

1996-01-01

Tissue cores, implanted into the subarachnoid space during subarachnoid injections, can develop into intraspinal lumbar epidermoid tumors. The availability of smaller needles has made spinal anesthesia more popular. Therefore, this prospective, randomized, blinded study was undertaken to determine whether tissue coring occurs with two of the currently used 25-gauge spinal needles. Fifteen 25-gauge Quincke and seventeen 25-gauge Whitacre spinal needles, in which cerebrospinal fluid (CSF) was not identified and the local anesthetic solution not injected, were obtained from adult male patients undergoing spinal anesthesia. The needles were then evaluated by a pathologist following randomization with similar sterile, unused spinal needles. Twenty additional needles, ten of each type, in which CSF was identified and through which local anesthetic was injected, were also randomized with similar sterile, unused spinal needles and examined. Tissue cores were identified in 12 of the 15 Quincke and 7 of the 17 Whitacre spinal needles in which CSF was not identified (P < .05). Of the 20 needles in which CSF was identified and local anesthetic injected, no tissue cores were identified in the 10 Whitacre needles and only one small tissue core was identified in the 10 Quincke needles. All the tissue cores were identified as fat tissue. The 25-gauge Quincke and 25-gauge Whitacre spinal needles currently used in anesthesia can produce tissue coring.

Endovascular retrieval of dental needle retained in the internal carotid artery.

PubMed

Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel

2017-07-01

Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cadaveric and Ultrasonographic Validation of Needling Placement in the Cervical Multifidus Muscle.

PubMed

Fernández-de-Las-Peñas, César; Mesa-Jiménez, Juan A; Paredes-Mancilla, Jose A; Koppenhaver, Shane L; Fernández-Carnero, Samuel

2017-06-01

The aim of this study was to determine if a needle is able to reach the cervical multifidus during the application of dry needling or acupuncture. Dry needling and ultrasound imaging of cervical multifidi was conducted on 5 patients (age: 32 ± 5 years) with mechanical neck pain and on 2 fresh cadavers (age: 64 ± 1 years). Dry needling was done using a needle of 40 mm in length inserted perpendicular to the skin about 1 cm lateral to the spinous process at C3-C4. The needle was advanced from a posterior to anterior direction into the cervical multifidus with a slight inferior-medial angle (approximately 10°) to reach the vertebra lamina. For the cadaveric study, the multifidus was isolated by carefully resecting the superficial posterior cervical muscles: trapezius, splenius, and semispinalis. For the ultrasonographic study, a convex transducer was placed transversely over C3-C4 after the insertion of the needle into the muscle. The results of both the cadaveric and ultrasonic studies found that the needle does pierce the cervical multifidus muscle during insertion and that the tip of the needle rests properly against the vertebral laminae, thereby guarding the sensitive underlying spinal structures from damage. This anatomical and ultrasound imaging study supports that dry needling of the cervical multifidus could be conducted clinically. Copyright © 2017. Published by Elsevier Inc.

The Hydrodynamics of Needle-Free Intradermal Jet Injection

NASA Astrophysics Data System (ADS)

Simmons, Jonathan; Marston, Jeremy; Fisher, Paul; Broderick, Kate

2017-11-01

Needle-free methods of drug delivery circumvent the drawbacks associated with the use of hypodermic needles such as needle-stick injuries, needle-phobia, cross contamination and disposal. Furthermore, pioneering DNA-based vaccines that aim to treat cancer and fight infectious diseases, such as HIV, Ebola and Zika, require precise deposition into the skin to target the immune response producing cells found only in the epidermis and dermis. Intradermal (ID) delivery can be achieved using a needle and the Mantoux technique but this requires a highly skilled technician and so extensive use of DNA vaccines calls for an alternative method of delivery. One option is jet injection which has been employed in mass vaccination programs for intramuscular or subcutaneous delivery and is used by some diabetic patients to inject insulin. In this talk I will present results from our ongoing ex-vivo experimental study into ID jet injection. Ultra-high-speed imaging is used to visualize the process of the jet exiting the nozzle and striking excised skin. A skin bleb grows as liquid is deposited within the skin. I will discuss how the control parameters, such as the rheological profile of the liquid and the stand-off distance, influence the volume of liquid successfully delivered intradermally.

Single Crystal Diamond Needle as Point Electron Source.

PubMed

Kleshch, Victor I; Purcell, Stephen T; Obraztsov, Alexander N

2016-10-12

Diamond has been considered to be one of the most attractive materials for cold-cathode applications during past two decades. However, its real application is hampered by the necessity to provide appropriate amount and transport of electrons to emitter surface which is usually achieved by using nanometer size or highly defective crystallites having much lower physical characteristics than the ideal diamond. Here, for the first time the use of single crystal diamond emitter with high aspect ratio as a point electron source is reported. Single crystal diamond needles were obtained by selective oxidation of polycrystalline diamond films produced by plasma enhanced chemical vapor deposition. Field emission currents and total electron energy distributions were measured for individual diamond needles as functions of extraction voltage and temperature. The needles demonstrate current saturation phenomenon and sensitivity of emission to temperature. The analysis of the voltage drops measured via electron energy analyzer shows that the conduction is provided by the surface of the diamond needles and is governed by Poole-Frenkel transport mechanism with characteristic trap energy of 0.2-0.3 eV. The temperature-sensitive FE characteristics of the diamond needles are of great interest for production of the point electron beam sources and sensors for vacuum electronics.

Single Crystal Diamond Needle as Point Electron Source

PubMed Central

Kleshch, Victor I.; Purcell, Stephen T.; Obraztsov, Alexander N.

2016-01-01

Diamond has been considered to be one of the most attractive materials for cold-cathode applications during past two decades. However, its real application is hampered by the necessity to provide appropriate amount and transport of electrons to emitter surface which is usually achieved by using nanometer size or highly defective crystallites having much lower physical characteristics than the ideal diamond. Here, for the first time the use of single crystal diamond emitter with high aspect ratio as a point electron source is reported. Single crystal diamond needles were obtained by selective oxidation of polycrystalline diamond films produced by plasma enhanced chemical vapor deposition. Field emission currents and total electron energy distributions were measured for individual diamond needles as functions of extraction voltage and temperature. The needles demonstrate current saturation phenomenon and sensitivity of emission to temperature. The analysis of the voltage drops measured via electron energy analyzer shows that the conduction is provided by the surface of the diamond needles and is governed by Poole-Frenkel transport mechanism with characteristic trap energy of 0.2–0.3 eV. The temperature-sensitive FE characteristics of the diamond needles are of great interest for production of the point electron beam sources and sensors for vacuum electronics. PMID:27731379

Single Crystal Diamond Needle as Point Electron Source

NASA Astrophysics Data System (ADS)

Kleshch, Victor I.; Purcell, Stephen T.; Obraztsov, Alexander N.

2016-10-01

Diamond has been considered to be one of the most attractive materials for cold-cathode applications during past two decades. However, its real application is hampered by the necessity to provide appropriate amount and transport of electrons to emitter surface which is usually achieved by using nanometer size or highly defective crystallites having much lower physical characteristics than the ideal diamond. Here, for the first time the use of single crystal diamond emitter with high aspect ratio as a point electron source is reported. Single crystal diamond needles were obtained by selective oxidation of polycrystalline diamond films produced by plasma enhanced chemical vapor deposition. Field emission currents and total electron energy distributions were measured for individual diamond needles as functions of extraction voltage and temperature. The needles demonstrate current saturation phenomenon and sensitivity of emission to temperature. The analysis of the voltage drops measured via electron energy analyzer shows that the conduction is provided by the surface of the diamond needles and is governed by Poole-Frenkel transport mechanism with characteristic trap energy of 0.2-0.3 eV. The temperature-sensitive FE characteristics of the diamond needles are of great interest for production of the point electron beam sources and sensors for vacuum electronics.

Optimizing EUS-guided liver biopsy sampling: comprehensive assessment of needle types and tissue acquisition techniques.

PubMed

Schulman, Allison R; Thompson, Christopher C; Odze, Robert; Chan, Walter W; Ryou, Marvin

2017-02-01

EUS-guided liver biopsy sampling using FNA and, more recently, fine-needle biopsy (FNB) needles has been reported with discrepant diagnostic accuracy, in part due to differences in methodology. We aimed to compare liver histologic yields of 4 EUS-based needles and 2 percutaneous needles to identify optimal number of needle passes and suction. Six needle types were tested on human cadaveric tissue: one 19G FNA needle, one existing 19G FNB needle, one novel 19G FNB needle, one 22G FNB needle, and two 18G percutaneous needles (18G1 and 18G2). Two needle excursion patterns (1 vs 3 fanning passes) were performed on all EUS needles. Primary outcome was number of portal tracts. Secondary outcomes were degree of fragmentation and specimen adequacy. Pairwise comparisons were performed using t tests, with a 2-sided P < .05 considered to be significant. Multivariable regression analysis was performed. In total, 288 liver biopsy samplings (48 per needle type) were performed. The novel 19G FNB needle had significantly increased mean portal tracts compared with all needle types. The 22G FNB needle had significantly increased portal tracts compared with the 18G1 needle (3.8 vs 2.5, P < .001) and was not statistically different from the 18G2 needle (3.8 vs 3.5, P = .68). FNB needles (P < .001) and 3 fanning passes (P ≤ .001) were independent predictors of the number of portal tracts. A novel 19G EUS-guided liver biopsy needle provides superior histologic yield compared with 18G percutaneous needles and existing 19G FNA and core needles. Moreover, the 22G FNB needle may be adequate for liver biopsy sampling. Investigations are underway to determine whether these results can be replicated in a clinical setting. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Single-incision laparoscopic cholecystectomy with needle graspers.

PubMed

Sumiyoshi, Kinjiro; Sato, Norihiro; Akagawa, Shin; Hirano, Tatsuya; Koikawa, Kazuhiro; Horioka, Kohei; Ozono, Keigo; Fujiwara, Kenji; Tanaka, Masao; Sada, Masayuki

2012-01-01

Single-incision laparoscopic cholecystectomy (SILC) is a promising alternative to standard multi-incision laparoscopic cholecystectomy (LC). However, generalization of SILC is still hampered by technical difficulties mainly associated with the lack of trocars used for retraction of the gallbladder. We therefore developed a modified method of SILC with the use of needle graspers (SILC-N) for optimal retraction and exposure. In addition to two trocars inserted through a single transumbilical incision, two needle ports were placed on the right subcostal and lateral abdominal wall, through which needle graspers were used for retraction of the gallbladder. Since December, 2009, 12 patients with symptomatic cholelithiasis were treated by SILC-N. SILC-N was successfully performed in all but one patient requiring a conversion to the 4-port LC with a mean operative time of 71.5 (48-107) minutes. None of the patients experienced intraoperative or postoperative complications. The transumbilical incision and pinholes for needle graspers were almost invisible on discharge. Our preliminary results suggest that SILC-N is a simple, safe and feasible technique of cholecystectomy offering similar postoperative recovery and better cosmetic outcome as compared to conventional LC.

An alternative and inexpensive percutaneous access needle in pediatric patients.

PubMed

Penbegul, Necmettin; Soylemez, Haluk; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Bodakci, Mehmet Nuri; Hatipoglu, Namik Kemal; Atar, Murat; Yildirim, Kadir

2012-10-01

The most important factor that increases the cost of percutaneous surgery is the disposable instruments used for the surgery. In this study we present the advantages of using an intravenous cannula instead of a percutaneous access needle for renal access. Recently, percutaneous stone surgery has grown in use in pediatric cases and is considered a minimally invasive surgery. The most important step in this surgery is access to the renal collecting systems. Although fluoroscopy has been used frequently at this stage, the use of ultrasound has recently increased. During percutaneous accesses under all types of imaging techniques, disposable 11- to 15-cm-long 18-ga needles are used. In pediatric cases, these longer needles are difficult to use. Using disposable materials in percutaneous nephrolithotomy increases the cost of the procedure. Therefore, we asserted that percutaneous access especially in pediatric cases could be performed using a 16-ga intravenous cannula (angiocath). Indeed, percutaneous access was performed successfully, especially in pediatric preschool patients. Shorter needle length, easy skin entry, comfort of manipulation, clear visualization of the metal needle on ultrasound, and wide availability can be considered advantages of this method. The angiocath is also less expensive than a percutaneous access needle. Angiocath is inexpensive, easily available, and practical, and it is the shortest needle to perform percutaneous access in pediatric patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Needle echogenicity in ultrasound-guided lumbar spine injections: a cadaveric study.

PubMed

Gofeld, Michael; Krashin, Daniel L; Ahn, Sangmin

2013-01-01

Echogenicity of regional anesthesia needles has been tested on different preclinical models; however, previous studies were done in an ideal experimental setting utilizing high-frequency insonation and superficially located targets. Because steep-angle deep injections are typically required for spinal and other chronic pain procedures, and low-frequency transducers are used, further feasibility study is warranted. To determine effectiveness of steep-angle deep injections, typically required for spinal and other chronic pain procedures. Experimental laboratory study. Willed Body Program, University of Washington. In-plane lumbar spine procedures with 50° and 70° angles were performed on a human cadaver. The images and video clips of a non-echogenic (Quincke-type) and echogenic (SonoPlex, StimuQuick, and EchoStim) needle placements were presented to 3 blinded assessors who rated the needle visibility on a 4-point scale. The data was statistically analyzed to determine the differences in visibility between the needles with and without the digital image enhancement, and to compare the video clips to captured images. ANOVA analysis demonstrated that overall SonoPlex was significantly better (P = 0.02) than other needles. SonoPlex maintained its superiority in the subset of facet joint injections (P = 0.02), followed by Quincke-type, then the StimuQuik, and EchoStim needles. In deep procedures, EchoStim was comparable with SonoPlex (P = 0.03), and they both were better than the other 2 needles. The enhanced images received higher rates, with a 0.6 point mean improved rating (P = 0). This study is limited by choice of needles, number of experiments performed, and potential postmortem changes of echogenicity. The SonoPlex needle appeared to have better echogenicity in this study. While non-echogenic Quincke-type needle visibility was adequate in superficial placements, it was limited in deep injections. An imaging enhancement is effective in improving needle visibility

[The effect of needle type and immobilization on postspinal headache].

PubMed

Hafer, J; Rupp, D; Wollbrück, M; Engel, J; Hempelmann, G

1997-10-01

Post-dural puncture headache (PDPH) is a significant complication of spinal anaesthesia. Diameter and tip of the needle as well as the patient's age have been proven to be important determinants. The question of whether post-operative recumbency can reduce the risk of PDPH has not been answered uniformly. And besides, some studies referring to this subject reveal methodical failures, for example, as to clear definition and exact documentation of post-operative immobilization. Furthermore, fine-gauge needles (26G or more) have not been investigated yet. The first aim of our study was therefore to examine the role of recumbency in the prevention of PDPH under controlled conditions using thin needles. Secondly, we wanted to confirm the reported prophylactic effect of needles with a modified, atraumatic tip (Whitacre and Atraucan) by comparing them to Quincke needles of identical diameter. Most of the former investigators compared Quincke with atraumatic needles of different size regardless of the known influence of the diameter on PDPH. In a prospective study we included 481 consecutive patients undergoing a total of 500 orthopaedic operations under spinal anaesthesia. The latter was performed in a standardized manner (patient sitting, midline approach, needle with parallel bevel direction), using four different needles allocated randomly (26-gauge and 27-gauge needles with Quincke tip, 26-gauge Atraucan and 27-gauge Whitacre cannula). Half of the patients were instructed to stay in bed for 24 h (horizontal position without raising head), the others to get up as early as possible. An anaesthesiologist visited the patients on the fourth postoperative day or later and questioned them about headache and duration of recumbency. Additionally, the patients had to fill out a questionnaire 1 week after surgery. Any postural headache was considered as PDPH. The four groups of different needles had homogeneous demographic characteristics (see Table 1). A total of 47 patients (9

Needle oils of three pine species and species hybrids

Treesearch

Robert Z. Callaham

1956-01-01

The composition and characteristics of the needle oils of western pines may provide criteria for distinguishing pine hybrids and may help explain why some needle-feeding insects select certain pine species as hosts.

Thermoelectric needle probe for temperature measurements in biological materials.

PubMed

Korn, U; Rav-Noy, Z; Shtrikman, S; Zafrir, M

1980-04-01

In certain biological and medical applications it is important to measure and follow temperature changes inside a body or tissue. Any probe inserted into a tissue causes damage to tissue and distortion to the initial temperature distribution. To minimize this interference, a fine probe is needed. Thus, thin film technology is advantageous and was utilized by us to produce sensitive probes for these applications. The resulting probe is a small thermocouple at the tip of a thin needle (acupuncture stainless steel needle, approximately 0.26 mm in diameter and length in the range 5-10 cm was used). The junction was produced at the needle's tip by coating the needle with thin layers of insulating and thermoelectric materials. The first layer is an insulating one and is composed of polyacrylonitrile (PAN) and polymide produced by plasma polymerization and dip-coating respectively. This layer covers all the needle except the tip. The second layer is a vacuum deposited thermoelectric thin layer of Bi-5% Sb alloy coating also the tip. The third layer is for insulation and protection and is composed of PAN and polyimide. In this arrangement the junction is at the needle's tip, the needle is one conductor, the thermoelectric layer is the other and they are isolated by the plastic layer. The probe is handy and mechanically sturdy. The sensitivity is typically 77 microV/degrees C at room temperature and is constant to within 2% up to 90 degrees C. The response is fast (less than 1 sec) the noise is small, (less than 0.05 degrees C) and because of the small dimension, damage to tissue and disturbance to the measured temperature field are minimal.

[Pneumothorax following dry needling treatment: legal and ethical aspects].

PubMed

Ronconi, Gianpaolo; De Giorgio, Fabio; Ricci, Eleonora; Maggi, Loredana; Spagnolo, Antonio G; Ferrara, Paola Emilia

2016-01-01

Trigger point "dry needling" is a technique used to treat myofascial pain. It involves using filiform needles which are inserted into muscles to give local pain relief. Few cases of serious adverse events following this treatment have been reported in the literature. In this paper we describe the case of a professional swimmer who developed pneumothorax after dry needling treatment and discuss the medicolegal and ethical aspects related to competencies and responsibilities of medical doctors and physiotherapists performing the procedure.

Kalman filter-based EM-optical sensor fusion for needle deflection estimation.

PubMed

Jiang, Baichuan; Gao, Wenpeng; Kacher, Daniel; Nevo, Erez; Fetics, Barry; Lee, Thomas C; Jayender, Jagadeesan

2018-04-01

In many clinical procedures such as cryoablation that involves needle insertion, accurate placement of the needle's tip at the desired target is the major issue for optimizing the treatment and minimizing damage to the neighboring anatomy. However, due to the interaction force between the needle and tissue, considerable error in intraoperative tracking of the needle tip can be observed as needle deflects. In this paper, measurements data from an optical sensor at the needle base and a magnetic resonance (MR) gradient field-driven electromagnetic (EM) sensor placed 10 cm from the needle tip are used within a model-integrated Kalman filter-based sensor fusion scheme. Bending model-based estimations and EM-based direct estimation are used as the measurement vectors in the Kalman filter, thus establishing an online estimation approach. Static tip bending experiments show that the fusion method can reduce the mean error of the tip position estimation from 29.23 mm of the optical sensor-based approach to 3.15 mm of the fusion-based approach and from 39.96 to 6.90 mm, at the MRI isocenter and the MRI entrance, respectively. This work established a novel sensor fusion scheme that incorporates model information, which enables real-time tracking of needle deflection with MRI compatibility, in a free-hand operating setup.

Comparison of Histologic Core Portions Acquired from a Core Biopsy Needle and a Conventional Needle in Solid Mass Lesions: A Prospective Randomized Trial.

PubMed

Lee, Ban Seok; Cho, Chang-Min; Jung, Min Kyu; Jang, Jung Sik; Bae, Han Ik

2017-07-15

The superiority of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) over EUS-guided fine needle aspiration (EUS-FNA) remains controversial. Given the lack of studies analyzing histologic specimens acquired from EUS-FNB or EUS-FNA, we compared the proportion of the histologic core obtained from both techniques. A total of 58 consecutive patients with solid mass lesions were enrolled and randomly assigned to the EUS-FNA or EUS-FNB groups. The opposite needle was used after the failure of core tissue acquisition using the initial needle with up to three passes. Using computerized analyses of the scanned histologic slide, the overall area and the area of the histologic core portion in specimens obtained by the two techniques were compared. No significant differences were identified between the two groups with respect to demographic and clinical characteristics. Fewer needle passes were required to obtain core specimens in the FNB group (p<0.001). There were no differences in the proportion of histologic core (11.8%±19.5% vs 8.0%±11.1%, p=0.376) or in the diagnostic accuracy (80.6% vs 81.5%, p=0.935) between two groups. The proportion of histologic core and the diagnostic accuracy were comparable between the FNB and FNA groups. However, fewer needle passes were required to establish an accurate diagnosis in EUS-FNB.

Accidental needle sticks, the Occupational Safety and Health Administration, and the fallacy of public policy.

PubMed

Wolf, Bruce L; Marks, Albert; Fahrenholz, John M

2006-07-01

Current Occupational Safety and Health Administration (OSHA) guidelines mandate the use of safety needles when allergy injections are given. Safety needles for intradermal testing remain optional. Whether safety needles reduce the number of accidental needle sticks (ANSs) in the outpatient setting has yet to be proven. To determine the rate of ANSs with new (safety) needles vs old needles used in allergy immunotherapy and intradermal testing. Allergy practices from 22 states were surveyed by e-mail. Seventy practices (28%) responded to the survey. Twice as many ANSs occurred in practices giving immunotherapy when using new needles vs old needles (P < .01). The rate of ANSs was roughly the same for intradermal testing with new needles vs old needles. These findings further question whether OSHA's guidelines for safety needle use in outpatient practice need revision and if allergy practices might be excluded from the requirement to use safety needles.

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration With a 19-G Needle Device.

PubMed

Tremblay, Alain; McFadden, Seamus; Bonifazi, Martina; Luzzi, Valentina; Kemp, Samuel V; Gasparini, Stefano; Chee, Alex; MacEachern, Paul; Dumoulin, Elaine; A Hergott, Christopher; Shah, Pallav L

2018-05-16

Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration is a well-established first-line minimally invasive modality for mediastinal lymph node sampling. Although results are excellent overall, the technique underperforms in certain situations. We aimed to describe our results using a new 19-G EBUS-guided transbronchial needle aspiration device to determine safety and feasibility of this approach. We completed a retrospective chart review of all cases performed to the time of data analysis at each of 3 study sites. A total of 165 procedures were performed with a total of 297 individual lymph nodes or lesions sampled with the 19-G device by 10 bronchoscopists. Relatively large targets were selected for sampling with the device (mean lymph node size: 20.4 mm; lung lesions: 33.5 mm). A specific diagnosis was obtained in 77.3% of cases with an additional 13.6% of cases with benign lymphocytes, for a procedural adequacy rate of 90.9%. Procedure sample adequacy was 88.6% in suspected malignant cases, 91.0% in suspected sarcoidosis/lymphadenopathy cases, and 85.7% of cases with suspected lymphoma. On a per-node basis, a specific diagnosis was noted in 191/280 (68.2%) of samples, with an additional 61 showing benign lymphocytes for a per-node sample adequacy rate of 90%. One case (0.6%) of intraprocedure bleeding was noted. A new flexible 19-G EBUS needle was successfully and safely applied in a large patient cohort for sampling of lung and enlarged mediastinal lesions with high diagnostic rates across clinical indications.

[Professor Feng Run-Shen's essential experience in penetration needling method].

PubMed

Feng, Mu-Lan

2009-04-01

Professor Feng Run-Shen is engaged in medicine for more than 60 years. He pays attention to medical ethics and has perfect medical skill. He energetically advocates combination of acupuncture with medication and stresses the concept of viewing the situation as a whole in selection of acupoints and treatment, particularly, clinical application of point properties. Clinically, he is accomplished in penetration needling, for which one needle acts on two or more points, enlarging the range of needling sensation, so it has very good therapeutic effects on many diseases. In the paper, the case samples about penetration needling in his clinical practice are summarized and introduced.

A comparison of Espocan and Tuohy needles for the combined spinal-epidural technique for labor analgesia.

PubMed

Browne, Ingrid M; Birnbach, David J; Stein, Deborah J; O'Gorman, David A; Kuroda, Maxine

2005-08-01

When using the needle-through-needle combined spinal-epidural (CSE) technique for labor analgesia, failure to obtain cerebrospinal fluid (CSF), paresthesias, and intrathecal or intravascular migration of the catheter are of concern. Epidural needles with spinal needle apertures, such as the back-hole Espocan (ES) needles, are available and may reduce these risks. We describe the efficacy and adverse events associated with a modified epidural needle (ES) versus a conventional Tuohy needle for CSE. One-hundred parturients requesting labor analgesia (CSE) were randomized into 2 groups: 50-ES 18-gauge modified epidural needle with 27-gauge Pencan atraumatic spinal needle, 50-conventional 18-gauge Tuohy needle with 27-gauge Gertie Marx atraumatic spinal needle. Information on intrathecal or intravascular catheter placement, paresthesia on introduction of spinal needle, failure to obtain CSF through the spinal needle after placement of epidural needle, unintentional dural puncture, and epidural catheter function was obtained. No intrathecal catheter placement occurred in either group. Rates of intravascular catheter placement and unintentional dural puncture were similar between the groups. Significant differences were noted regarding spinal needle-induced paresthesia (14% ES versus 42% Tuohy needles, P = 0.009) and failure to obtain CSF on first attempt (8% ES versus 28% Tuohy needles, P < 0.02). Use of ES needles for CSE significantly reduces paresthesia associated with the insertion of the spinal needle and is associated with more frequent successful spinal needle placement on the first attempt. The use of modified epidural needles with a back hole for combined spinal-epidural technique significantly reduces paresthesia associated with the insertion of the spinal needle and is associated with more frequent successful spinal needle placement on the first attempt.

Helical-Tip Needle for Transthoracic Percutaneous Image-Guided Biopsy of Lung Tumors: Results of a Pilot Prospective Comparative Study with a Standard Tru-Cut Needle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veltri, Andrea, E-mail: andrea.veltri@unito.it; Busso, Marco; Sardo, Diego

PurposeTo prospectively evaluate feasibility and diagnostic performance of the 14-gauge helical-tip (Spirotome™, Cook{sup ®} Medical, Bloomington, USA) needle in transthoracic needle biopsy (TTNB) of lung lesions, compared to a conventional 18-gauge Tru-Cut needle.Materials and MethodsStudy was institutional review board approved, with informed consent obtained. Data from synchronous Spirotome and Tru-Cut image-guided TTNB of 20 consecutive patients with malignant peripheral lung tumors larger than 3 cm were enrolled for pathologic characterization and mutational analysis. Samples obtained with Spirotome and Tru-Cut needle were compared for fragmentation, length, weight, morphologic and immunohistochemistry typifying, tumor cellularity (TC) and DNA concentration.ResultsThe technical success rate for TTNBmore » with Spirotome was 100%, and no major complications occurred. Less fragmentation (mean 2 vs. 3 fragments, P = .418), greater weight (mean 13 vs. 8.5 mg, P = .027) and lower length (mean 10.2 vs. 12.6 mm, P = .174) were observed with Spirotome compared to Tru-Cut needle. Accuracy of Spirotome and Tru-Cut needle in defining cancer histotype was similar (90%). Absolute and relative TC (mean 42 vs. 38, 124 vs. 108/10HPF), and DNA concentration (mean 49.6 vs. 39.0 ng/μl) were higher with Spirotome compared to Tru-Cut needle, with no statistical significance (P = .787 and P = .140, respectively).Conclusions Percutaneous 14-gauge Spirotome TTNB of selected lesions is feasible and accurate. It provides adequate samples for diagnosis, comparable to 18-gauge Tru-Cut needle, with a higher amount of tumor tissue (weight, TC, DNA concentration) even in shorter samples.« less

[Incidence of postmyelography syndrome and postmyelography complaints after lumbar puncture with the Sprotte pencil-like needle in comparison with the Quincke needle].

PubMed

Fox, R G; Reiche, W; Kiefer, M; Hagen, T; Huber, G

1996-11-01

Myelography in combination with a postmyelography CT is an important presurgical examination because of its excellent visualisation of the disc, the bone and the contrast-filled dura. Side effects after myelography can be observed in up to 50% of patients. The pathophysiological mechanism is thought to be increased cerebrospinal fluid leakage at the puncture site. Since the introduction by Sprotte in 1979 of the pencil-point needle, a modification of Whitacre's needle, fewer complaints after lumbar puncture have been reported. The aim of the study was to examine the influence of two types of needle points and the temperature (37 degrees C vs 21 degrees C) of the contrast medium (CM; iotrolan, Isovist) on the incidence of side effects of lumbar puncture for myelography. In a prospective randomized trial the incidence of complaints after lumbar puncture with intrathecal CM application was evaluated by the use of a 21-G pencil-point needle as modified by Sprotte compared to our usual 22-G needle with a Quincke bevel. Some 412 patients (201 female, 211 male; mean age 54.05 +/- 7.4 years) were investigated. Directly after examination and 1. 3 and 5 days later the patients were questioned about complaints (headache, neck stiffness nausea, vomiting, buzzing in the ear and dizziness). The results were tested by the chi square test. A significantly lower incidence of complaints was seen after lumbar puncture with the pencil-point needle/Quincke needle (headache: 6.3%/18.9%, P < 0.0001; headache lasting 3 days: 0.5%/7.8%, P < 0.0001; headache lasting 5 days: 0%/2.4%, P = 0.0305; nausea: 0%/4.9%, P = 0.0009; vomiting: 0%/3.4%, P = 0.0009; dizziness: 0%/3.4%, P = 0.0074; neck stiffness: 0%/3.4%, P = 0.0074). The temperature of the CM had no influence on the complaints. No influence was seen on the quality of the myelogram. No relation to sex and age was found. Complaints after lumbar puncture and myelography are caused by the cerebrospinal fluid leakage at the puncture site

A variable stiffness mechanism for steerable percutaneous instruments: integration in a needle.

PubMed

De Falco, Iris; Culmone, Costanza; Menciassi, Arianna; Dankelman, Jenny; van den Dobbelsteen, John J

2018-06-04

Needles are advanced tools commonly used in minimally invasive medical procedures. The accurate manoeuvrability of flexible needles through soft tissues is strongly determined by variations in tissue stiffness, which affects the needle-tissue interaction and thus causes needle deflection. This work presents a variable stiffness mechanism for percutaneous needles capable of compensating for variations in tissue stiffness and undesirable trajectory changes. It is composed of compliant segments and rigid plates alternately connected in series and longitudinally crossed by four cables. The tensioning of the cables allows the omnidirectional steering of the tip and the stiffness tuning of the needle. The mechanism was tested separately under different working conditions, demonstrating a capability to exert up to 3.6 N. Afterwards, the mechanism was integrated into a needle, and the overall device was tested in gelatine phantoms simulating the stiffness of biological tissues. The needle demonstrated the capability to vary deflection (from 11.6 to 4.4 mm) and adapt to the inhomogeneity of the phantoms (from 21 to 80 kPa) depending on the activation of the variable stiffness mechanism. Graphical abstract ᅟ.

SU-D-213AB-06: Surface Texture and Insertion Speed Effect on Needle Friction.

PubMed

Abdullah, A; Golecki, C; Barnett, A; Moore, J

2012-06-01

High frictional forces between the needle surface and tissue cause tissue deflection which hinders accurate needle placement for procedures such as brachytherapy and needle biopsy. Accurate needle placement isimportant to maximize procedure efficacy. This work investigates how needle surface roughness and insertion speed affect the frictional forcebetween a needle and tissue. A friction experiment was conducted to measure the force of friction between bovine liver and three 11 gauge needles having Ra surface roughness of 3.43, 1.33, and 0.2 μm. Each of the three needles were mounted on a linear slide and were advanced and retracted through bovine liver at speeds of 50, 100, 150, and 200 mm/s for a total of 12 trials. In each trial the needle was advanced and retracted in 10 cycles producing a steady state insertion force and a steady state retraction force for each cycle. A force sensor connecting the needle to the linear slide recorded the resistance force of the needle sliding through the liver. The liver was mounted in a box with a pneumatic cylinder which compressed the liver sample by 11.65 kPa. The roughest needle (Ra = 3.43 μm) on average produced 68, 73, 74, and 73% lower friction force than the smoothest needle (Ra = 0.2 μm) for the speeds of 50, 100, 150, and 200mm/s, respectively. The second roughest needle (Ra = 1.33 μm) on average produced 25, 45, 60 and 64% lower friction force than the smoothest needle (Ra = 0.2 μm) for the speeds of 50, 100, 150, and 200 mm/s, respectively. Rougher needle surface texture and higher insertion speed reduced frictional forces between the tissue and the needle. Future studies will examine how frictional forces can be modeled and predicted given surface texture and insertion speed. © 2012 American Association of Physicists in Medicine.

Smartphone-Guided Needle Angle Selection During CT-Guided Procedures.

PubMed

Xu, Sheng; Krishnasamy, Venkatesh; Levy, Elliot; Li, Ming; Tse, Zion Tsz Ho; Wood, Bradford John

2018-01-01

In CT-guided intervention, translation from a planned needle insertion angle to the actual insertion angle is estimated only with the physician's visuospatial abilities. An iPhone app was developed to reduce reliance on operator ability to estimate and reproduce angles. The iPhone app overlays the planned angle on the smartphone's camera display in real-time based on the smartphone's orientation. The needle's angle is selected by visually comparing the actual needle with the guideline in the display. If the smartphone's screen is perpendicular to the planned path, the smartphone shows the Bull's-Eye View mode, in which the angle is selected after the needle's hub overlaps the tip in the camera. In phantom studies, we evaluated the accuracies of the hardware, the Guideline mode, and the Bull's-Eye View mode and showed the app's clinical efficacy. A proof-of-concept clinical case was also performed. The hardware accuracy was 0.37° ± 0.27° (mean ± SD). The mean error and navigation time were 1.0° ± 0.9° and 8.7 ± 2.3 seconds for a senior radiologist with 25 years' experience and 1.5° ± 1.3° and 8.0 ± 1.6 seconds for a junior radiologist with 4 years' experience. The accuracy of the Bull's-Eye View mode was 2.9° ± 1.1°. Combined CT and smart-phone guidance was significantly more accurate than CT-only guidance for the first needle pass (p = 0.046), which led to a smaller final targeting error (mean distance from needle tip to target, 2.5 vs 7.9 mm). Mobile devices can be useful for guiding needle-based interventions. The hardware is low cost and widely available. The method is accurate, effective, and easy to implement.

Detection of Membrane Puncture with Haptic Feedback using a Tip-Force Sensing Needle.

PubMed

Elayaperumal, Santhi; Bae, Jung Hwa; Daniel, Bruce L; Cutkosky, Mark R

2014-09-01

This paper presents calibration and user test results of a 3-D tip-force sensing needle with haptic feedback. The needle is a modified MRI-compatible biopsy needle with embedded fiber Bragg grating (FBG) sensors for strain detection. After calibration, the needle is interrogated at 2 kHz, and dynamic forces are displayed remotely with a voice coil actuator. The needle is tested in a single-axis master/slave system, with the voice coil haptic display at the master, and the needle at the slave end. Tissue phantoms with embedded membranes were used to determine the ability of the tip-force sensors to provide real-time haptic feedback as compared to external sensors at the needle base during needle insertion via the master/slave system. Subjects were able to determine the position of the embedded membranes with significantly better accuracy using FBG tip feedback than with base feedback using a commercial force/torque sensor (p = 0.045) or with no added haptic feedback (p = 0.0024).

The Significance of Harm Reduction as a Social and Health Care Intervention for Injecting Drug Users: An Exploratory Study of a Needle Exchange Program in Fresno, California.

PubMed

Clarke, Kris; Harris, Debra; Zweifler, John A; Lasher, Marc; Mortimer, Roger B; Hughes, Susan

2016-01-01

Infectious disease remains a significant social and health concern in the United States. Preventing more people from contracting HIV/AIDS or Hepatitis C (HCV), requires a complex understanding of the interconnection between the biomedical and social dimensions of infectious disease. Opiate addiction in the US has skyrocketed in recent years. Preventing more cases of HIV/AIDS and HCV will require dealing with the social determinants of health. Needle exchange programs (NEPs) are based on a harm reduction approach that seeks to minimize the risk of infection and damage to the user and community. This article presents an exploratory small-scale quantitative study of the injection drug using habits of a group of injection drug users (IDUs) at a needle exchange program in Fresno, California. Respondents reported significant decreases in high risk IDU behaviors, including sharing of needles and to a lesser extent re-using of needles. They also reported frequent use of clean paraphernalia. Greater collaboration between social and health outreach professionals at NEPs could provide important frontline assistance to people excluded from mainstream office-based services and enhance efforts to reduce HIV/AIDS or HCV infection.

A needle guidance system for biopsy and therapy using two-dimensional ultrasound

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bluvol, Nathan; Sheikh, Allison; Kornecki, Anat

2008-02-15

Image-guided needle biopsies are currently used to provide a definitive diagnosis of breast cancer; however, difficulties in tumor targeting exist as the ultrasound (United States) scan plane and biopsy needle must remain coplanar throughout the procedure to display the actual needle tip position. The additional time associated with aligning and maintaining this coplanar relationship results in increased patient discomfort. Biopsy procedural efficiency is further hindered since needle pathway interpretation is often difficult, especially for needle insertions at large depths that usually require multiple reinsertions. The authors developed a system that would increase the speed and accuracy of current breast biopsymore » procedures using readily available two-dimensional (2D) US technology. This system is composed of a passive articulated mechanical arm that attaches to a 2D US transducer. The arm is connected to a computer through custom electronics and software, which were developed as an interface for tracking the positioning of the mechanical components in real time. The arm couples to the biopsy needle and provides visual guidance for the physician performing the procedure in the form of a real-time projected needle pathway overlay on an US image of the breast. An agar test phantom, with stainless steel targets interspersed randomly throughout, was used to validate needle trajectory positioning accuracy. The biopsy needle was guided by both the software and hardware components to the targets. The phantom, with the needle inserted and device decoupled, was placed in an x-ray stereotactic mammography (SM) machine. The needle trajectory and bead target locations were determined in three dimensions from the SM images. Results indicated a mean needle trajectory accuracy error of 0.75{+-}0.42 mm. This is adequate to sample lesions that are <2 mm in diameter. Chicken tissue test phantoms were used to compare core needle biopsy procedure times between experienced

Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device.

PubMed

Ambastha, Shikha; Umesh, Sharath; Dabir, Sundaresh; Asokan, Sundarrajan

2016-11-01

A technique for real-time dynamic monitoring of force experienced by a spinal needle during lumbar puncture using a fiber Bragg grating (FBG) sensor is presented. The proposed FBG force device (FBGFD) evaluates the compressive force on the spinal needle during lumbar puncture, particularly avoiding the bending effect on the needle. The working principle of the FBGFD is based on transduction of force experienced by the spinal needle into strain variations monitored by the FBG sensor. FBGFD facilitates external mounting of a spinal needle for its smooth insertion during lumbar puncture without any intervention. The developed FBGFD assists study and analysis of the force required for the spinal needle to penetrate various tissue layers from skin to the epidural space; this force is indicative of the varied resistance offered by different tissue layers for the spinal needle traversal. Calibration of FBGFD is performed on a micro-universal testing machine for 0 to 20 N range with an obtained resolution of 0.021 N. The experimental trials using spinal needles mounted on FBGFD are carried out on a human cadaver specimen with punctures made in the lumbar region from different directions. Distinct forces are recorded when the needle encounters skin, muscle tissue, and a bone in its traversing path. Real-time spinal needle force monitoring using FBGFD may reduce potentially serious complications during the lumbar puncture, such as overpuncturing of tissue regions, by impeding the spinal needle insertion at epidural space.

Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device

NASA Astrophysics Data System (ADS)

Ambastha, Shikha; Umesh, Sharath; Dabir, Sundaresh; Asokan, Sundarrajan

2016-11-01

A technique for real-time dynamic monitoring of force experienced by a spinal needle during lumbar puncture using a fiber Bragg grating (FBG) sensor is presented. The proposed FBG force device (FBGFD) evaluates the compressive force on the spinal needle during lumbar puncture, particularly avoiding the bending effect on the needle. The working principle of the FBGFD is based on transduction of force experienced by the spinal needle into strain variations monitored by the FBG sensor. FBGFD facilitates external mounting of a spinal needle for its smooth insertion during lumbar puncture without any intervention. The developed FBGFD assists study and analysis of the force required for the spinal needle to penetrate various tissue layers from skin to the epidural space; this force is indicative of the varied resistance offered by different tissue layers for the spinal needle traversal. Calibration of FBGFD is performed on a micro-universal testing machine for 0 to 20 N range with an obtained resolution of 0.021 N. The experimental trials using spinal needles mounted on FBGFD are carried out on a human cadaver specimen with punctures made in the lumbar region from different directions. Distinct forces are recorded when the needle encounters skin, muscle tissue, and a bone in its traversing path. Real-time spinal needle force monitoring using FBGFD may reduce potentially serious complications during the lumbar puncture, such as overpuncturing of tissue regions, by impeding the spinal needle insertion at epidural space.

Complete prevention of blood loss with self-sealing haemostatic needles

NASA Astrophysics Data System (ADS)

Shin, Mikyung; Park, Sung-Gurl; Oh, Byung-Chang; Kim, Keumyeon; Jo, Seongyeon; Lee, Moon Sue; Oh, Seok Song; Hong, Seon-Hui; Shin, Eui-Cheol; Kim, Ki-Suk; Kang, Sun-Woong; Lee, Haeshin

2017-01-01

Bleeding is largely unavoidable following syringe needle puncture of biological tissues and, while inconvenient, this typically causes little or no harm in healthy individuals. However, there are certain circumstances where syringe injections can have more significant side effects, such as uncontrolled bleeding in those with haemophilia, coagulopathy, or the transmission of infectious diseases through contaminated blood. Herein, we present a haemostatic hypodermic needle able to prevent bleeding following tissue puncture. The surface of the needle is coated with partially crosslinked catechol-functionalized chitosan that undergoes a solid-to-gel phase transition in situ to seal punctured tissues. Testing the capabilities of these haemostatic needles, we report complete prevention of blood loss following intravenous and intramuscular injections in animal models, and 100% survival in haemophiliac mice following syringe puncture of the jugular vein. Such self-sealing haemostatic needles and adhesive coatings may therefore help to prevent complications associated with bleeding in more clinical settings.

NEEDLE KNIFE SPHINCTEROTOMY - THE CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL EXPERIENCE.

PubMed

Thomson, J T; Smith, M D; Omoshoro-Jones, J A O; Devar, J D; Khan, Z K; Jugmohan, B J

2017-06-01

Deep biliary cannulation is essential in performing a therapeutic ERCP. Cannulation can be enhanced through the utilization of a pre-cut by means of a needle knife sphincterotomy. Retrospective analysis of the Chris Hani Baragwanath Academic Hospital's ERCP database was performed. All ERCPs performed with the aid of a needle knife were identified and analysed for successful and unsuccessful deep biliary cannulation. 2830 ERCPs were performed during the study period. 369 (13%) required needle knife sphincterotomies and successful deep biliary cannulation was achieved in 229 (62%) of these patients. Repeat ERCPs were performed on 125 (34%) patients. 61 (49%) of the repeat ERCPs were performed because of previously failed cannulation. 34 (56%) of these repeat ERCPs resulted in successful deep biliary cannulation at re-attempt. 99% of successful cannulations at repeat ERCP had had a needle knife sphincterotomy at the first ERCP. Needle knife sphincterotomy improves deep biliary cannulation at initial ERCP and subsequent ERCPs with low incidences of complications.

Acupuncture sensation during ultrasound guided acupuncture needling

PubMed Central

Park, Jongbae J.; Akazawa, Margeaux; Ahn, Jaeki; Beckman-Harned, Selena; Lin, Feng-Chang; Lee, Kwangjae; Fine, Jason; Davis, Robert T; Langevin, Helene

2014-01-01

Background Although acupuncture sensation (also known as de qi) is a cornerstone of traditional acupuncture therapy, most research has accepted the traditional method of defining acupuncture sensation only through subjective patient reports rather than on any quantifiable physiological basis. Purpose To preliminarily investigate the frequency of key sensations experienced while needling to specific, quantifiable tissue levels (TLs) guided by ultrasound (US) imaging. Methods Five participants received needling at two acupuncture points and two control points at four TLs. US scans were used to determine when each TL was reached. Each volunteer completed 32 sets of modified Southampton Needle Sensation Questionnaires. Part one of the study tested sensations experienced at each TL and part two compared the effect of oscillation alone versus oscillation + rotation. Results In all volunteers, the frequency of pricking, sharp sensations was significantly greater in shallower TLs than deeper (p=0.007); the frequency of sensations described as deep, dull and heavy, as spreading, and as electric shocks was significantly greater in deeper TLs than shallower (p=0.002). Sensations experienced did not significantly differ between real and control points within each of three TLs (p>0.05) except TL 4 (p=0.006). The introduction of needle rotation significantly increased deep, dull, heavy sensations, but not pricking and sharp sensations; within each level, the spectrum of sensation experienced during both oscillation + rotation and oscillation alone did not significantly differ between acupuncture and control points. Conclusion The preliminary study indicates a strong connection between acupuncture sensation and both tissue depth and needle rotation. Furthermore, the new methodology has been proven feasible. A further study with an objective measurement is warranted. PMID:21642648

Dry needling: a literature review with implications for clinical practice guidelines1

PubMed Central

Dunning, James; Butts, Raymond; Mourad, Firas; Young, Ian; Flannagan, Sean; Perreault, Thomas

2014-01-01

Background: Wet needling uses hollow-bore needles to deliver corticosteroids, anesthetics, sclerosants, botulinum toxins, or other agents. In contrast, dry needling requires the insertion of thin monofilament needles, as used in the practice of acupuncture, without the use of injectate into muscles, ligaments, tendons, subcutaneous fascia, and scar tissue. Dry needles may also be inserted in the vicinity of peripheral nerves and/or neurovascular bundles in order to manage a variety of neuromusculoskeletal pain syndromes. Nevertheless, some position statements by several US State Boards of Physical Therapy have narrowly defined dry needling as an ‘intramuscular’ procedure involving the isolated treatment of ‘myofascial trigger points’ (MTrPs). Objectives: To operationalize an appropriate definition for dry needling based on the existing literature and to further investigate the optimal frequency, duration, and intensity of dry needling for both spinal and extremity neuromusculoskeletal conditions. Major findings: According to recent findings in the literature, the needle tip touches, taps, or pricks tiny nerve endings or neural tissue (i.e. ‘sensitive loci’ or ‘nociceptors’) when it is inserted into a MTrP. To date, there is a paucity of high-quality evidence to underpin the use of direct dry needling into MTrPs for the purpose of short and long-term pain and disability reduction in patients with musculoskeletal pain syndromes. Furthermore, there is a lack of robust evidence validating the clinical diagnostic criteria for trigger point identification or diagnosis. High-quality studies have also demonstrated that manual examination for the identification and localization of a trigger point is neither valid nor reliable between-examiners. Conclusions: Several studies have demonstrated immediate or short-term improvements in pain and/or disability by targeting trigger points (TrPs) using in-and-out techniques such as ‘pistoning’ or �

Comparison of 21-gauge and 22-gauge aspiration needle in endobronchial ultrasound-guided transbronchial needle aspiration: results of the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation Registry.

PubMed

Yarmus, Lonny B; Akulian, Jason; Lechtzin, Noah; Yasin, Faiza; Kamdar, Biren; Ernst, Armin; Ost, David E; Ray, Cynthia; Greenhill, Sarah R; Jimenez, Carlos A; Filner, Joshua; Feller-Kopman, David

2013-04-01

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure originally performed using a 22-gauge (22G) needle. A recently introduced 21-gauge (21G) needle may improve the diagnostic yield and sample adequacy of EBUS-TBNA, but prior smaller studies have shown conflicting results. To our knowledge, this is the largest study undertaken to date to determine whether the 21G needle adds diagnostic benefit. We retrospectively evaluated the results of 1,299 patients from the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation (AQuIRE) Diagnostic Registry who underwent EBUS-TBNA between February 2009 and September 2010 at six centers throughout the United States. Data collection included patient demographics, sample adequacy, and diagnostic yield. Analysis consisted of univariate and multivariate hierarchical logistic regression comparing diagnostic yield and sample adequacy of EBUS-TBNA specimens by needle gauge. A total of 1,235 patients met inclusion criteria. Sample adequacy was obtained in 94.9% of the 22G needle group and in 94.6% of the 21G needle group (P = .81). A diagnosis was made in 51.4% of the 22G and 51.3% of the 21G groups (P = .98). Multivariate hierarchical logistic regression showed no statistical difference in sample adequacy or diagnostic yield between the two groups. The presence of rapid onsite cytologic evaluation was associated with significantly fewer needle passes per procedure when using the 21G needle (P < .001). There is no difference in specimen adequacy or diagnostic yield between the 21G and 22G needle groups. EBUS-TBNA in conjunction with rapid onsite cytologic evaluation and a 21G needle is associated with fewer needle passes compared with a 22G needle.

Semicircular thermocouple needle depth gauge for cryoprocedures.

PubMed

Pappenfort, R B

1981-06-01

A semicircular thermocouple needle depth gauge made of an aluminum alloy drilled with tracks at different angles to place thermocouple needles at various depths below the surface is described herein. Its shape offers definite advantages over circular jigs (templates) when doing cryoexperimentation and when used clinically. The material of which it is made is more durable than plastic. Grommets that firmly snap in place within the inner rim of the instrument permit accurate placement of liquid gas spray, cryoprobes, and other applicators directly over the thermocouple needle tips. This is of special importance when doing cryoexperiments. Furthermore, with this design, the advancing ice front and possible liquid gas runoff are more easily seen. By using both halves it is suitable for monitoring the temperature when freezing large tumors at two different sites and a different depths.

Silviculture and Swiss needle cast: research and recommendations.

Treesearch

Gregory M. Filip; A. Kanaskie; K. Kavanagh; G. Johnson; R. Johnson; D. Maguire

2000-01-01

For the past ten years, Douglas-fir on the Oregon and Washington coast has shown a progressive decrease in height and diameter increment as a result of Swiss needle cast, which is caused by Phaeocryptopus gaeumannii. In this contribution, we discuss the effects of silvicultural operations on Swiss needle cast and recommend specific actions to...

[Closed needle-biopsy in the diagnosis of neoplasms].

PubMed

Sforza, M; Perelli Ercolini, M; Beani, G

1979-04-01

The AA. demonstrate with this communication the validity of the needle biopsie for the diagnosis of neoplasms. They had used it for the breast, thyroid, flg and some other superficial tumefactions. In the mass-screening for the feminine neoplasms the clinical examination and the needle biopsy are very good method for a careful diagnosis.

Experimental platform for intra-uterine needle placement procedures

NASA Astrophysics Data System (ADS)

Madjidi, Yashar; Haidegger, Tamás.; Ptacek, Wolfgang; Berger, Daniel; Kirisits, Christian; Kronreif, Gernot; Fichtinger, Gabor

2013-03-01

A framework has been investigated to enable a variety of comparative studies in the context of needle-based gynaecological brachytherapy. Our aim was to create an anthropomorphic phantom-based platform. The three main elements of the platform are the organ model, needle guide, and needle drive. These have been studied and designed to replicate the close environment of brachytherapy treatment for cervical cancer. Key features were created with the help of collaborating interventional radio-oncologists and the observations made in the operating room. A phantom box, representing the uterus model, has been developed considering available surgical analogies and operational limitations, such as organs at risk. A modular phantom-based platform has been designed and prototyped with the capability of providing various boundary conditions for the target organ. By mimicking the female pelvic floor, this framework has been used to compare a variety of needle insertion techniques and configurations for cervical and uterine interventions. The results showed that the proposed methodology is useful for the investigation of quantifiable experiments in the intraabdominal and pelvic regions.

Multi-resolution Gabor wavelet feature extraction for needle detection in 3D ultrasound

NASA Astrophysics Data System (ADS)

Pourtaherian, Arash; Zinger, Svitlana; Mihajlovic, Nenad; de With, Peter H. N.; Huang, Jinfeng; Ng, Gary C.; Korsten, Hendrikus H. M.

2015-12-01

Ultrasound imaging is employed for needle guidance in various minimally invasive procedures such as biopsy guidance, regional anesthesia and brachytherapy. Unfortunately, a needle guidance using 2D ultrasound is very challenging, due to a poor needle visibility and a limited field of view. Nowadays, 3D ultrasound systems are available and more widely used. Consequently, with an appropriate 3D image-based needle detection technique, needle guidance and interventions may significantly be improved and simplified. In this paper, we present a multi-resolution Gabor transformation for an automated and reliable extraction of the needle-like structures in a 3D ultrasound volume. We study and identify the best combination of the Gabor wavelet frequencies. High precision in detecting the needle voxels leads to a robust and accurate localization of the needle for the intervention support. Evaluation in several ex-vivo cases shows that the multi-resolution analysis significantly improves the precision of the needle voxel detection from 0.23 to 0.32 at a high recall rate of 0.75 (gain 40%), where a better robustness and confidence were confirmed in the practical experiments.

Double needle technique: an alternative method for performing difficult sacroiliac joint injections.

PubMed

Gupta, Sanjeeva

2011-01-01

The sacroiliac joint (SIJ) is a common source of low back pain. The most appropriate method of confirming SIJ pain is to inject local anesthesia into the joint to find out if the pain decreases. Unfortunately, although the SIJ is a large joint, it can be difficult to enter due to the complex nature of the joint and variations in anatomy. In my experience a double needle technique for sacroiliac joint injection can increase the chances of accurate injection into the SIJ in difficult cases. After obtaining appropriate fluoroscopic images, the tip of the needle is advanced into the SIJ. Once the tip of the needle is correctly placed, its position is checked under continuous fluoroscopy while moving the C-arm in the right and left oblique directions (dynamic fluoroscopy). On dynamic fluoroscopy the tip of the needle should remain within the joint line and not appear to be on the bone. If the tip of the needle appears to be on the bone a new joint line will need to be identified (the most translucent area through the joint) by dynamic fluoroscopy and another needle advanced into the newly identified joint line. Dynamic fluoroscopy is repeated again to confirm that the tip of the second needle remains within the joint line. Once both needles are in place contrast dye is injected through the needle that is most likely to be in the SIJ. If the contrast dye spread is not satisfactory then it is injected through the other needle. I have used this technique in 10 patients and found it very helpful in accurately performing SIJ injection which can at times be challenging.

Examination of surface conditions and other physical properties of commonly used stainless steel acupuncture needles.

PubMed

Xie, Yi Min; Xu, Shanqing; Zhang, Claire Shuiqing; Xue, Charlie Changli

2014-04-01

The present work examined the surface conditions and various other physical properties of sterilised single-use stainless steel acupuncture needles from two of the most popular brands widely used in many countries. Scanning electron microscope (SEM) images were taken for 10 randomly chosen needles from each brand. Further SEM images were taken after each of these needles underwent a standard manipulation with an acupuncture needling practice gel. A comparison of forces and torques during the needling process was also carried out. The SEM images revealed significant surface irregularities and inconsistencies at the needle tips, especially for needles from one of the two brands. Metallic lumps and small, loosely attached pieces of material were observed on the surfaces of some needles. Some of the lumps and pieces of material seen on the needle surfaces disappeared after the acupuncture manipulation. If these needles had been used on patients, the metallic lumps and small pieces of material could have been deposited in human tissues, which could have caused adverse events such as dermatitis. Malformed needle tips might also cause other adverse effects including bleeding, haematoma/bruising, or strong pain during needling. An off-centre needle tip could result in the needle altering its direction during insertion and consequently failing to reach the intended acupuncture point or damaging adjacent tissues. These findings highlight the need for improved quality control of acupuncture needles, with a view to further enhancing the safety and comfort of acupuncture users.

The provision of non-needle/syringe drug injecting paraphernalia in the primary prevention of HCV among IDU: a systematic review.

PubMed

Gillies, Michelle; Palmateer, Norah; Hutchinson, Sharon; Ahmed, Syed; Taylor, Avril; Goldberg, David

2010-11-23

Sharing drug injecting paraphernalia other than needles and syringes (N/S) has been implicated in the transmission of Hepatitis C virus (HCV) among injecting drug users (IDU). We aimed to determine whether the provision of sterile non-N/S injecting paraphernalia reduces injecting risk behaviours or HCV transmission among IDU. A systematic search of seven databases and the grey literature for articles published January 1989-February 2010 was undertaken. Thirteen studies (twelve observational and one non-randomized uncontrolled pilot intervention) were identified and appraised for study design and quality by two investigators. No studies examined the association between the provision of non-N/S injecting paraphernalia and incident HCV infection. One cross-sectional study found that individuals who frequently, compared to those who infrequently, used sterile cookers and water, were less likely to report prevalent HCV infection. Another found no association between the uptake of sterile non-N/S injecting paraphernalia and self-reported sharing of this paraphernalia. The remaining observational studies used attendance at needle and syringe exchange programmes (NSP) or safer injection facilities (SIF) that provided non-N/S injecting paraphernalia as a proxy measure. Eight studies presented adjusted odds ratios, ranging from 0.3 to 0.9, suggesting a reduced likelihood of self-reported sharing of non-N/S injecting paraphernalia associated with use of NSP or SIF. There was substantial uncertainty associated with these estimates however. Three unadjusted studies reported a reduction in the prevalence of sharing of non-N/S injecting paraphernalia over time among NSP users. Only one study reported an adjusted temporal trend in the prevalence of sharing non-N/S injecting paraphernalia, finding higher rates among non-NSP users than NSP users at each time point, and a greater reduction in sharing among non-NSP than NSP users over time. Study limitations included the use of

Design of a Teleoperated Needle Steering System for MRI-guided Prostate Interventions

PubMed Central

Seifabadi, Reza; Iordachita, Iulian; Fichtinger, Gabor

2013-01-01

Accurate needle placement plays a key role in success of prostate biopsy and brachytherapy. During percutaneous interventions, the prostate gland rotates and deforms which may cause significant target displacement. In these cases straight needle trajectory is not sufficient for precise targeting. Although needle spinning and fast insertion may be helpful, they do not entirely resolve the issue. We propose robot-assisted bevel-tip needle steering under MRI guidance as a potential solution to compensate for the target displacement. MRI is chosen for its superior soft tissue contrast in prostate imaging. Due to the confined workspace of the MRI scanner and the requirement for the clinician to be present inside the MRI room during the procedure, we designed a MRI-compatible 2-DOF haptic device to command the needle steering slave robot which operates inside the scanner. The needle steering slave robot was designed to be integrated with a previously developed pneumatically actuated transperineal robot for MRI-guided prostate needle placement. We describe design challenges and present the conceptual design of the master and slave robots and the associated controller. PMID:24649480

Cutting performance orthogonal test of single plane puncture biopsy needle based on puncture force

NASA Astrophysics Data System (ADS)

Xu, Yingqiang; Zhang, Qinhe; Liu, Guowei

2017-04-01

Needle biopsy is a method to extract the cells from the patient's body with a needle for tissue pathological examination. Many factors affect the cutting process of soft tissue, including the geometry of the biopsy needle, the mechanical properties of the soft tissue, the parameters of the puncture process and the interaction between them. This paper conducted orthogonal experiment of main cutting parameters based on single plane puncture biopsy needle, and obtained the cutting force curve of single plane puncture biopsy needle by studying the influence of the inclination angle, diameter and velocity of the single plane puncture biopsy needle on the puncture force of the biopsy needle. Stage analysis of the cutting process of biopsy needle puncture was made to determine the main influencing factors of puncture force during the cutting process, which provides a certain theoretical support for the design of new type of puncture biopsy needle and the operation of puncture biopsy.

MLESAC Based Localization of Needle Insertion Using 2D Ultrasound Images

NASA Astrophysics Data System (ADS)

Xu, Fei; Gao, Dedong; Wang, Shan; Zhanwen, A.

2018-04-01

In the 2D ultrasound image of ultrasound-guided percutaneous needle insertions, it is difficult to determine the positions of needle axis and tip because of the existence of artifacts and other noises. In this work the speckle is regarded as the noise of an ultrasound image, and a novel algorithm is presented to detect the needle in a 2D ultrasound image. Firstly, the wavelet soft thresholding technique based on BayesShrink rule is used to denoise the speckle of ultrasound image. Secondly, we add Otsu’s thresholding method and morphologic operations to pre-process the ultrasound image. Finally, the localization of the needle is identified and positioned in the 2D ultrasound image based on the maximum likelihood estimation sample consensus (MLESAC) algorithm. The experimental results show that it is valid for estimating the position of needle axis and tip in the ultrasound images with the proposed algorithm. The research work is hopeful to be used in the path planning and robot-assisted needle insertion procedures.

Factors predicting the success of trabeculectomy bleb enhancement with needling.

PubMed

Than, Jonathan Y-X L; Al-Mugheiry, Toby S; Gale, Jesse; Martin, Keith R

2018-02-09

Bleb needling is widely used to restore flow and lower intraocular pressure (IOP) in a failing trabeculectomy. We aimed to measure the safety and efficacy of needling in a large cohort and identify factors that were associated with success and failure. This retrospective audit included all patients who underwent needling at Addenbrooke's Hospital, Cambridge over a 10-year period. Data were available on 91 patients (98% of patients identified), including 191 needlings on 96 eyes. Success was defined as IOP below 21 mm Hg or 16 mm Hg or 13 mm Hg consistently, without reoperation or glaucoma medication. Risk factors for failure were assessed by Cox proportional hazard regression and Kaplan-Meier curves. Success defined as IOP <16 mm Hg was 66.6% at 12 months and 53% at 3 years and success defined as IOP <21 mm Hg was 77.1% at 12 months and 73.1% at 3 years. Failure after needling was most common in the first 6 months. Factors that predicted failure were flat or fibrotic blebs (non-functional) and no longer injected, while success was predicted by achieving a low IOP immediately after needling. No significant complications were identified. Needling was most successful soon after trabeculectomy, but resuscitation of a long-failed trabeculectomy had lower likelihood of success. The safety and efficacy compare favourably with alternative treatment approaches. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surgical motion characterization in simulated needle insertion procedures

NASA Astrophysics Data System (ADS)

Holden, Matthew S.; Ungi, Tamas; Sargent, Derek; McGraw, Robert C.; Fichtinger, Gabor

2012-02-01

PURPOSE: Evaluation of surgical performance in image-guided needle insertions is of emerging interest, to both promote patient safety and improve the efficiency and effectiveness of training. The purpose of this study was to determine if a Markov model-based algorithm can more accurately segment a needle-based surgical procedure into its five constituent tasks than a simple threshold-based algorithm. METHODS: Simulated needle trajectories were generated with known ground truth segmentation by a synthetic procedural data generator, with random noise added to each degree of freedom of motion. The respective learning algorithms were trained, and then tested on different procedures to determine task segmentation accuracy. In the threshold-based algorithm, a change in tasks was detected when the needle crossed a position/velocity threshold. In the Markov model-based algorithm, task segmentation was performed by identifying the sequence of Markov models most likely to have produced the series of observations. RESULTS: For amplitudes of translational noise greater than 0.01mm, the Markov model-based algorithm was significantly more accurate in task segmentation than the threshold-based algorithm (82.3% vs. 49.9%, p<0.001 for amplitude 10.0mm). For amplitudes less than 0.01mm, the two algorithms produced insignificantly different results. CONCLUSION: Task segmentation of simulated needle insertion procedures was improved by using a Markov model-based algorithm as opposed to a threshold-based algorithm for procedures involving translational noise.

Detection of Membrane Puncture with Haptic Feedback using a Tip-Force Sensing Needle

PubMed Central

Elayaperumal, Santhi; Bae, Jung Hwa; Daniel, Bruce L.; Cutkosky, Mark R.

2015-01-01

This paper presents calibration and user test results of a 3-D tip-force sensing needle with haptic feedback. The needle is a modified MRI-compatible biopsy needle with embedded fiber Bragg grating (FBG) sensors for strain detection. After calibration, the needle is interrogated at 2 kHz, and dynamic forces are displayed remotely with a voice coil actuator. The needle is tested in a single-axis master/slave system, with the voice coil haptic display at the master, and the needle at the slave end. Tissue phantoms with embedded membranes were used to determine the ability of the tip-force sensors to provide real-time haptic feedback as compared to external sensors at the needle base during needle insertion via the master/slave system. Subjects were able to determine the position of the embedded membranes with significantly better accuracy using FBG tip feedback than with base feedback using a commercial force/torque sensor (p = 0.045) or with no added haptic feedback (p = 0.0024). PMID:26509101

Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multi-Center Randomized Clinical Trial.

PubMed

Dunning, James; Butts, Raymond; Young, Ian; Mourad, Firas; Galante, Victoria; Bliton, Paul; Tanner, Michelle; Fernández-de-Las-Peñas, César

2018-05-28

To compare the effects of adding electrical dry needling into a manual therapy and exercise program on pain, stiffness, function, and disability in individuals with painful knee osteoarthritis (OA). Two hundred and forty-two participants (n=242) with painful knee OA were randomized to receive 6 weeks of electrical dry needling, manual therapy and exercise (n=121) or manual therapy and exercise (n=121). The primary outcome was related-disability as assessed by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index at 3 months. Individuals receiving the combination of electrical dry needling, manual therapy and exercise experienced significantly greater improvements in related-disability (WOMAC: F=35.504; P<0.001) than those receiving manual therapy and exercise alone at 6 weeks and 3 months. Patients receiving electrical dry needling were 1.7 times more likely to have completely stopped taking medication for their pain at 3 months than individuals receiving manual therapy and exercise (OR: 1.6; 95%CI: 1.24-2.01; P=0.001). Based on the cutoff score of +5 on the Global Rating of Change (GROC), significantly (X =14.887; P<0.001) more patients (n=91, 75%) within the dry needling group achieved a successful outcome compared to the manual therapy and exercise group (n=22, 18%) at 3 months. Effect sizes were large (SMD>0.82) for all outcome measures in favor of the electrical dry needling group at 3 months. The inclusion of electrical dry needling into a manual therapy and exercise program was more effective for improving pain, function and related-disability than the application of manual therapy and exercise alone in individuals with painful knee OA. Therapy, Level 1b. Prospectively registered February 10, 2015 on http://www.clinicaltrials.gov (NCT02373631)This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share

Double-pointed 30-gauge needle for keratocentesis.

PubMed

Angi, M R; Endara, N I

1985-12-01

A new, efficient instrument for performing keratocentesis for aqueous humour aspiration and anterior chamber microinfusion is described. It consists of a double-pointed 30-gauge needle, a liquid container (a nonflexible vinyl tube plugged at one end with a rubber stopper) and a aspiration-infusion syringe connected to the container and needle by a flexible vinyl tube. The instrument's advantages are a safer technique, complete collection of the aqueous humour and better handling of the sample.

[An atraumatic needle for the puncture of ports and pumps].

PubMed

Haindl, H; Müller, H

1988-10-17

Huber-point needles have been found to induce substantial coring during puncture of ports or pumps, which may lead to leakage or obturation of these devices. Therefore, different types of cannulas were tested in order to evaluate their applicability for this purpose. Pencil-point needles led to increased pain during puncture and thus seemed unsuitable. A newly developed port-cannula bent inwards within the length of the bevel ("protected bevel") and proved to be definitely noncoring during electron microscopy. Consequently the force required to introduce this needle was reduced by 50% in comparison with the Huber-type needle. In addition, this cannula allowed up to 3000 punctures of one port without leakage and, thus, correspondingly therefore relevantly increased the durability of this device.

Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease.

PubMed

Molenkamp, Sanne; Schouten, Tanneke A M; Broekstra, Dieuwke C; Werker, Paul M N; Moolenburgh, J Daniel

2017-06-01

Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account. The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively. The authors described the early postoperative results of percutaneous needle fasciotomy and applied linear mixed models to compare mean correction of passive extension deficit between joints and efficacy of primary versus secondary percutaneous needle fasciotomy. Mean preoperative passive extension deficits at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 37, 40, and 31 degrees, respectively. Mean preoperative total passive extension deficit was 54 degrees. Results were excellent, with a mean total passive extension deficit correction of 85 percent. Percutaneous needle fasciotomy was most effective for metacarpophalangeal joints and less effective for proximal interphalangeal and distal interphalangeal joints. Secondary percutaneous needle fasciotomy was as effective as primary percutaneous needle fasciotomy. Complications were rare and mostly minor. The results of this study confirm that percutaneous needle fasciotomy is an effective and safe treatment modality for patients with mild to moderate disease who prefer a minimally invasive procedure. Therapeutic, IV.

Vaccines, our shared responsibility.

PubMed

Pagliusi, Sonia; Jain, Rishabh; Suri, Rajinder Kumar

2015-05-05

The Developing Countries Vaccine Manufacturers' Network (DCVMN) held its fifteenth annual meeting from October 27-29, 2014, New Delhi, India. The DCVMN, together with the co-organizing institution Panacea Biotec, welcomed over 240 delegates representing high-profile governmental and nongovernmental global health organizations from 36 countries. Over the three-day meeting, attendees exchanged information about their efforts to achieve their shared goal of preventing death and disability from known and emerging infectious diseases. Special praise was extended to all stakeholders involved in the success of polio eradication in South East Asia and highlighted challenges in vaccine supply for measles-rubella immunization over the coming decades. Innovative vaccines and vaccine delivery technologies indicated creative solutions for achieving global immunization goals. Discussions were focused on three major themes including regulatory challenges for developing countries that may be overcome with better communication; global collaborations and partnerships for leveraging investments and enable uninterrupted supply of affordable and suitable vaccines; and leading innovation in vaccines difficult to develop, such as dengue, Chikungunya, typhoid-conjugated and EV71, and needle-free technologies that may speed up vaccine delivery. Moving further into the Decade of Vaccines, participants renewed their commitment to shared responsibility toward a world free of vaccine-preventable diseases. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Achievement of needle-like focus by engineering radial-variant vector fields.

PubMed

Gu, Bing; Wu, Jia-Lu; Pan, Yang; Cui, Yiping

2013-12-16

We present and demonstrate a novel method for engineering the radial-variant polarization on the incident field to achieve a needle of transversally polarized field without any pupil filters. We generate a new kind of localized linearly-polarized vector fields with distributions of states of polarization (SoPs) describing by the radius to the power p and explore its tight focusing, nonparaxial focusing, and paraxial focusing properties. By tuning the power p, we obtain the needle-like focal field with hybrid SoPs and give the formula for describing the length of the needle. Experimentally, we systematically investigate both the intensity distributions and the polarization evolution of the optical needle by paraxial focusing the generated vector field. Such an optical needle, which enhances the light-matter interaction, has intriguing applications in optical microma-chining and nonlinear optics.

The case of a needle exchange policy debate in Fresno, California

PubMed Central

Clarke, KRIS

2016-01-01

Needle exchange is one of the most effective public health interventions to prevent the transmission of infectious disease by injecting drug users. Despite the preponderance of scientific evidence, US federal funding for needle exchange programmes has been banned since 1988. This prohibition has resulted in the lack of a centralised policy on needle exchange and has given birth to a patchwork of diverse practices and regulations throughout the nation. This article focuses on how various local players interpreted the meaning of needle exchange through the debate on an unauthorised site in Fresno, California. In exploring a specific context, this study delineates the narratives used to outline competing views about needle exchange and to offer a snapshot of how the issue of widespread injecting drug use was handled in an impoverished and socially conservative region of the United States. PMID:28035171

Evaluating the advances and use of hypodermic needles in dentistry.

PubMed

Boynes, Sean G

2014-10-01

Different injection techniques and patient management methodologies have been proposed to decrease the fear patients may have concerning dental needles. Dental providers should have an understanding of the technological advances, changes in techniques, and patient perceptions associated with the hypodermic needle. This article provides an overview of the pain perception process associated with dental injections. It reviews the two main sensory nerve fibers associated with injection pain and discusses needle properties as well as complications and adverse occurrences.

Development of Needle Insertion Manipulator for Central Venous Catheterization

NASA Astrophysics Data System (ADS)

Kobayashi, Yo; Hong, Jaesung; Hamano, Ryutaro; Hashizume, Makoto; Okada, Kaoru; Fujie, Masakatsu G.

Central venous catheterization is a procedure, which a doctor insert a catheter into the patient’s vein for transfusion. Since there are risks of bleeding from arterial puncture or pneumothorax from pleural puncture. Physicians are strictly required to make needle reach up into the vein and to stop the needle in the middle of vein. We proposed a robot system for assisting the venous puncture, which can relieve the difficulties in conventional procedure, and the risks of complication. This paper reports the design structuring and experimental results of needle insertion manipulator. First, we investigated the relationship between insertion force and angle into the vein. The results indicated that the judgment of perforation using the reaction force is possible in case where the needling angle is from 10 to 20 degree. The experiment to evaluate accuracy of the robot also revealed that it has beyond 0.5 mm accuracy. We also evaluated the positioning accuracy in the ultrasound images. The results displays that the accuracy is beyond 1.0 mm and it has enough for venous puncture. We also carried out the venous puncture experiment to the phantom and confirm our manipulator realized to make needle reach up into the vein.

Real-time tracking of liver motion and deformation using a flexible needle

PubMed Central

Lei, Peng; Moeslein, Fred; Wood, Bradford J.

2012-01-01

Purpose A real-time 3D image guidance system is needed to facilitate treatment of liver masses using radiofrequency ablation, for example. This study investigates the feasibility and accuracy of using an electromagnetically tracked flexible needle inserted into the liver to track liver motion and deformation. Methods This proof-of-principle study was conducted both ex vivo and in vivo with a CT scanner taking the place of an electromagnetic tracking system as the spatial tracker. Deformations of excised livers were artificially created by altering the shape of the stage on which the excised livers rested. Free breathing or controlled ventilation created deformations of live swine livers. The positions of the needle and test targets were determined through CT scans. The shape of the needle was reconstructed using data simulating multiple embedded electromagnetic sensors. Displacement of liver tissues in the vicinity of the needle was derived from the change in the reconstructed shape of the needle. Results The needle shape was successfully reconstructed with tracking information of two on-needle points. Within 30 mm of the needle, the registration error of implanted test targets was 2.4 ± 1.0 mm ex vivo and 2.8 ± 1.5 mm in vivo. Conclusion A practical approach was developed to measure the motion and deformation of the liver in real time within a region of interest. The approach relies on redesigning the often-used seeker needle to include embedded electromagnetic tracking sensors. With the nonrigid motion and deformation information of the tracked needle, a single- or multimodality 3D image of the intraprocedural liver, now clinically obtained with some delay, can be updated continuously to monitor intraprocedural changes in hepatic anatomy. This capability may be useful in radiofrequency ablation and other percutaneous ablative procedures. PMID:20700662

Teleoperation of steerable flexible needles by combining kinesthetic and vibratory feedback.

PubMed

Pacchierotti, Claudio; Abayazid, Momen; Misra, Sarthak; Prattichizzo, Domenico

2014-01-01

Needle insertion in soft-tissue is a minimally invasive surgical procedure that demands high accuracy. In this respect, robotic systems with autonomous control algorithms have been exploited as the main tool to achieve high accuracy and reliability. However, for reasons of safety and responsibility, autonomous robotic control is often not desirable. Therefore, it is necessary to focus also on techniques enabling clinicians to directly control the motion of the surgical tools. In this work, we address that challenge and present a novel teleoperated robotic system able to steer flexible needles. The proposed system tracks the position of the needle using an ultrasound imaging system and computes needle's ideal position and orientation to reach a given target. The master haptic interface then provides the clinician with mixed kinesthetic-vibratory navigation cues to guide the needle toward the computed ideal position and orientation. Twenty participants carried out an experiment of teleoperated needle insertion into a soft-tissue phantom, considering four different experimental conditions. Participants were provided with either mixed kinesthetic-vibratory feedback or mixed kinesthetic-visual feedback. Moreover, we considered two different ways of computing ideal position and orientation of the needle: with or without set-points. Vibratory feedback was found more effective than visual feedback in conveying navigation cues, with a mean targeting error of 0.72 mm when using set-points, and of 1.10 mm without set-points.

Study on design and cutting parameters of rotating needles for core biopsy.

PubMed

Giovannini, Marco; Ren, Huaqing; Cao, Jian; Ehmann, Kornel

2018-06-15

Core needle biopsies are widely adopted medical procedures that consist in the removal of biological tissue to better identify a lesion or an abnormality observed through a physical exam or a radiology scan. These procedures can provide significantly more information than most medical tests and they are usually performed on bone lesions, breast masses, lymph nodes and the prostate. The quality of the samples mainly depends on the forces exerted by the needle during the cutting process. The reduction of these forces is critical to extract high-quality tissue samples. The most critical factors that affect the cutting forces are the geometry of the needle tip and its motion while it is penetrating the tissue. However, optimal needle tip configurations and cutting parameters are not well established for rotating insertions. In this paper, the geometry and cutting forces of hollow needles are investigated. The fundamental goal of this study is to provide a series of guidelines for clinicians and surgeons to properly select the optimal tip geometries and speeds. Analytical models related to the cutting angles of several needle tip designs are presented and compared. Several needle tip geometries were manufactured from a 14-gauge cannula, commonly adopted during breast biopsies. The needles were then tested at different speeds and on different phantom tissues. According to these experimental measurements recommendations were formulated for rotating needle insertions. The findings of this study can be applied and extended to several biopsy procedures in which a cannula is used to extract tissue samples. Copyright © 2018 Elsevier Ltd. All rights reserved.

Robotic Needle Guide for Prostate Brachytherapy: Clinical Testing of Feasibility and Performance

PubMed Central

Song, Danny Y; Burdette, Everette C; Fiene, Jonathan; Armour, Elwood; Kronreif, Gernot; Deguet, Anton; Zhang, Zhe; Iordachita, Iulian; Fichtinger, Gabor; Kazanzides, Peter

2010-01-01

Purpose Optimization of prostate brachytherapy is constrained by tissue deflection of needles and fixed spacing of template holes. We developed and clinically tested a robotic guide towards the goal of allowing greater freedom of needle placement. Methods and Materials The robot consists of a small tubular needle guide attached to a robotically controlled arm. The apparatus is mounted and calibrated to operate in the same coordinate frame as a standard template. Translation in x and y directions over the perineum ±40mm are possible. Needle insertion is performed manually. Results Five patients were treated in an IRB-approved study. Confirmatory measurements of robotic movements for initial 3 patients using infrared tracking showed mean error of 0.489 mm (SD 0.328 mm). Fine adjustments in needle positioning were possible when tissue deflection was encountered; adjustments were performed in 54/179 (30.2%) needles placed, with 36/179 (20.1%) adjustments of > 2mm. Twenty-seven insertions were intentionally altered to positions between the standard template grid to improve the dosimetric plan or avoid structures such as pubic bone and blood vessels. Conclusions Robotic needle positioning provided a means of compensating for needle deflections as well as the ability to intentionally place needles into areas between the standard template holes. To our knowledge, these results represent the first clinical testing of such a system. Future work will be incorporation of direct control of the robot by the physician, adding software algorithms to help avoid robot collisions with the ultrasound, and testing the angulation capability in the clinical setting. PMID:20729152

Needle Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations

DTIC Science & Technology

2012-07-06

SUBJECT: Needle Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations 2012-05 2 demonstrating the...Decompression of Tension Pneumothorax Tactical Combat Casualty Care Guideline Recommendations 2012-05 3 needle may be too short to reliably reach the...at the AAL as the preferred site for needle decompression of a presumed tension pneumothorax . Further, studies evaluating chest wall thickness are

Antioxidant, antimutagenic, and antitumor effects of pine needles (Pinus densiflora).

PubMed

Kwak, Chung Shil; Moon, Sung Chae; Lee, Mee Sook

2006-01-01

Pine needles (Pinus densiflora Siebold et Zuccarini) have long been used as a traditional health-promoting medicinal food in Korea. To investigate their potential anticancer effects, antioxidant, antimutagenic, and antitumor activities were assessed in vitro and/or in vivo. Pine needle ethanol extract (PNE) significantly inhibited Fe(2+)-induced lipid peroxidation and scavenged 1,1-diphenyl- 2-picrylhydrazyl radical in vitro. PNE markedly inhibited mutagenicity of 2-anthramine, 2-nitrofluorene, or sodium azide in Salmonella typhimurium TA98 or TA100 in Ames tests. PNE exposure effectively inhibited the growth of cancer cells (MCF-7, SNU-638, and HL-60) compared with normal cell (HDF) in 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. In in vivo antitumor studies, freeze-dried pine needle powder supplemented (5%, wt/wt) diet was fed to mice inoculated with Sarcoma-180 cells or rats treated with mammary carcinogen, 7,12-dimethylbenz[a]anthracene (DMBA, 50 mg/kg body weight). Tumorigenesis was suppressed by pine needle supplementation in the two model systems. Moreover, blood urea nitrogen and aspartate aminotransferase levels were significantly lower in pine needle-supplemented rats in the DMBA-induced mammary tumor model. These results demonstrate that pine needles exhibit strong antioxidant, antimutagenic, and antiproliferative effects on cancer cells and also antitumor effects in vivo and point to their potential usefulness in cancer prevention.

A systematic approach to fabricate high aspect ratio silicon micro-needles for transdermal drug delivery

NASA Astrophysics Data System (ADS)

Ng, H. B.; Shearwood, C.

2007-12-01

The successful development of micro-needles can help transport drugs and vaccines both effectively and painlessly across the skin. However, not all micro-needles are strong enough to withstand the insertion forces and viscoelasticity of the skin. The work here focuses on the micro-fabrication of high aspect ratio needles with careful control of needle-profile using dry etching technologies. Silicon micro-needles, 150μm in length with base-diameters ranging from 90 to 240μm have been investigated in this study. A novel, multiple-sacrificial approach has been demonstrated as suited to the fabrication of long micro-needle bodies with positive profiles. The parameters that control the isotropic etching are adjusted to control the ratio of the needle-base diameter to needle length. By careful control of geometry, the needle profile can be engineered to give a suitable tip size for penetration, as well as a broad needle base to facilitate the creation of either single or multiple-through holes. This approach allows the mechanical properties of the otherwise brittle needles to be optimized. Finite element analysis indicates that the micro-needles will fracture prematurely due to buckling, with forces ranging from 10 to 30mN.

Fast 5DOF needle tracking in iOCT.

PubMed

Weiss, Jakob; Rieke, Nicola; Nasseri, Mohammad Ali; Maier, Mathias; Eslami, Abouzar; Navab, Nassir

2018-06-01

Intraoperative optical coherence tomography (iOCT) is an increasingly available imaging technique for ophthalmic microsurgery that provides high-resolution cross-sectional information of the surgical scene. We propose to build on its desirable qualities and present a method for tracking the orientation and location of a surgical needle. Thereby, we enable the direct analysis of instrument-tissue interaction directly in OCT space without complex multimodal calibration that would be required with traditional instrument tracking methods. The intersection of the needle with the iOCT scan is detected by a peculiar multistep ellipse fitting that takes advantage of the directionality of the modality. The geometric modeling allows us to use the ellipse parameters and provide them into a latency-aware estimator to infer the 5DOF pose during needle movement. Experiments on phantom data and ex vivo porcine eyes indicate that the algorithm retains angular precision especially during lateral needle movement and provides a more robust and consistent estimation than baseline methods. Using solely cross-sectional iOCT information, we are able to successfully and robustly estimate a 5DOF pose of the instrument in less than 5.4 ms on a CPU.

Jammed systems of oriented needles always percolate on square lattices

NASA Astrophysics Data System (ADS)

Kondrat, Grzegorz; Koza, Zbigniew; Brzeski, Piotr

2017-08-01

Random sequential adsorption (RSA) is a standard method of modeling adsorption of large molecules at the liquid-solid interface. Several studies have recently conjectured that in the RSA of rectangular needles, or k -mers, on a square lattice, percolation is impossible if the needles are sufficiently long (k of order of several thousand). We refute these claims and present rigorous proof that in any jammed configuration of nonoverlapping, fixed-length, horizontal, or vertical needles on a square lattice, all clusters are percolating clusters.

Percutaneous Biopsy of Osteoid Osteomas Prior to Percutaneous Treatment Using Two Different Biopsy Needles

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laredo, Jean-Denis, E-mail: jean-denis.laredo@lrb.aphp.fr; Hamze, Bassam; Jeribi, Riadh

2009-09-15

Biopsy is usually performed as the first step in percutaneous treatment of osteoid osteomas prior to laser photocoagulation. At our institution, 117 patients with a presumed diagnosis of osteoid osteoma had a trephine biopsy before a percutaneous laser photocoagulation. Biopsies were made using two different types of needles. A Bonopty biopsy needle (14-gauge cannula, 16-gauge trephine needle; Radi Medical Systems, Uppsala, Sweden) was used in 65 patients, and a Laurane biopsy needle (11-gauge cannula, 12.5-gauge trephine needle; Laurane Medical, Saint-Arnoult, France) in 43 patients. Overall biopsy results were positive for osteoid osteoma in 83 (70.9%) of the 117 cases. Themore » Laurane needle provided a significantly higher positive rate (81.4%) than the Bonopty needle (66.1%; p < 0.05). This difference was not due to the size of the nidus, which was similar in the two groups (p < 0.05) and may be an effect of differences in needle caliber (12.5 vs. 14 gauge) as well as differences in needle design. The rate of positive biopsy results obtained in the present series with the Laurane biopsy needle is, to our knowledge, the highest rate reported in series dealing with percutaneous radiofrequency ablation and laser photocoagulation of osteoid osteomas.« less

Seasonal changes in needle water content and needle ABA concentration of Japanese red pine, Pinus densiflora, in declining forests on Mt. Gokurakuji, Hiroshima prefecture, Japan.

PubMed

Kume, Atsushi; Hanba, Yuko T; Nakane, Kaneyuki; Sakurai, Naoki; Sakugawa, Hiroshi

2006-05-01

To evaluate the effects of air pollution on the decline of Pinus densiflora forests, various research has been conducted around Mt. Gokurakuji (34 degrees 23'N, 132 degrees 19'E, 693 m a.s.l.) north of the Seto Inland Sea, west Japan. To investigate the mechanisms responsible for decreases in photosynthesis (Pn) and stomatal conductance (gl), delta13C of needles and seasonal changes in the water content (WC) and abscisic acid concentration (ABA) of needles were measured in various stands. The delta13C values were less negative in declining stands and younger needles. ABA and WC were not correlated with each other. WC decreased consistently with needle age while the ABA showed a minimum in August and a smaller content in older needles. Monthly precipitation and the daily maximum vapor pressure were not correlated with ABA and WC. In declining stands, WC and ABA tended to be higher and lower, respectively, than in nondeclining stands. These results suggest that the trees in declining stands received less water stress than those in nondeclining stands and the differences in gl and delta13C are not caused by the difference in water stress. The possibilities of the effects of air pollution and the infection of pine-wood nematode on the physiological decline on the pine needles are discussed.

Convolution neural networks for real-time needle detection and localization in 2D ultrasound.

PubMed

Mwikirize, Cosmas; Nosher, John L; Hacihaliloglu, Ilker

2018-05-01

We propose a framework for automatic and accurate detection of steeply inserted needles in 2D ultrasound data using convolution neural networks. We demonstrate its application in needle trajectory estimation and tip localization. Our approach consists of a unified network, comprising a fully convolutional network (FCN) and a fast region-based convolutional neural network (R-CNN). The FCN proposes candidate regions, which are then fed to a fast R-CNN for finer needle detection. We leverage a transfer learning paradigm, where the network weights are initialized by training with non-medical images, and fine-tuned with ex vivo ultrasound scans collected during insertion of a 17G epidural needle into freshly excised porcine and bovine tissue at depth settings up to 9 cm and [Formula: see text]-[Formula: see text] insertion angles. Needle detection results are used to accurately estimate needle trajectory from intensity invariant needle features and perform needle tip localization from an intensity search along the needle trajectory. Our needle detection model was trained and validated on 2500 ex vivo ultrasound scans. The detection system has a frame rate of 25 fps on a GPU and achieves 99.6% precision, 99.78% recall rate and an [Formula: see text] score of 0.99. Validation for needle localization was performed on 400 scans collected using a different imaging platform, over a bovine/porcine lumbosacral spine phantom. Shaft localization error of [Formula: see text], tip localization error of [Formula: see text] mm, and a total processing time of 0.58 s were achieved. The proposed method is fully automatic and provides robust needle localization results in challenging scanning conditions. The accurate and robust results coupled with real-time detection and sub-second total processing make the proposed method promising in applications for needle detection and localization during challenging minimally invasive ultrasound-guided procedures.

Prevalence and correlates of needle-stick injuries among active duty police officers in Tijuana, Mexico

PubMed Central

Mittal, María Luisa; Beletsky, Leo; Patiño, Efraín; Abramovitz, Daniela; Rocha, Teresita; Arredondo, Jaime; Bañuelos, Arnulfo; Rangel, Gudelia; Strathdee, Steffanie A

2016-01-01

Introduction Police officers are at an elevated risk for needle-stick injuries (NSI), which pose a serious and costly occupational health risk for HIV and viral hepatitis. However, research on NSIs among police officers is limited, especially in low- and middle-income countries. Despite the legality of syringe possession in Mexico, half of people who inject drugs (PWID) in Tijuana report extrajudicial syringe-related arrests and confiscation by police, which has been associated with needle-sharing and HIV infection. We assessed the prevalence and correlates of NSIs among Tijuana police officers to inform efforts to improve occupational safety and simultaneously reduce HIV risks among police and PWID. Methods Tijuana's Department of Municipal Public Safety (SSPM) is among Mexico's largest. Our binational, multi-sectoral team analyzed de-identified data from SSPM's 2014 anonymous self-administered occupational health survey. The prevalence of NSI and syringe disposal practices was determined. Logistic regression with robust variance estimation via generalized estimating equations identified factors associated with ever having an occupational NSI. Results Approximately one-quarter of the Tijuana police force was given the occupational health survey (N=503). Respondents were predominantly male (86.5%) and ≤35 years old (42.6%). Nearly one in six officers reported ever having a NSI while working at SSPM (15.3%), of whom 14.3% reported a NSI within the past year. Most participants reported encountering needles/syringes while on duty (n=473, 94%); factors independently associated with elevated odds of NSIs included frequently finding syringes that contain drugs (adjusted odds ratio (AOR): 2.98; 95% confidence interval (CI): 1.56–5.67) and breaking used needles (AOR: 2.25; 95% CI: 1.29–3.91), while protective factors included being willing to contact emergency services in case of NSIs (AOR: 0.39; 95% CI: 0.22–0.69), and wearing needle-stick resistant gloves (AOR: 0

Prevalence and correlates of needle-stick injuries among active duty police officers in Tijuana, Mexico.

PubMed

Mittal, María Luisa; Beletsky, Leo; Patiño, Efraín; Abramovitz, Daniela; Rocha, Teresita; Arredondo, Jaime; Bañuelos, Arnulfo; Rangel, Gudelia; Strathdee, Steffanie A

2016-01-01

Police officers are at an elevated risk for needle-stick injuries (NSI), which pose a serious and costly occupational health risk for HIV and viral hepatitis. However, research on NSIs among police officers is limited, especially in low- and middle-income countries. Despite the legality of syringe possession in Mexico, half of people who inject drugs (PWID) in Tijuana report extrajudicial syringe-related arrests and confiscation by police, which has been associated with needle-sharing and HIV infection. We assessed the prevalence and correlates of NSIs among Tijuana police officers to inform efforts to improve occupational safety and simultaneously reduce HIV risks among police and PWID. Tijuana's Department of Municipal Public Safety (SSPM) is among Mexico's largest. Our binational, multi-sectoral team analyzed de-identified data from SSPM's 2014 anonymous self-administered occupational health survey. The prevalence of NSI and syringe disposal practices was determined. Logistic regression with robust variance estimation via generalized estimating equations identified factors associated with ever having an occupational NSI. Approximately one-quarter of the Tijuana police force was given the occupational health survey (N=503). Respondents were predominantly male (86.5%) and ≤35 years old (42.6%). Nearly one in six officers reported ever having a NSI while working at SSPM (15.3%), of whom 14.3% reported a NSI within the past year. Most participants reported encountering needles/syringes while on duty (n=473, 94%); factors independently associated with elevated odds of NSIs included frequently finding syringes that contain drugs (adjusted odds ratio (AOR): 2.98; 95% confidence interval (CI): 1.56-5.67) and breaking used needles (AOR: 2.25; 95% CI: 1.29-3.91), while protective factors included being willing to contact emergency services in case of NSIs (AOR: 0.39; 95% CI: 0.22-0.69), and wearing needle-stick resistant gloves (AOR: 0.43; 95% CI: 0.19-0.91). Tijuana

Comparison of sprotte and Quincke needles with respect to spinal fluid leakage using artificial spinal cord.

PubMed

Amaki, Yoshikiyo; Moriyama, Michihiko; Kuzuta, Toshimichi; Yabe, Keiko; Kaneko, Misato

1997-12-01

This research investigated whether the Sprotte needle causes less leakage of CSF than the Quincke needle in the artificial spinal cord. The changes in intradural pressure, extradural pressure, and leaked volume of CSF were evaluated following puncture with Sprotte and Quincke needles in the artificial spinal cord. The decrease in intradural pressure was 9.7±1.8 mm H 2 O with the Sprotte needle and 20.5±2.7 mm H 2 O with the Quincke needle (P<0.05). The volume of leakage of artificial CSF was 2.0±0.3 ml with the Sprotte needle and 3.3 ±0.3 ml with the Quincke needle (P<0.01). The extradural pressure increase was 166.1±8.2 mm H 2 O with the Sprotte needle and 186.8±13.2 mm H 2 O with the Quincke needle (P<0.05). The Sprotte needle produces less CSF leakage than the Quincke needle.

Effects of insertion speed and trocar stiffness on the accuracy of needle position for brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.

2012-04-15

Purpose: In prostate brachytherapy, accurate positioning of the needle tip to place radioactive seeds at its target site is critical for successful radiation treatment. During the procedure, needle deflection leads to seed misplacement and suboptimal radiation dose to cancerous cells. In practice, radiation oncologists commonly use high-speed hand needle insertion to minimize displacement of the prostate as well as the needle deflection. Effects of speed during needle insertion and stiffness of trocar (a solid rod inside the hollow cannula) on needle deflection are studied. Methods: Needle insertion experiments into phantom were performed using a 2{sup 2} factorial design (2 parametersmore » at 2 levels), with each condition having replicates. Analysis of the deflection data included calculating the average, standard deviation, and analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: The stiffer tungsten carbide trocar is effective in reducing the average and standard deviation of needle deflection. The fast insertion speed together with the stiffer trocar generated the smallest average and standard deviation for needle deflection for almost all cases. Conclusions: The combination of stiff tungsten carbide trocar and fast needle insertion speed are important to decreasing needle deflection. The knowledge gained from this study can be used to improve the accuracy of needle insertion during brachytherapy procedures.« less

Assessing the Effects of Acupuncture by Comparing Needling the Hegu Acupoint and Needling Nearby Nonacupoints by Spectral Analysis of Microcirculatory Laser Doppler Signals

PubMed Central

Hsiu, Hsin; Hsu, Wei-Chen; Hsu, Chia-Liang; Huang, Shih-Min

2011-01-01

We aimed to assess the effects of acupuncture by analyzing the frequency content of skin blood-flow signals simultaneously recorded at the Hegu acupoint and two nearby nonacupoints following acupuncture stimulation (AS). Laser Doppler flowmetry (LDF) signals were measured in male healthy volunteers in two groups of experiments: needling the Hegu acupoint (n = 13) and needling a nearby nonacupoint (control experiment; n = 10). Each experiment involved recording a 20 min baseline-data sequence and two sets of effects data recorded 0–20 and 50–70 min after stopping AS. Wavelet transform with Morlet mother wavelet was applied to the measured LDF signals. Needling the Hegu acupoint significantly increased the blood flow, significantly decreased the relative energy contribution at 0.02–0.06 Hz and significantly increased the relative energy contribution at 0.4–1.6 Hz at Hegu, but induced no significant changes at the nonacupoints. Also, needling a nearby nonacupoint had no effect in any band at any site. This is the first time that spectral analysis has been used to investigate the microcirculatory blood-flow responses induced by AS, and has revealed possible differences in sympathetic nerve activities between needling the Hegu acupoint and its nearby nonacupoint. One possible weakness of the present design is that different De-Qi feelings following AS could lead to nonblind experimental setup, which may bias the comparison between needling Hegu and its nearby nonacupoint. Our results suggest that the described noninvasive method can be used to evaluate sympathetic control of peripheral vascular activity, which might be useful for studying the therapeutic effects of AS. PMID:21804856

Is the pencil point spinal needle a better choice in younger patients? A comparison of 24G Sprotte with 27G Quincke needles in an unselected group of general surgical patients below 46 years of age.

PubMed

Brattebø, G; Wisborg, T; Rodt, S A; Røste, I

1995-05-01

Reports have indicated that there are less postoperative complaints after the use of pencil pointed spinal needles. We compared a 24G Sprotte needle with a 27G Quincke needle in a randomised study of 200 healthy patients (49% females), aged 15-46 years. Four patients (2%) reported postdural puncture headache, three with the 24G Sprotte needle and one with the 27G Quincke needle. Thirteen patients (7%) suffered with nonspecific headache, with no significant difference between the two groups. Of the 57 (29%) who reported backpain, a significantly higher proportion had received spinal anaesthesia with the Sprotte needle (OR = 2.06). There was a significantly higher incidence of insufficient blocks after dural puncture with the Sprotte needle. Ease of needle insertion and number of puncture attempts was the same for both needle types.

Morphology of jack pine and tamarack needles in dense stands.

Treesearch

Terry F. Strong; J. Zavitkovski

1978-01-01

Effects of position in the crown on needle morphology and surface area were studied. Needle length, surface area, and dry weight increased and specific needs area decreased from the lower to the upper third of the crown.

Is Skin-Touch Sham Needle Not Placebo? A Double-Blind Crossover Study on Pain Alleviation

PubMed Central

Homma, Ikuo; Izumizaki, Masahiko

2015-01-01

It remains an open question whether placebo/sham acupuncture, in which the needle tip presses the skin, can be used as a placebo device for research on pain. We compare the analgesic effect of the skin-touch placebo needle with that of the no-touch placebo needle, in which the needle tip does not touch the skin, in a double-blind crossover manner including no-treatment control in 23 healthy volunteers. The subjects received painful electrical stimulation in the forearm before and during needle retention to the LI 4 acupoint and after the removal of the needle and rated pain intensity using a visual analogue scale. We found no significant difference in analgesic effects among the skin-touch placebo needle, no-touch placebo needle, and no-treatment control at every point before, during, and after the treatments (p > 0.05). The results indicate that the skin-touch placebo needle can be used as a placebo device in clinical studies on pain. PMID:26064153

Effect of beam steering on the visibility of echogenic and non-echogenic needles: a laboratory study.

PubMed

Uppal, Vishal; Sondekoppam, Rakesh V; Ganapathy, Sugantha

2014-10-01

During peripheral nerve block procedures, needle visibility decreases as the angle of needle insertion relative to skin increases due to loss of reflective signals. The primary aim of our study was to compare the effect of beam steering on the visibility of echogenic and non-echogenic block needles. PAJUNK non-echogenic and echogenic needles were inserted into pork meat at 20°, 40°, 60°, and 70° angles, and electronic beam steering was applied at three different angles (shallow, medium, and steep) to obtain the best possible needle images. Eleven anesthesiologists blinded to the type of needle or use of beam steering scored the images obtained (0 = needle not visible; 10 = excellent needle shaft and tip visibility). Mean scores were used to classify the needles as poor visibility (mean score 0-3.3), intermediate visibility (mean score 3.4-6.6), or good visibility (mean score 6.7-10). At 20°, the visibility scores were intermediate to good in all groups. At 40°, the mean (SD) visibility score for the non-echogenic needle improved significantly from 3.1 (1.4) to 7.9 (1.8) with application of beam steering (difference = 4.8; 95% confidence interval [CI]: 3.1 to 6.6; P < 0.001). At 60°, the mean (SD) visibility score for the non-echogenic needle was poor 0.6 (0.7) and remained poor 2.4 (1.1) with beam steering. One the other hand, the echogenic needle without beam steering 6.5 (1.8) scored significantly better than the non-echogenic needle with beam steering 2.4 (1.1) (difference = 4.2; 95% CI: 2.7 to 5.6; P < 0.001). At 70°, the mean needle visibility score was poor for the non-echogenic needle with or without beam steering. In contrast, the echogenic needle attained an intermediate visibility score with or without beam steering. Beam steering did not significantly change the visibility scores of either the echogenic or the non-echogenic needle (P = 0.088 and 0.056, respectively) at a 70° angle. The PAJUNK echogenic needle, with or without beam steering, was

Comparison of Sample Adequacy and Diagnostic Yield of 19- and 22-G EBUS-TBNA Needles.

PubMed

Chaddha, Udit; Ronaghi, Reza; Elatre, Waafa; Chang, Ching-Fei; Mahdavi, Ramyar

2018-05-16

The 2016 CHEST consensus guidelines recommend use of either 21- or 22-G needles for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). We decided to prospectively compare sample adequacy and diagnostic yield of the 19-G with the 22-G EBUS needle, hypothesizing that a larger gauge difference might magnify the differences between 2 needle sizes. Twenty-seven patients undergoing EBUS-TBNA at our institution were evaluated. All cases were performed by a single operator formally trained in interventional pulmonology. Both Olympus 19- and 22-G needles were used at each lymph node station in an alternating manner. Rapid on-site cytology evaluation was used and a separate cell block was prepared for each needle at each station. Fifty-six lymph nodes were analyzed. Diagnoses included cancer (36%, including 1 lymphoma), reactive lymphoid tissue (53%), and sarcoidosis (11%). One hundred sixty-two and 163 passes were made with the 22- and 19-G needle, respectively. Sample adequacy was 73% and 46% with the 22 and 19-G needle, respectively (P<0.001). Significantly fewer passes were bloody with the 22-G compared with the 19-G needle (19% vs. 59%; P<0.001). Diagnostic yield was not different between the 22- and 19-G needles (95% vs. 93%; P=0.62). In addition to no difference in diagnostic yield, the 19-G needle yielded samples that were frequently less adequate and more often bloody compared with the 22-G needle. Despite the larger caliber lumen, we conclude that the 19-G needle does not confer a diagnostic advantage.

An ultrasound needle insertion guide in a porcine phantom model.

PubMed

Whittaker, S; Lethbridge, G; Kim, C; Keon Cohen, Z; Ng, I

2013-08-01

We compared nerve blockade with and without the Infiniti(TM) needle guide in an ultrasound in-plane porcine simulation. We recruited 30 anaesthetists with varying blockade experience. Using the guide, the needle tip was more visible (for a median (IQR [range]) of 67 (56-100]) % of the time; and invisible for 2 (1-4 [0-19]) s) than when the guide was not used (respectively 23 (13-43 [0-80]) % and 25 (9-52 [1-198]) s; both p < 0.001). The corresponding block times were 8 (6-10 [3-28]) s and 32 (15-67 [5-225]) s, respectively; p < 0.001. The needle guide reduced the block time and the time that the needle was invisible, irrespective of anaesthetist experience. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

[Treatment of Persistent Somatoform Pain Disorder by Floating Needle Therapy and Duloxetine].

PubMed

Ren, Wan-wen; Zhou, Zhi-ying; Xu, Mi-mi; Long, Sen; Tang, Guang-zheng; Mao, Hong-jing; Chen, Shu-lin

2016-02-01

To evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD). Totally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study. (1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of

Needle-Free Inhalable Vaccine and Antibiotic Powder Aerosols

DTIC Science & Technology

2004-11-15

NEEDLE-FREE INHALABLE VACCINE AND ANTIBIOTIC POWDER AEROSOLS R. E. Sievers, J.L. Burger,, S. P. Cape, E.T.S. Huang, J.A. Best, J.A. Madsen and...currently valid OMB control number. 1. REPORT DATE 15 NOV 2004 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Needle-Free Inhalable ...soluble drugs: naproxen, budesonide, betamethsone, amphotericin B, cyclosporin, DPPC Sugars: lactose, sucrose, trehalose , mannitol Polymers: PLA, PLGA

Needle position estimation from sub-sampled k-space data for MRI-guided interventions

NASA Astrophysics Data System (ADS)

Schmitt, Sebastian; Choli, Morwan; Overhoff, Heinrich M.

2015-03-01

MRI-guided interventions have gained much interest. They profit from intervention synchronous data acquisition and image visualization. Due to long data acquisition durations, ergonomic limitations may occur. For a trueFISP MRI-data acquisition sequence, a time sparing sub-sampling strategy has been developed that is adapted to amagnetic needle detection. A symmetrical and contrast rich susceptibility needle artifact, i.e. an approximately rectangular gray scale profile is assumed. The 1-D-Fourier transformed of a rectangular function is a sinc-function. Its periodicity is exploited by sampling only along a few orthogonal trajectories in k-space. Because a needle moves during intervention, its tip region resembles a rectangle in a time-difference image that is reconstructed from such sub-sampled k-spaces acquired at different time stamps. In different phantom experiments, a needle was pushed forward along a reference trajectory, which was determined from a needle holders geometric parameters. In addition, the trajectory of the needle tip was estimated by the method described above. Only ca. 4 to 5% of the entire k-space data was used for needle tip estimation. The misalignment of needle orientation and needle tip position, i.e. the differences between reference and estimated values, is small and even in its worst case less than 2 mm. The results show that the method is applicable under nearly real conditions. Next steps are addressed to the validation of the method for clinical data.

Measurement of bio-impedance with a smart needle to confirm percutaneous kidney access.

PubMed

Hernandez, D J; Sinkov, V A; Roberts, W W; Allaf, M E; Patriciu, A; Jarrett, T W; Kavoussi, L R; Stoianovici, D

2001-10-01

The traditional method of percutaneous renal access requires freehand needle placement guided by C-arm fluoroscopy, ultrasonography, or computerized tomography. This approach provides limited objective means for verifying successful access. We developed an impedance based percutaneous Smart Needle system and successfully used it to confirm collecting system access in ex vivo porcine kidneys. The Smart Needle consists of a modified 18 gauge percutaneous access needle with the inner stylet electrically insulated from the outer sheath. Impedance is measured between the exposed stylet tip and sheath using Model 4275 LCR meter (Hewlett-Packard, Sunnyvale, California). An ex vivo porcine kidney was distended by continuous gravity infusion of 100 cm. water saline from a catheter passed through the parenchyma into the collecting system. The Smart Needle was gradually inserted into the kidney to measure depth precisely using a robotic needle placement system, while impedance was measured continuously. The Smart Needle was inserted 4 times in each of 4 kidneys. When the needle penetrated the distended collecting system in 11 of 16 attempts, a characteristic sharp drop in resistivity was noted from 1.9 to 1.1 ohm m. Entry into the collecting system was confirmed by removing the stylet and observing fluid flow from the sheath. This characteristic impedance change was observed only at successful entry into the collecting system. A characteristic sharp drop in impedance signifies successful entry into the collecting system. The Smart Needle system may prove useful for percutaneous kidney access.

Real-time three-dimensional optical coherence tomography image-guided core-needle biopsy system.

PubMed

Kuo, Wei-Cheng; Kim, Jongsik; Shemonski, Nathan D; Chaney, Eric J; Spillman, Darold R; Boppart, Stephen A

2012-06-01

Advances in optical imaging modalities, such as optical coherence tomography (OCT), enable us to observe tissue microstructure at high resolution and in real time. Currently, core-needle biopsies are guided by external imaging modalities such as ultrasound imaging and x-ray computed tomography (CT) for breast and lung masses, respectively. These image-guided procedures are frequently limited by spatial resolution when using ultrasound imaging, or by temporal resolution (rapid real-time feedback capabilities) when using x-ray CT. One feasible approach is to perform OCT within small gauge needles to optically image tissue microstructure. However, to date, no system or core-needle device has been developed that incorporates both three-dimensional OCT imaging and tissue biopsy within the same needle for true OCT-guided core-needle biopsy. We have developed and demonstrate an integrated core-needle biopsy system that utilizes catheter-based 3-D OCT for real-time image-guidance for target tissue localization, imaging of tissue immediately prior to physical biopsy, and subsequent OCT imaging of the biopsied specimen for immediate assessment at the point-of-care. OCT images of biopsied ex vivo tumor specimens acquired during core-needle placement are correlated with corresponding histology, and computational visualization of arbitrary planes within the 3-D OCT volumes enables feedback on specimen tissue type and biopsy quality. These results demonstrate the potential for using real-time 3-D OCT for needle biopsy guidance by imaging within the needle and tissue during biopsy procedures.

Fiber sensor assisted in-vivo needle guidance for minimally invasive procedures (Conference Presentation)

NASA Astrophysics Data System (ADS)

Baghdadchi, Saharnaz; Chao, Cherng; Esener, Sadik; Mattrey, Robert F.; Eghtedari, Mohammad A.

2017-02-01

Image-guided procedures are performed frequently by radiologists to insert a catheter within a target vessel or lumen or to perform biopsy of a lesion. For instance, an interventional radiologist uses fluoroscopy during percutaneous biliary drainage procedure (a procedure during which a catheter is inserted through the skin to drain the bile from liver) to identify the location of the needle tip within liver parenchyma, hepatic blood vessel or bile duct. However, the identification of the target organ under fluoroscopy exposes the patient to x-ray irradiation, which may be significant if the time of procedure is prolonged. We have designed a fiber core needle system that may help the radiologist identify the location of the needle tip in real time without exposing the patient to x-ray. Our needle system transmits a low power modulated light into the tissue through a fiber cable embedded in the needle and detects the backscattered light using another fiber inside the needle. We were able to successfully distinguish the location of our prototype needle tip inside a cow liver phantom to identify if the needle tip was within liver parenchyma, liver vessels, or in the bile duct based on the recorded backscattered light.

Efficacy of ultrasound-guided percutaneous needle treatment of calcific tendinitis.

PubMed

Vignesh, K Nithin; McDowall, Adam; Simunovic, Nicole; Bhandari, Mohit; Choudur, Hema N

2015-01-01

The purpose of this study was to conduct a systematic review of the efficacy of ultrasound-guided needle lavage in treating calcific tendinitis. Two independent assessors searched medical databases and screened studies for eligibility. Eleven articles were included. Heterogeneity among included studies precluded meta-analysis. Results of randomized controlled trials suggested no difference in pain relief between needle lavage and other interventions, but the studies were of low quality. Additional high-quality evidence is required to determine the relative efficacy of ultrasound-guided needle lavage in the management of calcific tendinitis of the rotator cuff.

Effect of ponderosa pine needle litter on grass seedling survival.

Treesearch

Burt R. McConnell; Justin G. Smith

1971-01-01

Hard fescue survival rates were followed for 6 years on four different pine needle treatment plots. Needle litter had a significant effect on initial survival of fescue seedlings, but subsequent losses undoubtedly resulted from the interaction of many factors.

Comparing the variation of needle and wood terpenoids in Scots pine provenances.

PubMed

Manninen, A M; Tarhanen, S; Vuorinen, M; Kainulaine, P

2002-01-01

We determined variation in both the concentration and composition of terpenoids in needles and wood within nine Scots pine (Pinus sylvestris) provenances. Seedlings of different provenances representing a 1200-km N-S transect from Estonia to northern Finland were cultivated in Suonenjoki nursery field, central Finland, for seven years. Growth of seedlings and the number of vertical resin ducts in wood were also determined. alpha-Pinene and 3-carene were the major monoterpenes both in the needles and wood. The total monoterpene concentration was about five times higher in the needles than in the wood. A strong positive correlation was found between proportional quantities of several terpenes of the needles and wood, particularly for 3-carene, sabinene, and terpinolene. The needles contained both labdane-type and tricyclic resin acids, whereas the wood contained only tricyclic ones. The wood had a four times higher tricyclic resin acid concentration than the needles. The highest total monoterpene concentration in the needles and in the wood occurred in the most northern Muonio provenance and in the most southern Saaremaa provenance plants, respectively. The amount of high 3-carene genotype trees decreased among the northern provenances. The wood of the most northern Muonio provenance showed the lowest total resin acid concentration, but provenance did not affect total tricyclic resin acids in the needles. Korpilahti provenance trees from central Finland had the best growth in height. In addition, Korpilahti and Ruokolahti provenance trees showed largest radial growth of stem and smallest number of vertical resin ducts. The results suggest that especially the proportional quantity of 3-carene in the needles could be used in estimating the amount of this compound in the wood and vice versa.

Micro-Biocidal Activity of Yeast Cells by Needle Plasma Irradiation at Atmospheric Pressure

NASA Astrophysics Data System (ADS)

Kurumi, Satoshi; Takahashi, Hideyuki; Taima, Tomohito; Suzuki, Kaoru; Hirose, Hideharu; Masutani, Shigeyuki

In this study, we report on the biocidal activity technique by needle helium plasma irradiation at atmospheric pressure using borosilicate capillary nozzle to apply for the oral surgery. The diameter of needle plasma was less than 50 µm, and temperature of plasma irradiated area was less than body temperature. Needle plasma showed emission due to OH and O radical. Raman spectra and methylene blue stain showed yeast cells were inactivated by needle plasma irradiation.

Transversely polarized sub-diffraction optical needle with ultra-long depth of focus

NASA Astrophysics Data System (ADS)

Guan, Jian; Lin, Jie; Chen, Chen; Ma, Yuan; Tan, Jiubin; Jin, Peng

2017-12-01

We generated purely transversely polarized sub-diffraction optical needles with ultra-long depth of focus (DOF) by focusing azimuthally polarized (AP) beams that were modulated by a vortex 0-2 π phase plate and binary phase diffraction optical elements (DOEs). The concentric belts' radii of the DOEs were optimized by a hybrid genetic particle swarm optimization (HGPSO) algorithm. For the focusing system with the numerical aperture (NA) of 0.95, an optical needle with the full width at half maximum (FWHM) of 0.40 λ and the DOF of 6.23 λ was generated. Similar optical needles were also generated by binary phase DOEs with different belts. The results demonstrated that the binary phase DOEs could achieve smaller FWHMs and longer DOFs simultaneously. The generated needles were circularly polarized on the z-axis and there were no longitudinally polarized components in the focal fields. The radius fabrication errors of a DOE have little effect on the optical needle produced by itself. The generated optical needles can be applied to the fields of photolithography, high-density optical data storage, microscope imaging and particle trapping.

Painless needle insertion in regional anesthesia of the eye.

PubMed

Vaalamo, M O; Paloheimo, M P; Nikki, P H

1995-04-01

We examined a new technique of applying topical anesthetic with cotton tip sticks to the conjunctiva before needle insertion in regional anesthesia of the eye. Oxybuprocaine 0.4% and lidocaine 4% were compared with balanced salt solution (BSS) as topical anesthetics of the conjunctiva in Study 1. Ninety patients were randomly assigned into three groups (n = 30) to receive one of the three topical anesthetics in a double-blind manner. Pain of the needle insertions was measured with visual analog scale score (VAS) and quantitative surface electromography (qEMG). Both oxybuprocaine and lidocaine reduced pain significantly when compared to BSS. In Study 2, with healthy volunteers, we compared our previous practice of merely applying three consecutive drops of oxybuprocaine on the conjunctiva before needle insertions to the new technique of placing additional cotton tip sticks soaked in oxybuprocaine on the conjunctiva. We found the needle insertion virtually pain free when the cotton tip sticks were added to the topical anesthesia. The use of this simple method of topical anesthesia before the eye block increases patient comfort significantly.

Piezoelectric control of needle-free transdermal drug delivery.

PubMed

Stachowiak, Jeanne C; von Muhlen, Marcio G; Li, Thomas H; Jalilian, Laleh; Parekh, Sapun H; Fletcher, Daniel A

2007-12-04

Transdermal drug delivery occurs primarily through hypodermic needle injections, which cause pain, require a trained administrator, and may contribute to the spread of disease. With the growing number of pharmaceutical therapies requiring transdermal delivery, an effective, safe, and simple needle-free alternative is needed. We present and characterize a needle-free jet injector that employs a piezoelectric actuator to accelerate a micron-scale stream of fluid (40-130 microm diameter) to velocities sufficient for skin penetration and drug delivery (50-160 m/s). Existing jet injectors, powered by compressed springs and gases, are not widely used due to painful injections and poor reliability in skin penetration depth and dose. In contrast, our device offers electronic control of the actuator expansion rate, resulting in direct control of jet velocity and thus the potential for more precise injections. We apply a simple fluid-dynamic model to predict the device response to actuator expansion. Further, we demonstrate that injection parameters including expelled volume, jet pressure, and penetration depth in soft materials vary with actuator expansion rate, but are highly coupled. Finally, we discuss how electronically-controlled jet injectors may enable the decoupling of injection parameters such as penetration depth and dose, improving the reliability of needle-free transdermal drug delivery.

Chondromalacia patellae treated by warming needle and rehabilitation training.

PubMed

Qiu, Ling; Zhang, Min; Zhang, Ji; Gao, Le-Nv; Chen, Da-wei; Liu, Jun; She, Jia-yi; Wang, Ling; Yu, Jin-yan; Huang, Le-ping; Bai, Yang

2009-06-01

To observe the effect of warming needle combined with rehabilitation training on chondromalacia patellae in a randomized controlled trial. The 92 cases were randomly divided into a treatment group treated by warming needle plus rehabilitation training (47 cases) and a control group treated by medication plus rehabilitation training (45 cases), and the therapeutic effect was compared after 20 sessions. The pain was relieved more obviously in the treatment group than in the control group (P < 0.05), and the total effective rate was 91.8% and 71.1% respectively (P < 0.01). Warming needle plus rehabilitation training was superior in the therapeutic effect and duration of producing relief of pain to medication plus rehabilitation training in treating chondromalacia patellae.

Photosynthesis in Norway spruce seedlings infected by the needle rust Chrysomyxa rhododendri.

PubMed

Bauer, Helmut; Plattner, Karin; Volgger, Waltraud

2000-02-01

Chrysomyxa rhododendri (DC.) De Bary is a needle rust with a host shift between Rhododendron sp. and Norway spruce (Picea abies (L.) Karst.), penetrating only the new developing flushes of the conifer. Because little is known about its effects on trees, we investigated several parameters related to photosynthesis in artificially infected 3-year-old Norway spruce seedlings. The potential efficiency of photosystem II (PSII; derived from chlorophyll fluorescence measurements) was reduced in infected current-year needles as soon as disease symptoms were visible, about three weeks after inoculation. Two weeks later, photosynthetic O(2) evolution (P(max)) of infected needles was less than 20% of control needles, whereas respiratory O(2) uptake (R(D)) was about three times higher than that of control needles. Nonstructural carbohydrate concentrations were about 60% of control values in all parts of the shoots of infected trees. Photosynthetic inhibition was associated with marked decreases in chlorophyll concentration and chlorophyll a/b ratio but only a small reduction in carotenoid concentration. In infected trees, P(max) of noninfected 1-year-old and 2-year-old needles was 50 and 80% higher than in the corresponding age class of needles of control trees. Estimation of potential daily net dry mass production, based on P(max), R(D), specific leaf area, carbon content and needle biomass, indicated that seedlings infected once were able to produce 60%, and those infected twice only 25%, of the dry mass of controls. We conclude that afforestation and regeneration of Norway spruce is seriously impaired in regions where seedlings are frequently attacked by Chrysomyxa.

C-arm cone beam computed tomography needle path overlay for fluoroscopic guided vertebroplasty.

PubMed

Tam, Alda L; Mohamed, Ashraf; Pfister, Marcus; Chinndurai, Ponraj; Rohm, Esther; Hall, Andrew F; Wallace, Michael J

2010-05-01

Retrospective review. To report our early clinical experience using C-arm cone beam computed tomography (C-arm CBCT) with fluoroscopic overlay for needle guidance during vertebroplasty. C-arm CBCT is advanced three-dimensional (3-D) imaging technology that is currently available on state-of-the-art flat panel based angiography systems. The imaging information provided by C-arm CBCT allows for the acquisition and reconstruction of "CT-like" images in flat panel based angiography/interventional suites. As part of the evolution of this technology, enhancements allowing the overlay of cross-sectional imaging information can now be integrated with real time fluoroscopy. We report our early clinical experience with C-arm CBCT with fluoroscopic overlay for needle guidance during vertebroplasty. This is a retrospective review of 10 consecutive oncology patients who underwent vertebroplasty of 13 vertebral levels using C-arm CBCT with fluoroscopic overlay for needle guidance from November 2007 to December 2008. Procedural data including vertebral level, approach (transpedicular vs. extrapedicular), access (bilateral vs. unilateral) and complications were recorded. Technical success with the overlay technology was assessed based on accuracy which consisted of 4 measured parameters: distance from target to needle tip, distance from planned path to needle tip, distance from midline to needle tip, and distance from the anterior 1/3 of the vertebral body to needle tip. Success within each parameter required that the distance between the needle tip and parameter being evaluated be no more than 5 mm on multiplanar CBCT or fluoroscopy. Imaging data for 12 vertebral levels was available for review. All vertebral levels were treated using unilateral access and 9 levels were treated with an extrapedicular approach. Technical success rates were 92% for both distance from planned path and distance from midline to final needle tip, 100% when distance from needle tip to the anterior 1

Induction of Listeria monocytogenes infection by the consumption of ponderosa pine needles.

PubMed Central

Adams, C J; Neff, T E; Jackson, L L

1979-01-01

An infectious microorganism, identified as Listeria monocytogenes, has been isolated from the bloodstream of pregnant mice fed a diet containing Pinus ponderosa needles. When the isolate was injected into pregnant mice, reproductive dysfunction and other changes, including speckled livers, spleen atrophy, and hemorrhagic intestines, appeared to mimic the signs of the disease in pregnant mice fed pine needles. Moreover, these pathological changes are similar to those observed in cattle and other mammals experiencing abortions or toxemia, or both, attributed to the ingestion of P. ponderosa needles, suggesting that L. monocytogenes may be a part of the etiology of "pine needle abortion." PMID:113341

New Coaxial Transseptal Needle for Creation of Atrial Septal Defects in Adult Sheep

DOE Office of Scientific and Technical Information (OSTI.GOV)

Uchida, Barry T.; Pavcnik, Dusan, E-mail: pavcnikd@ohsu.edu; Shimohira, Masashi

Objectives: To introduce a new transseptal (TS) needle assembled in our laboratory-the coaxial TS (CTS) needle-and describe our experience with it in creating experimental atrial septal defects (ASD) in adult sheep.BackgroundWith commercially available TS needles, we were not able to consistently perform TS puncture at the fossa ovalis in adult sheep.Material and MethodsTen adult sheep with a mean weight of 63.5 kg were used. The CTS needle consists of four components: a 9F Teflon catheter, a 14-gauge blunt curved-tip metal cannula, a 4F tapered catheter, and a 20-gauge open needle. A transjugular 5F pigtail catheter was used to display themore » septal anatomy by angiocardiography and was left in place to mark the level of the fossa ovalis. The septum was then probed by a transfemoral 5F curved-tip end-hole catheter. The CTS needle was aligned with the tip of the transjugular catheter, and the TS puncture was performed under fluoroscopic guidance. After documenting a left atrial position, a balloon angioplasty catheter was used for creation of the ASD. Results: A small patent foramen ovale was discovered by septal probing in one sheep. All sheep underwent successful TS punctures without complications. The ASD size ranged from 13 to 15 mm. In eight sheep, the ASD was in fossa ovalis. In the first two sheep where the needle was not well aligned with the marking catheter, the ASD was in the septum secundum. No damage to the atrial or other heart structures was found at necropsy. Conclusion: The CTS needle is a suitable needle for TS puncture and ASD creation in adult sheep. Proper alignment of the CTS needle with a catheter marking the fossa ovalis is essential for successful puncture.« less

Development of 3D ultrasound needle guidance for high-dose-rate interstitial brachytherapy of gynaecological cancers

NASA Astrophysics Data System (ADS)

Rodgers, J.; Tessier, D.; D'Souza, D.; Leung, E.; Hajdok, G.; Fenster, A.

2016-04-01

High-dose-rate (HDR) interstitial brachytherapy is often included in standard-of-care for gynaecological cancers. Needles are currently inserted through a perineal template without any standard real-time imaging modality to assist needle guidance, causing physicians to rely on pre-operative imaging, clinical examination, and experience. While two-dimensional (2D) ultrasound (US) is sometimes used for real-time guidance, visualization of needle placement and depth is difficult and subject to variability and inaccuracy in 2D images. The close proximity to critical organs, in particular the rectum and bladder, can lead to serious complications. We have developed a three-dimensional (3D) transrectal US system and are investigating its use for intra-operative visualization of needle positions used in HDR gynaecological brachytherapy. As a proof-of-concept, four patients were imaged with post-insertion 3D US and x-ray CT. Using software developed in our laboratory, manual rigid registration of the two modalities was performed based on the perineal template's vaginal cylinder. The needle tip and a second point along the needle path were identified for each needle visible in US. The difference between modalities in the needle trajectory and needle tip position was calculated for each identified needle. For the 60 needles placed, the mean trajectory difference was 3.23 +/- 1.65° across the 53 visible needle paths and the mean difference in needle tip position was 3.89 +/- 1.92 mm across the 48 visible needles tips. Based on the preliminary results, 3D transrectal US shows potential for the development of a 3D US-based needle guidance system for interstitial gynaecological brachytherapy.

Learning Ultrasound-Guided Needle Insertion Skills through an Edutainment Game

NASA Astrophysics Data System (ADS)

Chan, Wing-Yin; Ni, Dong; Pang, Wai-Man; Qin, Jing; Chui, Yim-Pan; Yu, Simon Chun-Ho; Heng, Pheng-Ann

Ultrasound-guided needle insertion is essential in many of minimally invasive surgeries or procedures, such as biopsy, drug delivery, spinal anaesthesia, etc. Accurate and safe needle insertion is a difficult task due to the high requirement of hand-eye coordination skills. Many proposed virtual reality (VR) based training systems put their emphasis on realistic simulation instead of pedagogical efficiency. The lack of schematic training scenario leads to boredom of repetitive operations. To solve this, we present our novel training system with the integration of game elements in order to retain the trainees' enthusiasm. Task-oriented scenarios, time attack scenarios and performance evaluation are introduced. Besides, some state-of-art technologies are also presented, including ultrasound simulation, needle haptic rendering as well as a mass-spring-based needle-tissue interaction simulation. These works are shown to be effective to keep the trainees up with learning.

String flash-boiling in gasoline direct injection simulations with transient needle motion

DOE PAGES

Baldwin, Eli T.; Grover, Jr., Ronald O.; Parrish, Scott E.; ...

2016-09-06

A computational study was performed to investigate the influence of transient needle motion on gasoline direct injection (GDI) internal nozzle flow and near-field sprays. Simulations were conducted with a compressible Eulerian flow solver modeling liquid, vapor, and non-condensable gas phases with a diffuse interface. Variable rate generation and condensation of fuel vapor were captured using the homogeneous relaxation model (HRM). The non-flashing (spray G) and flashing (spray G2) conditions specified by the Engine Combustion Network were modeled using the nominal spray G nozzle geometry and transient needle lift and wobble were based upon ensemble averaged x-ray imaging preformed at Argonnemore » National Lab. The minimum needle lift simulated was 5 μm and dynamic mesh motion was achieved with Laplacian smoothing. The results were qualitatively validated against experimental imaging and the experimental rate of injection profile was captured accurately using pressure boundary conditions and needle motion to actu- ate the injection. Needle wobble was found to have no measurable effect on the flow. Low needle lift is shown to result in vapor generation as fuel rushes past the needle. In conclusion, the internal injector flow is shown to contain many transient and interacting vortices which cause perturbations in the spray angle, fluctuations in the mass flux, and frequently result in string flash-boiling.« less

String flash-boiling in gasoline direct injection simulations with transient needle motion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baldwin, Eli T.; Grover, Jr., Ronald O.; Parrish, Scott E.

A computational study was performed to investigate the influence of transient needle motion on gasoline direct injection (GDI) internal nozzle flow and near-field sprays. Simulations were conducted with a compressible Eulerian flow solver modeling liquid, vapor, and non-condensable gas phases with a diffuse interface. Variable rate generation and condensation of fuel vapor were captured using the homogeneous relaxation model (HRM). The non-flashing (spray G) and flashing (spray G2) conditions specified by the Engine Combustion Network were modeled using the nominal spray G nozzle geometry and transient needle lift and wobble were based upon ensemble averaged x-ray imaging preformed at Argonnemore » National Lab. The minimum needle lift simulated was 5 μm and dynamic mesh motion was achieved with Laplacian smoothing. The results were qualitatively validated against experimental imaging and the experimental rate of injection profile was captured accurately using pressure boundary conditions and needle motion to actu- ate the injection. Needle wobble was found to have no measurable effect on the flow. Low needle lift is shown to result in vapor generation as fuel rushes past the needle. In conclusion, the internal injector flow is shown to contain many transient and interacting vortices which cause perturbations in the spray angle, fluctuations in the mass flux, and frequently result in string flash-boiling.« less

A novel actuator for simulation of epidural anesthesia and other needle insertion procedures.

PubMed

Magill, John C; Byl, Marten F; Hinds, Michael F; Agassounon, William; Pratt, Stephen D; Hess, Philip E

2010-06-01

When navigating a needle from skin to epidural space, a skilled clinician maintains a mental model of the anatomy and uses the various forms of haptic and visual feedback to track the location of the needle tip. Simulating the procedure requires an actuator that can produce the feel of tissue layers even as the needle direction changes from the ideal path. A new actuator and algorithm architecture simulate forces associated with passing a needle through varying tissue layers. The actuator uses a set of cables to suspend a needle holder. The cables are wound onto spools controlled by brushless motors. An electromagnetic tracker is used to monitor the position of the needle tip. Novice and expert clinicians simulated epidural insertion with the simulator. Preliminary depth-time curves show that the user responds to changes in tissue properties as the needle is advanced. Some discrepancy in clinician response indicates that the feel of the simulator is sensitive to technique, thus perfect tissue property simulation has not been achieved. The new simulator is able to approximately reproduce properties of complex multilayer tissue structures, including fine-scale texture. Methods for improving fidelity of the simulation are identified.

Characterization of tissue-simulating phantom materials for ultrasound-guided needle procedures

NASA Astrophysics Data System (ADS)

Buchanan, Susan; Moore, John; Lammers, Deanna; Baxter, John; Peters, Terry

2012-02-01

Needle biopsies are standard protocols that are commonly performed under ultrasound (US) guidance or computed tomography (CT)1. Vascular access such as central line insertions, and many spinal needle therapies also rely on US guidance. Phantoms for these procedures are crucial as both training tools for clinicians and research tools for developing new guidance systems. Realistic imaging properties and material longevity are critical qualities for needle guidance phantoms. However, current commercially available phantoms for use with US guidance have many limitations, the most detrimental of which include harsh needle tracks obfuscating US images and a membrane comparable to human skin that does not allow seepage of inner media. To overcome these difficulties, we tested a variety of readily available media and membranes to evaluate optimal materials to fit our current needs. It was concluded that liquid hand soap was the best medium, as it instantly left no needle tracks, had an acceptable depth of US penetration and portrayed realistic imaging conditions, while because of its low leakage, low cost, acceptable durability and transparency, the optimal membrane was 10 gauge vinyl.

Thinning effect on photosynthesis depends on needle ages in a Chinese fir (Cunninghamia lanceolata) plantation.

PubMed

Li, Ren-Shan; Yang, Qing-Peng; Zhang, Wei-Dong; Zheng, Wen-Hui; Chi, Yong-Gang; Xu, Ming; Fang, Yun-Ting; Gessler, Arthur; Li, Mai-He; Wang, Si-Long

2017-02-15

Canopies in evergreen coniferous plantations often consist of various-aged needles. However, the effect of needle age on the photosynthetic responses to thinning remains ambiguous. Photosynthetic responses of different-aged needles to thinning were investigated in a Chinese fir (Cunninghamia lanceolata) plantation. A dual isotope approach [simultaneous measurements of stable carbon (δ 13 C) and oxygen (δ 18 O) isotopes] was employed to distinguish between biochemical and stomatal limitations to photosynthesis. Our results showed that increases in net photosynthesis rates upon thinning only occurred in the current-year and one-year-old needles, and not in the two- to four-year-old needles. The increased δ 13 C and declined δ 18 O in current year needles of trees from thinned stands indicated that both the photosynthetic capacity and stomatal conductance resulted in increasing photosynthesis. In one-year-old needles of trees from thinned stands, an increased needle δ 13 C and a constant needle δ 18 O were observed, indicating the photosynthetic capacity rather than stomatal conductance contributed to the increasing photosynthesis. The higher water-soluble nitrogen content in current-year and one-year-old needles in thinned trees also supported that the photosynthetic capacity plays an important role in the enhancement of photosynthesis. In contrast, the δ 13 C, δ 18 O and water-soluble nitrogen in the two- to four-year-old needles were not significantly different between the control and thinned trees. Thus, the thinning effect on photosynthesis depends on needle age in a Chinese fir plantation. Our results highlight that the different responses of different-aged needles to thinning have to be taken into account for understanding and modelling ecosystem responses to management, especially under the expected environmental changes in future. Copyright © 2016 Elsevier B.V. All rights reserved.

Efficient needle plasma actuators for flow control and surface cooling

NASA Astrophysics Data System (ADS)

Zhao, Pengfei; Portugal, Sherlie; Roy, Subrata

2015-07-01

We introduce a milliwatt class needle actuator suitable for plasma channels, vortex generation, and surface cooling. Electrode configurations tested for a channel configuration show 1400% and 300% increase in energy conversion efficiency as compared to conventional surface and channel corona actuators, respectively, generating up to 3.4 m/s air jet across the channel outlet. The positive polarity of the needle is shown to have a beneficial effect on actuator efficiency. Needle-plate configuration is demonstrated for improving cooling of a flat surface with a 57% increase in convective heat transfer coefficient. Vortex generation by selective input signal manipulation is also demonstrated.

[Acupuncture therapy for regaining consciousness in terms of acupoint location, needle insertion and needle manipulation].

PubMed

Meng, Xianggang; Gu, Wenlong; Ma, Fen; Du, Yuzheng; Zhao, Qi

2015-03-01

Acupuncture therapy for regaining consciousness activates soreness, numbness, distention, heaviness, radiating and moving, electric shock and ant climbing sensations at the specific acupoints in the stroke patients. Radiating and moving sensations are the summary of needling sensations such as soreness, numbness and twitching presenting during lifting and thrusting manipulation. These sensations are the essential factors of the therapeutic effect of regaining consciousness. Radiating sensation refers to the conduction along meridians and radiation of soreness and numbness. Moving sensation refers to the local muscular twitching at acupoints and the involuntary movement of limbs, joints and the distal. Acupuncture at the specific acupoints achieves radiating and moving sensations for promoting the circulation in meridians, regulating qi and mind and balancing yin and yang in stroke patients. This therapy was introduced in the paper in view of acupoint location, needle insertion and manipulation.

Characterization of optically actuated MRI-compatible active needles for medical interventions

NASA Astrophysics Data System (ADS)

Black, Richard J.; Ryu, Seokchang; Moslehi, Behzad; Costa, Joannes M.

2014-03-01

The development of a Magnetic Resonance Imaging (MRI) compatible optically-actuated active needle for guided percutaneous surgery and biopsy procedures is described. Electrically passive MRI-compatible actuation in the small diameter needle is provided by non-magnetic materials including a shape memory alloy (SMA) subject to precise fiber laser operation that can be from a remote (e.g., MRI control room) location. Characterization and optimization of the needle is facilitated using optical fiber Bragg grating (FBG) temperature sensors arrays. Active bending of the needle during insertion allows the needle to be accurately guided to even relatively small targets in an organ while avoiding obstacles and overcoming undesirable deviations away from the planned path due to unforeseen or unknowable tissue interactions. This feature makes the needle especially suitable for use in image-guided surgical procedures (ranging from MRI to CT and ultrasound) when accurate targeting is imperative for good treatment outcomes. Such interventions include reaching small tumors in biopsies, delineating freezing areas in, for example, cryosurgery and improving the accuracy of seed placement in brachytherapy. Particularly relevant are prostate procedures, which may be subject to pubic arch interference. Combining diagnostic imaging and actuation assisted biopsy into one treatment can obviate the need for a second exam for guided biopsy, shorten overall procedure times (thus increasing operating room efficiencies), address healthcare reimbursement constraints and, most importantly, improve patient comfort and clinical outcomes.

Electrolytic echo enhancement: a novel method to make needles more reflective to ultrasound.

PubMed

Cockburn, John F; Khosh, Stefan K

2014-04-01

This study examines the effect of augmenting the ultrasound reflectivity of needles using a novel electrolytic echo enhancement method. Needles were connected by a lead to the negative terminal of a 4.5 V direct current source. A grounding pad, connected to the positive terminal, was positioned on the undersurface of an ex vivo ox liver phantom. During needle insertion into the liver, electrolysis was induced creating a layer of gas on the needle electrode. Analysis of images showed a significant increase in needle brightness using electrolytic echo enhancement. Brightness was found to increase by a factor of ×3.6 compared with controls (P < 0.001). Electrolytic echo enhancement has the potential to make ultrasound-guided procedures safer and quicker for patients and increase the confidence of operators in their ability to see the whole needle including its tip. © 2014 The Royal Australian and New Zealand College of Radiologists.

Prospective clinical evaluation of the Polyperf® Safe, a safety Huber needle, in cancer patients.

PubMed

Goossens, Godelieve A; Moons, Philip; Jérôme, Martine; Stas, Marguerite

2011-01-01

Evaluation of the Polyperf® Safe (PPS) needle on safety and user-friendliness, as experienced by first-time and non-first-time users of the device. A prospective, descriptive study was carried out at the University Hospitals Leuven, Belgium. Five hundred PPS needles were individually evaluated in cancer patients. Different aspects of the PPS were assessed: packaging, needle insertion, and needle removal. Nurses were asked whether they had previously inserted or removed this type of needle. We compared the PPS needle with the standard Gripper® needle in terms of safety, ease of use, and ease of training. Three hundred sixty-six evaluation forms were available for analysis (73.2%). Packaging and access evaluations were scored positively, except for two aspects: (1) needle stability, and (2) ease of dressing. Ease of removal was scored unsatisfactory in up to 22.4% of the registrations. Pain at insertion was reported in about 20% registrations, and blood contact was reported by 2.5% of non-first-time users. Safety was scored as good, although ease of use and ease in training scored 25.4% and 43.8%, respectively, lower than the Gripper®. In general, nurses evaluated the PPS positively, with the exception of needle stability, ease of dressing, and ease of removal. No needlestick accidents were recorded. Aspects of ease of use and ease of training for PPS needles scored less than those for the Gripper® needles in up to one-third of the registrations.

Automatic Multiple-Needle Surgical Planning of Robotic-Assisted Microwave Coagulation in Large Liver Tumor Therapy

PubMed Central

Liu, Shaoli; Xia, Zeyang; Liu, Jianhua; Xu, Jing; Ren, He; Lu, Tong; Yang, Xiangdong

2016-01-01

The “robotic-assisted liver tumor coagulation therapy” (RALTCT) system is a promising candidate for large liver tumor treatment in terms of accuracy and speed. A prerequisite for effective therapy is accurate surgical planning. However, it is difficult for the surgeon to perform surgical planning manually due to the difficulties associated with robot-assisted large liver tumor therapy. These main difficulties include the following aspects: (1) multiple needles are needed to destroy the entire tumor, (2) the insertion trajectories of the needles should avoid the ribs, blood vessels, and other tissues and organs in the abdominal cavity, (3) the placement of multiple needles should avoid interference with each other, (4) an inserted needle will cause some deformation of liver, which will result in changes in subsequently inserted needles’ operating environment, and (5) the multiple needle-insertion trajectories should be consistent with the needle-driven robot’s movement characteristics. Thus, an effective multiple-needle surgical planning procedure is needed. To overcome these problems, we present an automatic multiple-needle surgical planning of optimal insertion trajectories to the targets, based on a mathematical description of all relevant structure surfaces. The method determines the analytical expression of boundaries of every needle “collision-free reachable workspace” (CFRW), which are the feasible insertion zones based on several constraints. Then, the optimal needle insertion trajectory within the optimization criteria will be chosen in the needle CFRW automatically. Also, the results can be visualized with our navigation system. In the simulation experiment, three needle-insertion trajectories were obtained successfully. In the in vitro experiment, the robot successfully achieved insertion of multiple needles. The proposed automatic multiple-needle surgical planning can improve the efficiency and safety of robot-assisted large liver tumor

Facile fabrication of super-hydrophobic nano-needle arrays via breath figures method.

PubMed

Kim, Jiseok; Lew, Brian; Kim, Woo Soo

2011-12-06

Super-hydrophobic surfaces which have been fabricated by various methods such as photolithography, chemical treatment, self-assembly, and imprinting have gained enormous attention in recent years. Especially 2D arrays of nano-needles have been shown to have super-hydrophobicity due to their sharp surface roughness. These arrays can be easily generated by removing the top portion of the honeycomb films prepared by the breath figures method. The hydrophilic block of an amphiphilic polymer helps in the fabrication of the nano-needle arrays through the production of well-ordered honeycomb films and good adhesion of the film to a substrate. Anisotropic patterns with water wettability difference can be useful for patterning cells and other materials using their selective growth on the hydrophilic part of the pattern. However, there has not been a simple way to generate patterns with highly different wettability. Mechanical stamping of the nano-needle array with a polyurethane stamp might be the simplest way to fabricate patterns with wettability difference. In this study, super-hydrophobic nano-needle arrays were simply fabricated by removing the top portion of the honeycomb films. The maximum water contact angle obtained with the nano-needle array was 150°. By controlling the pore size and the density of the honeycomb films, the height, width, and density of nano-needle arrays were determined. Anisotropic patterns with different wettability were fabricated by simply pressing the nano-needle array at ambient temperature with polyurethane stamps which were flexible but tough. Mechanical stamping of nano-needle arrays with micron patterns produced hierarchical super-hydrophobic structures.PACS: 05.70.Np, 68.55.am, 68.55.jm.

Facile fabrication of super-hydrophobic nano-needle arrays via breath figures method

PubMed Central

2011-01-01

Super-hydrophobic surfaces which have been fabricated by various methods such as photolithography, chemical treatment, self-assembly, and imprinting have gained enormous attention in recent years. Especially 2D arrays of nano-needles have been shown to have super-hydrophobicity due to their sharp surface roughness. These arrays can be easily generated by removing the top portion of the honeycomb films prepared by the breath figures method. The hydrophilic block of an amphiphilic polymer helps in the fabrication of the nano-needle arrays through the production of well-ordered honeycomb films and good adhesion of the film to a substrate. Anisotropic patterns with water wettability difference can be useful for patterning cells and other materials using their selective growth on the hydrophilic part of the pattern. However, there has not been a simple way to generate patterns with highly different wettability. Mechanical stamping of the nano-needle array with a polyurethane stamp might be the simplest way to fabricate patterns with wettability difference. In this study, super-hydrophobic nano-needle arrays were simply fabricated by removing the top portion of the honeycomb films. The maximum water contact angle obtained with the nano-needle array was 150°. By controlling the pore size and the density of the honeycomb films, the height, width, and density of nano-needle arrays were determined. Anisotropic patterns with different wettability were fabricated by simply pressing the nano-needle array at ambient temperature with polyurethane stamps which were flexible but tough. Mechanical stamping of nano-needle arrays with micron patterns produced hierarchical super-hydrophobic structures. PACS: 05.70.Np, 68.55.am, 68.55.jm PMID:22145673

Transcription through the eye of a needle: daily and annual cyclic gene expression variation in Douglas-fir needles.

PubMed

Cronn, Richard; Dolan, Peter C; Jogdeo, Sanjuro; Wegrzyn, Jill L; Neale, David B; St Clair, J Bradley; Denver, Dee R

2017-07-24

Perennial growth in plants is the product of interdependent cycles of daily and annual stimuli that induce cycles of growth and dormancy. In conifers, needles are the key perennial organ that integrates daily and seasonal signals from light, temperature, and water availability. To understand the relationship between seasonal cycles and seasonal gene expression responses in conifers, we examined diurnal and circannual needle mRNA accumulation in Douglas-fir (Pseudotsuga menziesii) needles at diurnal and circannual scales. Using mRNA sequencing, we sampled 6.1 × 10 9 reads from 19 trees and constructed a de novo pan-transcriptome reference that includes 173,882 tree-derived transcripts. Using this reference, we mapped RNA-Seq reads from 179 samples that capture daily and annual variation. We identified 12,042 diurnally-cyclic transcripts, 9299 of which showed homology to annotated genes from other plant genomes, including angiosperm core clock genes. Annual analysis revealed 21,225 circannual transcripts, 17,335 of which showed homology to annotated genes from other plant genomes. The timing of maximum gene expression is associated with light intensity at diurnal scales and photoperiod at annual scales, with approximately half of transcripts reaching maximum expression +/- 2 h from sunrise and sunset, and +/- 20 days from winter and summer solstices. Comparisons with published studies from other conifers shows congruent behavior in clock genes with Japanese cedar (Cryptomeria), and a significant preservation of gene expression patterns for 2278 putative orthologs from Douglas-fir during the summer growing season, and 760 putative orthologs from spruce (Picea) during the transition from fall to winter. Our study highlight the extensive diurnal and circannual transcriptome variability demonstrated in conifer needles. At these temporal scales, 29% of expressed transcripts show a significant diurnal cycle, and 58.7% show a significant circannual cycle. Remarkably

Automatic Robotic Steering of Flexible Needles from 3D Ultrasound Images in Phantoms and Ex Vivo Biological Tissue.

PubMed

Mignon, Paul; Poignet, Philippe; Troccaz, Jocelyne

2018-05-29

Robotic control of needle bending aims at increasing the precision of percutaneous procedures. Ultrasound feedback is preferable for its clinical ease of use, cost and compactness but raises needle detection issues. In this paper, we propose a complete system dedicated to robotized guidance of a flexible needle under 3D ultrasound imaging. This system includes a medical robot dedicated to transperineal needle positioning and insertion, a rapid path planning for needle steering using bevel-tip needle natural curvature in tissue, and an ultrasound-based automatic needle detection algorithm. Since ultrasound-based automatic needle steering is often made difficult by the needle localization in biological tissue, we quantify the benefit of using flexible echogenic needles for robotized guidance under 3D ultrasound. The "echogenic" term refers to the etching of microstructures on the needle shaft. We prove that these structures improve needle visibility and detection robustness in ultrasound images. We finally present promising results when reaching targets using needle steering. The experiments were conducted with various needles in different media (synthetic phantoms and ex vivo biological tissue). For instance, with nitinol needles the mean accuracy is 1.2 mm (respectively 3.8 mm) in phantoms (resp. biological tissue).

Postdural puncture headache: comparison of 25-gauge Whitacre and Quincke needles.

PubMed

Buettner, J; Wresch, K P; Klose, R

1993-01-01

To evaluate the influence of the shape of the needle tip on postdural puncture headache (PDPH) independent of the needle diameter, a 25-gauge Whitacre and a 25-gauge Quincke needle were compared. In a prospective, randomized, double-blind fashion, the study was carried out on 400 patients who received spinal anesthesia for operations of the lower extremities. The 25-gauge Whitacre needle (group 1) and the 25-gauge Quincke needle (group 2) were randomly assigned to the patients, 200 in each group. Patients were interviewed postoperatively on days 1, 3, 5, and 7 using a standardized questionnaire. Only postural headache was defined as PDPH. The intensity of both postural and nonpostural headache were quantified using a 4-point rating scale and a visual analog pain scale (VAS). Statistical analysis was performed with parametric and nonparametric tests when appropriate, p < or = 0.05 was considered as significant. There were no differences in age and sex distribution between the two groups. Significantly more patients in group 2 (8.5%) complained of PDPH than in group 1 (3%, p < or = 0.02). Duration of PDPH ranged from 1-3 days (median: 1) in group 1, and from 1-9 days (median: 3) in group 2. This difference closely approached significance (p = 0.058). The mean maximal intensity of PDPH was comparable in both groups. Severe PDPH occurred only in two patients of group 2. One of them required a blood patch. With respect to the nonpostural headache, no significant differences were seen. The use of a conical tipped Whitacre needle results in significantly less PDPH compared to a standard Quincke spinal needle of the same size.

Influence of needle position on lumbar segmental nerve root block selectivity.

PubMed

Wolff, André P; Groen, Gerbrand J; Wilder-Smith, Oliver H

2006-01-01

In patients with chronic low back pain radiating to the leg, segmental nerve root blocks (SNRBs) are performed to predict surgical outcome and identify the putative symptomatic spinal nerve. Epidural spread may lead to false interpretation, affecting clinical decision making. Systematic fluoroscopic analysis of epidural local anesthetic spread and its relationship to needle tip location has not been published to date. Study aims include assessment of epidural local anesthetic spread and its relationship to needle position during fluoroscopy-assisted blocks. Patients scheduled for L4, L5, and S1 blocks were included in this prospective observational study. Under fluoroscopy and electrostimulation, they received 0.5 mL of a mixture containing lidocaine 5 mg and iohexol 75 mg. X-rays with needle tip and contrast were scored for no epidural spread (grade 0), local spread epidurally (grade 1), or to adjacent nerve roots (grade 2). Sixty-five patients were analyzed for epidural spread, 62 for needle position. Grade 1 epidural spread occurred in 47% of L4 and 28% of L5 blocks and grade 2 spread in 3 blocks (5%; L5 n = 1, S1 n = 2). For lumbar blocks, the needle was most frequently found in the lateral upper half of the intervertebral foramen. Epidural spread occurred more frequently with medial needle positions (P = .06). The findings suggest (P = .06) that the risk of grade 1 and 2 lumbar epidural spread, which results in decreased SNRB selectivity, is greater with medial needle positions in the intervertebral foramen. The variability in anatomic position of the dorsal root ganglion necessitates electrostimulation to guide SNRB in addition to fluoroscopy.

Study on Ballistic Absorbing Energy Character of High Performance Polyethylene Needle Felt

NASA Astrophysics Data System (ADS)

Kailiang, Zhu; Jianqiao, Fu

2017-11-01

The ballistic performance of polyethylene needle felt is tested and the failure morphology after test is also observed. The results showed that when the non-dimensionally non-stressed fibers in polyethylene needles are subjected to high-speed projectile, secondary movement such as stretching and twisting occurs first. This secondary movement is very full, it is the main way of ballistic absorbing energy of the polyethylene needle felt which can avoid the polyethylene fiber short-term rapid heating-up and destroyed. Analysis results show that under normal temperature and humidity conditions, the V50 of 6-layer forded polyethylene needle felt sample is 250m/s. At (450 ± 50) m/s speed range of the target missile, the mean value of the penetrative specific energy absorption for 3-layer forded polyethylene needle felt anti-1.1g simulated projectiles (tapered column) reaches 24.1J·m2/kg.

SU-E-J-81: Beveled Needle Tip Detection Error in Ultrasound-Guided Prostate Brachytherapy.

PubMed

Leu, S; Ruiz, B; Podder, T

2012-06-01

To quantify the needle tip detection errors in ultrasound images due to bevel-tip orientation in relation to the location on template grid. Transrectal ultrasound (TRUS) system (BK Medical) with physical template grid and 18-gauge bevel-tip (20-deg beveled angle) brachytherapy needle (Bard Medical, Covington, GA) were used. The TRUS was set at 6.5MHz in water phantom at 40°C and measurements were taken with 50% and 100% TRUS gains. Needles were oriented with bevel-tip facing up (0-degree) and inserted through template grid-holes. Reference needle depths were measured when needle tip image intensity was bright enough for potentially consistent readings. High-resolution digital vernier caliper was used to measure needle depth. Needle bevel-tip orientation was then changed to bevel down (by rotating 180-degree) and needle depth was adjusted by retracting so that the needle-tip image intensity appeared similar to when the needle bevel-tip was at 0-degree orientation. Clinically relevant locations were considered for needle placement on the template grids (1st row to 9th row, and 'a-f' columns). For 50% TRUS gain, bevel tip detection errors/differences were 0.69±0.30mm (1st row) to 3.23±0.22mm (9th row) and 0.78±0.71mm (1st row) to 4.14±0.56mm (9th row) in columns 'a' and 'D', respectively. The corresponding errors for 100% TRUS gain were 0.57±0.25mm to 5.24±0.36mm and 0.84±0.30mm to 4.2±0.20mm in columns 'a' and 'D', respectively. These errors/differences varied linearly for grid-hole locations on the rows and columns in between, smaller to large depending on distance from the TRUS probe. Observed no effect of gains (50% vs. 100%) along 'D' column, which was directly above the TRUS probe. Experiment results revealed that the beveled needle tip orientation could significantly impact the detection accuracy of the needle tips, based on which the seeds might be delivered. These errors may lead to considerable dosimetric deviations in prostate brachytherapy seed

Using Huygens Multipole Arrays to Realize Unidirectional Needle-Like Radiation

NASA Astrophysics Data System (ADS)

Ziolkowski, Richard W.

2017-07-01

For nearly a century, the concept of needle radiation has captured the attention of the electromagnetics communities in both physics and engineering, with various types of contributions reoccurring every decade. With the near-term needs for highly directive, electrically small radiators and scatterers for a variety of communications and sensor applications, superdirectivity has again become a topic of interest. While it is well known that superdirective solutions exist and suffer ill-posedness issues in principle, a detailed needle solution has not been reported previously. We demonstrate explicitly, for the first time, how needle radiation can be obtained theoretically from currents driven on an arbitrary spherical surface, and we explain why such a result can only be attained in practice with electrically large spheres. On the other hand, we also demonstrate, more practically, how broadside radiating Huygens source multipoles can be combined into an end-fire array configuration to achieve needle-like radiation performance without suffering the traditional problems that have previously plagued superdirectivity.

[Sleep disorder of schizophrenia treated with shallow needling: a randomized controlled trial].

PubMed

Huang, Yanxi; Zheng, Ying

2015-09-01

To compare the clinical effective differences between shallow needling and medication for the sleep disorder of schizophrenia. Ninety-six patients with the sleep disorder of schizophrenia were randomly divided into a shallow needling group and a medication group, 48 cases in each one (one case dropping in the shallow needling group and two cases dropping in the medication group). The same dose paliperidone tablets were adopted in the two groups. In the shallow needling group, the main acupoints were Baihui (GV 20), Shangenxue (Extra) and Ezhongxian (MS 1), and the acupoints based on syndrome differentiation were selected. The shallow needling manipulation was used once a day, 5 times a week. In the medication group, 3 mg eszopiclone tablets were prescribed orally before sleep once every night. The patients were treated for 6 weeks in the two groups. Sleep condition was evaluated by Pittsburgh sleep quality index (PSQI) before and after treatment, and the clinical efficacy and the adverse reaction were assessed by positive and negative symptoms scale (PANSS) and treatment emergent symptom scale (TESS) before and after 2-week, 4-week and 6-week treatment. The clinical effects between the two groups were compared. After treatment in the two groups, both the total scores and the each factor score of the PSQI and the PANSS were apparently decreased (P<0. 05, P<0. 01). As for the PSQI scale, after treatment the daytime dysfunctional score of the shallow needling group was reduced more obviously than that of the medication group (P<0. 05), and the falling asleep time in the medication group was declined more markedly compared with that in the shallow needling group (P<0. 05). Regarding the PANSS, the improvement of the pathological factor in the shallow needling group was better than that in the medication group after treatment (P<0. 05), and the improvement of the positive factor in the medication group was superior to that in the shallow needling group after treatment

Environmental distribution of PAHs in pine needles, soils, and sediments.

PubMed

Navarro-Ortega, Alícia; Ratola, Nuno; Hildebrandt, Alain; Alves, Arminda; Lacorte, Sílvia; Barceló, Damià

2012-03-01

The content of 16 polycyclic aromatic hydrocarbons (PAHs) was determined in 60 samples from three environmental matrices (soils, sediments, and pine needles) in an effort to assess their distribution on a river basin scale. A sampling campaign was carried out in 2006, selecting urban, industrial, and agricultural sampling sites along the northeast of Spain. Techniques used included pressurized liquid extraction and solid-liquid ultrasonic extraction followed by gas chromatography-electron impact ionization mass spectrometry. The mean total PAHs concentrations were 290 < 613 < 1,628 ng/g (dry weight) in pine needles, soil, and sediments, respectively. There is a good correspondence between the total concentration of soils and pine needles, as opposed to the levels between sediments and pine needles. The high concentrations found in some Pinus halepensis samples may reflect a superior uptake potential of this species in comparison to the others studied. The three matrices present a very different PAH distribution pattern, with pine needles showing a predominance of the lighter (2-, 3-, and 4-ring) PAHs, whereas 5- and 6-ring PAHs are the most abundant in soils. Sediments display a more heterogeneous pattern, with contributions of all the PAHs but different distribution depending on the site, suggesting a wider range of input sources. Established PAH molecular ratios and principal component analysis were used to identify the origins and profiles of PAHs. While sediments showed a wide range attributed to historical inputs, soils and pine needles confirmed the compartmentalization of the PAHs, with lighter airborne PAHs accumulated in pine needles and heavier ones in soils. It can be suggested that the monitoring of several matrices is a strong tool to elucidate the contamination sources and accumulation patterns of PAHs. However, given the influence of the matrix type on this assessment, the information should be considered complementary, yet allowing a more

Automatic planning of needle placement for robot-assisted percutaneous procedures.

PubMed

Belbachir, Esia; Golkar, Ehsan; Bayle, Bernard; Essert, Caroline

2018-04-18

Percutaneous procedures allow interventional radiologists to perform diagnoses or treatments guided by an imaging device, typically a computed tomography (CT) scanner with a high spatial resolution. To reduce exposure to radiations and improve accuracy, robotic assistance to needle insertion is considered in the case of X-ray guided procedures. We introduce a planning algorithm that computes a needle placement compatible with both the patient's anatomy and the accessibility of the robot within the scanner gantry. Our preoperative planning approach is based on inverse kinematics, fast collision detection, and bidirectional rapidly exploring random trees coupled with an efficient strategy of node addition. The algorithm computes the allowed needle entry zones over the patient's skin (accessibility map) from 3D models of the patient's anatomy, the environment (CT, bed), and the robot. The result includes the admissible robot joint path to target the prescribed internal point, through the entry point. A retrospective study was performed on 16 patients datasets in different conditions: without robot (WR) and with the robot on the left or the right side of the bed (RL/RR). We provide an accessibility map ensuring a collision-free path of the robot and allowing for a needle placement compatible with the patient's anatomy. The result is obtained in an average time of about 1 min, even in difficult cases. The accessibility maps of RL and RR covered about a half of the surface of WR map in average, which offers a variety of options to insert the needle with the robot. We also measured the average distance between the needle and major obstacles such as the vessels and found that RL and RR produced needle placements almost as safe as WR. The introduced planning method helped us prove that it is possible to use such a "general purpose" redundant manipulator equipped with a dedicated tool to perform percutaneous interventions in cluttered spaces like a CT gantry.

Physical evaluation of a needle photostimulable phosphor based CR mammography system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marshall, Nicholas W.; Lemmens, Kim; Bosmans, Hilde

2012-02-15

Purpose: Needle phosphor based computed radiography (CR) systems promise improved image quality compared to powder phosphor based CR units for x-ray screening mammography. This paper compares the imaging performance of needle CR cassettes, powder based CR cassettes and a well established amorphous selenium (a-Se) based flat panel based mammography system, using consistent beam qualities. Methods: Detector performance was assessed using modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE). Mammography system performance was assessed against levels from the European Guidelines, including threshold gold thickness (c-d), relative signal difference to noise (SdNR) and mean glandular dose,more » for automatic exposure control settings suggested by the manufacturers. The needle based Agfa HM5.0 CR detector was compared against the single sided readout Agfa MM3.0R and dual sided readout Fuji Profect CS powder CR plates using a 28 kV Mo/Rh spectrum, while a 28 kV W/Rh spectrum was used to compare the Agfa HM5.0 against the Siemens MAMMOMAT Inspiration a-Se based system. Results: MTF at 5 mm{sup -1} was 0.16 and 0.24 for the needle CR detector in the fast and slow scan directions, respectively, indicating a slight improvement ({approx}20%) over the two powder CR systems but remained 50% lower than the result at 5 mm{sup -1} for the a-Se detector ({approx}0.55). Structured screen noise was lower for the needle phosphor compared to the powder plates. CR system gain, estimated from the measured absorption fraction and NNPS results, was 6.3 for the (single sided) needle phosphor and 5.1 and 7.2 for the single sided and dual sided powder phosphor systems. Peak DQE at {approx}100 {mu}Gy was 0.47 for the needle system compared to peak DQE figures of 0.33 and 0.46 for the single sided readout powder plates and dual sided readout plates. The high frequency DQE (at 5 mm{sup -1}) was 0.19 for the needle CR plates, a factor

Pelton turbine Needle erosion prediction based on 3D three- phase flow simulation

NASA Astrophysics Data System (ADS)

Chongji, Z.; Yexiang, X.; Wei, Z.; Yangyang, Y.; Lei, C.; Zhengwei, W.

2014-03-01

Pelton turbine, which applied to the high water head and small flow rate, is widely used in the mountainous area. During the operation period the sediment contained in the water does not only induce the abrasion of the buckets, but also leads to the erosion at the nozzle which may damage the needle structure. The nozzle and needle structure are mainly used to form high quality cylindrical jet and increase the efficiency of energy exchange in the runner to the most. Thus the needle erosion will lead to the deformation of jet, and then may cause the efficiency loss and cavitation. The favourable prediction of abrasion characteristic of needle can effectively guide the optimization design and maintenance of needle structure. This paper simulated the unsteady three-dimensional multi-phase flow in the nozzle and injected jet flow. As the jet containing water and sediment is injected into the free atmosphere air with high velocity, the VOF model was adopted to predict the water and air flow. The sediment is simplified into round solid particle and the discrete particle model (DPM) was employed to predict the needle abrasion characteristic. The sand particle tracks were analyzed to interpret the mechanism of sand erosion on the needle surface. And the numerical result of needle abrasion was obtained and compared with the abrasion field observation. The similarity of abrasion pattern between the numerical results and field observation illustrated the validity of the 3D multi-phase flow simulation method.

Biology of a Pine Needle Sheath Midge, Contarinia Acuta Gagne (Diptera: Cecidomyiidae), on Loblolly Pine

Treesearch

Julie C. Weatherby; John C. Moser; Raymond J. Gagné; Huey N. Wallace

1989-01-01

The biology of a pine needle sheath midge, Contarinia acuta Gagné is described for a new host in Louisiana. This midge was found feeding within the needle sheath on elongating needles of loblolly pine, P. taeda L. Needle droop and partial defoliation were evident on heavily infested trees. Overwintering C. acuta...

Needle localization using a moving stylet/catheter in ultrasound-guided regional anesthesia: a feasibility study

NASA Astrophysics Data System (ADS)

Beigi, Parmida; Rohling, Robert

2014-03-01

Despite the wide range and long history of ultrasound guided needle insertions, an unresolved issue in many cases is clear needle visibility. A well-known ad hoc technique to detect the needle is to move the stylet and look for changes in the needle appearance. We present a new method to automatically locate a moving stylet/catheter within a stationary cannula using motion detection. We then use this information to detect the needle trajectory and the tip. The differences between the current frame and the previous frame are detected and localized, to minimize the influence of tissue global motions. A polynomial fit based on the detected needle axis determines the estimated stylet shaft trajectory, and the extent of the differences along the needle axis represents the tip. Over a few periodic movements of the stylet including its full insertion into the cannula to the tip, a combination of polynomial fits determines the needle trajectory and the last detected point represents the needle tip. Experiments are conducted in water bath and bovine muscle tissue for several stylet/catheter materials. Results show that a plastic stylet has the best needle shaft and tip localization accuracy in the water bath with RMSE = 0:16 mm and RMSE = 0:51 mm, respectively. In the bovine tissue, the needle tip was best localized with the plastic catheter with RMSE = 0:33 mm. The stylet tip localization was most accurate with the steel stylet, with RMSE = 2:81 mm and the shaft was best localized with the plastic catheter, with RMSE = 0:32 mm.

Grading of severity of postdural puncture headache after 27-gauge Quincke and Whitacre needles.

PubMed

Corbey, M P; Bach, A B; Lech, K; Frørup, A M

1997-06-01

Small-gauge needles are reported to have a low incidence of complications. Pencil-point needles are associated with a lower frequency of postdural puncture headache (PDPH), but a higher failure rate than Quincke needles. The incidence of PDPH was investigated in 200 patients under the age of 45, undergoing day-care surgery, after spinal anaesthesia with either 27-gauge Quincke or Whitacre needle. The severity of headache was graded as I (mild), II (moderate) or III (severe) using a grading system based on the visual analogue scale (VAS) associated with a functional rating (FG). The frequency of PDPH following the Whitacre needle was 0% and 5.6% after the Quincke needle (P = 0.05). Two PDPHs were assessed as grade III, and three as grade II. All PDPHs occurred when the Quincke needle bevel was withdrawn perpendicular to the dural fibres following parallel insertion. No PDPH occurred when the bevel was inserted and removed parallel to the dural fibres (P < 0.05). There was no statistical difference (P > 0.08) in the incidence of PDPH and postdural puncture-related headaches (PDPR-H) in patients with recurrent headaches or migraine compared to patients with no previous history of headaches. We conclude that the 27-gauge Whitacre needle is the 'needle of choice' in patients with normal body stature. The incidence of PDPH following Quincke needles may not only be affected by the direction of the bevel during insertion but also during removal. Statistically, there was no gender variation in PDPH in this study (P = 0.5). A previous history of recurrent headache or migraine does not predispose to PDPH.

Radiocesium distribution in sugi (Cryptomeria japonica) in eastern Japan: translocation from needles to pollen.

PubMed

Kanasashi, Tsutomu; Sugiura, Yuki; Takenaka, Chisato; Hijii, Naoki; Umemura, Mitsutoshi

2015-01-01

We assessed the radiocesium contamination of sugi (Cryptomeria japonica) forests in eastern Japan from November 2012 to February 2013, including 80 sites in Fukushima and 35 sites in other regions (Tohoku and Kanto-Koshinetsu), by measuring the (137)Cs concentrations in needles of different ages, male flowers, and pollen. Over a wide geographic area, needles that were present at the time of the Fukushima Dai-ichi Nuclear Power Plant accident contained much higher (137)Cs concentrations than needles that emerged after the accident. This result, together with visual analysis of (137)Cs distribution using autoradiography, indicated that some of the (137)Cs derived from direct fallout remained on the surface of the older needles. Since we also detected (137)Cs in younger needles and male flowers, we concluded that (137)Cs was translocated toward the tips of sugi needles. The (137)Cs concentration in male flowers was higher than and positively correlated with that in the currently growing (2012) needles. Also, a positive relationship was observed between the (137)Cs concentration of male flowers and pollen, and they were found to be nearly identical (137)Cs concentration. These results indicate the occurrence of acropetal translocation of (137)Cs from old needles to young needles, male flowers and pollen. However, the results as related to (137)Cs concentration in the needles of three different ages differed from the results of similar studies conducted more than 4 y after the Chernobyl accident. This suggests that, 2 y after the Fukushima Dai-ichi NPP accident, the distribution of (137)Cs in the sugi forests has not yet reached a steady state. Copyright © 2014 Elsevier Ltd. All rights reserved.

A data-driven soft sensor for needle deflection in heterogeneous tissue using just-in-time modelling.

PubMed

Rossa, Carlos; Lehmann, Thomas; Sloboda, Ronald; Usmani, Nawaid; Tavakoli, Mahdi

2017-08-01

Global modelling has traditionally been the approach taken to estimate needle deflection in soft tissue. In this paper, we propose a new method based on local data-driven modelling of needle deflection. External measurement of needle-tissue interactions is collected from several insertions in ex vivo tissue to form a cloud of data. Inputs to the system are the needle insertion depth, axial rotations, and the forces and torques measured at the needle base by a force sensor. When a new insertion is performed, the just-in-time learning method estimates the model outputs given the current inputs to the needle-tissue system and the historical database. The query is compared to every observation in the database and is given weights according to some similarity criteria. Only a subset of historical data that is most relevant to the query is selected and a local linear model is fit to the selected points to estimate the query output. The model outputs the 3D deflection of the needle tip and the needle insertion force. The proposed approach is validated in ex vivo multilayered biological tissue in different needle insertion scenarios. Experimental results in five different case studies indicate an accuracy in predicting needle deflection of 0.81 and 1.24 mm in the horizontal and vertical lanes, respectively, and an accuracy of 0.5 N in predicting the needle insertion force over 216 needle insertions.

[Needle-free injection--science fiction or comeback of an almost forgotten drug delivery system?].

PubMed

Ziegler, Andreas

2007-08-01

The first to create a "needle-free injector" was the American anesthetist Robert A. Hingson, 65 year ago. Since that time those devices underwent a changeful history. In 1986 an outbreak of hepatitis B among patients receiving injections from a needle-free multiple-use-nozzle injector was documented and related to the use of the injector device. Due to such risk of transmission of infection with these reusable devices, their application has been restricted. In 1998 the WHO recommended that only conventional needles and syringes should be used for immunization until safe needle-free injectors are identified through independent safety testing. Since needle-free injection has shown numerous advantages in comparison to conventional injection, new systems were developed that combine the advantages of needle-free injection with sufficient safety in mass vaccination programs. As an alternative to this early injector type, the disposable-cartridge injectors were developed. The newest research field in the area of the needle-free injection systems opened with the development of powder injectors, in which the drug preparation is no longer a suspension or solution, but a powdered solid. This injector type using powder formulations shows a number of advantages in comparison with the conventional needle/syringe injection technique as well as towards the liquid jet injectors. Due to this new kind of injectors the comeback of the needle-free injection technique in large-scale vaccination programs of the WHO seems reasonable and within reach.

Imaging of implant needles for real-time HDR-brachytherapy prostate treatment using biplane ultrasound transducers.

PubMed

Siebert, Frank-André; Hirt, Markus; Niehoff, Peter; Kovács, György

2009-08-01

Ultrasound imaging is becoming increasingly important in prostate brachytherapy. In high-dose-rate (HDR) real-time planning procedures the definition of the implant needles is often performed by transrectal ultrasound. This article describes absolute measurements of the visibility and accuracy of manual detection of implant needle tips and compares measurement results of different biplane ultrasound systems in transversal and longitudinal (i.e., sagittal) ultrasound modes. To obtain a fixed coordinate system and stable conditions the measurements were carried out in a water tank using a dedicated marker system. Needles were manually placed in the phantom until the observer decided by the real-time ultrasound image that the zero position was reached. A comparison of three different ultrasound systems yielded an offset between 0.8 and 3.1 mm for manual detection of the needle tip in ultrasound images by one observer. The direction of the offset was discovered to be in the proximal direction, i.e., the actual needle position was located more distally compared to the ultrasound-based definition. In the second part of the study, the ultrasound anisotropy of trocar implant needles is reported. It was shown that the integrated optical density in a region of interest around the needle tip changes with needle rotation. Three peaks were observed with a phase angle of 120 degrees. Peaks appear not only in transversal but also in longitudinal ultrasound images, with a phase shift of 60 degrees. The third section of this study shows results of observer dependent influences on needle tip detection in sagittal ultrasound images considering needle rotation. These experiments were carried out using the marker system in a water tank. The needle tip was placed exactly at the position z=0 mm. It was found that different users tend to differently interpret the same ultrasound images. The needle tip was manually detected five times in the ultrasound images by three experienced observers

Lamellar keratoplasty using position-guided surgical needle and M-mode optical coherence tomography

NASA Astrophysics Data System (ADS)

Shin, Sungwon; Bae, Jung Kweon; Ahn, Yujin; Kim, Hyeongeun; Choi, Geonho; Yoo, Young-Sik; Joo, Choun-Ki; Moon, Sucbei; Jung, Woonggyu

2017-12-01

Deep anterior lamellar keratoplasty (DALK) is an emerging surgical technique for the restoration of corneal clarity and vision acuity. The big-bubble technique in DALK surgery is the most essential procedure that includes the air injection through a thin syringe needle to separate the dysfunctional region of the cornea. Even though DALK is a well-known transplant method, it is still challenged to manipulate the needle inside the cornea under the surgical microscope, which varies its surgical yield. Here, we introduce the DALK protocol based on the position-guided needle and M-mode optical coherence tomography (OCT). Depth-resolved 26-gage needle was specially designed, fabricated by the stepwise transitional core fiber, and integrated with the swept source OCT system. Since our device is feasible to provide both the position information inside the cornea as well as air injection, it enables the accurate management of bubble formation during DALK. Our results show that real-time feedback of needle end position was intuitionally visualized and fast enough to adjust the location of the needle. Through our research, we realized that position-guided needle combined with M-mode OCT is a very efficient and promising surgical tool, which also to enhance the accuracy and stability of DALK.

A Novel Actuator for Simulation of Epidural Anesthesia and Other Needle Insertion Procedures

PubMed Central

Magill, John C.; Byl, Marten F.; Hinds, Michael F.; Agassounon, William; Pratt, Stephen D.; Hess, Philip E.

2010-01-01

Introduction When navigating a needle from skin to epidural space, a skilled clinician maintains a mental model of the anatomy and uses the various forms of haptic and visual feedback to track the location of the needle tip. Simulating the procedure requires an actuator that can produce the feel of tissue layers even as the needle direction changes from the ideal path. Methods A new actuator and algorithm architecture simulate forces associated with passing a needle through varying tissue layers. The actuator uses a set of cables to suspend a needle holder. The cables are wound onto spools controlled by brushless motors. An electromagnetic tracker is used to monitor the position of the needle tip. Results Novice and expert clinicians simulated epidural insertion with the simulator. Preliminary depth-time curves show that the user responds to changes in tissue properties as the needle is advanced. Some discrepancy in clinician response indicates that the feel of the simulator is sensitive to technique, thus perfect tissue property simulation has not been achieved. Conclusions The new simulator is able to approximately reproduce properties of complex multilayer tissue structures, including fine-scale texture. Methods for improving fidelity of the simulation are identified. PMID:20651481

Endoscopic treatment for pancreatic diseases: Needle-knife-guided cannulation via the minor papilla

PubMed Central

Wang, Wei; Gong, Biao; Jiang, Wei-Song; Liu, Lei; Bielike, Kouken; Xv, Bin; Wu, Yun-Lin

2015-01-01

AIM: To determine the efficacy and safety of meticulous cannulation by needle-knife. METHODS: Three needle-knife procedures were used to facilitate cannulation in cases when standard cannulation techniques failed. A total of 104 cannulations via the minor papilla attempted in 74 patients at our center between January 2008 and June 2014 were retrospectively reviewed. RESULTS: Standard methods were successful in 79 cannulations. Of the 25 cannulations that could not be performed by standard methods, 19 were performed by needle-knife, while 17 (89.5%) were successful. Needle-knife use improved the success rate of cannulation [76.0%, 79/104 vs 92.3%, (79 + 17)/104; P = 0.001]. When the 6 cases not appropriate for needle-knife cannulation were excluded, the success rate was improved further (80.6%, 79/98 vs 98.0%, 96/98; P = 0.000). There were no significant differences in the rates of post-endoscopic retrograde cholangiopancreatography adverse events between the group using standard methods alone and the group using needle-knife after failure of standard methods (4.7% vs 10.5%, P = 0.301). CONCLUSION: The needle-knife procedure may be an alternative method for improving the success rate of cannulation via the minor papilla, particularly when standard cannulation has failed. PMID:26019460

Endoscopic treatment for pancreatic diseases: Needle-knife-guided cannulation via the minor papilla.

PubMed

Wang, Wei; Gong, Biao; Jiang, Wei-Song; Liu, Lei; Bielike, Kouken; Xv, Bin; Wu, Yun-Lin

2015-05-21

To determine the efficacy and safety of meticulous cannulation by needle-knife. Three needle-knife procedures were used to facilitate cannulation in cases when standard cannulation techniques failed. A total of 104 cannulations via the minor papilla attempted in 74 patients at our center between January 2008 and June 2014 were retrospectively reviewed. Standard methods were successful in 79 cannulations. Of the 25 cannulations that could not be performed by standard methods, 19 were performed by needle-knife, while 17 (89.5%) were successful. Needle-knife use improved the success rate of cannulation [76.0%, 79/104 vs 92.3%, (79 + 17)/104; P = 0.001]. When the 6 cases not appropriate for needle-knife cannulation were excluded, the success rate was improved further (80.6%, 79/98 vs 98.0%, 96/98; P = 0.000). There were no significant differences in the rates of post-endoscopic retrograde cholangiopancreatography adverse events between the group using standard methods alone and the group using needle-knife after failure of standard methods (4.7% vs 10.5%, P = 0.301). The needle-knife procedure may be an alternative method for improving the success rate of cannulation via the minor papilla, particularly when standard cannulation has failed.

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS – PART ONE

PubMed Central

Halle, Rob J.

2016-01-01

ABSTRACT Background Dry needling is an evidence-based treatment technique that is accepted and used by physical therapists in the United States. This treatment approach focuses on releasing or inactivating muscular trigger points to decrease pain, reduce muscle tension, and assist patients with an accelerated return to active rehabilitation. Issue While commonly used, the technique has some patient risk and value of the treatment should be based on benefit compared to the potential risk. Adverse effects (AEs) with dry needling can be mild or severe, with overall incidence rates varying from zero to rates of approximately 10 percent. While mild AEs are the rule, any procedure that involves a needle insertion has the potential for an AE, with select regions and the underlying anatomy increasing the risk. Known significant AEs from small diameter needle insertion include pneumothorax, cardiac tamponade, hematoma, infection, central nervous system injury, and other complications. Purpose/Objective Underlying anatomy across individuals has variability, requiring an in-depth knowledge of anatomy prior to any needle placement. This commentary is an overview of pertinent anatomy in the region of the thorax, with a ‘part two’ that addresses the abdomen, pelvis, back, vasovagal response, informed consent and other pertinent issues. The purpose of the commentary is to minimize the risk of a dry needling AE. Conclusions/Implications Dry needling is an effective adjunct treatment procedure that is within the recognized scope of physical therapy practice. Physical therapy education and training provides practitioners with the anatomy, basic sciences, and clinical foundation to use this intervention safely and effectively. A safe and evidenced-based implementation of the procedure is based on a thorough understanding of the underlying anatomy and the potential risks, with risks coordinated with patients via informed consent. Levels of Evidence Level 5 PMID:27525188

Evaluation of a multi-fibre needle Raman probe for tissue analysis

NASA Astrophysics Data System (ADS)

Fullwood, Leanne M.; Iping Petterson, Ingeborg E.; Dudgeon, Alexander P.; Lloyd, Gavin R.; Kendall, Catherine; Hall, Charlie; Day, John C. C.; Stone, Nick

2016-03-01

Raman spectroscopy is a rapid technique for the identification of cancers. Its coupling with a hypodermic needle provides a minimally invasive instrument with the potential to aid real time assessment of suspicious lesions in vivo and guide surgery. A fibre optic Raman needle probe was utilised in this study to evaluate the classification ability of the instrument as a diagnostic tool together with multivariate analysis, through measurements of tissues from different animal species as well as various different porcine tissue types. Cross validation was performed and preliminary classification accuracies were calculated as 100% for the identification of tissue type and 97.5% for the identification of animal species. A lymph node sample was also measured using the needle probe to assess the use of the technique for human tissue and hence its efficiency as a clinical instrument. This needle probe has been demonstrated to have the capabilities to classify tissue samples based on their biochemical components. The Raman needle probe also has the potential to act as a diagnostic and surgical tool to delineate cancerous from non-cancerous cells in real time, thus assisting complete removal of a tumour.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation.

PubMed

Limmer, Alexandra M; Clement, Zackariah

2017-01-01

Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was decompressed in the emergency department using a needle under local anaesthetic. The patient subsequently underwent laparoscopic hernia repair and had an uncomplicated recovery. When conducted safely and with precision in an appropriate patient, percutaneous needle caecostomy can provide immediate symptom relief, reduce risk of caecal perforation, and allow a laparoscopic surgical approach.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation

PubMed Central

Clement, Zackariah

2017-01-01

Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was decompressed in the emergency department using a needle under local anaesthetic. The patient subsequently underwent laparoscopic hernia repair and had an uncomplicated recovery. When conducted safely and with precision in an appropriate patient, percutaneous needle caecostomy can provide immediate symptom relief, reduce risk of caecal perforation, and allow a laparoscopic surgical approach. PMID:28894618

Next-Generation Sequencing Identifies Gene Mutations That Are Predictive of Malignancy in Residual Needle Rinses Collected From Fine-Needle Aspirations of Thyroid Nodules.

PubMed

Fuller, Maren Y; Mody, Dina; Hull, April; Pepper, Kristi; Hendrickson, Heather; Olsen, Randall

2018-02-01

- Thyroid nodules have a prevalence of approximately 70% in adults. Fine-needle aspiration (FNA) is a minimally invasive, cost-effective, standard method to collect tissue from thyroid nodules for cytologic examination. However, approximately 15% of thyroid FNA specimens cannot be unambiguously diagnosed as benign or malignant. - To investigate whether clinically actionable data can be obtained using next-generation sequencing of residual needle rinse material. - A total of 24 residual needle rinse specimens with malignant (n = 6), indeterminate (n = 9), or benign (n = 9) thyroid FNA diagnoses were analyzed in our clinical molecular diagnostics laboratory using next-generation sequencing assays designed to detect gene mutations and translocations that commonly occur in thyroid cancer. Results were correlated with surgical diagnoses and clinical outcomes. - Interpretable data were generated from 23 of 24 residual needle rinse specimens. Consistent with its well-known role in thyroid malignancy, BRAF V600E mutations were detected in 4 malignant cases. An NRAS mutation was detected in 1 benign case. No mutations were detected from specimens with indeterminate diagnoses. - Our data demonstrate that residual thyroid FNA needle rinses are an adequate source of material for molecular diagnostic testing. Importantly, detection of a mutation implicated in thyroid malignancy was predictive of the final surgical diagnosis and clinical outcome. Our strategy to triage thyroid nodules with indeterminate cytology with molecular testing eliminates the need to perform additional FNA passes into dedicated media or to schedule additional invasive procedures. Further investigation with a larger sample size to confirm the clinical utility of our proposed strategy is underway.

MDCA Needle 1 Replacement

NASA Image and Video Library

2013-04-22

ISS035-E-025557(22 April 2013) ---Multi-user Droplet Combustion Apparatus (MDCA) Hardware Replacement: Cassidy accessed the Combustion Integration Rack (CIR) Combustion Chamber and removed the MDCA Chamber Insert Assembly (CIA). He then replaced the MDCA Needle 1 due to a fuel line that was damaged during previous activities when the MDCA CIA was being removed from the Combustion Chamber.

Pine Needles as Potential Energy Feedstock: Availability in the Central Himalayan State of Uttarakhand, India

NASA Astrophysics Data System (ADS)

Kala, L. D.; Subbarao, P. M. V.

2017-11-01

The amount of pine needles (pinus roxburgii) potentially available for use as energy feedstock in the Central Himalayan state of Uttarakhand in India has been estimated. It involves estimating the gross annual amount of pine needle yield followed by a comprehensive identification and quantification of the factors that affect the net annual pine needle yield available as energy feedstock. These factors include considerations such as accessibility, alternative uses, forest fires, other losses, etc., that are influenced by aspects ranging from physical constraints to traditional societal traits. Tree canopy cover method has been used for estimating the gross annual pine needle yield. The information on canopy density is obtained from remote sensing data, that forms the basis for forest classification. The annual gross pine needle yield has been estimated at 1.9 million tonnes while the annual net pine needle yield at 1.33 million tonnes. The annual primary energy potential of pine needles available as energy feedstock has also been estimated. For annual net energy potential estimation, thermal and electrical routes are considered. Electrical energy generation from pine needles using thermochemical conversion has been examined and the corresponding potential for electricity generation been estimated. An installed capacity of 789 MW can be supported with pine needles feedstock for supplying electricity in rural areas for five hours a day. For round the clock generation, an installed capacity of 165 MW can be supported by the pine needle energy feedstock.

Randomized in vitro and in vivo evaluation of different biopsy needles and devices for breast biopsy.

PubMed

Helbich, T H; Rudas, M; Böhm, G; Huber, S; Wagner, T; Taucher, S; Wolf, G; Mostbeck, G H

1999-01-01

In an experimental study (in vitro and in vivo) we evaluated the efficacy of various biopsy needles/devices for breast biopsy. In vitro, biopsies of five human cadaveric breast specimens were performed using 33 different needles/devices ranging from 14 to 20-gauge. Of these 33 needles/devices, 22 optimally performing needles were selected for the in vivo study. In the clinical part of the study, 44 breast lesions were randomly biopsied with each of the 22 needles/devices under stereotactic guidance. Tissue specimens were analysed quantitatively and qualitatively. Several automatic long-throw guns (Acecut, Asap, Biopty, Magnum) obtained greater tissue areas and had a better histopathologic score than the conventional type of a side-notch needle like Trucut, an aspiration needle like Surecut, or an end-cut needle like Autovac. The automatic long-throw guns performed better than the short-throw Monopty gun. Regardless of needle size (14-20-gauge), breast biopsies should be routinely performed with automated long-throw side-notch guns (Acecut, Asap, Biopty, Magnum).

Comparison of success rates, learning curves, and inter-subject performance variability of robot-assisted and manual ultrasound-guided nerve block needle guidance in simulation.

PubMed

Morse, J; Terrasini, N; Wehbe, M; Philippona, C; Zaouter, C; Cyr, S; Hemmerling, T M

2014-06-01

This study focuses on a recently developed robotic nerve block system and its impact on learning regional anaesthesia skills. We compared success rates, learning curves, performance times, and inter-subject performance variability of robot-assisted vs manual ultrasound (US)-guided nerve block needle guidance. The hypothesis of this study is that robot assistance will result in faster skill acquisition than manual needle guidance. Five co-authors with different experience with nerve blocks and the robotic system performed both manual and robot-assisted, US-guided nerve blocks on two different nerves of a nerve phantom. Ten trials were performed for each of the four procedures. Time taken to move from a shared starting position till the needle was inserted into the target nerve was defined as the performance time. A successful block was defined as the insertion of the needle into the target nerve. Average performance times were compared using analysis of variance. P<0.05 was considered significant. Data presented as mean (standard deviation). All blocks were successful. There were significant differences in performance times between co-authors to perform the manual blocks, either superficial (P=0.001) or profound (P=0.0001); no statistical difference between co-authors was noted for the robot-assisted blocks. Linear regression indicated that the average decrease in time between consecutive trials for robot-assisted blocks of 1.8 (1.6) s was significantly (P=0.007) greater than the decrease for manual blocks of 0.3 (0.3) s. Robot assistance of nerve blocks allows for faster learning of needle guidance over manual positioning and reduces inter-subject performance variability. © The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparison of Sprotte and Quincke needles with respect to post dural puncture headache and backache.

PubMed

Tarkkila, P J; Heine, H; Tervo, R R

1992-01-01

The objective of this study was to compare 24-gauge Sprotte and 25-gauge Quincke needles with respect to post dural puncture headache and backache. Three hundred ASA Physical Status I or II patients scheduled for minor orthopedic or urologic operations under spinal anesthesia were chosen for this randomized, prospective study at a university hospital and a city hospital. Anesthetic technique, intravenous fluids, and postoperative pain therapy were standardized. Patients were randomly divided into three equal groups. Spinal anesthesia was performed with either a 24-gauge Sprotte needle or a 25-gauge Quincke needle with the cutting bevel parallel or perpendicular to the dural fibers. Anesthesia could not be performed in three cases with the Sprotte needle and in one case with the Quincke needle. The most common complications were post dural puncture backache (18.0%), post dural puncture headache (8.2%), and non-postural headache (6.7%). No major complications occurred. The Quincke needle with bevel perpendicular to the dural fibers caused a 17.9% incidence of post dural puncture headache. The Quincke with bevel parallel to the dural fibers and the Sprotte needles caused similar post dural puncture headache rates (4.5% and 2.4%, respectively). Other factors associated with post dural puncture headache were young age, early ambulation, and sedation during spinal anesthesia. There were no significant differences between needles in the incidence of post dural puncture backache. Our data indicate that Quincke needles should not be used with the needle bevel inserted perpendicular to the dural fibers. The Sprotte needle does not solve the problem of post dural puncture headache and backache.

Whitacre Needle Reduces the Incidence of Intravascular Uptake in Lumbar Transforaminal Epidural Steroid Injections.

PubMed

Hong, JiHee; Jung, Sungwon; Chang, Hyuckwon

2015-01-01

Transforaminal epidural steroid injection (TFESI) is a commonly used interventional pain management procedures to treat radicular leg pain. Although most reported complications of TFESI are minor, serious morbidity has also been demonstrated including spinal cord infarction, paraplegia, and quadriparesis. Suggested mechanisms include direct vascular injury or intravascular injection of particulate steroid. We compared 2 different needle types, Whitacre and Quincke type needles, with regard to intravascular injection rate with total procedure time and the amount of radiation during lumbar TFESI. Prospective, randomized trial. An interventional pain management practice in South Korea. After Institutional Review Board approval, 149 patients undergoing lumbar TFESI for radicular leg pain were randomly assigned to one of 2 needle groups (Whitacre needle or Quincke type needle). After final confirmation of intravascular injection with digital subtraction angiography, total procedure time and amount of radiation exposure during TFESI were measured. The overall incidence of intravascular injection was 10.4% (28/269). We analyzed the overall incidence of intravascular injection according to the 2 different needle types. The incidence of intravascular injection of the Whitacre needle was 5.4% (8/146), whereas the incidence of intravascular injection of the Quincke needle was 16.2% (20/123). Total procedure time and amount of radiation required to complete the TFESI in the Whitacre and Quincke needle groups was 168.4 ± 57.9 (seconds) and 33.4 ± 15.9 (cGy/cm2), 131.9 ± 46.0 (seconds) and 33.2 ± 15.8 (cGy/cm2), respectively. The physician who performed the TFESI was not blinded to the type of needle for detecting intravascular injection. This study was focused on lumbar TFESI, however, most TFESIs are performed at the L4-5 or L5-S1 level. The Whitacre needle had the benefit of reducing the incidence of intravascular injection with minimal differences in technical

WE-G-204-08: Optimized Digital Radiographic Technique for Lost Surgical Devices/Needle Identification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gorman, A; Seabrook, G; Brakken, A

Purpose: Small surgical devices and needles are used in many surgical procedures. Conventionally, an x-ray film is taken to identify missing devices/needles if post procedure count is incorrect. There is no data to indicate smallest surgical devices/needles that can be identified with digital radiography (DR), and its optimized acquisition technique. Methods: In this study, the DR equipment used is a Canon RadPro mobile with CXDI-70c wireless DR plate, and the same DR plate on a fixed Siemens Multix unit. Small surgical devices and needles tested include Rubber Shod, Bulldog, Fogarty Hydrogrip, and needles with sizes 3-0 C-T1 through 8-0 BV175-6.more » They are imaged with PMMA block phantoms with thickness of 2–8 inch, and an abdomen phantom. Various DR techniques are used. Images are reviewed on the portable x-ray acquisition display, a clinical workstation, and a diagnostic workstation. Results: all small surgical devices and needles are visible in portable DR images with 2–8 inch of PMMA. However, when they are imaged with the abdomen phantom plus 2 inch of PMMA, needles smaller than 9.3 mm length can not be visualized at the optimized technique of 81 kV and 16 mAs. There is no significant difference in visualization with various techniques, or between mobile and fixed radiography unit. However, there is noticeable difference in visualizing the smallest needle on a diagnostic reading workstation compared to the acquisition display on a portable x-ray unit. Conclusion: DR images should be reviewed on a diagnostic reading workstation. Using optimized DR techniques, the smallest needle that can be identified on all phantom studies is 9.3 mm. Sample DR images of various small surgical devices/needles available on diagnostic workstation for comparison may improve their identification. Further in vivo study is needed to confirm the optimized digital radiography technique for identification of lost small surgical devices and needles.« less

SU-F-P-59: Detection of Missing Surgical Needles with Intraoperative Mobile X-Ray

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, L; Berger, B

Purpose: To determine the minimal detectable size of a surgical needle using intraoperative mobile x-ray imaging. Also, varying techniques such as low kVp and high tube current were tested to investigate whether this improved the detection of the various needle sizes. Methods: Seven surgical needle sizes, 6.5, 8, 11, 13, 16, 17 and 19 mm, were positioned on three regions (thoracic, abdominal and pelvic) of an adult size anthropomorphic RANDO phantom. The phantom represents an average size adult. The phantom, in front of detector, was imaged with 44” x-ray tube to detector distance. For the thoracic region, each needle sizemore » was imaged 4 times using the following technique (81 kVp at 32 mAs and 200 mAs; then 100 kVp at 32 mAs and 200 mAs. This was repeated for the abdominal and pelvic regions of the phantom. The images were reviewed by a board certified diagnostic radiologist. Results: The surgical needles sized 13 mm and above were visible at all three body regions using all four kVp and mAs combinations. For surgical needle sizes 8 and 11 mm, the visibility of needle was ambiguous in thoracic region and barely visible abdominal and pelvic regions. Surgical needles, with size smaller than 8 mm, could not be visualized on x-ray with unassisted eyesight. The detectability of the smaller sized needles was not improved with increasing mAs or decreasing kVp. Conclusion: Surgical needle sizes less that 13 mm were not visualized with intraoperative mobile x-ray imaging using various mAs and kVp combinations. Intraoperative mobile x-ray is not recommended to locate surgical needle sizes less than 13 mm for the following reasons: (1) it prevents unnecessary radiation exposure to patient, (2) it avoids the delay time with wound closure and completion of the operative procedure, and (3) it saves radiologist reading time.« less

Determining the Optimal Number of Core Needle Biopsy Passes for Molecular Diagnostics.

PubMed

Hoang, Nam S; Ge, Benjamin H; Pan, Lorraine Y; Ozawa, Michael G; Kong, Christina S; Louie, John D; Shah, Rajesh P

2018-03-01

The number of core biopsy passes required for adequate next-generation sequencing is impacted by needle cut, needle gauge, and the type of tissue involved. This study evaluates diagnostic adequacy of core needle lung biopsies based on number of passes and provides guidelines for other tissues based on simulated biopsies in ex vivo porcine organ tissues. The rate of diagnostic adequacy for pathology and molecular testing from lung biopsy procedures was measured for eight operators pre-implementation (September 2012-October 2013) and post-implementation (December 2013-April 2014) of a standard protocol using 20-gauge side-cut needles for ten core biopsy passes at a single academic hospital. Biopsy pass volume was then estimated in ex vivo porcine muscle, liver, and kidney using side-cut devices at 16, 18, and 20 gauge and end-cut devices at 16 and 18 gauge to estimate minimum number of passes required for adequate molecular testing. Molecular diagnostic adequacy increased from 69% (pre-implementation period) to 92% (post-implementation period) (p < 0.001) for lung biopsies. In porcine models, both 16-gauge end-cut and side-cut devices require one pass to reach the validated volume threshold to ensure 99% adequacy for molecular characterization, while 18- and 20-gauge devices require 2-5 passes depending on needle cut and tissue type. Use of 20-gauge side-cut core biopsy needles requires a significant number of passes to ensure diagnostic adequacy for molecular testing across all tissue types. To ensure diagnostic adequacy for molecular testing, 16- and 18-gauge needles require markedly fewer passes.

Finite element analyses of a dual actuated prototype of a smart needle

NASA Astrophysics Data System (ADS)

Konh, Bardia; Podder, Tarun K.

2017-04-01

Brachytherapy is one of the most effective modalities for treating early stage prostate cancer. In this procedure, radioactive seeds are being placed in the prostate to kill the tumorous cells. Inaccurate placement of seeds can underdose the tumor and dangerously overdose the critical structures (urethra, rectum, bladder) and adjacent healthy tissues. It is very difficult, if not impossible, for the surgeons to compensate the needle misplacement errors while using the conventional passive straight needles. The smart needles actuated by shape memory alloy (SMA) wires are being developed to provide more actuation and control for the surgeons to achieve more geometric conformity. In our recent work, a prototype of a smart needle was developed where not only the actuation of SMA wires were incorporated, but also shape memory polymers (SMPs) were included in the design introducing a soft joint element to further assist the flexibility of the active surgical needles. The additional actuation of shape memory polymers provided the capability of reaching much high flexibility that was not achievable before. However, there are some disadvantages using this active SMP component compared to a passive Nylon joint component that are discussed in this work. The utilization of a heated SMP as a soft joint showed about 20% improvement in the final needle tip deflection. This work presents the finite element studies of the developed prototype. A finite element model that could accurately predict the behavior of the smart needle could be very valuable in analyzing and optimizing the future novel designs.

Detection of needle to nerve contact based on electric bioimpedance and machine learning methods.

PubMed

Kalvoy, Havard; Tronstad, Christian; Ullensvang, Kyrre; Steinfeldt, Thorsten; Sauter, Axel R

2017-07-01

In an ongoing project for electrical impedance-based needle guidance we have previously showed in an animal model that intraneural needle positions can be detected with bioimpedance measurement. To enhance the power of this method we in this study have investigated whether an early detection of the needle only touching the nerve also is feasible. Measurement of complex impedance during needle to nerve contact was compared with needle positions in surrounding tissues in a volunteer study on 32 subjects. Classification analysis using Support-Vector Machines demonstrated that discrimination is possible, but that the sensitivity and specificity for the nerve touch algorithm not is at the same level of performance as for intra-neuralintraneural detection.

Port needles: do they need to be removed as frequently in infusional chemotherapy?

PubMed

Karamanoglu, Ayla; Yumuk, P Fulden; Gumus, Mahmut; Ekenel, Meltem; Aliustaoglu, Mehmet; Selimen, Deniz; Sengoz, Meric; Turhal, N Serdar

2003-01-01

Protracted chemotherapy regimens are new treatment modalities used to treat patients with cancer. These treatments are preferred because of the ease of administration and limited side effects in the outpatient setting. Sixty patients were treated with continuous infusion chemotherapy via implanted infusion ports at Marmara University Hospital Outpatient Chemotherapy Unit in Istanbul, Turkey, from January 2000 to December 2001. Although usage of Huber needles for central venous catheters was limited to between 48 and 72 hours, needles were not removed unless there were signs of inflammatory reaction. The needles remained in place for 28 days (1-49 days) on average. No catheter infections, signs of local irritation, or thrombus formation were observed despite prolonged stay of the Huber needles. Huber needles can be left in place up to several weeks without any untoward effects as long as proper aseptic technique is used.

Real-time image-based B-mode ultrasound image simulation of needles using tensor-product interpolation.

PubMed

Zhu, Mengchen; Salcudean, Septimiu E

2011-07-01

In this paper, we propose an interpolation-based method for simulating rigid needles in B-mode ultrasound images in real time. We parameterize the needle B-mode image as a function of needle position and orientation. We collect needle images under various spatial configurations in a water-tank using a needle guidance robot. Then we use multidimensional tensor-product interpolation to simulate images of needles with arbitrary poses and positions using collected images. After further processing, the interpolated needle and seed images are superimposed on top of phantom or tissue image backgrounds. The similarity between the simulated and the real images is measured using a correlation metric. A comparison is also performed with in vivo images obtained during prostate brachytherapy. Our results, carried out for both the convex (transverse plane) and linear (sagittal/para-sagittal plane) arrays of a trans-rectal transducer indicate that our interpolation method produces good results while requiring modest computing resources. The needle simulation method we present can be extended to the simulation of ultrasound images of other wire-like objects. In particular, we have shown that the proposed approach can be used to simulate brachytherapy seeds.

A clinical evaluation of four non-Luer spinal needle and syringe systems.

PubMed

Kinsella, S M; Goswami, A; Laxton, C; Kirkham, L; Wharton, N; Bowen, M

2012-11-01

We performed an evaluation of non-Luer spinal devices supplied by four manufacturers or suppliers: Polymedic; Pajunk; Sarstedt; and Smiths. For each supplier, 100 evaluations were performed using a 25-G 90-mm spinal needle, 3-ml syringe, 5-ml syringe and filter needle; for comparison, 100 evaluations were performed with our standard Luer equipment. The non-Luer devices were associated with more qualitative problems compared with the Luer devices, for example, poor feel of dural puncture (9-32% vs 10%, respectively), poor observation of cerebrospinal fluid in the hub (3-27% vs 0%), and connection problem of the syringe to the spinal needle (7-33% vs 0%). There was also more frequent failure to achieve the spinal injection due to equipment-related causes (4-7% vs 0%, respectively). Median (IQR [range]) numeric satisfaction scores for the spinal needles were: Luer 10 (9-10 [7-10]); Polymedic 7 (4-8 [0-10]; Pajunk 7 (5-8 [0-10]); Sarstedt 7 (6-8 [0-10]); and Smiths 9 (7-10 [0-10]) (p<0.0001). Satisfaction scores for all spinal equipment were: Luer 10 (9-10 [5-10]); Polymedic 8 (6-8 [0-10]); Pajunk 7 (5-7 [1-9]); Sarstedt 8 (6-8 [0-10]); and Smiths 8 (8-9 [2-10]) (p<0.0001). Between 21% and 75% of non-Luer evaluations were rated with satisfaction worse than the usual Luer needle compared with 0-10% rated better, depending on the needle type. Between 22% and 76% of non-Luer evaluations were rated with satisfaction worse than the usual Luer equipment compared with 0-14% rated better. Specific concerns included poor feel of tissue planes and observation of cerebrospinal fluid (Polymedic), difficulty with connection of the syringe to the spinal needle and trocar removal (Pajunk), poor feel of tissue planes and needle flexibility (Sarstedt) and difficulty with connection of the syringe to the spinal needle (Smiths). We could not demonstrate a short-term learning curve for the new devices. Decisions on purchasing and implementation of the new non-Luer equipment will have to

Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

PubMed Central

Xu, Hong; Liu, Yang; Song, WenYe; Kan, ShunLi; Liu, FeiFei; Zhang, Di; Ning, GuangZhi; Feng, ShiQing

2017-01-01

Abstract Background: Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle. Methods: We included all randomly designed trials, assessing the clinical outcomes in patients given elective spinal anesthesia or diagnostic lumbar puncture with either cutting or pencil-point spinal needle as eligible studies. All selected studies and the risk of bias of them were assessed by 2 investigators. Clinical outcomes including success rates, frequency of PDPH, reported severe PDPH, and the use of epidural blood patch (EBP) were recorded as primary results. Results were evaluated using risk ratio (RR) with 95% confidence interval (CI) for dichotomous variables. Rev Man software (version 5.3) was used to analyze all appropriate data. Results: Twenty-five randomized controlled trials (RCTs) were included in our study. The analysis result revealed that pencil-point spinal needle would result in lower rate of PDPH (RR 2.50; 95% CI [1.96, 3.19]; P < 0.00001) and severe PDPH (RR 3.27; 95% CI [2.15, 4.96]; P < 0.00001). Furthermore, EBP was less used in pencil-point spine needle group (RR 3.69; 95% CI [1.96, 6.95]; P < 0.0001). Conclusions: Current evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture. PMID:28383416

Needle segmentation using 3D Hough transform in 3D TRUS guided prostate transperineal therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qiu Wu; Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario N6A 5K8; Yuchi Ming

Purpose: Prostate adenocarcinoma is the most common noncutaneous malignancy in American men with over 200 000 new cases diagnosed each year. Prostate interventional therapy, such as cryotherapy and brachytherapy, is an effective treatment for prostate cancer. Its success relies on the correct needle implant position. This paper proposes a robust and efficient needle segmentation method, which acts as an aid to localize the needle in three-dimensional (3D) transrectal ultrasound (TRUS) guided prostate therapy. Methods: The procedure of locating the needle in a 3D TRUS image is a three-step process. First, the original 3D ultrasound image containing a needle is cropped;more » the cropped image is then converted to a binary format based on its histogram. Second, a 3D Hough transform based needle segmentation method is applied to the 3D binary image in order to locate the needle axis. The position of the needle endpoint is finally determined by an optimal threshold based analysis of the intensity probability distribution. The overall efficiency is improved through implementing a coarse-fine searching strategy. The proposed method was validated in tissue-mimicking agar phantoms, chicken breast phantoms, and 3D TRUS patient images from prostate brachytherapy and cryotherapy procedures by comparison to the manual segmentation. The robustness of the proposed approach was tested by means of varying parameters such as needle insertion angle, needle insertion length, binarization threshold level, and cropping size. Results: The validation results indicate that the proposed Hough transform based method is accurate and robust, with an achieved endpoint localization accuracy of 0.5 mm for agar phantom images, 0.7 mm for chicken breast phantom images, and 1 mm for in vivo patient cryotherapy and brachytherapy images. The mean execution time of needle segmentation algorithm was 2 s for a 3D TRUS image with size of 264 Multiplication-Sign 376 Multiplication-Sign 630 voxels

Preoperative Antibiotics Do Not Reduce Postoperative Infections Following Needle-Localized Lumpectomy.

PubMed

Petersen, Lindsay; Carlson, Kjirsten; Kopkash, Katherine; Witt, Thomas; Madrigrano, Andrea

2017-01-01

Many surgeons routinely use a single preoperative prophylactic dose of an antibiotic prior to needle-localized lumpectomy, despite the lack of evidence that this practice reduces the rate of infection. The aim of this study is to determine if antibiotic administration reduces wound infection for needle-localized lumpectomy. A retrospective chart review of patients that underwent needle-localized lumpectomy from 2010 to 2012 was conducted. Data regarding patient demographics, comorbid conditions, medical history, operative details, and pathology were collected. Surgical infections requiring opening of the wound or treatment with antibiotics were documented if occurred during the first 3 months following surgery. Fisher's exact tests were used for statistical analyses. Two hundred and twenty patients were identified. Thirty-six percent (80/220) of patients received preoperative prophylactic antibiotics. The antibiotic and the nonantibiotic group were similar in age, body mass index, tobacco use, history of radiation, history of neo-adjuvant chemotherapy, duration of surgery, duration needle in place, and pathology. Two percent (4/220) of patients had wound infections. Two percent (3/140) of patients in the nonantibiotic group had infections, versus 1% (1/80) in the antibiotic group. In an analysis of patients that developed infections (n = 4) and patients that did not (n = 216), there was no statistically significant difference in patient demographic, duration of surgery, duration of time needle in place, or pathology. It is safe to omit the use of antibiotics prior to needle-localized lumpectomy and avoid the cost of the medication, patient adverse reactions, and increase in resistant organisms. © 2016 Wiley Periodicals, Inc.

Success rate of repeated fine needle aspiration biopsy of clinically suspicious thyroid nodules.

PubMed

Nagarajah, J; Farahati, J; Görges, R; Grabellus, F; Bockisch, A; Sheu-Grabellus, S-Y

2012-01-01

In this study we evaluated the success rate of double fine needle aspiration biopsy (FNAB) of clinically suspicious thyroid nodules in one session. The success rate of FNAB in clinical setting is quite low. There were several attempts made to improve the success rate of this method. It is anticipated that a double FNAB in one session would increase the success rate of FNAB. 176 consecutive patients (130 women, 46 men; mean age 56 years ± 11) with at least one clinically suspicious nodule were included in this study. Each individual nodule was biopsied twice (20G- and 21G-needle). In 33 patients, two suspicious nodules were biopsied, accounting for a total of 209 biopsied thyroid nodules. To evaluate the success rate the number of cell formations and the total number of cells in each cell formation were counted. The biopsy with the 20G needle provided in mean 40 cell cluster with a mean of 830 cells whereas the 21G needle provided in mean 41 cell cluster with a mean of 1010 cells. With the 20G needle the success rate was 73%, with the 21G needle 78% and the combination of the both biopsies provided a success rate of 87% (p = 0.01). Based on the number of cell formations and the total number of cells, the difference between the two needle sizes was not significant (p = 0.5 for cell formations and p = 0.9 for the total number of cells, respectively). A double FNAB of suspicious thyroid nodules in one session provides a higher success rate, and a 21G needle is sufficient enough.

MR-guided fine needle aspiration of breast lesions: Initial experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wald, D.S.; Weinreb, J.C.; Newstead, G.

1996-01-01

Fine needle aspiration (FNA) is a minimally invasive procedure that is used to obtain cytologic specimens of suspicious lesions in the breast. The goal of this study was to evaluate the logistics and limitations of MR-guided FNA using a prototype breast localization coil. MR-guided FNAs were attempted on 18 lesions (detected on mammography and/or palpation) in 16 patients. Patients were prone with their compressed mediolaterally between two plates in a circularly polarized RF coil. Lesion position was determined by reference to fiducial makers that corresponded to a grid of holes placed at 5 mm intervals in compression plate. FNA wasmore » performed with a 22G non-ferromagnetic needle. FNA was successful for 11 of 18 lesions (61%). Of the seven unsuccessful cases, there were four in which the lesions were too posteriorly placed to be accessed through the compression plate by the needle. Three cases were too anteriorly placed to be effectively immobilized and, although successfully localized, were insufficiently sampled by the FNA technique. MR-guided FNA is possible using a prototype breast localization device in a select group of patients. Current coil design limits its use in performing MR-guided FNA on the most anteriorly and posteriorly placed breast lesions. Unique requirements of FNA under MR guidance as compared to needle localization and biopsy have been identified. Modifications in localization hardware and cytology aspiration needles should overcome these restrictions. 15 refs., 3 figs.« less

Estimating needle tip deflection in biological tissue from a single transverse ultrasound image: application to brachytherapy.

PubMed

Rossa, Carlos; Sloboda, Ron; Usmani, Nawaid; Tavakoli, Mahdi

2016-07-01

This paper proposes a method to predict the deflection of a flexible needle inserted into soft tissue based on the observation of deflection at a single point along the needle shaft. We model the needle-tissue as a discretized structure composed of several virtual, weightless, rigid links connected by virtual helical springs whose stiffness coefficient is found using a pattern search algorithm that only requires the force applied at the needle tip during insertion and the needle deflection measured at an arbitrary insertion depth. Needle tip deflections can then be predicted for different insertion depths. Verification of the proposed method in synthetic and biological tissue shows a deflection estimation error of [Formula: see text]2 mm for images acquired at 35 % or more of the maximum insertion depth, and decreases to 1 mm for images acquired closer to the final insertion depth. We also demonstrate the utility of the model for prostate brachytherapy, where in vivo needle deflection measurements obtained during early stages of insertion are used to predict the needle deflection further along the insertion process. The method can predict needle deflection based on the observation of deflection at a single point. The ultrasound probe can be maintained at the same position during insertion of the needle, which avoids complications of tissue deformation caused by the motion of the ultrasound probe.

Diagnostic accuracy of lymphoma established by fine-needle aspiration cytological biopsy

NASA Astrophysics Data System (ADS)

Delyuzar; Amir, Z.; Suryadi, D.

2018-03-01

Based on Globocan data in 2012, it is estimated that about 14,495 Indonesians suffer from lymphoma, both Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma. Some areas of specialization still doubt the accuracy of cytology diagnosis of fine needle aspiration biopsy.This study is a diagnostic test with a cross sectional analytic design to see how the cytology diagnostic accuracy of fine needle aspiration aspirate in lymphoma. It was in Department of Anatomical Pathology Faculty of Medicine USU, Haji Adam Malik Hospital, Dr.Pirngadi hospital, or private clinic in Medan. Peripheral cytology technique biopsy of fine needle aspiration on lymph node subsequently stained with Giemsa, when the cytology of lymphoma is obtained and confirmed by histopathologic examination. Cytology and histopathologic examination will be tested by Diagnostic Test and assessed for its sensitivity and specificity. The diagnostic of lymphoma cytology provides 93.33% sensitivity and 92.31% specificity when confirmed by histopathological examination. Positive predictive value and negative predictive value of 96.55% and 85.71% respectively. In conclusion, the cytology of fine needle aspiration biopsy is accurate enough to be used as a diagnostic tool, so it is advisable to establish a lymphoma diagnosis to perform a needle aspiration biopsy examination.

Corona-glow transition in the atmospheric pressure RF-excited plasma needle

NASA Astrophysics Data System (ADS)

Sakiyama, Y.; Graves, D. B.

2006-08-01

We present clear evidence of two different discharge modes of the atmospheric pressure RF-excited plasma needle and the transition mechanism by the finite element method. The gas used is helium with 0.1% nitrogen addition. The needle has a point-to-plane geometry with a radius of 30 µm at the tip, 150 µm at the base and an inter-electrode gap of 1 mm. We employ the one-moment fluid model with the local field approximation. Our simulation results indicate that the plasma needle operates as a corona discharge at low power and that the discharge mode transitions to a glow discharge at a critical power. The discharge power increases but the discharge voltage drops abruptly by a factor of about 2 in the corona-glow transition. The plasma density and ionization is confined near the needle tip in corona-mode while it spreads back along the needle surface in glow-mode. The corona-glow transition is also characterized by a dramatic decrease in sheath thickness and an order of magnitude increase in plasma density and volume-averaged ionization. The transition is observed whether or not secondary electron emission is included in the model, and therefore we suggest that this is not an α -γ transition.

[Therapeutic effect observation of chronic knee joint pain assisted with the central-square needling technique of the thumb-tack needles].

PubMed

Yang, Yang; Qi, Si; Liu, Mengyue; Zhao, Yu; Li, Ning

2017-10-12

To compare the differences in the clinical therapeutic effects on chronic knee joint pain between the combination of the central-square needling technique of thumb-tack needles with the routine therapy of acupuncture, moxibustion and tuina and the routine therapy of acupuncture, moxibustion and tuina . One hundred and twenty patients of chronic knee joint pain were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine therapy of acupuncture, moxibustion and tuina was adopted. In the observation group, at the end of treatment with the routine therapy of acupuncture, moxibustion and tuina , the subcutaneous embedding therapy was followed with four thumb-tack needles at the sites 1 to 1.5 cm above, below and bilateral to the main point ( ashi point) separately, and the needles were retained for 24 h to 48 h. The treatment was given once every two days, three times a week, totally 6 times in two weeks; and the follow-up visit was done for 3 months in patients of the two groups. The visual analogue scale (VAS) score before and after each treatment, Lequesne index score before treatment and at the end of follow-up and the case numbers of proactive use of painkillers or receiving acupuncture treatment in the follow-up stage were compared and observed in the patients of the two groups. The VAS score was reduced gradually after treatment in the patients of the two groups. The differences were significant statistically after the second treatment as compared with those before the treatment in the two groups (all P <0.05), in which, the improvements in VAS scores after the third treatment in the observation group were more obvious than those in the control group (all P <0.05). At the end of follow-up visit, Lequesne index scores were all improved as compared with those before treatment in the two groups (both P <0.05) and the improvements were similar between the two groups ( P >0.05). In the follow-up stage, there

Plasticity in mesophyll volume fraction modulates light-acclimation in needle photosynthesis in two pines.

PubMed

Niinemets, Ulo; Lukjanova, Aljona; Turnbull, Matthew H; Sparrow, Ashley D

2007-08-01

Acclimation potential of needle photosynthetic capacity varies greatly among pine species, but the underlying chemical, anatomical and morphological controls are not entirely understood. We investigated the light-dependent variation in needle characteristics in individuals of Pinus patula Schlect. & Cham., which has 19-31-cm long pendulous needles, and individuals of P. radiata D. Don., which has shorter (8-17-cm-long) stiffer needles. Needle nitrogen and carbon contents, mesophyll and structural tissue volume fractions, needle dry mass per unit total area (M(A)) and its components, volume to total area ratio (V/A(T)) and needle density (D = M(A)/(V/A(T))), and maximum carboxylase activity of Rubisco (V(cmax)) and capacity of photosynthetic electron transport (J(max)) were investigated in relation to seasonal mean integrated irradiance (Q(int)). Increases in Q(int) from canopy bottom to top resulted in proportional increases in both needle thickness and width such that needle total to projected surface area ratio, characterizing the efficiency of light interception, was independent of Q(int). Increased light availability also led to larger M(A) and nitrogen content per unit area (N(A)). Light-dependent modifications in M(A) resulted from increases in both V/A(T) and D, whereas N(A) changed because of increases in both M(A) and mass-based nitrogen content (N(M)) (N(A) = N(M)M(A)). Overall, the volume fraction of mesophyll cells increased with increasing irradiance and V/A(T) as the fraction of hypodermis and epidermis decreased with increasing needle thickness. Increases in M(A) and N(A) resulted in enhanced J(max) and V(cmax) per unit area in both species, but mass-based photosynthetic capacity increased only in P. patula. In addition, J(max) and V(cmax) showed greater plasticity in response to light in P. patula. Species differences in mesophyll volume fraction explained most of the variation in mass-based needle photosynthetic capacity between species

Impact of Type of Needle on Incidence of Intravascular Injection During Diagnostic Lumbar Medial Branch Block.

PubMed

Joo, Young; Kim, Yong Chul; Lee, Sang Chul; Kim, Hye Young; Park, Keun Suk; Choi, Eun Joo; Moon, Jee Youn

2016-01-01

Intravascular (IV) injection of local anesthetics is a potential cause of false-negative results after lumbar medial branch nerve blockade (L-MBB) performed to diagnose facetogenic back pain. The aim of the present study was to identify the relationship between the needle type and the incidence of IV injection in patients undergoing L-MBB using fluoroscopy with digital subtraction imaging (DSI). In this prospective randomized study, we compared the incidence of IV uptake of contrast medium using the Quincke needle and Whitacre needle under real-time DSI during L-MBB. Clinical and demographic factors associated with the occurrence of IV uptake were also investigated. In total, 126 patients were randomized into the Quincke needle group (n = 62) and Whitacre needle group (n = 64). Intravascular uptake of contrast medium was observed in 66 (9.8%) of 671 L-MBB procedures under DSI. The incidence of IV uptake was 13.9% (47/338) using the Quincke needle and 5.7% (19/333) using the Whitacre needle. In the multivariate generalized estimating equations analysis, use of a Quincke needle was related to positive IV injection at a 1.898-fold higher rate than was use of a Whitacre needle (95% confidence interval, 1.025-3.516) and a positive aspiration test predicted IV injection at a 21.735-fold higher rate (95% confidence interval, 11.996-52.258). Lumbar medial branch nerve blockade using the Quincke needle was associated with a 1.9-fold higher rate of IV injection than was L-MBB using the Whitacre needle under DSI. Although further study is needed to confirm the clinical efficacy, Whitacre needles can be considered to reduce the risk of IV injection during L-MBB.

Introduction of Sprotte needles to a single-centre acute neurology service: before and after study

PubMed Central

Vakharia, Vejay N; Lote, Hazel

2012-01-01

Objectives To introduce atraumatic (Sprotte) lumbar puncture needles and compare complication rates with traumatic (Quincke) needles. Design Complication rates associated with traumatic needle use were retrospectively analysed over a four-week period. Atraumatic needles were then implemented and a prospective analysis of the complication rates was undertaken for a further six weeks. Setting A single-centre acute neurology unit in a London teaching hospital Participants Traumatic needles (n = 24 patients); atraumatic needles (n = 36 patients) Main outcome measures Headache rates, use of over-the-counter medications, further medical assistance, time off work, nausea and vomiting, traumatic taps (as per the count of red blood cells per millilitre in the first sample of cerebrospinal fluid [CSF]) and back pain. Results A comparison of traumatic and atraumatic needles revealed a significant reduction in the incidence of post-lumbar puncture headaches (*P < 0.01), headaches requiring over-the-counter medication (*P < 0.00001), need for further medical assistance (*P < 0.006), time off work (*P < 0.003), nausea and vomiting (*P < 0.01) and traumatic taps as per the count of red blood cells per millilitre in the first sample of CSF (*P < 0.02). There was no significant difference in the incidence of back pain (P > 0.05). Conclusions Most complication outcomes are significantly lower with the use of atraumatic lumbar puncture needles. We present for the first time in the literature that the rate of ‘traumatic taps’ are significantly lower with atraumatic needles. The implementation of atraumatic needles in an acute neurology service is safe and produces reliable, reproducible results in keeping with previously published randomized controlled trials. PMID:23476725

Development of a high frequency single-element ultrasound needle transducer for anesthesia delivery

NASA Astrophysics Data System (ADS)

Ameri, Golafsoun; Son, Jungik; Liang, Jingwei; Foster, F. Stuart; Ganapathy, Sugantha; Peters, Terry M.

2017-03-01

Epidural anesthesia is one of the most commonly used and yet challenging techniques employed for pain management and anesthesia delivery. The major complications of this procedure are due to accidental dural puncture, with an incidence of 1-3%, which could lead to both temporary and irreversible permanent neurological complications. Needle placement under ultrasound (US) guidance has received increasing interest for improving needle placement accuracy. However, poor needle visibility in US, difficulties in displaying relevant anatomical structure such as dura mater due to attenuation and bone shadowing, and image interpretation variability among users pose significant hurdles for any US guidance system. As a result, US guidance for epidural injections has not been widely adopted for everyday use for the performance of neuraxial blocks. The difficulties in localizing the ligamentum flavum and dura with respect to the needle tip can be addressed by integrating A-mode US, provided by a single-element transducer at the needle tip, into the B-mode US guidance system. We have taken the first steps towards providing such a guidance system. Our goal is to improve the safety of this procedure with minimal changes to the clinical workflow. This work presents the design and development of a 20 MHz single-element US transducer housed at the tip of a 19 G needle hypodermic tube, which can fit inside an epidural introducer needle. In addition, the results from initial transducer characterization tests and performance evaluation of the transducer in a euthanized porcine model are provided.

Automatic needle segmentation in 3D ultrasound images using 3D Hough transform

NASA Astrophysics Data System (ADS)

Zhou, Hua; Qiu, Wu; Ding, Mingyue; Zhang, Songgeng

2007-12-01

3D ultrasound (US) is a new technology that can be used for a variety of diagnostic applications, such as obstetrical, vascular, and urological imaging, and has been explored greatly potential in the applications of image-guided surgery and therapy. Uterine adenoma and uterine bleeding are the two most prevalent diseases in Chinese woman, and a minimally invasive ablation system using an RF button electrode which is needle-like is being used to destroy tumor cells or stop bleeding currently. Now a 3D US guidance system has been developed to avoid accidents or death of the patient by inaccurate localizations of the electrode and the tumor position during treatment. In this paper, we described two automated techniques, the 3D Hough Transform (3DHT) and the 3D Randomized Hough Transform (3DRHT), which is potentially fast, accurate, and robust to provide needle segmentation in 3D US image for use of 3D US imaging guidance. Based on the representation (Φ , θ , ρ , α ) of straight lines in 3D space, we used the 3DHT algorithm to segment needles successfully assumed that the approximate needle position and orientation are known in priori. The 3DRHT algorithm was developed to detect needles quickly without any information of the 3D US images. The needle segmentation techniques were evaluated using the 3D US images acquired by scanning water phantoms. The experiments demonstrated the feasibility of two 3D needle segmentation algorithms described in this paper.

Improvements to the Processing and Characterization of Needled Composite Laminates

DTIC Science & Technology

2014-01-01

the automated processing equipment are shown and discussed. The modifications allow better spatial control at the penetration sites and the ability... automated processing equipment are shown and discussed. The modifications allow better spatial control at the penetration sites and the ability to...semi- automated processing equipment, commercial off-the-shelf (COTS) needles and COTS aramid mat designed for other applications. Needled material

Two-dimensional mapping of needle visibility with linear and curved array for ultrasound-guided interventional procedure

NASA Astrophysics Data System (ADS)

Susanti, Hesty; Suprijanto, Kurniadi, Deddy

2018-02-01

Needle visibility in ultrasound-guided technique has been a crucial factor for successful interventional procedure. It has been affected by several factors, i.e. puncture depth, insertion angle, needle size and material, and imaging technology. The influences of those factors made the needle not always well visible. 20 G needles of 15 cm length (Nano Line, facet) were inserted into water bath with variation of insertion angles and depths. Ultrasound measurements are performed with BK-Medical Flex Focus 800 using 12 MHz linear array and 5 MHz curved array in Ultrasound Guided Regional Anesthesia mode. We propose 3 criteria to evaluate needle visibility, i.e. maximum intensity, mean intensity, and the ratio between minimum and maximum intensity. Those criteria were then depicted into representative maps for practical purpose. The best criterion candidate for representing the needle visibility was criterion 1. Generally, the appearance pattern of the needle from this criterion was relatively consistent, i.e. for linear array, it was relatively poor visibility in the middle part of the shaft, while for curved array, it is relatively better visible toward the end of the shaft. With further investigations, for example with the use of tissue-mimicking phantom, the representative maps can be built for future practical purpose, i.e. as a tool for clinicians to ensure better needle placement in clinical application. It will help them to avoid the "dead" area where the needle is not well visible, so it can reduce the risks of vital structures traversing and the number of required insertion, resulting in less patient morbidity. Those simple criteria and representative maps can be utilized to evaluate general visibility patterns of the needle in vast range of needle types and sizes in different insertion media. This information is also important as an early investigation for future research of needle visibility improvement, i.e. the development of beamforming strategies and

Randomized, open trial comparing a modified double-lumen needle follicular flushing system with a single-lumen aspiration needle in IVF patients with poor ovarian response.

PubMed

von Horn, Kyra; Depenbusch, Marion; Schultze-Mosgau, Askan; Griesinger, Georg

2017-04-01

Is a modified double-lumen aspiration needle system with follicular flushing able to increase the mean oocyte yield by at least one in poor response IVF patients as compared to single-lumen needle aspiration without flushing? Follicular flushing with the modified flushing system did not increase the number of oocytes, but increased the procedure duration. Most studies on follicular flushing were performed with conventional double-lumen needles in patients who were normal responders. Overall, these studies indicated no benefit of follicular flushing. Prospective, single-centre, randomized, controlled, open, superiority trial comparing the 17 G Steiner-Tan Needle® flushing system with a standard 17 G single-lumen aspiration needle (Gynetics®); time frame February 2015-March 2016. Eighty IVF patients, 18-45 years, BMI >18 kg/m2 to <35 kg/m2, presenting with ≤ five follicles >10 mm in both ovaries at the end of the follicular phase were randomized to either aspirating and flushing each follicle 3× with the Steiner-Tan-Needle® automated flushing system (n = 40) or a conventional single-lumen needle aspiration (n = 40). Primary outcome was the number of cumulus-oocyte-complexes (COCs). Procedure duration, burden (Depression Anxiety and Stress Scale; DASS-21) and post-procedure pain were also assessed. Flushing was not superior with a mean (SD) number of COCs of 2.4 (2.0) and 3.1 (2.3) in the Steiner-Tan Needle® and in the Gynectics® group, respectively (mean difference -0.7, 95% CI: 0.3 to -1.6; P = 0.27). Likewise no differences were observed in metaphase II  oocytes, two pronuclear oocytes, number of patients having an embryo transfer and DASS 21 scores. The procedure duration was significantly 2-fold increased. Testing for differences in the number of patients achieving an embryo transfer or differences in pregnancy rate would require a much larger sample size. The use of follicular flushing is unlikely to benefit the prognosis of patients with poor ovarian

Needle path planning and steering in a three-dimensional non-static environment using two-dimensional ultrasound images

PubMed Central

Vrooijink, Gustaaf J.; Abayazid, Momen; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2015-01-01

Needle insertion is commonly performed in minimally invasive medical procedures such as biopsy and radiation cancer treatment. During such procedures, accurate needle tip placement is critical for correct diagnosis or successful treatment. Accurate placement of the needle tip inside tissue is challenging, especially when the target moves and anatomical obstacles must be avoided. We develop a needle steering system capable of autonomously and accurately guiding a steerable needle using two-dimensional (2D) ultrasound images. The needle is steered to a moving target while avoiding moving obstacles in a three-dimensional (3D) non-static environment. Using a 2D ultrasound imaging device, our system accurately tracks the needle tip motion in 3D space in order to estimate the tip pose. The needle tip pose is used by a rapidly exploring random tree-based motion planner to compute a feasible needle path to the target. The motion planner is sufficiently fast such that replanning can be performed repeatedly in a closed-loop manner. This enables the system to correct for perturbations in needle motion, and movement in obstacle and target locations. Our needle steering experiments in a soft-tissue phantom achieves maximum targeting errors of 0.86 ± 0.35 mm (without obstacles) and 2.16 ± 0.88 mm (with a moving obstacle). PMID:26279600

Modelling and characterisation of a ultrasound-actuated needle for improved visibility in ultrasound-guided regional anaesthesia and tissue biopsy.

PubMed

Kuang, Y; Hilgers, A; Sadiq, M; Cochran, S; Corner, G; Huang, Z

2016-07-01

Clear needle visualisation is recognised as an unmet need for ultrasound guided percutaneous needle procedures including regional anaesthesia and tissue biopsy. With inadequate needle visibility, these procedures may result in serious complications or a failed operation. This paper reports analysis of the modal behaviour of a previously proposed ultrasound-actuated needle configuration, which may overcome this problem by improving needle visibility in colour Doppler imaging. It uses a piezoelectric transducer to actuate longitudinal resonant modes in needles (outer diameter 0.8-1.2mm, length>65mm). The factors that affect the needle's vibration mode are identified, including the needle length, the transducer's resonance frequency and the gripping position. Their effects are investigated using finite element modelling, with the conclusions validated experimentally. The actuated needle was inserted into porcine tissue up to 30mm depth and its visibility was observed under colour Doppler imaging. The piezoelectric transducer is able to generate longitudinal vibration with peak-to-peak amplitude up to 4μm at the needle tip with an actuating voltage of 20Vpp. Actuated in longitudinal vibration modes (distal mode at 27.6kHz and transducer mode at 42.2kHz) with a drive amplitude of 12-14Vpp, a 120mm needle is delineated as a coloured line in colour Doppler images, with both needle tip and shaft visualised. The improved needle visibility is maintained while the needle is advanced into the tissue, thus allowing tracking of the needle position in real time. Moreover, the needle tip is highlighted by strong coloured artefacts around the actuated needle generated by its flexural vibration. A limitation of the technique is that the transducer mode requires needles of specific lengths so that the needle's resonance frequency matches the transducer. This may restrict the choice of needle lengths in clinical applications. Copyright © 2016 The Authors. Published by Elsevier B

A biplanar fluoroscopic approach for the measurement, modeling, and simulation of needle and soft-tissue interaction.

PubMed

Hing, James T; Brooks, Ari D; Desai, Jaydev P

2007-02-01

A methodology for modeling the needle and soft-tissue interaction during needle insertion is presented. The approach consists of the measurement of needle and tissue motion using a dual C-arm fluoroscopy system. Our dual C-arm fluoroscopy setup allows real time 3-D extraction of the displacement of implanted fiducials in the soft tissue during needle insertion to obtain the necessary parameters for accurate modeling of needle and soft-tissue interactions. The needle and implanted markers in the tissue are tracked during the insertion and withdrawal of the needle at speeds of 1.016 mm/s, 12.7 mm/s and 25.4 mm/s. Both image and force data are utilized to determine important parameters such as the approximate cutting force, puncture force, the local effective modulus (LEM) during puncture, and the relaxation of tissue. We have also validated the LEM computed from our finite element model with arbitrary needle puncture tasks. Based on these measurements, we developed a model for needle insertion and withdrawal that can be used to generate a 1-DOF force versus position profile that can be experienced by a user operating a haptic device. This profile was implemented on a 7-DOf haptic device designed in our laboratory.

Treatment of supraspinatus tendinopathy with ultrasound guided dry needling.

PubMed

Settergren, Roy

2013-03-01

The purpose of this case study is to describe the treatment of a patient with tendinopathy using sonographically guided dry needling. Tendinopathies are a highly prevalent problem in musculoskeletal medicine, and no one form of treatment has gained universal acceptance as being superior to another. A 30-year-old woman with a 4-month history of anterolateral right shoulder pain was diagnosed with supraspinatus tendinopathy upon physical examination, which was confirmed with diagnostic sonography. Sonography was used to guide an acupuncture needle into the pathologic tissue to induce a humoral healing response. Therapeutic exercise was also prescribed. At 10-day follow-up, increased echogenicity was found in the previously heterogenous hypoechoic areas. The patient also experienced a subjective resolution of her shoulder pain, which did not return with increased physical activity. Sonographically guided dry needling was shown to be beneficial for this patient as evident by sonographic changes pre- and postprocedure.

Needle blight of ponderosa pine.

Treesearch

T.W. Childs

1955-01-01

This progress report describes the appearance and behavior of needle blight of pondersoa pine as it has been observed in central and eastern Oregon since 1945. Sorts and extent of damage are briefly discussed, results to date are presented from continuing studies, and timber marking and improvement practices are recommended for infected stands.

Flexible needle with integrated optical coherence tomography probe for imaging during transbronchial tissue aspiration

NASA Astrophysics Data System (ADS)

Li, Jiawen; Quirk, Bryden C.; Noble, Peter B.; Kirk, Rodney W.; Sampson, David D.; McLaughlin, Robert A.

2017-10-01

Transbronchial needle aspiration (TBNA) of small lesions or lymph nodes in the lung may result in nondiagnostic tissue samples. We demonstrate the integration of an optical coherence tomography (OCT) probe into a 19-gauge flexible needle for lung tissue aspiration. This probe allows simultaneous visualization and aspiration of the tissue. By eliminating the need for insertion and withdrawal of a separate imaging probe, this integrated design minimizes the risk of dislodging the needle from the lesion prior to aspiration and may facilitate more accurate placement of the needle. Results from in situ imaging in a sheep lung show clear distinction between solid tissue and two typical constituents of nondiagnostic samples (adipose and lung parenchyma). Clinical translation of this OCT-guided aspiration needle holds promise for improving the diagnostic yield of TBNA.

Presenting hydrothorax predicts failure of needle aspiration in primary spontaneous pneumothorax.

PubMed

Wu, Kwok Kei; Lui, Chun Tat; Ho, Chik Leung; Tsui, Kwok Leung; Fung, Hin Tat

2016-06-01

The objective was to evaluate if existence of hydrothorax in initial chest radiograph predicts treatment outcome in patients with primary spontaneous pneumothorax who received needle thoracostomy. This is a retrospective cohort study carried out from January 2011 to August 2014 in 1 public hospital in Hong Kong. All consecutive adult patients aged 18years or above who attended the emergency department with the diagnosis of primary spontaneous pneumothorax with needle aspiration performed as primary treatment were included. Age, smoking status, size of pneumothorax, previous history of pneumothorax, aspirated gas volume and presence of hydropneumothorax in initial radiograph were included in the analysis. The outcome was success or failure of the needle aspiration. Logistic regression was used to identify the predicting factors of failure of needle aspiration. There were a total of 127 patients included. Seventy-three patients (57.5%) were successfully treated with no recurrence upon discharge. Among 54 failure cases, 13 patients (10.2%) failed immediately after procedure as evident by chest radiograph and required second treatment. Forty-one patients (32.3%) failed upon subsequent chest radiographs. Multivariate logistic regression showed factors independently associated with the failure of needle aspiration, which included hydropneumothorax in the initial radiograph (odds ratio [OR]=4.47 [1.56i12.83], P=.005), previous history of pneumothorax (OR=3.92 [1.57-9.79], P=.003), and large size of pneumothorax defined as apex-to-cupola distance ≥5cm (OR=2.75 [1.21-6.26], P=.016). Hydropneumothorax, previous history of pneumothorax, and large size were independent predictors of failure of needle aspiration in treatment of primary spontaneous pneumothorax. Copyright © 2016 Elsevier Inc. All rights reserved.

Laser-photofield emission from needle cathodes for low-emittance electron beams.

PubMed

Ganter, R; Bakker, R; Gough, C; Leemann, S C; Paraliev, M; Pedrozzi, M; Le Pimpec, F; Schlott, V; Rivkin, L; Wrulich, A

2008-02-15

Illumination of a ZrC needle with short laser pulses (16 ps, 266 nm) while high voltage pulses (-60 kV, 2 ns, 30 Hz) are applied, produces photo-field emitted electron bunches. The electric field is high and varies rapidly over the needle surface so that quantum efficiency (QE) near the apex can be much higher than for a flat photocathode due to the Schottky effect. Up to 150 pC (2.9 A peak current) have been extracted by photo-field emission from a ZrC needle. The effective emitting area has an estimated radius below 50 microm leading to a theoretical intrinsic emittance below 0.05 mm mrad.

Toxoplasma lymphadenitis diagnosed by fine-needle aspiration cytology: a rare finding.

PubMed

Hosokawa, S; Kusama, Y; Ono, T; Mineta, H

2014-06-01

There are only very few reports of cervical toxoplasma lymphadenitis being diagnosed exclusively via fine-needle aspiration cytology (with serology). We describe a case of toxoplasma lymphadenitis that was successfully diagnosed by fine-needle aspiration cytology. The case involved a male patient who was immunocompromised as a result of recurrent acute myelogenous leukaemia with cervical lymphadenopathy. The biopsy showed typical features of a well-defined pseudocyst containing Toxoplasma gondii tachyzoites. Toxoplasma lymphadenitis is a common cause of lymph node enlargement. Fine-needle aspiration cytology is a useful method for diagnosing and differentiating toxoplasma lymphadenitis from more serious causes of lymphadenopathy, such as metastatic lymphadenopathy or lymphoma.

Mechanics of anesthetic needle penetration into human sciatic nerve.

PubMed

Pichamuthu, Joseph E; Maiti, Spandan; Gan, Maria G; Verdecchia, Nicole M; Orebaugh, Steven L; Vorp, David A

2018-06-06

Nerve blocks are frequently performed by anesthesiologists to control pain. For sciatic nerve blocks, the optimal placement of the needle tip between its paraneural sheath and epineurial covering is challenging, even under ultrasound guidance, and frequently results in nerve puncture. We performed needle penetration tests on cadaveric isolated paraneural sheath (IPS), isolated nerve (IN), and the nerve with overlying paraneural sheath (NPS), and quantified puncture force requirement and fracture toughness of these specimens to assess their role in determining the clinical risk of nerve puncture. We found that puncture force (123 ± 17 mN) and fracture toughness (45.48 ± 9.72 J m -2 ) of IPS was significantly lower than those for NPS (1440 ± 161 mN and 1317.46 ± 212.45 Jm -2 , respectively), suggesting that it is not possible to push the tip of the block needle through the paraneural sheath only, without pushing it into the nerve directly, when the sheath is lying directly over the nerve. Results of this study provide a physical basis for tangential placement of the needle as the ideal situation for local anesthetic deposition, as it allows for the penetration of the sheath along the edge of the nerve without entering the epineurium. Copyright © 2018 Elsevier Ltd. All rights reserved.

Percutaneous needle placement using laser guidance: a practical solution

NASA Astrophysics Data System (ADS)

Xu, Sheng; Kapoor, Ankur; Abi-Jaoudeh, Nadine; Imbesi, Kimberly; Hong, Cheng William; Mazilu, Dumitru; Sharma, Karun; Venkatesan, Aradhana M.; Levy, Elliot; Wood, Bradford J.

2013-03-01

In interventional radiology, various navigation technologies have emerged aiming to improve the accuracy of device deployment and potentially the clinical outcomes of minimally invasive procedures. While these technologies' performance has been explored extensively, their impact on daily clinical practice remains undetermined due to the additional cost and complexity, modification of standard devices (e.g. electromagnetic tracking), and different levels of experience among physicians. Taking these factors into consideration, a robotic laser guidance system for percutaneous needle placement is developed. The laser guidance system projects a laser guide line onto the skin entry point of the patient, helping the physician to align the needle with the planned path of the preoperative CT scan. To minimize changes to the standard workflow, the robot is integrated with the CT scanner via optical tracking. As a result, no registration between the robot and CT is needed. The robot can compensate for the motion of the equipment and keep the laser guide line aligned with the biopsy path in real-time. Phantom experiments showed that the guidance system can benefit physicians at different skill levels, while clinical studies showed improved accuracy over conventional freehand needle insertion. The technology is safe, easy to use, and does not involve additional disposable costs. It is our expectation that this technology can be accepted by interventional radiologists for CT guided needle placement procedures.

Hematoma formation during breast core needle biopsy in women taking antithrombotic therapy.

PubMed

Chetlen, Alison L; Kasales, Claudia; Mack, Julie; Schetter, Susann; Zhu, Junjia

2013-07-01

The purpose of this study was to compare hematoma formation after breast core needle biopsy performed on patients undergoing and those not undergoing concurrent antithrombotic therapy. A prospective assessment of core needle biopsies (stereotactic, ultrasound guided, or MRI guided) performed on patients enrolled between September 2011 and July 2012 formed the basis of this study. Postprocedure mediolateral and craniocaudal mammograms were evaluated for the presence and size of hematomas. Patients were clinically evaluated for complications 24-48 hours after the procedure through telephone call or face-to-face consultation. Needle size, type of biopsy, and presence of hematoma and documented complications were correlated with use of antithrombotic agents (including aspirin, warfarin, clopidogrel, and daily nonsteroidal antiinflammatory medications). No clinically significant hematomas or bleeding complications were found. Eighty-nine of 617 (14.4%) non-clinically significant hematomas were detected on postprocedure mammograms. The probability of development of a non-clinically significant hematoma was 21.6% for patients taking antithrombotics and 13.0% for those not taking antithrombotics. Concurrent antithrombotic therapy and larger needle gauge were significant factors contributing to the probability of hematoma formation. The volume of the hematoma was not related to needle gauge or presence of antithrombotic therapy. No clinically significant hematomas were found. Because there are potential life-threatening risks to stopping antithrombotic therapy before breast biopsy, withholding antithrombotic therapy for core needle breast biopsy is not recommended because the incidence of non-clinically significant hematoma is low.

Spectral signatures of viewing a needle approaching one's body when anticipating pain.

PubMed

Höfle, Marion; Pomper, Ulrich; Hauck, Michael; Engel, Andreas K; Senkowski, Daniel

2013-10-01

When viewing the needle of a syringe approaching your skin, anticipation of a painful prick may lead to increased arousal. How this anticipation is reflected in neural oscillatory activity and how it relates to activity within the autonomic nervous system is thus far unknown. Recently, we found that viewing needle pricks compared with Q-tip touches increases the pupil dilation response (PDR) and perceived unpleasantness of electrical stimuli. Here, we used high-density electroencephalography to investigate whether anticipatory oscillatory activity predicts the unpleasantness of electrical stimuli and PDR while viewing a needle approaching a hand that is perceived as one's own. We presented video clips of needle pricks and Q-tip touches, and delivered spatiotemporally aligned painful and nonpainful intracutaneous electrical stimuli. The perceived unpleasantness of electrical stimuli and the PDR were enhanced when participants viewed needle pricks compared with Q-tip touches. Source reconstruction using linear beamforming revealed reduced alpha-band activity in the posterior cingulate cortex (PCC) and fusiform gyrus before the onset of electrical stimuli when participants viewed needle pricks compared with Q-tip touches. Moreover, alpha-band activity in the PCC predicted PDR on a single trial level. The anticipatory reduction of alpha-band activity in the PCC may reflect a neural mechanism that serves to protect the body from forthcoming harm by facilitating the preparation of adequate defense responses. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Partner Relationships and Injection Sharing Practices among Rural Appalachian Women.