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Sample records for 14-gauge needle core

  1. Laryngeal chondrosarcoma diagnosed by core-needle biopsy.

    PubMed

    Miyamaru, Satoru; Haba, Koichi

    2014-01-01

    We report a case of chondrosarcoma of the larynx, diagnosed by a percutaneous core-needle biopsy (CNB). Cartilaginous tumors of the larynx are usually diagnosed by biopsy with direct laryngomicroscopy under general anesthesia. However, patients find it difficult to undergo a biopsy under general anesthesia, for physical, economic, and social reasons. Instead, we can readily detect and sample tumors of the larynx using ultrasound under local anesthesia with reduced stress. Concerning needle-puncture biopsies, including fine-needle aspiration cytology (FNAC) and CNB, some studies have reported needle track dissemination, a possible complication in patients with malignant tumors. Thus, in the head and neck region, we generally use FNAC for biopsies, not CNB. However, it can be difficult to diagnose bone tumors by cytology alone. Regarding primary bone tumors, only one study has reported needle track dissemination by CNB, in osteosarcoma of the femur. Additionally, this complication has not been reported before with chondrosarcoma anywhere in the body. To our knowledge, this is the first report concerning chondrosarcoma of the larynx diagnosed by percutaneous CNB. We recommend CNB as a useful and safe diagnostic technique for primary bone tumors in the head and neck region.

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

    PubMed

    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

  3. Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

    PubMed Central

    Hari, Smriti; Kumari, Swati; Srivastava, Anurag; Thulkar, Sanjay; Mathur, Sandeep; Veedu, Prasad Thotton

    2016-01-01

    Background & objectives: Biopsy of palpable breast masses can be performed manually by palpation guidance or under imaging guidance. Based on retrospective studies, image guided biopsy is considered more accurate than palpation guided breast biopsy; however, these techniques have not been compared prospectively. We conducted this prospective study to verify the superiority and determine the size of beneficial effect of image guided biopsy over palpation guided biopsy. Methods: Over a period of 18 months, 36 patients each with palpable breast masses were randomized into palpation guided and image guided breast biopsy arms. Ultrasound was used for image guidance in 33 patients and mammographic (stereotactic) guidance in three patients. All biopsies were performed using 14 gauge automated core biopsy needles. Inconclusive, suspicious or imaging-histologic discordant biopsies were repeated. Results: Malignancy was found in 30 of 36 women in palpation guided biopsy arm and 27 of 36 women in image guided biopsy arm. Palpation guided biopsy had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 46.7, 100, 100, 27.3 per cent, respectively, for diagnosing breast cancer. Nineteen of 36 women (52.8%) required repeat biopsy because of inadequate samples (7 of 19), suspicious findings (2 of 19) or imaging-histologic discordance (10 of 19). On repeat biopsy, malignancy was found in all cases of imaging-histologic discordance. Image guided biopsy had 96.3 per cent sensitivity and 100 per cent specificity. There was no case of inadequate sample or imaging-histologic discordance with image guided biopsy. Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates. PMID:27488003

  4. Mammographically Occult Asymptomatic Radial Scars/Complex Sclerosing Lesions at Ultrasonography-Guided Core Needle Biopsy: Follow-Up Can Be Recommended.

    PubMed

    Park, Vivian Youngjean; Kim, Eun-Kyung; Kim, Min Jung; Yoon, Jung Hyun; Moon, Hee Jung

    2016-10-01

    An increasing number of radial scars are detected by ultrasound (US), but their management is controversial. This study investigated the upgrade rate in mammographically occult radial scars/complex sclerosing lesions without epithelial atypia at US-guided 14-gauge core needle biopsy in asymptomatic patients. Nineteen mammographically occult benign radial scars/complex sclerosing lesions (median size, 7 mm; range, 3-23 mm) were included. Patients underwent surgical excision (n = 10) or vacuum-assisted excision, with follow-up US at least 6 mo after benign vacuum-assisted excision results (n = 8), or underwent US follow-up for 2 y after core needle biopsy (n = 1). Any cases with change in diagnosis to high-risk lesions or malignancy at excision were considered upgrades. The upgrade rate was 0.0%. Based on US findings, 15.8% (3/19) were Breast Imaging Reporting and Data System (BI-RADS) category 3, 68.4% (13/19) were BI-RADS category 4a and 15.8% (3/19) were BI-RADS category 4b. Follow-up with US can be considered for mammographically occult benign radial scar/complex sclerosing lesions diagnosed by US core needle biopsy in asymptomatic patients. PMID:27444865

  5. Core needle biopsy guidance based on EMOCT imaging (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Iftimia, Nicusor V.; Park, Jesung; Maguluri, Gopi

    2016-03-01

    We present a novel method, based on encoder mapping OCT imaging, for real-time guidance of core biopsy procedures. This method provides real-time feedback to the interventional radiologist, such that he/she can reorient the needle during the biopsy and sample the most representative area of the suspicious mass that is being investigated. This aspect is very important for tailoring therapy to the specific cancer based on biomarker analysis, which will become one of the next big advances in our search for the optimal cancer therapy. To enable individualized treatment, the genetic constitution and the DNA repair status in the affected areas is needed for each patient. Thus, representative sampling of the tumor is needed for analyzing various biomarkers, which are used as a tool to personalize cancer therapy. The encoder-based OCT enables samping of large size masses and provides full control on the imaging probe, which is passed through the bore of the biopsy guidance needle. The OCT image is built gradually, based on the feedback of an optical encoder which senses the incremental movement of the needle with a few microns resolution. Tissue mapping is independent of the needle speed, while it is advanced through the tissue. The OCT frame is analyzed in real-time and tissue cellularity is reported in a very simple manner (pie chart). Our preliminary study on a rabbit model of cancer has demonstrated the capability of this technology for accurately differentiating between viable cancer and heterogeneous or necrotic tissue.

  6. Comparison of a new aspiration needle device and the Quick-Core biopsy needle for transjugular liver biopsy

    PubMed Central

    Ishikawa, Toru; Kamimura, Hiroteru; Tsuchiya, Atsunori; Togashi, Tadayuki; Watanabe, Kouji; Seki, Kei-ichi; Ohta, Hironobu; Yoshida, Toshiaki; Ishihara, Noriko; Kamimura, Tomoteru

    2006-01-01

    AIM: To evaluate sample adequacy, safety, and needle passes of a new biopsy needle device compared to the Quick-Core biopsy needle for transjugular liver biopsy in patients affected by liver disease. METHODS: Thirty consecutive liver-disease patients who had major coagulation abnormalities and/or relevant ascites underwent transjugular liver biopsy using either a new needle device (18 patients) or the Quick-Core biopsy needle (12 patients). The length of the specimens was measured before fixation. A pathologist reviewed the histological slides for sample adequacy and pathologic diagnoses. The two methods’ specimen adequacy and complication rates were assessed. RESULTS: Liver biopsies were technically successful in all 30 (100%) patients, with diagnostic histological core specimens obtained in 30 of 30 (100%) patients, for an overall success rate of 100%. With the new device, 18 specimens were obtained, with an average of 1.1 passes per patient. Using the Quick-Core biopsy needle, 12 specimens were obtained, with an average of 1.8 passes per patient. Specimen length was significantly longer with the new needle device than with the Quick-Core biopsy needle (P < 0.05). The biopsy tissue was not fragmented in any of the specimens with the new aspiration needle device, but tissue was fragmented in 3 of 12 (25.0%) specimens obtained using the Quick-Core biopsy needle. Complications included cardiac arrhythmia in 3 (10.0%) patients, and transient abdominal pain in 4 (13.3%) patients. There were no cases of subcapsular hematoma, hemoperitoneum, or sepsis, and there was no death secondary to the procedure. In particular, no early or delayed major procedure-related complications were observed in any patient. CONCLUSION: Transjugular liver biopsy is a safe and effective procedure, and there was significant difference in the adequacy of the specimens obtained using the new needle device compared to the Quick-Core biopsy needle. Using the new biopsy needle device, the

  7. Percutaneous CT-Guided Core Needle Biopsy Versus Fine Needle Aspiration in Diagnosing Pneumonia and Mimics of Pneumonia

    SciTech Connect

    Thanos, Loukas; Galani, Panagiota Mylona, Sophia; Pomoni, Maria; Mpatakis, Nikolaos

    2004-08-15

    The purpose of this study was to determine the diagnostic value of percutaneous core needle biopsy (CNB) relative to fine needle aspiration (FNA) in patients with pneumonia and pneumonia mimics. In this prospective study we present our experience with 48 thoracic FNAs and CNBs carried out on 48 patients with pneumonia and pneumonia mimics. Samples were obtained from all patients using both CNB (with an automated 18-G core biopsy needle and a gun) and FNA (with a 22-G needle). A specific diagnosis was made in 10/48 cases (20.83%) by FNA and in 42/48 (87.5%) by CNB. The main complications encountered were pneumothorax (n = 4) and hemoptysis (n = 2), yielding a total complication rate of 12.5%. We concluded that CNB using an automated biopsy gun results in a higher diagnostic accuracy for pneumonia and pneumonia mimic biopsies than FNA. Complications should be considered and proper patient observation should follow the procedure.

  8. Pathologic evaluation of a new endoscopic ultrasound needle designed to obtain core tissue samples: A pilot study

    PubMed Central

    Adler, Douglas G.; Witt, Benjamin; Chadwick, Barbara; Wells, Jason; Taylor, Linda Jo; Dimaio, Christopher; Schmidt, Robert

    2016-01-01

    Background and Objectives: Standard endoscopic ultrasound-fine-needle aspiration (EUS-FNA) needles are in widespread use. Meaningful differences between the available needles have been difficult to identify. Recently, a new EUS needle (Shark Core®, Covidien, Dublin, Leinster, Ireland), has been introduced in an attempt to improve diagnostic accuracy, tissue yield, and to potentially obtain a core tissue sample. We performed a pilot study prospectively to evaluate this new needle when compared to a standard EUS-FNA needle. Materials and Methods: Analysis of the first 15 patients undergoing EUS-FNA with the Shark Core needle was performed and it was compared to EUS-FNA in 15 patients who underwent EUS-FNA with a standard needle. Results: The Shark Core needle required fewer needle passes to obtain diagnostic adequacy than the standard needle [(χ2(1) = 11.3, P < 0.001]. The Shark Core needle required 1.5 passes to reach adequacy, whereas the standard needle required three passes. For cases with cell blocks, the Shark Core needle produced diagnostic material in 85% of cases [95% confidence interval (CI): 54–98], whereas the standard needle produced diagnostic material in 38% of the cases (95% CI: 9-76). The Shark Core needle produced actual tissue cores 82% of the time (95% CI: 48–98) and the standard needle produced no tissue cores (95% CI: 0-71) (P = 0.03). Conclusion: This pilot study found that the Shark Core needle had a high rate of producing adequate cytologic material for the diagnosis of pancreatic and peri-pancreatic lesions sampled by EUS with fewer passes required to obtain a definitive diagnosis and with a high rate of tissue cores being obtained when compared to a standard FNA needle. PMID:27386475

  9. Combination of needle aspiration and core needle biopsy: A new technique of stereotactic biopsy

    PubMed Central

    Wani, Abrar Ahad; Wani, M. Afzal; Ramzan, Altaf U.; Nizami, Furqan A.; Malik, Nayil K.; Shafiq, S.; Ahmad, Rais; Kumar, Ashish; Lone, Iqbal; Makhdoomi, Rumana

    2016-01-01

    Aim: The study aims at describing the results of using a new technique to acquire the tissue sample in stereotactic biopsy of brain lesions. Materials and Methods: The study was performed in 19 patients over a period of 5 years in which we used the new technique, i.e., Abrar and Afzal technique (AT) of obtaining tissue biopsy. It is a combination of core tissue biopsy and needle aspiration techniques. The technique was devised to acquire greater amount of tissue for pathologic study. Results: While we could give pathologic diagnosis in 18 patients out of 19 (94.7%), in one patient, the tissue sample revealed only inflammatory cells and definitive diagnosis could not be reached. There was no significant morbidity or any mortality in the series. Conclusion: Abrar and Afzal technique is a reasonably accurate technique of acquiring larger tissue sample in stereotactic brain biopsy without any additional risks. It can be done with little modification of the conventional equipment available with the stereotactic system. PMID:27057212

  10. Efficacy of Core Needle Biopsy Technique for Jawbone Diseases.

    PubMed

    Stolbizer, Federico; Cabrini, Romulo L; Keszler, Alicia

    2015-12-01

    Core needle biopsy (CNB) has been proven useful for diagnosing bone lesions, although it is not often used for jawbone lesions. The aim of this study was to evaluate the efficacy of the CNB method in a series of cases of intramaxillary lesions. CNB was performed on 85 patients with intraosseous lesions which were grouped according to radiographic appearance as: radiopaque lesions (RO, n=13), radiolucent lesions (RL, n=39) and mixed lesions with both radiolucent and radiopaque areas (RL-RO, n=33). The technique enabled us to obtain several tissue cylinders from each lesion (average 2.5 cylinders), which were processed following routine histopathological technique and H&E stain, plus special techniques when necessary. The histopathological analysis together with clinical data enabled accurate diagnosis (AD) in 81% of the cases and descriptive diagnosis (DD) in 14%. The material obtained in 5% of the cases was not appropriate for study (ND). The difference between successful (AD) and unsuccessful (DD+ND) CNB cases is statistically significant. The highest percentage of successful CBNs was for RO and RLRO lesions (85% and 100% respectively). RL lesions were more difficult because most of them were cystic lesions with fluid content.

  11. Core needle biopsy versus fine needle aspiration biopsy in breast--a historical perspective and opportunities in the modern era.

    PubMed

    Nassar, Aziza

    2011-05-01

    Breast fine-needle aspiration biopsy (FNAB) by palpation is on the decline, due to its limitations in diagnostic accuracy, decreased sensitivity, and its replacement with core needle biopsy (CNB). Despite its decreasing utility, superficial fine-needle aspiration (FNA) in breast is still the main modality for evaluating metastatic lesions, recurrence, and axillary lymph node metastasis. New modalities including proteomic pattern expression and methylation profiling of breast lesions are other promising techniques that can be used as ancillary tests for refining the diagnosis of breast lesions using FNAB. Image-guided breast FNA proves to be a successful alternative with high sensitivity and specificity. In this review, the advantages, disadvantages, and inherent limitations of breast FNA and CNB, and new advanced techniques are discussed.

  12. Are We Overtreating Papillomas Diagnosed on Core Needle Biopsy?

    PubMed Central

    Cyr, Amy E.; Novack, Deborah; Trinkaus, Kathryn; Margenthaler, Julie A.; Gillanders, William E.; Eberlein, Timothy J.; Ritter, Jon; Aft, Rebecca L.

    2014-01-01

    Background Breast papillomas often are diagnosed with core needle biopsy (CNB). Most studies support excision for atypical papillomas, because as many as one half will be upgraded to malignancy on final pathology. The literature is less clear on the management of papillomas without atypia on CNB. Our goal was to determine factors associated with pathology upgrade on excision. Methods Our pathology database was searched for breast papillomas diagnosed by CNB during the past 10 years. We identified 277 charts and excluded lesions associated with atypia or malignancy on CNB. Two groups were identified: papillomas that were surgically excised (group 1) and those that were not (group 2). Charts were reviewed for the subsequent diagnosis of cancer or high-risk lesions. Appropriate statistical tests were used to analyze the data. Results A total of 193 papillomas were identified. Eighty-two lesions were excised (42%). Caucasian women were more likely to undergo excision (p = 0.03). Twelve percent of excised lesions were upgraded to malignancy. Increasing age was a predictor of upgrading, but this was not significant. Clinical presentation, lesion location, biopsy technique, and breast cancer history were not associated with pathology upgrade. Two lesions in group 2 ultimately required excision due to enlargement, and both were upgraded to malignancy. Conclusions Twenty-four percent of papillomas diagnosed on CNB have upgraded pathology on excision—half to malignancy. All of the cancers diagnosed were stage 0 or I. For patients in whom excision was not performed, 2 of 111 papillomas were later excised and upgraded to malignancy. PMID:21046266

  13. A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

    PubMed Central

    Osborn, G; Wilton, F; Stevens, G; Vaughan-Williams, E; Gower-Thomas, K

    2010-01-01

    INTRODUCTION Radial scars are benign breast lesions; their appearance on mammography may, however, mimic carcinoma. Needle core biopsy is performed for pre-operative diagnosis and, currently in Wales, all lesions with benign biopsy results are surgically excised. We have reviewed all cases of needle core biopsy-diagnosed radial scars from the Welsh breast screening programme, Breast Test Wales (BTW), and investigated the outcome of radial scars based on histology from surgical excision in order to evaluate the appropriateness of the current management of these lesions in Wales. PATIENTS AND METHODS All needle core biopsy diagnosed radial scars were identified from the BTW screening database from the start of screening in 1989 until the end of 2007. RESULTS A total of 118 patients were diagnosed with radial scars on needle core biopsy; two patients had bilateral radial scars. Median patient age was 54 years (range, 49-68 years). Ninety-five lesions (79%) were thought to be pure radial scars on needle core biopsy; however, only 81 pure radial scars were identified on excision biopsy histology. Carcinoma was present in seven patients and ductal carcinoma in situ in nine patients at excision biopsy. In two patients, the cancers occurred in lesions reported as pure radial scars on needle core biopsy. Twenty-two lesions showed atypical ductal or lobular hyperplasia (ADH/ALH) or both on excision biopsy; 14 of these lesions were classed as pure radial scars by needle core biopsy. CONCLUSIONS All core biopsy diagnosed radial scars, presenting as screen detected abnormalities, should be excised due to their association with premalignant and malignant conditions. PMID:21073820

  14. 49 CFR 178.337-14 - Gauging devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices. 178.337-14 Section 178.337-14... Specifications for Containers for Motor Vehicle Transportation § 178.337-14 Gauging devices. (a) Liquid level gauging devices. See § 173.315(h) of this subchapter. (b) Pressure gauges. (1) See § 173.315(h) of...

  15. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices. 178.338-14 Section 178.338-14... Specifications for Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices. (1) Unless a cargo tank is intended to be filled by weight, it must be equipped with...

  16. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure,...

  17. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure,...

  18. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure,...

  19. Transjugular Core Liver Biopsy with a 19-Gauge Spring-Loaded Cutting Needle

    SciTech Connect

    Choh, Jeffery; Dolmatch, Bart; Safadi, Rami; Long, Phil; Geisinger, Michael; Lammert, Gary; Dempsey, James

    1998-01-15

    One hundred and five sequential transjugular core liver biopsies (TJLBx) were performed in 101 patients with coagulopathy and/or ascites using the 19-gauge Quick-Core Biopsy (QCB) needle. Two-hundred and seventy-three cores were obtained in 295 passes (92.5%). One-hundred and two of the 105 procedures (97.1%) led to a histopathologic diagnosis. One of the three nondiagnostic biopsies was done because of severe autolysis of the liver. There was one subcapsular hematoma, one hepatic arteriovenous fistula, and one liver capsular puncture. Two minor neck hematomas occurred. One death was reported (unrelated to the procedure). QCB needle TJLBx is an effective and relatively safe way to obtain core liver samples.

  20. Intramuscular Hemangioma in the Anterior Scalene Muscle Diagnosed by Core Needle Biopsy

    PubMed Central

    Cho, Jae-Keun; Sung, Myung-Whun

    2015-01-01

    Intramuscular hemangioma (IMH) is a rare, benign vascular lesion that frequently develops within skeletal muscles. Preoperatively, accurate diagnosis of IMH is often extremely difficult because of nonspecific clinical findings and the inaccuracy of fine-needle aspiration cytology. IMH is suspected in only 8% of preoperative diagnoses before surgical exploration. Here, we report a case of a 44-year-old man with a huge IMH in the anterior scalene muscle that was preoperatively diagnosed using ultrasonography-guided core needle biopsy, and was successfully treated based on preoperative clinical information. PMID:26330928

  1. Use of Core Needle Biopsy rather than Fine-Needle Aspiration Cytology in the Diagnostic Approach of Breast Cancer

    PubMed Central

    Pagni, Paola; Spunticchia, Flaminia; Barberi, Simona; Caprio, Giuliana; Paglicci, Carlo

    2014-01-01

    Background and Aims In the following study case, we reviewed breast ultrasound-guided core needle biopsy (CNB), using Mammotome (vacuum-assisted breast biopsy) and Tru-cut, carried out on palpable and nonpalpable uncertain breast lumps or malignant large lesions to be submitted to neoadjuvant chemotherapy. Material and Methods Examinations were conducted during a 4-year period of clinical activity in a highly specialized center, from December 2009 to December 2013, in 712 patients previously subjected to fine-needle aspiration cytology (FNAC). Results The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up. Conclusions CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers. Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required. In accordance with recent publications, we can confirm the full validity of CNB in the diagnostic approach of breast lesions. PMID:25120471

  2. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the Lymph Node Registry Kiel.

    PubMed

    Johl, Alice; Lengfelder, Eva; Hiddemann, Wolfgang; Klapper, Wolfram

    2016-08-01

    Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation. PMID:27236576

  3. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the Lymph Node Registry Kiel.

    PubMed

    Johl, Alice; Lengfelder, Eva; Hiddemann, Wolfgang; Klapper, Wolfram

    2016-08-01

    Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation.

  4. Surgical excision of pure flat epithelial atypia identified on core needle breast biopsy.

    PubMed

    Prowler, Vanessa L; Joh, Jennifer E; Acs, Geza; Kiluk, John V; Laronga, Christine; Khakpour, Nazanin; Lee, M Catherine

    2014-08-01

    The biology of flat epithelial atypia (FEA) is still being investigated as its presence becomes more frequent on biopsy specimens. FEA is more commonly associated with malignancy when found in association with ADH, ALH or LCIS. Pure FEA is only upgraded to cancer in 3.2% of patients. Surgical excision of pure FEA found on core needle biopsy results in overtreatment in the vast majority of breast patients and may not be necessary.

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

    PubMed Central

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

    2012-01-01

    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. PMID:22741064

  6. Raman spectroscopy: a real-time tool for identifying microcalcifications during stereotactic breast core needle biopsies

    PubMed Central

    Saha, A.; Barman, I.; Dingari, N. C.; McGee, S.; Volynskaya, Z.; Galindo, L. H.; Liu, W.; Plecha, D.; Klein, N.; Dasari, R. R.; Fitzmaurice, M.

    2011-01-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. We present here a Raman spectroscopic tool for detecting microcalcifications in breast tissue based on their chemical composition. We collected ex vivo Raman spectra from 159 tissue sites in fresh stereotactic breast needle biopsies from 33 patients, including 54 normal sites, 75 lesions with microcalcifications and 30 lesions without microcalcifications. Application of our Raman technique resulted in a positive predictive value of 97% for detecting microcalcifications. This study shows that Raman spectroscopy has the potential to detect microcalcifications during stereotactic breast core biopsies and provide real-time feedback to radiologists, thus reducing non-diagnostic and false negative biopsies. PMID:22025985

  7. Feasibility of near-infrared diffuse optical spectroscopy on patients undergoing image-guided core-needle biopsy

    PubMed Central

    Yu, Bing; Burnside, Elizabeth S.; Sisney, Gale A.; Harter, Josephine M.; Zhu, Changfang; Dhalla, Al-Hafeez; Ramanujam, Nirmala

    2009-01-01

    We describe a side-firing fiber optic sensor based on near-infrared spectroscopy for guiding core needle biopsy diagnosis of breast cancer. The sensor is composed of three side firing optical fibers (two source fibers and one detection fiber), providing two source-detector separations. The entire assembly is inserted into a core biopsy needle, allowing for sampling to occur at the biopsy site. A multi-wavelength frequency-domain near-infrared instrument is used to collect diffuse reflectance in the breast tissue through an aperture on the biopsy needle before the tissue is removed for histology. Preliminary in vivo measurements performed on 10 normal or benign breast tissues from 5 women undergoing stereo- or ultrasound-guided core needle biopsy show the ability of the system to determine tissue optical properties and constituent concentrations, which are correlated with breast tissue composition derived from histopathology. PMID:19547057

  8. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy.

    PubMed

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-06-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled on the basis of the breast tissue components, and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma, and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity, and specificity of 100%, 95.6%, 62.5%, and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, fibroadenoma, or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study shows the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing nondiagnostic and false-negative biopsies. PMID:23729641

  9. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy

    PubMed Central

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-01-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled based on the breast tissue components and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma (FA) and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity and specificity of 100%, 95.6%, 62.5% and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, FA or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study demonstrates the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing non-diagnostic and false negative biopsies. PMID:23729641

  10. Malignant-looking thyroid nodules with size reduction: core needle biopsy results

    PubMed Central

    Shong, Young Kee

    2016-01-01

    Purpose The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. Methods From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. Results All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells. Conclusion In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery. PMID:27184652

  11. Diagnostic value of ultrasound-guided core needle biopsy in patients with salivary gland masses.

    PubMed

    Pfeiffer, J; Ridder, G J

    2012-04-01

    The salivary glands are unique in the diversity and complexity of their pathologies. Because fine needle aspiration cytology and frozen section are associated with major diagnostic difficulties, the authors analyzed the use of core needle biopsy (CNB) for the histologic assessment of salivary gland lesions. A systematic observational clinicopathologic quality assessment study was performed over 81 months including 161 CNB procedures in 76 patients with salivary gland pathologies. Adequate samples containing the target tissue were obtained in 73 patients. These samples revealed malignant disease in 45 (62%) patients, benign disease in 26 (36%) patients, and were inconclusive in 2 (3%) patients. Follow-up uncovered no false-positive or false-negative results. On the basis of secondary histologic and clinical follow-up, the statistical parameters were calculated as follows: sensitivity 94%; specificity 100%; accuracy 96%; positive predictive value 100%; negative predictive value 90%. The advantages and potential limitations of CNB in patients with salivary gland masses are discussed. CNB is a reliable biopsy technique for the assessment of salivary gland pathologies, although limitations remain for the subclassification of some neoplastic lesions. The authors recommend CNB as the biopsy technique of choice for a selection of indications.

  12. Feasibility and Diagnostic Yield of Endoscopic Ultrasonography-Guided Fine Needle Biopsy With a New Core Biopsy Needle Device in Patients With Gastric Subepithelial Tumors

    PubMed Central

    Lee, Minju; Min, Byung-Hoon; Lee, Hyuk; Ahn, Sangjeong; Lee, Jun Haeng; Rhee, Poong-Lyul; Kim, Jae J.; Sohn, Tae Sung; Kim, Sung; Kim, Kyoung-Mee

    2015-01-01

    Abstract As treatment decisions for patients with gastric subepithelial tumors (SETs) largely depend on the histopathologic diagnosis, noninvasive and effective tissue acquisition methods are definitely required for proper management of gastric SETs. Recently, a new endoscopic ultrasonography-guided fine needle biopsy (EUS-FNB) device with ProCore reverse bevel technology was developed. We aimed to elucidate the feasibility and diagnostic yield of EUS-FNB with this new core biopsy needle device in patients with gastric SETs. A prospectively maintained database was retrospectively reviewed to identify consecutive patients who underwent EUS-FNB with a 22-gauge ProCore needle for gastric SETs 2 cm or larger. The main outcome measurement was the diagnostic yield of EUS-FNB. Procedure results were categorized into diagnostic, suggestive, or nondiagnostic. Of the 43 patients, needle punctures were successful in all cases irrespective of tumor location. EUS-FNB procedure results were diagnostic in 86.0%, suggestive in 4.7%, and nondiagnostic in 9.3% of cases, respectively. The diagnostic yield was the highest in fundus (100.0%), followed by body (89.5%), cardia (83.3%), and antrum (50.0%). All 18 patients with cardiac SET were finally diagnosed to have leiomyoma, and 16 patients with diagnostic or suggestive results avoided surgery. A heterogeneous echo pattern on EUS was found in 33.3% of cases with nondiagnostic or suggestive results and in 5.4% with diagnostic results. In multivariate analysis, no independent predictor of unsuccessful EUS-FNB with nondiagnostic or suggestive results was identified. Agreement between EUS-FNB and surgical pathology was 100% with respect to the diagnosis of gastrointestinal stromal tumor. However, there was a significant discrepancy in mitotic counts observed between the EUS-FNB and surgical specimens in patients with gastrointestinal stromal tumor. There were no significant procedure-related adverse events during and after the

  13. Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American multicenter study

    PubMed Central

    DiMaio, Christopher J.; Kolb, Jennifer M.; Benias, Petros C.; Shah, Hiral; Shah, Shashin; Haluszka, Oleh; Maranki, Jennifer; Sharzehi, Kaveh; Lam, Eric; Gordon, Stuart R.; Hyder, Sarah M.; Kaimakliotis, Pavlos Z.; Allaparthi, Satya B.; Gress, Frank G.; Sethi, Amrita; Shah, Ashish R.; Nieto, Jose; Kaul, Vivek; Kothari, Shivangi; Kothari, Truptesh H.; Ho, Sammy; Izzy, Manhal J.; Sharma, Neil R.; Watson, Rabindra R.; Muthusamy, V. Raman; Pleskow, Douglas K.; Berzin, Tyler M.; Sawhney, Mandeep; Aljahdi, Emad; Ryou, Marvin; Wong, Clarence K.; Gupta, Parantap; Yang, Dennis; Gonzalez, Susana; Adler, Douglas G.

    2016-01-01

    Background and aims: The ability to safely and effectively obtain sufficient tissue for pathologic evaluation by using endoscopic ultrasound (EUS) guidance remains a challenge. Novel designs in EUS needles may provide for improved ability to obtain such core biopsies. The aim of this study was to evaluate the diagnostic yield of core biopsy specimens obtained using a novel EUS needle specifically designed to obtain core biopsies. Patients and methods: Multicenter retrospective review of all EUS-guided fine-needle biopsies obtained using a novel biopsy needle (SharkCore FNB needle, Medtronic, Dublin, Ireland). Data regarding patient demographics, lesion type/location, technical parameters, and diagnostic yield was obtained. Results: A total of 250 lesions were biopsied in 226 patients (Median age 66 years; 113 (50 %) male). Median size of all lesions (mm): 26 (2 – 150). Overall, a cytologic diagnosis was rendered in 81 % specimens with a median number of 3 passes. When rapid onsite cytologic evaluation (ROSE) was used, cytologic diagnostic yield was 126/149 (85 %) with a median number of 3 passes; without ROSE, cytologic diagnostic yield was 31/45 (69 %, P = 0.03) with a median number of 3 passes. Overall, a pathologic diagnosis was rendered in 130/147 (88 %) specimens with a median number of 2 passes. Pathologic diagnostic yield for specific lesion types: pancreas 70/81 (86 %), subepithelial lesion 13/15 (87 %), lymph node 26/28 (93 %). Ten patients (10/226, 4 %) experienced adverse events: 4 acute pancreatitis, 5 pain, 1 fever/cholangitis. Conclusions: Initial experience with a novel EUS core biopsy needle demonstrates excellent pathologic diagnostic yield with a minimum number of passes.

  14. Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American multicenter study

    PubMed Central

    DiMaio, Christopher J.; Kolb, Jennifer M.; Benias, Petros C.; Shah, Hiral; Shah, Shashin; Haluszka, Oleh; Maranki, Jennifer; Sharzehi, Kaveh; Lam, Eric; Gordon, Stuart R.; Hyder, Sarah M.; Kaimakliotis, Pavlos Z.; Allaparthi, Satya B.; Gress, Frank G.; Sethi, Amrita; Shah, Ashish R.; Nieto, Jose; Kaul, Vivek; Kothari, Shivangi; Kothari, Truptesh H.; Ho, Sammy; Izzy, Manhal J.; Sharma, Neil R.; Watson, Rabindra R.; Muthusamy, V. Raman; Pleskow, Douglas K.; Berzin, Tyler M.; Sawhney, Mandeep; Aljahdi, Emad; Ryou, Marvin; Wong, Clarence K.; Gupta, Parantap; Yang, Dennis; Gonzalez, Susana; Adler, Douglas G.

    2016-01-01

    Background and aims: The ability to safely and effectively obtain sufficient tissue for pathologic evaluation by using endoscopic ultrasound (EUS) guidance remains a challenge. Novel designs in EUS needles may provide for improved ability to obtain such core biopsies. The aim of this study was to evaluate the diagnostic yield of core biopsy specimens obtained using a novel EUS needle specifically designed to obtain core biopsies. Patients and methods: Multicenter retrospective review of all EUS-guided fine-needle biopsies obtained using a novel biopsy needle (SharkCore FNB needle, Medtronic, Dublin, Ireland). Data regarding patient demographics, lesion type/location, technical parameters, and diagnostic yield was obtained. Results: A total of 250 lesions were biopsied in 226 patients (Median age 66 years; 113 (50 %) male). Median size of all lesions (mm): 26 (2 – 150). Overall, a cytologic diagnosis was rendered in 81 % specimens with a median number of 3 passes. When rapid onsite cytologic evaluation (ROSE) was used, cytologic diagnostic yield was 126/149 (85 %) with a median number of 3 passes; without ROSE, cytologic diagnostic yield was 31/45 (69 %, P = 0.03) with a median number of 3 passes. Overall, a pathologic diagnosis was rendered in 130/147 (88 %) specimens with a median number of 2 passes. Pathologic diagnostic yield for specific lesion types: pancreas 70/81 (86 %), subepithelial lesion 13/15 (87 %), lymph node 26/28 (93 %). Ten patients (10/226, 4 %) experienced adverse events: 4 acute pancreatitis, 5 pain, 1 fever/cholangitis. Conclusions: Initial experience with a novel EUS core biopsy needle demonstrates excellent pathologic diagnostic yield with a minimum number of passes. PMID:27652304

  15. Can problematic fibroepithelial lesions be accurately classified on core needle biopsies?

    PubMed

    Bandyopadhyay, Sudeshna; Barak, Stephanie; Hayek, Kinda; Thomas, Sumi; Saeed, Haleema; Beydoun, Rafic; Shi, Dongping; Arabi, Haitham; Ruterbusch, Julie; Cote, Michele; Ali-Fehmi, Rouba

    2016-01-01

    Fibroepithelial lesions (FEL) of the breast are notoriously difficult to classify on core needle biopsies. The goal of this study was to evaluate interobserver variability and accuracy of subclassifying difficult FELs into fibroadenoma (FA) and phyllodes tumors (PTs). We identified 50 breast core needle biopsies, initially diagnosed generically as FEL, with subsequent excision and final diagnosis of either FA or benign PT. Five surgical pathologists from one institution independently reviewed these in 3 rounds. The pathologists were blinded to the final excisional diagnosis. Two diagnostic categories were allowed: FA and PT. A set of histologic criteria was provided including the presence of subepithelial condensation, stromal heterogeneity, overgrowth, pleomorphism, fragmentation, cellularity, adipose tissue entrapment, and mitotic count and asked to review the slides for the second round. A third round of interpretations was conducted after each criterion was defined. Interobserver agreement for the diagnosis and each criterion was evaluated using the κ level of agreement. Accuracy of ratings to final diagnosis was calculated using Wilcoxon signed-rank test. κ Values for interobserver agreement were fair for the first and second rounds varying from 0.20 to 0.22, respectively. This increased to 0.27 in round 3. When considering each category, the κ value varied from 0.26 to 0.29 for FA and 0.28 to 0.14 for PT. Overall, there was fair agreement between the pathologists in all categories. The rate of correctly diagnosed cases ranged from 40% in the first round, to 48% in the second round, to 67% in round 3. Overall the pathologists performed better in identifying FA than PT. The accuracy of interpretations was significantly different between the first (40%), second (48%), and third rounds (67%). PMID:26521710

  16. Prospective Study for Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using 25- and 22-Gauge Core Biopsy Needles in Solid Pancreatic Masses

    PubMed Central

    Lee, Sang Hoon; Lee, Hee Seung; Lee, Hyun Jik; Park, Jeong Yup; Park, Seung Woo; Song, Si Young; Kim, Hoguen; Chung, Jae Bock; Bang, Seungmin

    2016-01-01

    Background and Aims Although thicker needles theoretically allow more tissue to be collected, their decreased flexibility can cause mechanical damage to the endoscope, technical failure, and sample blood contamination. The effects of needle gauge on diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) of pancreatic mass lesions remain unknown. This study compared procurement rates of histologic cores obtained from EUS-FNB of pancreatic masses using 25- and 22-gauge core biopsy needles. Patients and Methods From March 2014 to July 2014, 66 patients with solid pancreatic mass underwent EUS-FNB with both 25- and 22-gauge core biopsy needles. Among them, 10 patients were excluded and thus 56 patients were eligible for the analyses. Needle sequences were randomly assigned, and two passes were made with each needle, consisting of 10 uniform to-and-fro movements on each pass with 10 mL syringe suction. A pathologist blinded to needle sequence evaluated specimens for the presence of histologic core. Results The mean patient age was 65.8 ± 9.5 years (range, 44–89 years); 35 patients (62.5%) were men. The mean pancreatic mass size was 35.3 ± 17.1 mm (range 14–122.3 mm). Twenty-eight patients (50%) had tumors at the pancreas head or uncinate process. There were no significant differences in procurement rates of histologic cores between 25-gauge (49/56, 87.5%) and 22-gauge (46/56, 82.1%, P = 0.581) needles or diagnostic accuracy using only histologic cores (98% and 95%). There were no technical failures or procedure-related adverse events. Conclusions The 25-gauge core biopsy needle could offer acceptable and comparable outcomes regarding diagnostic performance including histologic core procurement rates compared to the 22-gauge core biopsy needle, although the differences were not statistically significant. Trial Registration ClinicalTrials.gov NCT01795066 PMID:27149404

  17. 22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses

    PubMed Central

    Sterlacci, William; Sioulas, Athanasios D; Veits, Lothar; Gönüllü, Pervin; Schachschal, Guido; Groth, Stefan; Anders, Mario; Kontos, Christos K; Topalidis, Theodoros; Hinsch, Andrea; Vieth, Michael; Rösch, Thomas; Denzer, Ulrike W

    2016-01-01

    AIM To compare the aspiration needle (AN) and core biopsy needle (PC) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of abdominal masses. METHODS Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge (G) AN (Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22G PC (EchoTip ProCore; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications. RESULTS Fifty six consecutive patients (29 men; mean age 68 years) with pancreatic lesions (n = 38), lymphadenopathy (n = 13), submucosal tumors (n = 4), or others lesions (n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy (AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy (AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes (AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score (AN: 1.7 vs PC: 1.1, P = 0.058), and complications (none). A diagnosis on the basis of histology was achieved in the PC group in 36 (64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN (AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance. CONCLUSION Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.

  18. Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer

    PubMed Central

    Ganott, Marie A.; Zuley, Margarita L.; Abrams, Gordon S.; Lu, Amy H.; Kelly, Amy E.; Chivukula, Mamatha; Carter, Gloria; Austin, R. Marshall; Bandos, Andriy I.

    2014-01-01

    Rationale and Objectives. To compare the sensitivities of ultrasound guided core biopsy and fine needle aspiration (FNA) for detection of axillary lymph node metastases in patients with a current diagnosis of ipsilateral breast cancer. Materials and Methods. From December 2008 to December 2010, 105 patients with breast cancer and abnormal appearing lymph nodes in the ipsilateral axilla consented to undergo FNA of an axillary node immediately followed by core biopsy of the same node, both with ultrasound guidance. Experienced pathologists evaluated the aspirate cytology without knowledge of the core histology. Cytology and core biopsy results were compared to sentinel node excision or axillary dissection pathology. Sensitivities were compared using McNemar's test. Results. Of 70 patients with axillary node metastases, FNA was positive in 55/70 (78.6%) and core was positive in 61/70 (87.1%) (P = 0.18). The FNA and core results were discordant in 14/70 (20%) patients. Ten cases were FNA negative/core positive. Four cases were FNA positive/core negative. Conclusion. Core biopsy detected six (8.6%) more cases of metastatic lymphadenopathy than FNA but the difference in sensitivities was not statistically significant. Core biopsy should be considered if the node is clearly imaged and readily accessible. FNA is a good alternative when a smaller needle is desired due to node location or other patient factors. This trial is registered with NCT01920139. PMID:24649373

  19. Computed tomography-guided percutaneous core needle biopsy in pancreatic tumor diagnosis

    PubMed Central

    Tyng, Chiang J; Almeida, Maria Fernanda A; Barbosa, Paula NV; Bitencourt, Almir GV; Berg, José Augusto AG; Maciel, Macello S; Coimbra, Felipe JF; Schiavon, Luiz Henrique O; Begnami, Maria Dirlei; Guimarães, Marcos D; Zurstrassen, Charles E; Chojniak, Rubens

    2015-01-01

    AIM: To evaluate the techniques, results, and complications related to computed tomography (CT)-guided percutaneous core needle biopsies of solid pancreatic lesions. METHODS: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle (10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect (transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year (range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm (range: 15-195 mm). Most (75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2% (23/103) of cases and indirect transhepatic or transgastric access was used in 4.8% (5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1% (101/103) of cases, confirming 3.9% (4/103) of tumors were benign and 94.2% (97/103) were malignant; results were atypical in 1.9% (2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients (8.7%), and they were more commonly associated with biopsies of lesions located in the head/uncinate process (n = 8), than of those located in the body/tail (n = 1) of the pancreas, but this difference was not significant. CONCLUSION: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally

  20. Transfemoral liver biopsy using a Quick-Core biopsy needle system in living donor liver transplantation recipients.

    PubMed

    Li, Fen Qiang; Ko, Gi-Young; Sung, Kyu-Bo; Gwon, Dong-Il; Ko, Heung Kyu; Kim, Jong Woo; Yu, Eunsil

    2014-10-01

    The purpose of this study was to evaluate the efficacy and safety of transfemoral liver biopsy with a Quick-Core biopsy needle in select living donor liver transplantation (LDLT) recipients. Eight LDLT recipients underwent 9 transfemoral liver biopsy sessions. Six patients had undergone modified right lobe (mRL) LDLT, and 2 patients had undergone dual-left lobe LDLT. The indications for transfemoral liver biopsy were a hepatic vein (HV) at an acute angle to the inferior vena cava (IVC) on the coronal plane and a thin (<10-mm) liver parenchyma surrounding the HV to be biopsied on enhanced computed tomography. Under fluoroscopic guidance, the right inferior HV in the mRL or the left HV in the right-sided left lobe with a cranial orientation was negotiated with a 5-Fr catheter via the common femoral vein. Then, a stiffening cannula was introduced into the HV over a stiff guide wire. Needle passage was then performed with an 18- or 19-gauge Quick-Core biopsy needle. Technical success was achieved in all sessions without major complications. The median number of needle passages was 4 (range = 2-6). The median total length of obtained liver specimens in each session was 44 mm (range = 24-75 mm). The median number of portal tracts was 18 (range = 10-29), and the obtained liver specimens were adequate for histological diagnosis in all sessions. In conclusion, transfemoral liver biopsy with a Quick-Core biopsy needle is an effective and safe alternative for obtaining a liver specimen when standard transjugular liver biopsy is not feasible because of an unfavorable HV angle with respect to the IVC and/or a thin liver parenchyma surrounding the HV. PMID:24916429

  1. Construction of tissue microarrays from core needle biopsies - a systematic literature review.

    PubMed

    Albanghali, Mohammad; Green, Andrew; Rakha, Emad; Aleskandarany, Mohamed; Nolan, Chris; Ellis, Ian; Cheung, Kwok-Leung

    2016-02-01

    In some clinical circumstances, core needle biopsy (CNB) may be the only source of material from cancer tissue for diagnostic use. The volume of tissue available in a CNB is low, and opportunities for research use can therefore be limited. The tissue microarray (TMA) principle, if applied to the use of CNBs, could facilitate research studies in circumstances where CNB specimens are available. However, various challenges are expected in applying such a technique in CNBs, which has limited their use in research. We therefore conducted a systematic review of the literature on this subject. A systematic search was carried out with CINAHL, EMBASE, the Cochrane library, and MEDLINE, to identify studies that have primarily developed methods for constructing TMAs from CNBs. Eight studies were found to meet the inclusion criteria; six of these employed the vertical rearrangement technique, and two used multiple layers of biopsy tissue. Representation of the CNB was significantly influenced by the quantity of tumour cells present in the original biopsy and the degree of heterogeneity of biomarker expression. This review shows that technologies have been developed to enable construction of TMAs from CNBs. However, challenges remain to improve amplification and representation.

  2. Pathologic findings in patients with targeted magnetic resonance imaging-guided prostate needle core biopsies

    PubMed Central

    Geller, Rachel L; Nour, Sherif G; Osunkoya, Adeboye O

    2015-01-01

    In contrast to the routine (non-targeted) sampling approach of transrectal ultrasound guided biopsies (TRUS-GB), targeted magnetic resonance imaging-guided biopsies (TMRI-GB) target regions of the prostate suspicious for prostate cancer (PCa), based on findings on multiparametric MRI. We sought to examine the pathologic findings identified on TMRI-GB, due to the fact that there are limited studies on this in the Pathology literature. A search was made through our Urologic Pathology files for prostate needle core biopsies that were obtained via TMRI-GB. Forty-six patients were identified. Mean patient (PT) age was 62 years (range: 50-78 years). Twenty one of 46 PTs (46%) had a history of PCa, 10/46 PTs (22%) had a history of negative TRUS-GB and rising PSA, and the remaining 15/46 PTs (32%) had never undergone biopsy. Cancer detection rate on TMRI-GB was 57% for PTs with a prior diagnosis of PCa, 50% for PTs with a history of benign biopsy, and 67% who were biopsy naïve. An average of 3.16 cores were sampled from malignant lesions and an average of 2.74 were sampled from benign lesions (P=0.02). TMRI-GB has a higher cancer detection rate than TRUS-GB. TMRI-GB may have a critical role as a tool for active surveillance, tumor mapping, and primary detection of PCa, which will likely evolve as the ability to identify malignant lesions improve. The roles of pathologists and radiologists in the validation of this procedure will continue to be even more vital in the future. PMID:26617689

  3. Inflammation and focal atrophy in prostate needle biopsy cores and association to prostatic adenocarcinoma.

    PubMed

    Benedetti, Ines; Bettin, Alfonso; Reyes, Niradiz

    2016-10-01

    The possible origin of proliferative inflammatory atrophy in the regenerative proliferation of prostate epithelial cells in response to injury caused by inflammation, and their relation to prostate adenocarcinoma have not been defined. Inflammation and focal atrophy are common pathological findings in prostate biopsies, currently not routinely included in surgical pathology reports. The objective of the study was to determine the correlation between inflammation and focal atrophy with prostate adenocarcinoma. Prostate needle biopsies from 203 patients with clinical parameters suspicious for malignancy were evaluated for the presence and extent of chronic inflammation, type and grade of focal atrophy, high-grade intraepithelial neoplasia, and adenocarcinoma. Relations among them and with age were also analyzed. χ(2) tests and binary logistic regression were used to estimate associations. Chronic inflammation was observed in 77.3% of the biopsies, significantly associated to adenocarcinoma (P = .031). Moderate/severe inflammation in at least 1 biopsy core increased the risk of prostate adenocarcinoma (odds ratio, 2.94; 95% confidence interval, 1.27-6.8), whereas glandular localization of inflammation decreased the risk. Focal atrophy was present in 72.9% of the biopsies, proliferative inflammatory atrophy was the most common type, and its grade was significantly associated to inflammation (P < .0001) and inflammation intensity (P = .003). An association between prostate adenocarcinoma and inflammation was found, with higher odds in presence of moderate/severe inflammation in at least 1 biopsy core. Increasing grades of proliferative inflammatory atrophy were associated to high levels of inflammation, supporting its previously proposed inflammatory nature. PMID:27649956

  4. Fluorescence Spectroscopy: An Adjunct Diagnostic Tool to Image-Guided Core Needle Biopsy of the Breast

    PubMed Central

    Zhu, Changfang; Burnside, Elizabeth S.; Sisney, Gale A.; Salkowski, Lonie R.; Harter, Josephine M.; Yu, Bing

    2009-01-01

    We explored the use of a fiber-optic probe for in vivo fluorescence spectroscopy of breast tissues during percutaneous image-guided breast biopsy. A total of 121 biopsy samples with accompanying histological diagnosis were obtained clinically and investigated in this study. The tissue spectra were analyzed using partial least-squares analysis and represented using a set of principal components (PCs) with dramatically reduced data dimension. For nonmalignant tissue samples, a set of PCs that account for the largest amount of variance in the spectra displayed correlation with the percent tissue composition. For all tissue samples, a set of PCs was identified using a Wilcoxon rank-sum test as showing statistically significant differences between: 1) malignant and fibrous/benign; 2) malignant and adipose; and 3) malignant and nonmalignant breast samples. These PCs were used to distinguish malignant from other nonmalignant tissue types using a binary classification scheme based on both linear and nonlinear support vector machine (SVM) and logistic regression (LR). For the sample set investigated in this study, the SVM classifier provided a cross-validated sensitivity and specificity of up to 81% and 87%, respectively, for discrimination between malignant and fibrous/benign samples, and up to 81% and 81%, respectively, for discriminating between malignant and adipose samples. Classification based on LR was used to generate receiver operator curves with an area under the curve (AUC) of 0.87 for discriminating malignant versus fibrous/benign tissues, and an AUC of 0.84 for discriminating malignant from adipose tissue samples. This study demonstrates the feasibility of performing fluorescence spectroscopy during clinical core needle breast biopsy, and the potential of this technique for identifying breast malignancy in vivo. PMID:19272976

  5. Core Needle Biopsy of Breast Cancer Tumors Increases Distant Metastases in a Mouse Model12

    PubMed Central

    Mathenge, Edward Gitau; Dean, Cheryl Ann; Clements, Derek; Vaghar-Kashani, Ahmad; Photopoulos, Steffany; Coyle, Krysta Mila; Giacomantonio, Michael; Malueth, Benjamin; Nunokawa, Anna; Jordan, Julie; Lewis, John D.; Gujar, Shashi Ashok; Marcato, Paola; Lee, Patrick W.K.; Giacomantonio, Carman Anthony

    2014-01-01

    INTRODUCTION: Incisional biopsies, including the diagnostic core needle biopsy (CNB), routinely performed before surgical excision of breast cancer tumors are hypothesized to increase the risk of metastatic disease. In this study, we experimentally determined whether CNB of breast cancer tumors results in increased distant metastases and examine important resultant changes in the primary tumor and tumor microenvironment associated with this outcome. METHOD: To evaluate the effect of CNB on metastasis development, we implanted murine mammary 4T1 tumor cells in BALB/c mice and performed CNB on palpable tumors in half the mice. Subsequently, emulating the human scenario, all mice underwent complete tumor excision and were allowed to recover, with attendant metastasis development. Tumor growth, lung metastasis, circulating tumor cell (CTC) levels, variation in gene expression, composition of the tumor microenvironment, and changes in immunologic markers were compared in biopsied and non-biopsied mice. RESULTS: Mice with biopsied tumors developed significantly more lung metastases compared to non-biopsied mice. Tumors from biopsied mice contained a higher frequency of myeloid-derived suppressor cells (MDSCs) accompanied by reduced CD4 + T cells, CD8 + T cells, and macrophages, suggesting biopsy-mediated development of an increasingly immunosuppressive tumor microenvironment. We also observed a CNB-dependent up-regulation in the expression of SOX4, Ezh2, and other key epithelial-mesenchymal transition (EMT) genes, as well as increased CTC levels among the biopsy group. CONCLUSION: CNB creates an immunosuppressive tumor microenvironment, increases EMT, and facilitates release of CTCs, all of which likely contribute to the observed increase in development of distant metastases. PMID:25425969

  6. High-Throughput Prostate Cancer Gland Detection, Segmentation, and Classification from Digitized Needle Core Biopsies

    NASA Astrophysics Data System (ADS)

    Xu, Jun; Sparks, Rachel; Janowczyk, Andrew; Tomaszewski, John E.; Feldman, Michael D.; Madabhushi, Anant

    We present a high-throughput computer-aided system for the segmentation and classification of glands in high resolution digitized images of needle core biopsy samples of the prostate. It will allow for rapid and accurate identification of suspicious regions on these samples. The system includes the following three modules: 1) a hierarchical frequency weighted mean shift normalized cut (HNCut) for initial detection of glands; 2) a geodesic active contour (GAC) model for gland segmentation; and 3) a diffeomorphic based similarity (DBS) feature extraction for classification of glands as benign or cancerous. HNCut is a minimally supervised color based detection scheme that combines the frequency weighted mean shift and normalized cuts algorithms to detect the lumen region of candidate glands. A GAC model, initialized using the results of HNCut, uses a color gradient based edge detection function for accurate gland segmentation. Lastly, DBS features are a set of morphometric features derived from the nonlinear dimensionality reduction of a dissimilarity metric between shape models. The system integrates these modules to enable the rapid detection, segmentation, and classification of glands on prostate biopsy images. Across 23 H & E stained prostate studies of whole-slides, 105 regions of interests (ROIs) were selected for the evaluation of segmentation and classification. The segmentation results were evaluated on 10 ROIs and compared to manual segmentation in terms of mean distance (2.6 ±0.2 pixels), overlap (62±0.07%), sensitivity (85±0.01%), specificity (94±0.003%) and positive predictive value (68±0.08%). Over 105 ROIs, the classification accuracy for glands automatically segmented was (82.5 ±9.10%) while the accuracy for glands manually segmented was (82.89 ±3.97%); no statistically significant differences were identified between the classification results.

  7. The value of forceps biopsy and core needle biopsy in prediction of pathologic complete remission in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy.

    PubMed

    Tang, Jing-Hua; An, Xin; Lin, Xi; Gao, Yuan-Hong; Liu, Guo-Chen; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-10-20

    Patients with pathological complete remission (pCR) after treated with neoadjuvant chemoradiotherapy (nCRT) have better long-term outcome and may receive conservative treatments in locally advanced rectal cancer (LARC). The study aimed to evaluate the value of forceps biopsy and core needle biopsy in prediction of pCR in LARC treated with nCRT. In total, 120 patients entered this study. Sixty-one consecutive patients received preoperative forceps biopsy during endoscopic examination. Ex vivo core needle biopsy was performed in resected specimens of another 43 consecutive patients. The accuracy for ex vivo core needle biopsy was significantly higher than forceps biopsy (76.7% vs. 36.1%; p < 0.001). The sensitivity for ex vivo core needle biopsy was significantly lower in good responder (TRG 3) than poor responder (TRG ≤ 2) (52.9% vs. 94.1%; p = 0.017). In vivo core needle biopsy was further performed in 16 patients with good response. Eleven patients had residual cancer cells in final resected specimens, among whom 4 (36.4%) patients were biopsy positive. In conclusion, routine forceps biopsy was of limited value in identifying pCR after nCRT. Although core needle biopsy might further identify a subset of patients with residual cancer cells, the accuracy was not substantially increased in good responders.

  8. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature

    PubMed Central

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist. PMID:27651820

  9. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature

    PubMed Central

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist.

  10. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature.

    PubMed

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist. PMID:27651820

  11. Efficacy of ultrasound-guided core-needle biopsy in the diagnosis of hepatic alveolar echinococcosis: a retrospective analysis

    PubMed Central

    Bulakci, Mesut; Ilhan, Mehmet; Bademler, Suleyman; Yilmaz, Erdem; Gulluoglu, Mine; Bayraktar, Adem; Asik, Murat; Guloglu, Recep

    2016-01-01

    Background: This study retrospectively analyzed the clinical data, laboratory results, imaging findings, and histopathological features of 28 patients who underwent ultrasound-guided core-needle biopsy from a hepatic lesion and were diagnosed with alveolar echinococcosis. Results: Among 28 patients included in the study, 16 were females and 12 were males. The mean age of the studied population was 53 ± 16 years, and the age range was 18–79 years. The most common presenting symptom was abdominal pain, which was observed in 14 patients. A total of 36 lesions were detected in the patients’ livers, out of which 7 had a cystic appearance. Hepatic vascular involvement, bile duct involvement, and other organ involvement were depicted in 14, 5, and 7 patients, respectively. The average number of cores taken from the lesions was 2.7, ranging between 2 and 5. In histopathological evaluation, PAS+ parasitic membrane structures were visualized on a necrotic background in all cases. Regarding seven patients, who were operated, the pathological findings of preoperative percutaneous biopsies were in perfect agreement with the pathological examinations after surgical resections. None of the patients developed major complications after biopsy. Conclusion: Ultrasound-guided core-needle biopsy is a minimally invasive, reliable, and effective diagnostic tool for the definitive diagnosis of hepatic alveolar echinococcosis. PMID:27101838

  12. Positron Emission Mammography Imaging with Low Activity Fluorodeoxyglucose and Novel Utilization in Core-needle Biopsy Sampling

    PubMed Central

    Choudhery, Sadia; Seiler, Stephen

    2015-01-01

    Positron emission mammography (PEM), a relatively novel breast imaging modality, provides certain advantages over magnetic resonance imaging, including the ability to image biopsy samples. However, the radiation activity associated with PEM has remained a concern in clinical practice. We present a case of an invasive ductal carcinoma that was adequately imaged with a much lower than the standard 185 to 370 MBq activity of 18F-fluorodeoxyglucose. In addition, we demonstrate ultrasound-guided core-needle biopsy sample imaging with PEM to assess adequacy of sampling, a strategy that has previously only been documented with vacuum-assisted biopsy samples. PMID:25709550

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

    SciTech Connect

    Bluvol, Nathan; Sheikh, Allison; Kornecki, Anat; Del Rey Fernandez, David; Downey, Donal; Fenster, Aaron

    2008-02-15

    radiologists and inexperienced resident radiologists using free-hand US and the needle guidance system. Cylindrical polyvinyl alcohol cryogel lesions, colored blue, were embedded in chicken tissue. Radiologists identified the lesions, visible as hypoechoic masses in the US images, and performed biopsy using a 14-gauge needle. Procedure times were compared based on experience and the technique performed. Using a pair-wise t test, lower biopsy procedure times were observed when using the guidance system versus the free-hand technique (t=12.59, p<0.001). The authors believe that with this improved biopsy guidance they will be able to reduce the ''false negative'' rate of biopsies, especially in the hands of less experienced physicians.

  14. Collagen, type XI, alpha 1: an accurate marker for differential diagnosis of breast carcinoma invasiveness in core needle biopsies.

    PubMed

    Freire, Javier; Domínguez-Hormaetxe, Saioa; Pereda, Saray; De Juan, Ana; Vega, Alfonso; Simón, Laureano; Gómez-Román, Javier

    2014-12-01

    Accurate diagnosis of invasive breast lesions, when analyzed by Core Needle Biopsy, may suppose a major challenge for the pathologist. Various markers of invasiveness such as laminin, S-100 protein, P63 or calponin have been described; however, none of them is completely reliable. The use of a specific marker of the infiltrating tumor microenvironment seems vital to support the diagnosis of invasive against in situ lesions. At this point, Collagen, type XI, alpha 1 (COL11A1), might be helpful since it has been described to be associated to cancer associated fibroblasts in other tumors such as lung, pancreas or colorectal. This paper aims to analyze the role of COL11A1 as a marker of invasiveness in breast tumor lesions. Two hundred and one breast Core Needle Biopsy samples were analyzed by immunohistochemistry against pro-COL11A1. The results show a significant difference (p < 0.0001) when comparing the expression in infiltrative tumors (93%) versus immunostaining of non-invasive lesions (4%). Forty cases of underestimated DCIS were also stained for COL11A1, presenting a sensitivity of 90% when compared with p63 and calponin which not tagged invasion. In conclusion, pro-COL11A1 expression is a promising marker of invasive breast lesions, and may be included in immunohistochemical panels aiming at identifying infiltration in problematic breast lesions.

  15. Changing attitudes toward needle biopsies of breast cancer in Shanghai: experience and current status over the past 8 years

    PubMed Central

    Hao, Shuang; Liu, Zhe-Bin; Ling, Hong; Chen, Jia-Jian; Shen, Ju-Ping; Yang, Wen-Tao; Shao, Zhi-Min

    2015-01-01

    Diagnostic patterns in breast cancer have greatly changed over the past few decades, and core needle biopsy (CNB) has become a reliable procedure for detecting breast cancer without invasive surgery. To estimate the changing diagnostic patterns of breast cancer in urban Shanghai, 11,947 women with breast lesions detected by preoperative needle biopsy between January 1995 and December 2012 were selected from the Shanghai Cancer Data base, which integrates information from approximately 50% of breast cancer patients in Shanghai. The CNB procedure uses an automated prone unit, biopsy gun, and 14-gauge needles under freehand or ultrasound guidance and was performed by experienced radiologists and surgeons specializing in needle biopsies. Diagnosis and classification for each patient were independently evaluated by pathologists. Over the indicated 8-year period, biopsy type consisted of 11,947 ultrasound-guided core needle biopsies (UCNBs), 2,015 ultrasound-guided vacuum-assisted biopsies (UVABs), and 654 stereotactic X-ray-guided vacuum-assisted biopsies (XVABs). For all the 11,947 women included in this study, image-guided needle biopsy was the initial diagnostic procedure. Approximately 81.0% of biopsied samples were histopathologically determined to be malignant lesions, 5.5% were determined to be high-risk lesions, and 13.5% were determined to be benign lesions. The number of patients choosing UCNB increased at the greatest rate, and UCNB has become a standard procedure for histodiagnosis because it is inexpensive, convenient, and accurate. The overall false-negative rate of CNB was 1.7%, and the specific false-negative rates for UCNB, UVAB, and XVAB, were 1.7%, 0%, and 0%, respectively. This study suggests that the use of preoperative needle biopsy as the initial breast cancer diagnostic procedure is acceptable in urban Shanghai. Preoperative needle biopsy is now a standard procedure in the Shanghai Cancer Center because it may reduce the number of surgeries

  16. Benign Papillomas Without Atypia Diagnosed on Core Needle Biopsy: Experience From a Single Institution and Proposed Criteria for Excision

    PubMed Central

    Nayak, Anupma; Carkaci, Selin; Gilcrease, Michael Z.; Liu, Ping; Middleton, Lavinia P.; Bassett, Roland L.; Zhang, Jinxia; Zhang, Hong; Coyne, Robin L.; Bevers, Therese B.; Sneige, Nour; Huo, Lei

    2015-01-01

    The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. We describe the clinicopathologic features of 80 patients with such lesions in our institution, with an upgrade rate to malignancy of 3.8%. A multidisciplinary approach to select patients for surgical excision is recommended. Background The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. In this study, we determined the upgrade rate to malignancy for BPs without atypia diagnosed on CNB and whether there are factors associated with upgrade. Methods Through our pathology database search, we studied 80 BPs without atypia identified on CNB from 80 patients from 1997 to 2010, including 30 lesions that had undergone excision and 50 lesions that had undergone ≥ 2 years of radiologic follow-up. Associations between surgery or upgrade to malignancy and clinical, radiologic, and pathologic features were analyzed. Results Mass lesions, lesions sampled by ultrasound-guided CNB, and palpable lesions were associated with surgical excision. All 3 upgraded cases were mass lesions sampled by ultrasound-guided CNB. None of the lesions with radiologic follow-up only were upgraded to malignancy. The overall upgrade rate was 3.8%. None of the clinical, radiologic, or histologic features were predictive of upgrade. Conclusion Because the majority of patients can be safely managed with radiologic surveillance, a selective approach for surgical excision is recommended. Our proposed criteria for excision include pathologic/radiologic discordance or sampling by ultrasound-guided CNB without vacuum assistance when the patient is symptomatic or lesion size is ≥ 1.5 cm. PMID:24119786

  17. Development and Evaluation of a Prediction Model for Underestimated Invasive Breast Cancer in Women with Ductal Carcinoma In Situ at Stereotactic Large Core Needle Biopsy

    PubMed Central

    Diepstraten, Suzanne C. E.; van de Ven, Stephanie M. W. Y.; Pijnappel, Ruud M.; Peeters, Petra H. M.; van den Bosch, Maurice A. A. J.; Verkooijen, Helena M.; Elias, Sjoerd G.

    2013-01-01

    Background We aimed to develop a multivariable model for prediction of underestimated invasiveness in women with ductal carcinoma in situ at stereotactic large core needle biopsy, that can be used to select patients for sentinel node biopsy at primary surgery. Methods From the literature, we selected potential preoperative predictors of underestimated invasive breast cancer. Data of patients with nonpalpable breast lesions who were diagnosed with ductal carcinoma in situ at stereotactic large core needle biopsy, drawn from the prospective COBRA (Core Biopsy after RAdiological localization) and COBRA2000 cohort studies, were used to fit the multivariable model and assess its overall performance, discrimination, and calibration. Results 348 women with large core needle biopsy-proven ductal carcinoma in situ were available for analysis. In 100 (28.7%) patients invasive carcinoma was found at subsequent surgery. Nine predictors were included in the model. In the multivariable analysis, the predictors with the strongest association were lesion size (OR 1.12 per cm, 95% CI 0.98-1.28), number of cores retrieved at biopsy (OR per core 0.87, 95% CI 0.75-1.01), presence of lobular cancerization (OR 5.29, 95% CI 1.25-26.77), and microinvasion (OR 3.75, 95% CI 1.42-9.87). The overall performance of the multivariable model was poor with an explained variation of 9% (Nagelkerke’s R2), mediocre discrimination with area under the receiver operating characteristic curve of 0.66 (95% confidence interval 0.58-0.73), and fairly good calibration. Conclusion The evaluation of our multivariable prediction model in a large, clinically representative study population proves that routine clinical and pathological variables are not suitable to select patients with large core needle biopsy-proven ductal carcinoma in situ for sentinel node biopsy during primary surgery. PMID:24147085

  18. Underestimation of cancer in case of diagnosis of atypical ductal hyperplasia (ADH) by vacuum assisted core needle biopsy

    PubMed Central

    Polom, Karol; Murawa, Dawid; Kurzawa, Paweł; Michalak, Michał; Murawa, Paweł

    2012-01-01

    Background With the introduction of mammography screening, we are more often dealing with the diagnosis of precancerous and preinvasive breast lesions. An increasing number of patients are observed to show a premalignant change of ADH (atypical ductal hyperplasia). It also involves a wider use of the vacuum assisted core biopsy as a tool for verifying nonpalpable changes identified by mammography. Aim This paper describes our experience of 134 cases of ADH diagnosed at Mammotome® vacuum core needle biopsy. Material and methods Of 4326 mammotomic biopsies performed at our institution in 2000–2006, ADH was diagnosed in 134 patients (3.1%). Patients underwent surgery to remove the suspected lesion. All histopathological blocks were again reviewed by one pathologist. Clinical, radiological and pathological data were collected for statistical evaluation. Results Underestimation of invasive changes occurred in 12 patients (9%). The only clinicopathologic feature of statistical significance radiologically and pathologically was the presence of radial scar in the mammography. Conclusions More frequent diagnosis of precancerous changes in the mammotomic breast biopsy forces us to establish a clear clinical practice. The problem is the underestimation of invasive changes. The occurrence of radial scar on mammography for diagnosis of the presence of ADH increases the risk of invasive changes. PMID:24377013

  19. Preoperative Assessment of TERT Promoter Mutation on Thyroid Core Needle Biopsies Supports Diagnosis of Malignancy and Addresses Surgical Strategy.

    PubMed

    Crescenzi, A; Trimboli, P; Modica, D C; Taffon, C; Guidobaldi, L; Taccogna, S; Rainer, A; Trombetta, M; Papini, E; Zelano, G

    2016-03-01

    In the last decade, several molecular markers have been proposed to improve the diagnosis of thyroid nodules. Among these, mutations in the telomerase reverse transcriptase (TERT) promoter have been correlated to malignant tumors, characterized by highest recurrence and decreased patients' survival. This suggests an important role of TERT mutational analysis in the clinical diagnosis and management of thyroid cancer patients. The aim of the study was to demonstrate the adequacy of core needle biopsy (CNB) for the preoperative assessment of TERT mutational status, to reach a more accurate definition of malignancy and a more appropriate surgical planning. Indeed, CNB is gaining momentum for improving diagnosis of thyroid nodules deemed inconclusive by fine needle aspirate (FNA). The study included 50 patients submitted to CNB due to inconclusive FNA report. TERT mutational status was correlated with BRAF mutation, definitive histology, and post-operative TNM staging of the neoplasia. C228T mutation of the TERT promoter was reported in 10% of the papillary carcinomas (PTC) series. When compared with final histology, all cases harboring TERT mutation resulted as locally invasive PTCs. The prevalence of TERT mutated cases was 17.6% among locally advanced PTCs. TERT analysis on CNB allows the assessment of the pathological population on paraffin sections before DNA isolation, minimizing the risk of false negatives due to poor sampling that affects FNA, and gathering aggregate information about morphology and TERT mutational status. Data indicating a worse outcome of the tumor might be used to individualize treatment decision, surgical option, and follow-up design. PMID:25951319

  20. Real-Time 3D Fluoroscopy-Guided Large Core Needle Biopsy of Renal Masses: A Critical Early Evaluation According to the IDEAL Recommendations

    SciTech Connect

    Kroeze, Stephanie G. C.; Huisman, Merel; Verkooijen, Helena M.; Diest, Paul J. van; Ruud Bosch, J. L. H.; Bosch, Maurice A. A. J. van den

    2012-06-15

    Introduction: Three-dimensional (3D) real-time fluoroscopy cone beam CT is a promising new technique for image-guided biopsy of solid tumors. We evaluated the technical feasibility, diagnostic accuracy, and complications of this technique for guidance of large-core needle biopsy in patients with suspicious renal masses. Methods: Thirteen patients with 13 suspicious renal masses underwent large-core needle biopsy under 3D real-time fluoroscopy cone beam CT guidance. Imaging acquisition and subsequent 3D reconstruction was done by a mobile flat-panel detector (FD) C-arm system to plan the needle path. Large-core needle biopsies were taken by the interventional radiologist. Technical success, accuracy, and safety were evaluated according to the Innovation, Development, Exploration, Assessment, Long-term study (IDEAL) recommendations. Results: Median tumor size was 2.6 (range, 1.0-14.0) cm. In ten (77%) patients, the histological diagnosis corresponded to the imaging findings: five were malignancies, five benign lesions. Technical feasibility was 77% (10/13); in three patients biopsy results were inconclusive. The lesion size of these three patients was <2.5 cm. One patient developed a minor complication. Median follow-up was 16.0 (range, 6.4-19.8) months. Conclusions: 3D real-time fluoroscopy cone beam CT-guided biopsy of renal masses is feasible and safe. However, these first results suggest that diagnostic accuracy may be limited in patients with renal masses <2.5 cm.

  1. A subset of malignant phyllodes tumors express p63 and p40: a diagnostic pitfall in breast core needle biopsies.

    PubMed

    Cimino-Mathews, Ashley; Sharma, Rajni; Illei, Peter B; Vang, Russell; Argani, Pedram

    2014-12-01

    Breast phyllodes tumors are rare fibroepithelial neoplasms of variable grade, and one key differential of malignant phyllodes on core biopsy is sarcomatoid carcinoma. p63 is reported to be sensitive and specific for sarcomatoid carcinoma, with rare expression in phyllodes in limited series. The p63 deltaNp63 isoform, p40, is postulated to be more specific for squamous differentiation but has not previously been evaluated in breast phyllodes or sarcomatoid carcinoma. Tissue microarrays containing 34 unambiguous phyllodes tumors (10 benign, 10 borderline, 14 malignant), 13 sarcomatoid carcinomas, and 10 fibroadenomas were labeled by immunohistochemistry for p63, p40, CD34, and cytokeratins AE1/AE3, 34betaE12, and CK8/18. No borderline phyllodes tumor, benign phyllodes tumor, or fibroadenoma labeled with p63, p40, or cytokeratin. However, p63 labeled 57% malignant phyllodes tumors and 62% sarcomatoid carcinomas, and p40 labeled 29% malignant phyllodes (focal) and 46% sarcomatoid carcinomas. Among established markers, cytokeratins labeled 21% malignant phyllodes tumors (focal) and 100% sarcomatoid carcinomas. CD34 labeled 57% malignant phyllodes tumors and no sarcomatoid carcinomas. Focal p63, p40, and cytokeratin labeling can be seen in malignant phyllodes tumors but not in lower-grade fibroepithelial lesions, and immunoreactivity with these markers alone is not diagnostic of sarcomatoid carcinoma on core needle biopsy. In the differential diagnosis of malignant phyllodes, p40 is a more specific but less sensitive marker of sarcomatoid carcinoma than p63. These results are consistent with the sarcoma literature in which p63 labeling has been increasingly reported and suggest caution in classifying malignant spindle cell tumors of the breast on core biopsy.

  2. Phyllodes tumors of the breast: ultrasonographic findings and diagnostic performance of ultrasound-guided core needle biopsy.

    PubMed

    Youn, Inyoung; Choi, Seon Hyeong; Moon, Hee Jung; Kim, Min Jung; Kim, Eun-Kyung

    2013-06-01

    We evaluated ultrasonography (US) findings between benign and malignant phyllodes tumors and analyzed diagnostic performance of US-guided core needle biopsy (CNB) for phyllodes tumors. Surgically removed phyllodes tumors of 168 women were divided into two groups according to the benign and malignant (including borderline tumor) groups and 116 were benign and 52 were malignant. On US, the complex cystic echogenicity (p = 0.021), presence of cleft (p = 0.005) and higher final US assessment (p = 0.008) were more frequent in the malignant group. The sensitivity of CNB including fibroepithelial tumors was 67.9% (114/168) and the concordant rate between CNB and surgical excision was 82.1% (32/39) and 5.8% (3/52) in the benign and malignant group. Our results suggested that the US findings of complex cystic echogenicity, cleft, higher final US assessment were more frequent in malignant phyllodes tumors. The sensitivity of CNB was 67.9% (114/168) and malignant phyllodes tumors were rarely diagnosed as malignant by US-guided CNB.

  3. Automated tru-cut imaging-guided core needle biopsy of canine orbital neoplasia. A prospective feasibility study

    PubMed Central

    Cirla, A.; Rondena, M.; Bertolini, G.

    2016-01-01

    The purpose of this study was to evaluate the diagnostic value of imaging-guided core needle biopsy for canine orbital mass diagnosis. A second excisional biopsy obtained during surgery or necropsy was used as the reference standard. A prospective feasibility study was conducted in 23 canine orbital masses at a single centre. A complete ophthalmic examination was always followed by orbital ultrasound and computed tomography (CT) examination of the head. All masses were sampled with the patient still on the CT table using ultrasound (US) guided automatic tru-cut device. The most suitable sampling approach to the orbit was chosen each time based on the CT image analysis. One of the following different approaches was used: trans-orbital, trans-conjunctival or trans-masseteric. In all cases, the imaging-guided biopsy provided a sufficient amount of tissue for the histopathological diagnosis, which concurred with the biopsies obtained using the excisional technique. CT examination was essential for morphological diagnosis and provided detailed topographic information that allowed us to choose the safest orbital approach for the biopsy. US guided automatic tru-cut biopsy based on CT images, performed with patient still on the CT table, resulted in a minimally invasive, relatively easy, and accurate diagnostic procedure in dogs with orbital masses. PMID:27540512

  4. Ductal carcinoma in situ in core needle biopsies and its association with extensive in situ component in the surgical specimen

    PubMed Central

    2012-01-01

    Background We evaluated the presence of ductal carcinoma in situ (DCIS) in core needle biopsies (CNB) from invasive ductal lesions. Methods Retrospective study, which analyzed 90 cases of invasive ductal carcinoma lesions. The percentage of DCIS was quantified in each specimens obtained from CNB, which were compared to the surgical specimens. CNB and surgical specimens were evaluated by the same pathologist, and the percentage of DCIS in CNB was evaluated (percentage) and divided into categories. We considered the following parameters regarding the amount of DCIS: 1 = 0; 2 = 1 for 5%; 3 = 6 for 24%; 4 = 25 for 50%; 5 = 51 for 75% and 6 = 76 for 99%. The number of fragments and the histological pattern of DCIS was found. Results We found the following results regarding the distribution of the percentage of DCIS in the CNB: 1 = 63.3%; 2 = 12.2%; 3 = 12.2%; 4 = 5.6%; 5 = 1.1% and 6 = 5.6%. The logistic regression analysis showed that CNB percentages above 45% reflected the presence of DCIS in the surgical specimen in 100% of the cases (p < 0.001), with a specificity of 100%, accuracy of 83.3% and false positive rate of 0% (p <0.001). Conclusion There is direct relationship between extensive intraductal component in the surgical specimen when the core biopsy shows 45% or more of the DCI or microinvasive in the material examined. PMID:22715888

  5. Retrieval Rate and Accuracy of Ultrasound-Guided 14-G Semi-Automated Core Needle Biopsy of Breast Microcalcifications

    PubMed Central

    Yi, Jisook; Kwak, Jeong Ja; Cha, Jang Gyu; Jung, Sun Hye

    2014-01-01

    Objective To evaluate the retrieval rate and accuracy of ultrasound (US)-guided 14-G semi-automated core needle biopsy (CNB) for microcalcifications in the breast. Materials and Methods US-guided 14-G semi-automated CNB procedures and specimen radiography were performed for 33 cases of suspicious microcalcifications apparent on sonography. The accuracy of 14-G semi-automated CNB and radiology-pathology concordance were analyzed and the microcalcification characteristics between groups with successful and failed retrieval were compared. Results Thirty lesions were successfully retrieved and the microcalcification retrieval rate was 90.9% (30/33). Thirty lesions were successfully retrieved. Twenty five were finally diagnosed as malignant (10 invasive ductal carcinoma, 15 ductal carcinoma in situ [DCIS]) and five as benign. After surgery and mammographic follow-up, the 25 malignant lesions comprised 12 invasive ductal carcinoma and 13 DCIS. Three lesions in the failed retrieval group (one DCIS and two benign) were finally diagnosed as two DCIS and one benign after surgery. The accuracy of 14-G semi-automated CNB was 90.9% (30/33) because of two DCIS underestimates and one false-negative diagnosis. The discordance rate was significantly higher in the failed retrieval group than in the successful retrieval group (66.7% vs. 6.7%; p < 0.05). Punctate calcifications were significantly more common in the failed retrieval group than in the successful retrieval group (66.7% vs. 3.7%; p < 0.05). Conclusion US-guided 14-G semi-automated CNB could be a useful procedure for suspicious microcalcifications in the breast those are apparent on sonography. PMID:24497787

  6. Association of breast cancer with the finding of atypical ductal hyperplasia at core breast biopsy.

    PubMed Central

    Moore, M M; Hargett, C W; Hanks, J B; Fajardo, L L; Harvey, J A; Frierson, H F; Slingluff, C L

    1997-01-01

    OBJECTIVE: The purpose of the study is to evaluate the prevalence of occult breast carcinoma in surgical breast biopsies performed on nonpalpable breast lesions diagnosed initially as atypical ductal hyperplasia (ADH) by core needle biopsy. BACKGROUND: Atypical ductal hyperplasia is a lesion with significant malignant potential. Some authors note that ADH and ductal carcinoma in situ (DCIS) frequently coexist in the same lesion. The criterion for the diagnosis of DCIS requires involvement of at least two ducts; otherwise, a lesion that is qualitatively consistent with DCIS but quantitatively insufficient is described as atypical ductal hyperplasia. Thus, the finding of ADH in a core needle breast biopsy specimen actually may represent a sample of a true in situ carcinoma. METHODS: Between May 3, 1994, and June 12, 1996, image-guided core biopsies of 510 mammographically identified lesions were performed using a 14-gauge automated device with an average of 7.5 cores obtained per lesion. Atypical ductal hyperplasia was found in 23 (4.5%) of 510 lesions, and surgical excision subsequently was performed in 21 of these cases. In these 21 cases, histopathologic results from core needle and surgical biopsies were reviewed and correlated. RESULTS: Histopathologic study of the 21 surgically excised lesions having ADH in their core needle specimens showed seven (33.3%) with DCIS. CONCLUSIONS: In the authors' patient population, one third of patients with ADH at core biopsy have an occult carcinoma. A core needle breast biopsy finding of ADH for nonpalpable lesions therefore warrants a recommendation for excisional biopsy. Images Figure 1. Figure 2. Figure 3. PMID:9230813

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

    SciTech Connect

    Laredo, Jean-Denis 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. The 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.

  8. The effect of excisional biopsy on the accuracy of sentinel lymph node mapping in early stage breast cancer: comparison with core needle biopsy.

    PubMed

    Forghani, Mohammad Naser; Memar, Bahram; Jangjoo, Ali; Zakavi, Rasoul; Mehrabibahar, Mostafa; Kakhki, Vahid Reza Dabbagh; Kashani, Ida; Hashemian, Farnaz; Sadeghi, Ramin

    2010-11-01

    Despite the successful application of sentinel node mapping in breast cancer patients, its use in patients with a history of previous excisional biopsy of the breast tumors is a matter of controversy. In the present study we evaluated the accuracy of sentinel node biopsy in this group of patients and compared the results with those in whom the diagnosis of breast cancer was established by core needle biopsy. Eighty patients with early stage breast carcinoma were included into our study. Forty patients had a history of previous excisional biopsy and the remainder 40 had undergone core needle biopsy. Intradermal injections of 99mTc-antimony sulfide colloid as well as patent blue were both used for sentinel node mapping. Sentinel nodes were harvested during surgery with the aid of surgical gamma probe. All patients underwent standard axillary lymph node dissection subsequently. Detection rate was 97.5 per cent for both groups of the study. Number of detected sentinel node during surgery was not significantly different between groups. False negative rate was 0 per cent for both groups of the study. In conclusion sentinel node biopsy is reliable in patients with previous history of excisional biopsy of the breast tumors and has a low false negative rate.

  9. Accuracy of fine needle aspiration and core lung biopsies to predict histology in patients with non-small cell lung cancer.

    PubMed

    Robertson, William Whitney; Steliga, Matthew A; Siegel, Eric R; Arnaoutakis, Konstantinos

    2014-06-01

    Management of advanced non-small cell lung cancer patients is dependent on the histologic diagnosis for both testing and treatment. This study was designed to determine the ability of fine needle aspiration and core biopsies to correctly determine histologic diagnosis in non-small cell lung cancer. Our institutional cardiothoracic surgery database was reviewed for cases of non-small cell lung cancer treated with lobectomy after a preoperative biopsy by CT guidance or bronchoscopy over a 10-year period from 2002 to 2011. The histologic diagnosis of the final lobectomy specimen was compared to the histologic diagnosis from the preoperative biopsy, and the concordance rate was calculated. 119 biopsy specimens from 117 patients were reviewed. Eighty of the 119 biopsies had the same histologic diagnosis as the lobectomy specimen, yielding an overall concordance rate of 67.2 %. Patients with poorly differentiated tumors were at the highest risk of an incorrect histologic diagnosis on preoperative biopsy. Reliance on fine needle aspiration and core biopsies to determine histologic diagnosis in non-small cell lung cancer may put some patients at risk for suboptimal treatment.

  10. Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision.

    PubMed

    Lavoué, Vincent; Roger, Claire Marie; Poilblanc, Mathieu; Proust, Nicolas; Monghal-Verge, Camille; Sagan, Christine; Tas, Patrick; Mesbah, Habiba; Porée, Philippe; Gay, Catherine; Body, Gilles; Levêque, Jean

    2011-01-01

    Flat epithelial atypia (FEA) is recognized as a precursor of breast cancer and its management (surgical excision or intensive follow-up) remains unclear after diagnosis on core needle biopsy (CNB). The aim of this study was to determine the underestimation rate of pure FEA on CNB and clinical, radiological, and pathological factors of underestimation. 4,062 CNBs from 5 breast cancer centers, performed over a 5-year period, were evaluated. A CNB diagnosis of pure FEA was made in 60 cases (1.5%) (the presence of atypical ductal hyperplasia, lobular neoplasia, radial scars, phyllodes tumor, papillary lesions, ductal carcinoma in situ or invasive carcinoma at CNB were exclusion criteria), and subsequent surgical excision was systematically performed. The histological diagnosis was retrospectively reviewed using standardized criteria and the precise terminology of the World Health Organization by two pathologist physicians. At surgical excision, 6 (10%) ductal carcinoma in situ and 2 (3%) invasive carcinoma were diagnosed. The total underestimation rate was 13%. FEA was associated with atypical ductal hyperplasia in 10 (17%) cases and with lobular neoplasia in 2 (3%) at final pathology. Residual FEA was found in 14 (23%) cases. No clinical, radiological or pathological factors were significantly associated with underestimation. Our data highlight the importance of recognizing and diagnosing FEA in core needle biopsies. Thus, the presence of FEA on CNB, even in isolation, warrants follow-up excision.

  11. Invasive lung cancer staging: influence of CT-guided core needle biopsy on onset of pleural carcinomatosis.

    PubMed

    Flechsig, Paul; Kunz, Josef; Heussel, Claus-Peter; Bozorgmehr, Farastuk; Schnabel, Philipp; Dienemann, Hendrik; Kauczor, Hans-Ulrich; Sedlaczek, Oliver

    2015-01-01

    In lung cancer patients with single peripheral lesions, CT-guided needle biopsies (CTNBs) are common for histological sampling. Recently published studies showed conflicting results for the influence of CTNB on the onset of pleural carcinomatosis (PC). In order to estimate the influence of CTNB on pleural tumor spread, 146 histologically confirmed cases of lung cancer diagnosed by CTNB were retrospectively compared to 112 control lung cancer patients diagnosed by non-CTNB. CTNB was not associated with an earlier onset of PC, identifying CTNB as a safe procedure for minimally invasive lung cancer staging.

  12. Reflex Estrogen Receptor (ER) and Progesterone Receptor (PR) Analysis of Ductal Carcinoma In Situ (DCIS) in Breast Needle Core Biopsy Specimens: An Unnecessary Exercise That Costs the United States $35 Million/y.

    PubMed

    VandenBussche, Christopher J; Cimino-Mathews, Ashley; Park, Ben Ho; Emens, Leisha A; Tsangaris, Theodore N; Argani, Pedram

    2016-08-01

    Most institutions reflexively test all breast core needle biopsy specimens showing ductal carcinoma in situ (DCIS) for estrogen receptor (ER) and progesterone receptor (PR). However, 5 factors suggest that this reflex testing unnecessarily increases costs. First, ER/PR results do not currently impact the next step in standard therapy; namely, surgical excision. Second, a subset of surgical excisions performed for DCIS diagnosed on core needle biopsy will harbor infiltrating mammary carcinoma, which will then need to be retested for ER/PR. Third, because ER and PR labeling is often heterogeneous in DCIS, negative results for ER/PR on small core needle biopsy specimens should logically be repeated on surgical excision specimens with larger amounts of DCIS to be sure that the result is truly negative. Fourth, many patients with pure ER/PR-positive DCIS after surgical excision will decline hormone therapy, so any ER/PR testing of their DCIS is unnecessary. Fifth, PR status in DCIS has no proven independent value. We now examine the unnecessary added costs associated with reflex ER/PR testing of DCIS on core needle biopsy specimens due to these factors. We reviewed 58 core needle biopsies showing pure DCIS that also had a resulting surgical excision specimen at our institution over a period of 2 years. No patient received neoadjuvant hormone therapy. On surgical excision, 5 (8.6%) had only benign findings, 44 (75.9%) had pure DCIS, and 9 (15.5%) had DCIS with invasive mammary carcinoma. The 9 cases with invasive mammary carcinoma in the surgical excision specimen (16%) and the 4 pure DCIS in surgical excision specimens that were ER/PR negative on core needle biopsy would need repeat ER/PR testing. The total unnecessary increased cost of core needle biopsy specimen testing of these 13 cases was $8148.92 ($140/patient for the 58 patients in the study). We found that ER/PR testing results impacted patient management in only 16/49 pure DCIS cases after surgical excision (33

  13. Immunohistochemistry for BRAF(V600E) antibody VE1 performed in core needle biopsy samples identifies mutated papillary thyroid cancers.

    PubMed

    Crescenzi, A; Guidobaldi, L; Nasrollah, N; Taccogna, S; Cicciarella Modica, D D; Turrini, L; Nigri, G; Romanelli, F; Valabrega, S; Giovanella, L; Onetti Muda, A; Trimboli, P

    2014-05-01

    BRAF(V600E) is the most frequent genetic mutation in papillary thyroid cancer (PTC) and has been reported as an independent predictor of poor prognosis of these patients. Current guidelines do not recommend the use of BRAF(V600E) mutational analysis on cytologic specimens from fine needle aspiration due to several reasons. Recently, immunohistochemistry using VE1, a mouse anti-human BRAF(V600E) antibody, has been reported as a highly reliable technique in detecting BRAF-mutated thyroid and nonthyroid cancers. The aim of this study was to test the reliability of VE1 immunohistochemistry on microhistologic samples from core needle biopsy (CNB) in identifying BRAF-mutated PTC. A series of 30 nodules (size ranging from 7 to 22 mm) from 30 patients who underwent surgery following CNB were included in the study. All these lesions had had inconclusive cytology. In all cases, both VE1 and BRAF(V600E) genotypes were evaluated. After surgery, final histology demonstrated 21 cancers and 9 benign lesions. CNB correctly diagnosed 20/20 PTC and 5/5 adenomatous nodules. One follicular thyroid cancer and 4 benign lesions were assessed at CNB as uncertain follicular neoplasm. VE1 immunohistochemistry revealed 8 mutated PTC and 22 negative cases. A 100% agreement was found when positive and negative VE1 results were compared with BRAF mutational status. These data are the first demonstration that VE1 immunohistochemistry performed on thyroid CNB samples perfectly matches with genetic analysis of BRAF status. Thus, VE1 antibody can be used on thyroid microhistologic specimens to detect BRAF(V600E)-mutated PTC before surgery.

  14. Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution*

    PubMed Central

    Badan, Gustavo Machado; Roveda Júnior, Decio; Piato, Sebastião; Fleury, Eduardo de Faria Castro; Campos, Mário Sérgio Dantas; Pecci, Carlos Alberto Ferreira; Ferreira, Felipe Augusto Trocoli; D'Ávila, Camila

    2016-01-01

    Objective To determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB) and vacuum-assisted biopsies (VABB) of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy. Materials and Methods Retrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system. Biopsy results were compared with those observed at surgery and the underestimation rate was calculated by means of specific mathematical equations. Results The underestimation rate at CNB was 50% for ADH and 28.57% for DCIS, and at VABB it was 25% for ADH and 14.28% for DCIS. ADH represented 10.25% of all cases undergoing biopsy, whereas DCIS accounted for 23.91%. Conclusion The diagnostic underestimation rate at CNB is two times the rate at VABB. Certainty that the target has been achieved is not the sole determining factor for a reliable diagnosis. Removal of more than 50% of the target lesion should further reduce the risk of underestimation. PMID:26929454

  15. Consecutive CT-guided core needle tissue biopsy of lung lesions in the same dog at different phases of radiation-induced lung injury

    PubMed Central

    Yin, Zhongyuan; Deng, Sisi; Liang, Zhiwen; Wang, Qiong

    2016-01-01

    This project aimed to set up a Beagle dog model of radiation-induced lung injury in order to supply fresh lung tissue samples in the different injury phases for gene and protein research. Three dogs received 18 Gy X-ray irradiation in one fraction, another three dogs received 8 Gy in each of three fractions at weekly intervals, and one control dog was not irradiated. Acute pneumonitis was observed during the first 3 months after radiation, and chronic lung fibrosis was found during the next 4–12 months in all the dogs exposed to radiation. CT-guided core needle lung lesion biopsies were extracted from each dog five times over the course of 1 year. The dogs remained healthy after each biopsy, and 50–100 mg fresh lung lesion tissues were collected in each operation. The incidence of pneumothorax and hemoptysis was 20% and 2.8%, respectively, in the 35 tissue biopsies. A successful and stable radiation-induced lung injury dog model was established. Lung lesion tissue samples from dogs in acute stage, recovery stage and fibrosis stage were found to be sufficient to support cytology, genomics and proteomics research. This model safely supplied fresh tissue samples that would allow future researchers to more easily explore and develop treatments for radiation-induced lung injury. PMID:27422930

  16. Adequacy and complication rates with 14- vs. 16-gauge automated needles in percutaneous renal biopsy of native kidneys.

    PubMed

    Chunduri, Svetha; Whittier, William L; Korbet, Stephen M

    2015-01-01

    In performing percutaneous renal biopsy (PRB) of native kidneys, an increasing use of 16-gauge automated biopsy needles has been observed. We compare the adequacy and safety of PRBs in adults performed with a 14-gauge (n = 82) vs. 16-gauge (n = 55) automated needle using real-time ultrasound (US) from 1/2010 to 12/2013. Baseline clinical and laboratory data along with outcome data (renal US 1-hour postbiopsy, biopsy adequacy, and safety) were collected prospectively. There was no difference in age, gender, blood pressure, serum creatinine, or pre-PRB hemoglobin at baseline for PRBs performed with a 14- vs. 16-gauge needle. The number of glomeruli obtained per biopsy was similar (29 ± 11 vs. 31 ± 14, p = 0.6) and adequate tissue for diagnosis was obtained in 99% and 100% of biopsies. The clinical complication (8.5% vs. 9.1%, p = 1.0), transfusion (7.3% vs. 7.2%, p = 1.0), and embolization (3.7% vs. 1.8%, p = 0.6) rates were not significantly different for 14- vs. 16-gauge needles, but by routine renal US 1-hour post-PRB, a perinephric hematoma was demonstrated more often in biopsies done with the 14-gauge needle (39% vs. 22%, P 0.04). Thus, while the success of PRB of native kidneys is similar for both needle gauges, the potential for complication may be less using a 16-gauge automated needle.

  17. Hepatic angiomyolipoma: a series of six cases with emphasis on pathological-radiological correlations and unusual variants diagnosed by core needle biopsy

    PubMed Central

    Agaimy, Abbas; Vassos, Nikolaos; Croner, Roland S; Strobel, Deike; Lell, Michael

    2012-01-01

    Hepatic angiomyolipoma is rare and may pose differential diagnostic difficulty, particularly if encountered in core needle biopsy. We studied 6 cases from 5 males and one female (median age, 48.6 yrs). All presented with non-specific symptoms or an incidentally discovered tumor mass. Two patients had a remote history of chemotherapy for hematological neoplasms (acute lymphoblastic leukemia and Hodgkin lymphoma respectively) and another had clear cell renal cell carcinoma and anaplastic pancreatic carcinoma diagnosed at autopsy without definable syndrome. None of the patients had evidence of the tuberous sclerosis complex or renal or other extra-renal angiomyolipoma. Three tumors were resected completely and three have been only biopsied and followed up. None of the resected cases recurred at a mean follow-up of 35 months. Histologically, tumors were classified as classical triphasic (1), lipomatous (2), epithelioid/oncocytoid (1), epithelioid trabecular (1) and myelolipoma-like (1). The adjacent liver parenchyma was normal in 3 cases, showed pigment cirrhosis in one case and mild fatty change in another case. One case had clinically diagnosed but histologically unverified cirrhosis. The initial diagnostic impression/frozen section was misleading in 5 of the cases and included vascular lesion, focal fatty change, myelolipoma, hepatocellular tumor and oncocytic neoplasm. All tumors expressed HMB45 and variably desmin. One epithelioid lesion expressed HMB45 and TFE3, but lacked desmin expression. In conclusion, hepatic angiomyolipomas are increasingly recognized as incidental findings during surveillance for cirrhosis or investigations for unrelated conditions. Awareness of their diverse morphological spectrum in liver biopsy is necessary to avoid misdiagnosis as hepatocellular carcinoma, metastatic melanoma or other malignant neoplasms. PMID:22949933

  18. Analysis of Clinical and Pathologic Factors of Pure, Flat Epithelial Atypia on Core Needle Biopsy to Aid in the Decision of Excision or Observation

    PubMed Central

    Berry, John S; Trappey, Alfred F; Vreeland, Timothy J; Pattyn, Adam R; Clifton, Guy T; Berry, Elizabeth A; Schneble, Erika J; Kirkpatrick, Aaron D; Saenger, Jeffrey S; Peoples, George E

    2016-01-01

    Background: The optimal treatment of flat epithelial atypia (FEA) found on breast core needle biopsy (CNB) is controversial. We performed a retrospective review of our institutional experience with FEA to determine if excisional biopsy may be deferred. Methods: Surgical records from 2009 to 2012 were reviewed for FEA diagnosis. After exclusion for concomitant lesions, CNBs of pure FEA were classified using a previously agreed upon descriptor of “focal” versus “prominent”. Data was analyzed with the Fisher's Exact and Student-t test as appropriate. Results: Of 71 CNBs evaluated, pure FEA was identified on 27 CNBs. Final excisional biopsy was benign in 24 of 27 cases (88%) with associated ductal carcinoma in-situ (DCIS) in 3 of 27 cases (11%). Eighteen of 27 (67%) CNBs were classified as focal while 9 (33%) were described as prominent. Zero of the 18 focal patients had a malignancy compared to 3 of the 9 in the prominent group (0% vs 33%, p=0.02). Of the 27 pure FEA CNBs, 6 patients had a personal history of breast carcinoma, five DCIS and one invasive ductal carcinoma. No malignancies were found in the 21 patients without a personal history of breast carcinoma versus three in the patients with a positive history (0/21 v 3/6, p=0.007). Conclusions: Our data suggests those women who have adequate sampling and sectioning of CNBs, with focal, pure FEA on pathology, and are without a personal history of breast cancer may undergo a period of imaging surveillance. Conversely, patients with a history of breast cancer or pure, prominent FEA on CNB disease should proceed to excisional biopsy. PMID:26722353

  19. C-arm cone-beam CT-guided transthoracic lung core needle biopsy as a standard diagnostic tool: an observational study.

    PubMed

    Jaconi, Marta; Pagni, Fabio; Vacirca, Francesco; Leni, Davide; Corso, Rocco; Cortinovis, Diego; Bidoli, Paolo; Bono, Francesca; Cuttin, Maria S; Valente, Maria G; Pesci, Alberto; Bedini, Vittorio A; Leone, Biagio E

    2015-03-01

    C-arm cone-beam computed tomography (CT)-guided transthoracic lung core needle biopsy (CNB) is a safe and accurate procedure for the evaluation of patients with pulmonary nodules. This article will focus on the clinical features related to CNB in terms of diagnostic performance and complication rate. Moreover, the concept of categorizing pathological diagnosis into 4 categories, which could be used for clinical management, follow-up, and quality assurance is also introduced. We retrospectively collected data regarding 375 C-arm cone-beam CT-guided CNBs from January 2010 and June 2014. Clinical and radiological variables were evaluated in terms of success or failure rate. Pathological reports were inserted in 4 homogenous groups (nondiagnostic--L1, benign--L2, malignant not otherwise specified--L3, and malignant with specific histotype--L4), defining for each category a hierarchy of suggested actions. The sensitivity, specificity, and positive and negative predictive value and accuracy for patients subjected to CNBs were of 96.8%, 100%, 100%, 100%, and 97.2%, respectively. Roughly 75% of our samples were diagnosed as malignant, with 60% lung adenocarcinoma diagnoses. Molecular analyses were performed on 85 malignant samples to verify applicability of targeted therapy. The rate of "nondiagnostic" samples was 12%. C-arm cone-beam CT-guided transthoracic lung CNB can represent the gold standard for the diagnostic evaluation of pulmonary nodules. A clinical and pathological multidisciplinary evaluation of CNBs was needed in terms of integration of radiological, histological, and oncological data. This approach provided exceptional performances in terms of specificity, positive and negative predictive values; sensitivity in our series was lower compared with other large studies, probably due to the application of strong criteria of adequacy for CNBs (L1 class rate). The satisfactory rate of collected material was evaluated not only in terms of merely diagnostic

  20. Computed tomography-guided percutaneous core needle biopsy for diagnosis of mediastinal mass lesions: Experience with 110 cases in two university hospitals in Isfahan, Iran

    PubMed Central

    Rabbani, Masoud; Sarrami, Amir Hossein

    2016-01-01

    Background: Computed tomography-guided percutaneous core needle biopsy (PCNB) is a diagnostic technique for initial assessment of mediastinal mass lesions. This study was conducted to evaluate its diagnostic yield and its complication rate. Materials and Methods: We reviewed the records of CT-guided PCNB in 110 patients with mediastinal mass lesions performed in Kashani and Alzahra Hospitals, Isfahan, from 2006 to 2012. Gender, age at biopsy, size, and anatomic location of the lesion, number of passes, site of approach, complications, and final diagnosis were extracted. Results: Our series encompasses 52 (47.2%) females and 58 (52/7%) males with mean age of 41 ± 8 years. The most common site of involvement was the anterior mediastinum (91.8% of cases). An average of 3/5 passes per patient has been taken for tissue sampling. Parasternal site was the most frequent approach taken for PCNB (in 78.1% of cases). Diagnostic tissue was obtained in 99 (90%) biopsies while, in 11 (10%) cases, specimen materials were inadequate. Lymphoma (49.5%) and bronchogenic carcinoma (33.3%) were the most frequent lesions in our series. The overall complication rate was 17.2% from which 10.9% was pneumothorax, 5.4% was hemoptysis, and 0.9% was vasovagal reflex. Conclusion: CT-guided PCNB is a safe and reliable procedure that can provide a precise diagnosis for patients with both benign and malignant mediastinal masses, and it is considered the preferred first diagnostic procedure use for this purpose. PMID:27713873

  1. Needle Phobia.

    PubMed

    Cook, Lynda S

    2016-01-01

    Venipuncture is generally associated with some degree of pain, discomfort, and/or apprehension. Yet most patients accept it with tolerance, even nonchalance. A few, not only pediatric patients, exhibit a higher degree of anxiety and face the procedure with tears, tension, and a variety of bargaining techniques (ie, stick on the count of 3; use only this vein). But for 1 group of people, venipuncture is associated with such fear that avoidance of the procedure is practiced. The end results are detrimental to the patient and may have an impact on society as well. These are patients the American Psychiatric Association classifies as needle phobic. What can a nurse with no training in psychiatry do to assist these patients? To form an appropriate professional response, it's beneficial for practitioners to recognize the different pathways that lead to needle phobia and the issues related to the disorder. PMID:27598066

  2. Impact of immediate evaluation of touch imprint cytology from computed tomography guided core needle biopsies of mass lesions: Single institution experience

    PubMed Central

    Moghadamfalahi, Mana; Podoll, Mirna; Frey, Amy B.; Alatassi, Houda

    2014-01-01

    Background: Computed tomography (CT) guided core needle biopsy (CT-guided CNB) is a minimally invasive, safe and effective manner of tissue sampling in many organs. The aim of our study is to determine the impact of on-site evaluation of touch imprint cytology (TIC) to minimize the number of passes required to obtain adequate tissue for diagnosis. Design: A retrospective review of all CT-guided CNBs performed during 4 year period, where pathologists were present for on-site TIC evaluation. Each case was evaluated for the number of passes required before TIC was interpreted as adequate for diagnosis. Results: A total of 140 CT-guided CNBs were included in the study (liver, lung, kidney, sacral, paraspinal, omental, splenic and adrenal masses). Of the 140 cases, 109 were diagnosed as malignant, 28 as benign and three insufficient. In 106 cases (75.7%), the biopsies were determined adequate by TIC on the first pass, 19 cases (13%) on the second pass and 7 cases (5%) on the third pass. Only in 5 cases (3.6%), more than three passes were required before diagnostic material was obtained. Three cases (2.14%) were interpreted as inadequate both on TIC and on the final diagnosis. Of the biopsies deemed adequate on the first pass, 71% resulted in either termination of the procedure, or only one additional pass was obtained. In five cases, based on the TIC evaluation, a portion of the sample was sent for either flow cytometric analysis or cytogenetic studies. Conclusions: In the majority of cases, adequate material was obtained in the first pass of CT-guided CNB and once this was obtained, either no additional passes, or one additional pass was performed. This study demonstrates the utility of on-site evaluation in minimizing the number of passes required for obtaining adequate diagnostic material and for proper specimen triage for ancillary studies, which in turn decreases the risk to the patient and costs. However, tumor exhaustion in the tissue as a result of TIC is an

  3. Pleural needle biopsy

    MedlinePlus

    ... lungs and chest wall (pleural membrane). A larger, hollow needle is then placed gently through the skin ... the needle. A smaller cutting needle inside the hollow one is used to collect tissue samples. During ...

  4. Past, present, and future for surgical needles and needle holders.

    PubMed

    Edlich, R F; Thacker, J G; McGregor, W; Rodeheaver, G T

    1993-11-01

    During the last two decades, major advances in surgical needle and needle holder technology have markedly improved surgical wound repair. These advances include quantitative tests for surgical needle and needle holders performance, high nickel maraging stainless steels, compound curved needles, needle sharpening methods, laser-drilled holes for swages, needle:suture ratios of 1:1, and the atraumatic needle holder.

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

    SciTech Connect

    Uchida, Barry T.; Pavcnik, Dusan Shimohira, Masashi; Choi, Young Ho; Jeromel, Miran; Keller, Frederick S.; Roesch, Josef

    2011-06-15

    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 the 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.

  6. Picosecond optical vortex pulse illumination forms a monocrystalline silicon needle

    NASA Astrophysics Data System (ADS)

    Takahashi, Fuyuto; Miyamoto, Katsuhiko; Hidai, Hirofumi; Yamane, Keisaku; Morita, Ryuji; Omatsu, Takashige

    2016-02-01

    The formation of a monocrystalline silicon needle by picosecond optical vortex pulse illumination was demonstrated for the first time in this study. The dynamics of this silicon needle formation was further revealed by employing an ultrahigh-speed camera. The melted silicon was collected through picosecond pulse deposition to the dark core of the optical vortex, forming the silicon needle on a submicrosecond time scale. The needle was composed of monocrystalline silicon with the same lattice index (100) as that of the silicon substrate, and had a height of approximately 14 μm and a thickness of approximately 3 μm. Overlaid vortex pulses allowed the needle to be shaped with a height of approximately 40 μm without any changes to the crystalline properties. Such a monocrystalline silicon needle can be applied to devices in many fields, such as core-shell structures for silicon photonics and photovoltaic devices as well as nano- or microelectromechanical systems.

  7. Research on needle exchange: redefining the agenda.

    PubMed Central

    Hantman, J. A.

    1995-01-01

    Researchers studying needle-exchange programs in the United States pursue a two-fold agenda that requires answers to these questions: (1) Do such programs successfully reduce HIV seroprevalence among injecting drug users? (2) Do they promote drug use? Several federal laws and regulations require convincing data on each question before the release of federal funds for needle exchange. Fears that needle exchange promotes drug use are at the core of federal concerns, and these fears are shared by community leaders, scientists, and public health professionals. Nonetheless, the manner in which the "drug use" question has been framed and addressed in scientific research has been given insufficient attention. This article aims to stimulate debate about current research, and restore a focus on HIV prevention, by addressing several methodological, logical, and ethical weaknesses that characterize the scientific inquiry into whether needle exchange promotes drug use. PMID:10101379

  8. [Intrapulmonary Sewing Needle].

    PubMed

    Hisama, Naoya; Tsunemitsu, Nobumasa; Yasumasu, Tetsuo; Yamasaki, Takashi; Uchida, Takahisa

    2016-06-01

    Intrapulmonary aberrant needles are rarely encountered in clinical practice. A 82-year-old woman, though she was asymptomatic, was referred to our department due to an abnormal shadow on a chest X-ray. Chest X-ray and chest computed tomography showed a foreign body suspected to be a sewing needle in the left upper lobe. The needle was successfully removed by video-assisted thoracoscopic surgery. PMID:27246130

  9. Immunohistochemical detection of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 in formalin-fixed breast carcinoma cell block preparations: correlation of results to corresponding tissue block (needle core and excision) samples.

    PubMed

    Kinsella, Mary D; Birdsong, George G; Siddiqui, Momin T; Cohen, Cynthia; Hanley, Krisztina Z

    2013-03-01

    Evaluation of ER, PR and Her 2 are routinely performed on breast carcinomas. For accurate detection of these markers, compliance with the ASCO/CAP guidelines is recommended. Our previous study showed that alcohol fixation did not affect ER results when alcohol-fixed cell block (CB) sections were compared to formalin-fixed tissue sections, while PR and Her2 showed less concordance. The aim of this study was to evaluate and to compare ER, PR and Her2 IHC results on formalin-fixed CB sections to those observed on subsequent surgical (needle core or resection) specimens (SS). Fifty cases of formalin fixed CB samples obtained from primary (18%) and metastatic (82%) breast carcinomas were studied, all of which had subsequent SS available. ER, PR, and Her2 IHC studies were done on all samples and results were compared. ER results on formalin-fixed CB samples showed excellent correlation with SS (correlation coefficient cc = 0.82). While there was minimal improvement in PR results (cc = 0.433), Her2 detection did not improve by formalin fixation (cc = 0.439). Formalin fixation for CB preparations does not significantly improve the already good detection of ER positive breast tumors. The concordance rate in PR and IHC results between formalin-fixed CB and SS samples showed improvement as compared with the alcohol-fixed CB results. However, there was no improvement in detection of Her2 overexpression by using formalin fixation on cytology specimens.

  10. Precessing Ferromagnetic Needle Magnetometer.

    PubMed

    Jackson Kimball, Derek F; Sushkov, Alexander O; Budker, Dmitry

    2016-05-13

    A ferromagnetic needle is predicted to precess about the magnetic field axis at a Larmor frequency Ω under conditions where its intrinsic spin dominates over its rotational angular momentum, Nℏ≫IΩ (I is the moment of inertia of the needle about the precession axis and N is the number of polarized spins in the needle). In this regime the needle behaves as a gyroscope with spin Nℏ maintained along the easy axis of the needle by the crystalline and shape anisotropy. A precessing ferromagnetic needle is a correlated system of N spins which can be used to measure magnetic fields for long times. In principle, by taking advantage of rapid averaging of quantum uncertainty, the sensitivity of a precessing needle magnetometer can far surpass that of magnetometers based on spin precession of atoms in the gas phase. Under conditions where noise from coupling to the environment is subdominant, the scaling with measurement time t of the quantum- and detection-limited magnetometric sensitivity is t^{-3/2}. The phenomenon of ferromagnetic needle precession may be of particular interest for precision measurements testing fundamental physics. PMID:27232012

  11. Precessing Ferromagnetic Needle Magnetometer

    NASA Astrophysics Data System (ADS)

    Jackson Kimball, Derek F.; Sushkov, Alexander O.; Budker, Dmitry

    2016-05-01

    A ferromagnetic needle is predicted to precess about the magnetic field axis at a Larmor frequency Ω under conditions where its intrinsic spin dominates over its rotational angular momentum, N ℏ≫I Ω (I is the moment of inertia of the needle about the precession axis and N is the number of polarized spins in the needle). In this regime the needle behaves as a gyroscope with spin N ℏ maintained along the easy axis of the needle by the crystalline and shape anisotropy. A precessing ferromagnetic needle is a correlated system of N spins which can be used to measure magnetic fields for long times. In principle, by taking advantage of rapid averaging of quantum uncertainty, the sensitivity of a precessing needle magnetometer can far surpass that of magnetometers based on spin precession of atoms in the gas phase. Under conditions where noise from coupling to the environment is subdominant, the scaling with measurement time t of the quantum- and detection-limited magnetometric sensitivity is t-3 /2. The phenomenon of ferromagnetic needle precession may be of particular interest for precision measurements testing fundamental physics.

  12. Precessing Ferromagnetic Needle Magnetometer.

    PubMed

    Jackson Kimball, Derek F; Sushkov, Alexander O; Budker, Dmitry

    2016-05-13

    A ferromagnetic needle is predicted to precess about the magnetic field axis at a Larmor frequency Ω under conditions where its intrinsic spin dominates over its rotational angular momentum, Nℏ≫IΩ (I is the moment of inertia of the needle about the precession axis and N is the number of polarized spins in the needle). In this regime the needle behaves as a gyroscope with spin Nℏ maintained along the easy axis of the needle by the crystalline and shape anisotropy. A precessing ferromagnetic needle is a correlated system of N spins which can be used to measure magnetic fields for long times. In principle, by taking advantage of rapid averaging of quantum uncertainty, the sensitivity of a precessing needle magnetometer can far surpass that of magnetometers based on spin precession of atoms in the gas phase. Under conditions where noise from coupling to the environment is subdominant, the scaling with measurement time t of the quantum- and detection-limited magnetometric sensitivity is t^{-3/2}. The phenomenon of ferromagnetic needle precession may be of particular interest for precision measurements testing fundamental physics.

  13. Short-term imaging follow-up of patients with concordant benign breast core needle biopsies: is it really worth it?

    PubMed Central

    Adams, Michelle C.; Falcon, Shannon; Mooney, Blaise P.; Laronga, Christine; Chau, Alec; Drukteinis, Jennifer S.

    2014-01-01

    PURPOSE Women with histologically proven concordant benign breast disease are often followed closely after biopsy for a period of two years, and they are considered to be at high-risk for cancer development. Our goal was to evaluate the utility of short-term (six-month) imaging follow-up and determine the incidence of breast cancer development in this population. METHODS Retrospective review of concordant benign breast pathology was performed in 558 patients who underwent multi-modality breast core biopsy. A total of 339 patients (60.7%) with 393 biopsies qualified for the study. The six-, 12-, and 24-month incidence rates of breast cancer development were estimated with 95% confidence intervals (CI), using the exact method binomial proportions. RESULTS No cancer was detected in 285 of 339 patients (84.1%) returning for the six-month follow-up. No cancer was detected in 271 of 339 patients (79.9%) returning for the 12-month follow-up. Among 207 follow-up exams (61.1%) performed at 24 months, three patients were detected to have cancer in the ipsilateral breast (1.45% [95% CI, 0.30%–4.18%]) and two patients were detected to have cancer in the contralateral breast (0.97% [95% CI, 0.12%–3.45%]). Subsequent patient biopsy rate was 30 of 339 (8.85%, [95% CI, 6.05%–12.39%]). Three ipsilateral biopsies occurred as a sole result of the six-month follow-up of 285 patients (1.05%, [95% CI, 0.22%–3.05%]). CONCLUSION Short-term imaging follow-up did not contribute to improved breast cancer detection, as all subsequent cancers were detected on annual mammography. Annual diagnostic mammography after benign breast biopsy may be sufficient. PMID:25205024

  14. Needle breakage: incidence and prevention.

    PubMed

    Malamed, Stanley F; Reed, Kenneth; Poorsattar, Susan

    2010-10-01

    Since the introduction of nonreusable, stainless steel dental local anesthetic needles, needle breakage has become an extremely rare complication of dental local anesthetic injections. But although rare, dental needle breakage can, and does, occur. Review of the literature and personal experience brings into focus several commonalities which, when avoided, can minimize the risk of needle breakage with the fragment being retained from occurring.

  15. Experiments with needle bearings

    NASA Technical Reports Server (NTRS)

    Ferretti, Pericle

    1933-01-01

    Experiments and results are presented in testing needle bearings, especially in comparison with roller bearings. Reduction in coefficient of friction is discussed as well as experimental methods and recording devices.

  16. Adequate histologic sectioning of prostate needle biopsies.

    PubMed

    Bostwick, David G; Kahane, Hillel

    2013-08-01

    No standard method exists for sampling prostate needle biopsies, although most reports claim to embed 3 cores per block and obtain 3 slices from each block. This study was undertaken to determine the extent of histologic sectioning necessary for optimal examination of prostate biopsies. We prospectively compared the impact on cancer yield of submitting 1 biopsy core per cassette (biopsies from January 2010) with 3 cores per cassette (biopsies from August 2010) from a large national reference laboratory. Between 6 and 12 slices were obtained with the former 1-core method, resulting in 3 to 6 slices being placed on each of 2 slides; for the latter 3-core method, a limit of 6 slices was obtained, resulting in 3 slices being place on each of 2 slides. A total of 6708 sets of 12 to 18 core biopsies were studied, including 3509 biopsy sets from the 1-biopsy-core-per-cassette group (January 2010) and 3199 biopsy sets from the 3-biopsy-cores-percassette group (August 2010). The yield of diagnoses was classified as benign, atypical small acinar proliferation, high-grade prostatic intraepithelial neoplasia, and cancer and was similar with the 2 methods: 46.2%, 8.2%, 4.5%, and 41.1% and 46.7%, 6.3%, 4.4%, and 42.6%, respectively (P = .02). Submission of 1 core or 3 cores per cassette had no effect on the yield of atypical small acinar proliferation, prostatic intraepithelial neoplasia, or cancer in prostate needle biopsies. Consequently, we recommend submission of 3 cores per cassette to minimize labor and cost of processing. PMID:23764163

  17. Needle Federated Search Engine

    SciTech Connect

    2009-12-01

    The Idaho National Laboratory (INL) has combined a number of technologies, tools, and resources to accomplish a new means of federating search results. The resulting product is a search engine called Needle, an open-source-based tool that the INL uses internally for researching across a wide variety of information repositories. Needle has a flexible search interface that allows end users to point at any available data source. A user can select multiple sources such as commercial databases (Web of Science, Engineering Index), external resources (WorldCat, Google Scholar), and internal corporate resources (email, document management system, library collections) in a single interface with one search query. In the future, INL hopes to offer this open-source engine to the public. This session will outline the development processes for making Needle™s search interface and simplifying the federation of internal and external data sources.

  18. Needle Federated Search Engine

    2009-12-01

    The Idaho National Laboratory (INL) has combined a number of technologies, tools, and resources to accomplish a new means of federating search results. The resulting product is a search engine called Needle, an open-source-based tool that the INL uses internally for researching across a wide variety of information repositories. Needle has a flexible search interface that allows end users to point at any available data source. A user can select multiple sources such as commercialmore » databases (Web of Science, Engineering Index), external resources (WorldCat, Google Scholar), and internal corporate resources (email, document management system, library collections) in a single interface with one search query. In the future, INL hopes to offer this open-source engine to the public. This session will outline the development processes for making Needle™s search interface and simplifying the federation of internal and external data sources.« less

  19. The Missing Needles: A Smooth Extension of Buffon's Needle Problem.

    ERIC Educational Resources Information Center

    McGivney, Raymond J., Jr.; Pollino, Benedict

    1989-01-01

    Describes the "Buffon's Needle" problem, which is calculating the probability that a needle will cross one of two separated lines. Calculates the probability when the length of the needle is greater than the space of the two lines. Provides an analytic solution and the results of a computer simulation. (YP)

  20. Fine needle aspiration of the thyroid

    MedlinePlus

    Thyroid nodule fine needle aspirate biopsy; Biopsy - thyroid - skinny-needle; Skinny-needle thyroid biopsy ... cleaned. A thin needle is inserted into the thyroid, and a sample of thyroid cells and fluid ...

  1. A Precessing Ferromagnetic Needle Magnetometer

    NASA Astrophysics Data System (ADS)

    Jackson Kimball, Derek; Sushkov, Alexander; Budker, Dmitry

    2016-05-01

    A ferromagnetic needle is predicted to precess about the magnetic field axis at a Larmor frequency Ω when IΩ << Nℏ , where I is the moment of inertia of the needle about the precession axis and N is the number of polarized spins in the needle. In this regime the needle behaves as a gyroscope with spin Nℏ maintained along the easy axis of the needle by the crystalline and shape anisotropy. A precessing ferromagnetic needle is a correlated system of N spins which can be used to measure magnetic fields for long times. In principle, the sensitivity of a precessing needle magnetometer can far surpass that of magnetometers based on spin precession of atoms in the gas phase. The phenomenon of ferromagnetic needle precession may be of particular interest for precision measurements testing fundamental physics. Supported by the Heising-Simons Foundation, Simons Foundation, and the National Science Foundation.

  2. Buffon's Needle--A Simulation.

    ERIC Educational Resources Information Center

    Hart, Derek; Roberts, Tony

    1989-01-01

    This paper describes a computer simulation of Buffon's needle problem. The problem considers the probability that a needle will cross a line when the needle is thrown in a random way onto the parallel lines a certain distance apart. The paper provides the algorithm and computer program. (YP)

  3. Needle ban vetoed.

    PubMed

    1999-10-15

    An appropriations bill with seven provisions, one of which barred the District of Columbia from spending money on needle-exchange programs, was vetoed by President Clinton. He called it objectionable and disruptive to the District's preventions efforts. The bill previously passed the House by a slim margin. Republicans objected to a contentious provision of the bill dealing with medicinal marijuana.

  4. NEEDLE TRADES, MATHEMATICS - I.

    ERIC Educational Resources Information Center

    COLICCHIO, ANTOINETTE J.

    THE NEEDLE TRADES INDUSTRY CONSISTS OF THREE TYPES OF ESTABLISHMENTS -- THE REGULAR MANUFACTURERS, THE APPAREL JOBBERS, AND THE CONTRACTORS. THE FUNCTIONS INCLUDED COVER A WIDE SCOPE FROM BUYING OF RAW MATERIAL TO SELLING OF THE FINISHED APPAREL. THE PURPOSE OF THIS STUDY GUIDE IS TO FURNISH BASIC KNOWLEDGE IN MATHEMATICS AND DEVELOP SKILL IN…

  5. Picosecond optical vortex pulse illumination forms a monocrystalline silicon needle.

    PubMed

    Takahashi, Fuyuto; Miyamoto, Katsuhiko; Hidai, Hirofumi; Yamane, Keisaku; Morita, Ryuji; Omatsu, Takashige

    2016-01-01

    The formation of a monocrystalline silicon needle by picosecond optical vortex pulse illumination was demonstrated for the first time in this study. The dynamics of this silicon needle formation was further revealed by employing an ultrahigh-speed camera. The melted silicon was collected through picosecond pulse deposition to the dark core of the optical vortex, forming the silicon needle on a submicrosecond time scale. The needle was composed of monocrystalline silicon with the same lattice index (100) as that of the silicon substrate, and had a height of approximately 14 μm and a thickness of approximately 3 μm. Overlaid vortex pulses allowed the needle to be shaped with a height of approximately 40 μm without any changes to the crystalline properties. Such a monocrystalline silicon needle can be applied to devices in many fields, such as core-shell structures for silicon photonics and photovoltaic devices as well as nano- or microelectromechanical systems. PMID:26907639

  6. 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

  7. Vancouver's needle exchange program.

    PubMed

    Bardsley, J; Turvey, J; Blatherwick, J

    1990-01-01

    To stem the spread of HIV among intravenous drug users, and between them and their sexual partners and offspring, Vancouver initiated a multifaceted "ways and means" needle exchange program in March of 1989. As of the end of October, over 2,600 users have registered. The needle exchange rate has increased steadily, reaching a peak of 98% in November. Increases have also been noted in the number of regular users, and requests for referral to addition, medical, social and HIV-related services. Outreach services, especially using a van, have expanded program availability. Success in terms of clientele response is accredited primarily to the nonjudgemental, nonintrusive approach. The main problems have been the lack of addiction treatment services, financial and personnel constraints created by the large enrollment, and difficulties with Federal/Provincial funding. Funding for evaluation has been requested.

  8. 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.

  9. Performance of needle valves.

    PubMed

    Hutton, P; Boaden, R W

    1986-08-01

    The pressure-flow characteristics of needle valves used on anaesthetic equipment were investigated. It was found that, under normal conditions of use, the valves behaved in a manner similar to convergent nozzles with sonic velocity at the throat. This means that, once the valve has been set, the mass flow rate of gas is effectively independent of the downstream changes in resistance and compliance encountered in normal anaesthetic practice. The error in a preset flow induced by the permissible variations in the upstream pipeline pressure was measured.

  10. Fine needle aspiration cytology.

    PubMed Central

    Lever, J V; Trott, P A; Webb, A J

    1985-01-01

    Fine needle aspiration cytology is an inexpensive, atraumatic technique for the diagnosis of disease sites. This paper describes the technique and illustrates how it may be applied to the management of tumours throughout the body. The limitations of the method, the dangers of false positive reports, and the inevitability of false negative diagnoses are emphasised. In a clinical context the method has much to offer by saving patients from inappropriate operations and investigations and allowing surgeons to plan quickly and more rationally. It is an economically valuable technique and deserves greater recognition. Images PMID:2578481

  11. Ban on needle swaps.

    PubMed

    1999-10-01

    A District of Columbia appropriations bill banning spending for needle-exchange programs will be going to President Clinton for signature. The House voted to approve the bill, and the Senate voted to accept it. Politicians from both parties are lobbying the President about the bill. Clinton's budget director, Jacob J. Lew, and D.C. Del. Eleanor Holmes Norton, argue against signing the bill. Rep. Thomas M. Davis warns a veto would scuttle legislation that funds education reforms and cleanup of the Anacostia River.

  12. Picosecond optical vortex pulse illumination forms a monocrystalline silicon needle

    PubMed Central

    Takahashi, Fuyuto; Miyamoto, Katsuhiko; Hidai, Hirofumi; Yamane, Keisaku; Morita, Ryuji; Omatsu, Takashige

    2016-01-01

    The formation of a monocrystalline silicon needle by picosecond optical vortex pulse illumination was demonstrated for the first time in this study. The dynamics of this silicon needle formation was further revealed by employing an ultrahigh-speed camera. The melted silicon was collected through picosecond pulse deposition to the dark core of the optical vortex, forming the silicon needle on a submicrosecond time scale. The needle was composed of monocrystalline silicon with the same lattice index (100) as that of the silicon substrate, and had a height of approximately 14 μm and a thickness of approximately 3 μm. Overlaid vortex pulses allowed the needle to be shaped with a height of approximately 40 μm without any changes to the crystalline properties. Such a monocrystalline silicon needle can be applied to devices in many fields, such as core–shell structures for silicon photonics and photovoltaic devices as well as nano- or microelectromechanical systems. PMID:26907639

  13. Physiologic effects of dry needling.

    PubMed

    Cagnie, Barbara; Dewitte, Vincent; Barbe, Tom; Timmermans, Frank; Delrue, Nicolas; Meeus, Mira

    2013-08-01

    During the past decades, worldwide clinical and scientific interest in dry needling (DN) therapy has grown exponentially. Various clinical effects have been credited to dry needling, but rigorous evidence about its potential physiological mechanisms of actions and effects is still lacking. Research identifying these exact mechanisms of dry needling action is sparse and studies performed in an acupuncture setting do not necessarily apply to DN. The studies of potential effects of DN are reviewed in reference to the different aspects involved in the pathophysiology of myofascial triggerpoints: the taut band, local ischemia and hypoxia, peripheral and central sensitization. This article aims to provide the physiotherapist with a greater understanding of the contemporary data available: what effects could be attributed to dry needling and what are their potential underlying mechanisms of action, and also indicate some directions at which future research could be aimed to fill current voids.

  14. Electrochemical Process Makes Fine Needles

    NASA Technical Reports Server (NTRS)

    Watkins, J. L.

    1986-01-01

    Electrochemical process makes fine tungsten needles for use as microscopic probes or field-emission cathodes. Etching vessel filled with dense, inert lower liquid covered by less-dense, caustic etching solution. Newly formed needle breaks off upper part of wire in etchant and falls into can in inert liquid below. Improved process does not require close monitoring and left unattended for an indefinite time.

  15. Mechanical performance of disposable surgical needle holders.

    PubMed

    Francis, E H; Towler, M A; Moody, F P; McGregor, W; Himel, H N; Rodeheaver, G T; Edlich, R F

    1992-01-01

    The mechanical performance of disposable Webster surgical needle holders supplied by three different surgical instrument companies was determined by recording the forces (clamping moment) applied by the different needle holder jaws to curved surgical needles. This investigation demonstrated that there was a large variability in the mechanical performance of the disposable needle holders supplied by each surgical instrument company. In addition, the mechanical performance of the disposable needle holder of each surgical instrument company was distinctly different.

  16. Fabrication of tungsten wire needles

    SciTech Connect

    Roder, A.

    1983-02-01

    Fine point needles for field emissoin are conventionally produced by electrolytically or chemically etching tungsten wire. Points formed in this manner have a typical tip radius of about 0.5 microns and a cone angle of some 30 degrees. The construction of needle matrix detector chambers has created a need for tungsten needles whose specifications are: 20 mil tungsten wire, 1.5 inch total length, 3 mm-long taper (resulting in a cone angle of about 5 degrees), and 25 micron-radius point (similar to that found on sewing needles). In the process described here for producing such needles, tungsten wire, immersed in a NaOH solution and in the presence of an electrode, is connected first to an ac voltage and then to a dc supply, to form a taper and a point on the end of the wire immersed in the solution. The process parameters described here are for needles that will meet the above specifications. Possible variations will be discussed under each approprite heading.

  17. Scientific basis for selecting surgical needles and needle holders for wound closure.

    PubMed

    Edlich, R F; Towler, M A; Rodeheaver, G T; Becker, D G; Lombardi, S A; Thacker, J G

    1990-07-01

    Standardized reproducible tests have been devised to determine surgical needle sharpness, resistance to bending, and ductility. Three comparable groups of reverse cutting edge needles were selected from different manufacturers for measurement of these needle performance parameters. This testing demonstrated that needle diameter, manufacturing process, needle material composition, cross-sectional design, and the manufacturer were all important determinants of surgical needle performance. In addition, the biomechanics of curved surgical needle bending has been related to the clamping moment of surgical needle holders. This relationship identifies the surgical needle holder that can be used with surgical needles without deformation. The results of these studies provide a scientific basis for the selection of surgical needles and needle holders for use in surgery.

  18. A decline in HIV-infected needles returned to New Haven's needle exchange program: client shift or needle exchange?

    PubMed Central

    Kaplan, E H; Khoshnood, K; Heimer, R

    1994-01-01

    The New Haven needle exchange program experienced a significant decline in the fraction of returned needles containing human immunodeficiency virus 1 (HIV-1) proviral DNA. Is this decline due to the operations of the needle exchange or to a shift in clients? Analysis of demographic and behavioral data revealed that only one variable, the race of participating clients, changed significantly over time. However, HIV-1 prevalences in needles given to Whites and to non-Whites were not statistically different. Thus, client shift cannot be responsible for the decline in the observed HIV prevalence in needles. Instead, needle circulation times were a significant predictor of HIV prevalence. PMID:7998644

  19. SISH/CISH or qPCR as alternative techniques to FISH for determination of HER2 amplification status on breast tumors core needle biopsies: a multicenter experience based on 840 cases

    PubMed Central

    2013-01-01

    Background Until now, FISH has been the gold standard technique to identify HER2 amplification status in ambiguous cases of breast cancer. Alternative techniques have been developed to increase the capacities of investigating HER2 amplification status. The aims of this multicenter study in a large series of breast cancer patients were to prospectively compare the level of performance of CISH, SISH, and qPCR alternative techniques on paraffin-embedded core biopsies with “gold standard FISH” for evaluation of HER2 amplification status. Methods This study was performed on 840 cases scored by immunohistochemistry (IHC): 0=317 (38%), 1+=183 (22%), 2+=109 (13%), 3+=231 (27%). Each of the 15 French centers participating in the study analyzed 56 breast carcinoma cases diagnosed on fixed paraffin-embedded core biopsies. HER2 amplification status was determined by commercially available FISH used as the reference technique with determination of the HER2/CEN17 ratio or HER2 copy number status. The alternative techniques performed on the same cases were commercially available SISH or CISH and a common qPCR method especially designed for the study including a set of 10 primer pairs: 2 for HER2 (exons 8 and 26), 5 to evaluate chromosome 17 polysomy TAOK1, UTP6, MRM1, MKS1, SSTR2 and 3 for diploidy control TSN, LAP3 and ADAMTS16. Results The concordance between IHC and FISH was 96% to 95% based on the HER2/CEN17 ratio (n=766) or HER2 copy number (n=840), respectively. The concordance of the alternative techniques with FISH was excellent: 97% and 98% for SISH (498 and 587 cases), 98% and 75% for CISH (108 and 204 cases) and 95% and 93% (699 and 773 cases) for qPCR based on the HER2/CEN17 ratio or HER2 copy number, respectively. Similarly, sensitivity ranged from 99% to 95% for SISH, 100% to 99% for CISH and 89% to 80% for qPCR. The concordance with FISH (ratio) in the 2+ cases was 89% for SISH, 100% for CISH and 93% for qPCR. Conclusion These alternative techniques showed an

  20. 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

  1. [Needle implantations--clinical report].

    PubMed

    Esswein, W

    1977-04-01

    In the last four years 27 patients with edentulous lower jaw were treated with implantation of rows of tantalum needles; 25 of them were followed up clinically and radiologically. After an average of two years and seven months where the success rate was found to be 72%. Reasons for failure were thought to be mistakes in operative technique, insufficient oral hygiene of the patients and less than optimal aftercare. These needle implants have proved their value also in cases with marked atrophy of the lower jaw where other prosthetic-surgical methods aimed at improving the prosthesis site have failed.

  2. Magnetic needles and superparamagnetic cells

    PubMed Central

    Bryant, H C; Sergatskov, D A; Lovato, Debbie; Adolphi, Natalie L; Larson, Richard S; Flynn, Edward R

    2007-01-01

    Superparamagnetic nanoparticles can be attached in great numbers to pathogenic cells using specific antibodies so that the magnetically-labeled cells themselves become superparamagnets. The cells can then be manipulated and drawn out of biological fluids, as in a biopsy, very selectively using a magnetic needle. We examine the origins and uncertainties in the forces exerted on magnetic nanoparticles by static magnetic fields, leading to a model for trajectories and collection times of dilute superparamagnetic cells in biological fluids. We discuss the design and application of such magnetic needles and the theory of collection times. We compare the mathematical model to measurements in a variety of media including blood. PMID:17664592

  3. 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.

  4. 21 CFR 880.5580 - Acupuncture needle.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in 21 CFR 801.109, (2) Device material biocompatibility, and (3) Device sterility. ... 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...

  5. 21 CFR 880.5580 - Acupuncture needle.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... in 21 CFR 801.109, (2) Device material biocompatibility, and (3) Device sterility. ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Acupuncture needle. 880.5580 Section 880.5580 Food... § 880.5580 Acupuncture needle. (a) Identification. An acupuncture needle is a device intended to...

  6. 21 CFR 880.5580 - Acupuncture needle.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... in 21 CFR 801.109, (2) Device material biocompatibility, and (3) Device sterility. ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Acupuncture needle. 880.5580 Section 880.5580 Food... § 880.5580 Acupuncture needle. (a) Identification. An acupuncture needle is a device intended to...

  7. 21 CFR 880.5580 - Acupuncture needle.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... in 21 CFR 801.109, (2) Device material biocompatibility, and (3) Device sterility. ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Acupuncture needle. 880.5580 Section 880.5580 Food... § 880.5580 Acupuncture needle. (a) Identification. An acupuncture needle is a device intended to...

  8. 21 CFR 880.5580 - Acupuncture needle.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... in 21 CFR 801.109, (2) Device material biocompatibility, and (3) Device sterility. ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Acupuncture needle. 880.5580 Section 880.5580 Food... § 880.5580 Acupuncture needle. (a) Identification. An acupuncture needle is a device intended to...

  9. 21 CFR 882.1350 - Needle electrode.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Needle electrode. 882.1350 Section 882.1350 Food... DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1350 Needle electrode. (a) Identification. A needle electrode is a device which is placed subcutaneously to stimulate or to...

  10. 21 CFR 882.1350 - Needle electrode.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Needle electrode. 882.1350 Section 882.1350 Food... DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1350 Needle electrode. (a) Identification. A needle electrode is a device which is placed subcutaneously to stimulate or to...

  11. 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... DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1350 Needle electrode. (a) Identification. A needle electrode is a device which is placed subcutaneously to stimulate or to...

  12. 21 CFR 882.1350 - Needle electrode.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Needle electrode. 882.1350 Section 882.1350 Food... DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1350 Needle electrode. (a) Identification. A needle electrode is a device which is placed subcutaneously to stimulate or to...

  13. 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... DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1350 Needle electrode. (a) Identification. A needle electrode is a device which is placed subcutaneously to stimulate or to...

  14. Brachytherapy needle deflection evaluation and correction

    SciTech Connect

    Wan Gang; Wei Zhouping; Gardi, Lori; Downey, Donal B.; Fenster, Aaron

    2005-04-01

    In prostate brachytherapy, an 18-gauge needle is used to implant radioactive seeds. This thin needle can be deflected from the preplanned trajectory in the prostate, potentially resulting in a suboptimum dose pattern and at times requiring repeated needle insertion to achieve optimal dosimetry. In this paper, we report on the evaluation of brachytherapy needle deflection and bending in test phantoms and two approaches to overcome the problem. First we tested the relationship between needle deflection and insertion depth as well as whether needle bending occurred. Targeting accuracy was tested by inserting a brachytherapy needle to target 16 points in chicken tissue phantoms. By implanting dummy seeds into chicken tissue phantoms under 3D ultrasound guidance, the overall accuracy of seed implantation was determined. We evaluated methods to overcome brachytherapy needle deflection with three different insertion methods: constant orientation, constant rotation, and orientation reversal at half of the insertion depth. Our results showed that needle deflection is linear with needle insertion depth, and that no noticeable bending occurs with needle insertion into the tissue and agar phantoms. A 3D principal component analysis was performed to obtain the population distribution of needle tip and seed position relative to the target positions. Our results showed that with the constant orientation insertion method, the mean needle targeting error was 2.8 mm and the mean seed implantation error was 2.9 mm. Using the constant rotation and orientation reversal at half insertion depth methods, the deflection error was reduced. The mean needle targeting errors were 0.8 and 1.2 mm for the constant rotation and orientation reversal methods, respectively, and the seed implantation errors were 0.9 and 1.5 mm for constant rotation insertion and orientation reversal methods, respectively.

  15. Microbial translocation of needle-free versus traditional needle injection-enhanced beef strip loins.

    PubMed

    Ray, A N; Dikeman, M E; Crow, B A; Phebus, R K; Grobbel, J P; Hollis, L C

    2010-01-01

    Our objective was to determine the effects of needle-free (NF) versus needle injection (N) enhancement on microbial translocation of generic Escherichia coli in beef strip loins. Fifteen longissimus muscles (LM) were obtained and halved. Surfaces were inoculated with generic E. coli at a level of 10(6) CFU/cm(2) (three replications of five strip loins). LM halves were injection-enhanced with a phosphate and salt solution with either NF or N injection. After injection, two cores were taken from each LM half and sliced cross-sectionally at depths of 2-mm (surface), 1, 3, and 5 cm. The paired samples were stomached, serially diluted, and plated. Surface samples from N-injected muscles had lower (P<0.05) E. coli counts (2.79 versus 3.23 log CFU/g for NF). Also, the 3- and 5-cm depth samples from N injection had the least (P<0.05) E. coli contamination (1.69 versus 2.12 CFU/g for NF). Although traditional N injection resulted in approximately 0.5 log CFU/g less microbial contamination at all depths, because the level of contamination was extremely high, the difference in the treatments could arguably be of little practical importance in terms of safety.

  16. Optimizing prostate needle biopsy through 3D simulation

    NASA Astrophysics Data System (ADS)

    Zeng, Jianchao; Kaplan, Charles; Xuan, Jian Hua; Sesterhenn, Isabell A.; Lynch, John H.; Freedman, Matthew T.; Mun, Seong K.

    1998-06-01

    Prostate needle biopsy is used for the detection of prostate cancer. The protocol of needle biopsy that is currently routinely used in the clinical environment is the systematic sextant technique, which defines six symmetric locations on the prostate surface for needle insertion. However, this protocol has been developed based on the long-term observation and experience of urologists. Little quantitative or scientific evidence supports the use of this biopsy technique. In this research, we aim at developing a statistically optimized new prostate needle biopsy protocol to improve the quality of diagnosis of prostate cancer. This new protocol will be developed by using a three-dimensional (3-D) computer- based probability map of prostate cancer. For this purpose, we have developed a computer-based 3-D visualization and simulation system with prostate models constructed from the digitized prostate specimens, in which the process of prostate needle biopsy can be simulated automatically by the computer. In this paper, we first develop an interactive biopsy simulation mode in the system, and evaluate the performance of the automatic biopsy simulation with the sextant biopsy protocol by comparing the results by the urologist using the interactive simulation mode with respect to 53 prostate models. This is required to confirm that the automatic simulation is accurate and reliable enough for the simulation with respect to a large number of prostate models. Then we compare the performance of the existing protocols using the automatic biopsy simulation system with respect to 107 prostate models, which will statistically identify if one protocol is better than another. Since the estimation of tumor volume is extremely important in determining the significance of a tumor and in deciding appropriate treatment methods, we further investigate correlation between the tumor volume and the positive core volume with 89 prostate models. This is done in order to develop a method to

  17. Tattoo machines, needles and utilities.

    PubMed

    Rosenkilde, Frank

    2015-01-01

    Starting out as a professional tattooist back in 1977 in Copenhagen, Denmark, Frank Rosenkilde has personally experienced the remarkable development of tattoo machines, needles and utilities: all the way from home-made equipment to industrial products of substantially improved quality. Machines can be constructed like the traditional dual-coil and single-coil machines or can be e-coil, rotary and hybrid machines, with the more convenient and precise rotary machines being the recent trend. This development has resulted in disposable needles and utilities. Newer machines are more easily kept clean and protected with foil to prevent crosscontaminations and infections. The machines and the tattooists' knowledge and awareness about prevention of infection have developed hand-in-hand. For decades, Frank Rosenkilde has been collecting tattoo machines. Part of his collection is presented here, supplemented by his personal notes. PMID:25833620

  18. Frictional insertion kinetics of bone biopsy needles.

    PubMed

    Heiner, A D; Brown, T D; Rossin, V; Buckwalter, J A

    2001-12-01

    Patients undergoing a percutaneous bone biopsy often complain of pain during needle insertion, despite local anesthesia. Bone biopsy needles are typically inserted with combined axial and twisting motions. These motions could cause pain through frictional heating or direct mechanical irritation. The hypothesis of this study is that the insertion energy of bone biopsy needles can be reduced by modifying the insertion kinetics or by adding a friction-lowering coating to the needles. Jamshidi bone biopsy needles were driven into a bone analog model by an MTS materials testing machine operating under axial and rotational displacement control. The load/torque recordings showed that, to significantly decrease insertion energy and peak resistance to needle insertion, axial velocity and angular frequency had to be decreased to one quarter of the baseline, typical-usage parameters. However the increased insertion time may not be acceptable clinically. The majority of the insertion energy was associated with the needle axial thrust rather than with needle twisting. Overcoming friction against the side of the needle consumed much more of the insertion energy than did the process of cutting per se. None of five needle coatings tested succeeded in appreciably lowering the insertion energy, and none achieved a substantial decrease in peak resisting force.

  19. 3T MR Guided in bore transperineal prostate biopsy: A Comparison of robotic and manual needle-guidance templates

    PubMed Central

    Tilak, Gaurie; Tuncali, Kemal; Song, Sang-Eun; Tokuda, Junichi; Olubiyi, Olutayo; Fennessy, Fiona; Fedorov, Andriy; Penzkofer, Tobias; Tempany, Clare; Hata, Nobuhiko

    2014-01-01

    Purpose To demonstrate the utility of a robotic needle-guidance template device as compared to a manual template for in-bore 3T transperineal MR-guided prostate biopsy. Materials and Methods This two-arm mixed retrospective-prospective study included 99 cases of targeted transperineal prostate biopsies. The biopsy needles were aimed at suspicious foci noted on multiparametric 3T MRI using manual template (historical control) as compared with a robotic template. The following data was obtained: the accuracy of average and closest needle placement to the focus, histologic yield, percentage of cancer volume in positive core samples, complication rate, and time to complete the procedure. Results 56 cases were performed using the manual template, and 43 cases were performed using the robotic template. The mean accuracy of the best needle placement attempt was higher in the robotic group (2.39 mm) than the manual group (3.71 mm, p<0.027). The mean core procedure time was shorter in the robotic (90.82min) than the manual group (100.63min, p<0.030). Percentage of cancer volume in positive core samples was higher in robotic group (p<0.001). Cancer yields and complication rates were not statistically different between the two sub-groups (p = 0.557 and p=0.172 respectively). Conclusion The robotic needle-guidance template helps accurate placement of biopsy needles in MRI-guided core biopsy of prostate cancer. PMID:25263213

  20. Fine needle aspiration cytology of cervical lymph node involvement by ovarian serous borderline tumor.

    PubMed

    Chen, Longwen; Butler, Kristina A; Bell, Debra A

    2016-01-01

    Serous borderline tumor (SBT) involving a cervical lymph node is extremely rare. In addition, fine needle aspiration (FNA) cytology of the involved cervical lymph node shares tremendous morphologic similarity with other low-grade papillary carcinomas. Thus, it can be easily misdiagnosed as metastatic carcinoma. A 42-year-old female had a history of bilateral SBT and postbilateral salpingo-oophorectomy. She presented with left cervical lymphadenopathy 6 months later. FNA cytology showed a low-grade papillary neoplasm with psammoma bodies. Needle core biopsy along with immunostains was diagnostic of cervical lymph node involvement (LNI) of SBT. although extremely rare, cervical LNI can be found in patients with SBTs. FNA cytology, sometimes, is indistinguishable from metastatic papillary adenocarcinoma. Cell block or needle core biopsy is essential to make the correct diagnosis. PMID:27563339

  1. Fine needle aspiration cytology of cervical lymph node involvement by ovarian serous borderline tumor

    PubMed Central

    Chen, Longwen; Butler, Kristina A.; Bell, Debra A.

    2016-01-01

    Serous borderline tumor (SBT) involving a cervical lymph node is extremely rare. In addition, fine needle aspiration (FNA) cytology of the involved cervical lymph node shares tremendous morphologic similarity with other low-grade papillary carcinomas. Thus, it can be easily misdiagnosed as metastatic carcinoma. A 42-year-old female had a history of bilateral SBT and postbilateral salpingo-oophorectomy. She presented with left cervical lymphadenopathy 6 months later. FNA cytology showed a low-grade papillary neoplasm with psammoma bodies. Needle core biopsy along with immunostains was diagnostic of cervical lymph node involvement (LNI) of SBT. although extremely rare, cervical LNI can be found in patients with SBTs. FNA cytology, sometimes, is indistinguishable from metastatic papillary adenocarcinoma. Cell block or needle core biopsy is essential to make the correct diagnosis. PMID:27563339

  2. 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

  3. Dry needling - peripheral and central considerations.

    PubMed

    Dommerholt, Jan

    2011-11-01

    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.

  4. Navigational transbronchial needle aspiration, percutaneous needle aspiration and its future

    PubMed Central

    Arias, Sixto; Yarmus, Lonny

    2015-01-01

    Peripheral lung nodule evaluation represents a clinical challenge. Given that many nodules will be incidentally found with lung cancer screening following the publication of the National Lung Screening Trial (NLST), the goal is to find an accurate, safe and minimally-invasive diagnostic modality to biopsy the concerning lesions. Unfortunately, conventional bronchoscopic techniques provide a poor diagnostic yield of 18–62%. In recent years advances in technology have led to the introduction of electromagnetic navigational bronchoscopy (ENB) as a tool to guide sampling of peripheral lung nodules. The same principle has also recently been expanded and applied to the transthoracic needle biopsy, referred to as electromagnetic transthoracic needle aspiration (E-TTNA). An improved diagnostic yield has afforded this technology a recommendation by the 2013 3rd Edition ACCP Guidelines for the Diagnosis and Management of Lung Cancer which state that “in patients with peripheral lung lesions difficult to reach with conventional bronchoscopy, ENB is recommended if the equipment and the expertise are available (Grade 1C)”. In this review we will discuss the technology, devices that are available, techniques and protocols, diagnostic yield, safety, cost effectiveness and more. PMID:26807280

  5. A subcutaneous Raman needle probe.

    PubMed

    Day, John C C; Stone, Nicholas

    2013-03-01

    Raman spectroscopy is a powerful tool for studying the biochemical composition of tissues and cells in the human body. We describe the initial results of a feasibility study to design and build a miniature, fiber optic probe incorporated into a standard hypodermic needle. This probe is intended for use in optical biopsies of solid tissues to provide valuable information of disease type, such as in the lymphatic system, breast, or prostate, or of such tissue types as muscle, fat, or spinal, when identifying a critical injection site. The optical design and fabrication of this probe is described, and example spectra of various ex vivo samples are shown. PMID:23452501

  6. Geographical and climatic limits of needle types of one- and two-needled pinyon pines

    USGS Publications Warehouse

    Cole, K.L.; Fisher, J.; Arundel, S.T.; Cannella, J.; Swift, S.

    2008-01-01

    Aim: The geographical extent and climatic tolerances of one- and two-needled pinyon pines (Pinus subsect. Cembroides) are the focus of questions in taxonomy, palaeoclimatology and modelling of future distributions. The identification of these pines, traditionally classified by one- versus two-needled fascicles, is complicated by populations with both one- and two-needled fascicles on the same tree, and the description of two more recently described one-needled varieties: the fallax-type and californiarum-type. Because previous studies have suggested correlations between needle anatomy and climate, including anatomical plasticity reflecting annual precipitation, we approached this study at the level of the anatomy of individual pine needles rather than species. Location: Western North America. Methods: We synthesized available and new data from field and herbarium collections of needles to compile maps of their current distributions across western North America. Annual frequencies of needle types were compared with local precipitation histories for some stands. Historical North American climates were modelled on a c. 1-km grid using monthly temperature and precipitation values. A geospatial model (ClimLim), which analyses the effect of climate-modulated physiological and ecosystem processes, was used to rank the importance of seasonal climate variables in limiting the distributions of anatomical needle types. Results: The pinyon needles were classified into four distinct types based upon the number of needles per fascicle, needle thickness and the number of stomatal rows and resin canals. The individual needles fit well into four categories of needle types, whereas some trees exhibit a mixture of two needle types. Trees from central Arizona containing a mixture of Pinus edulis and fallax-type needles increased their percentage of fallax-type needles following dry years. All four needle types occupy broader geographical regions with distinctive precipitation regimes

  7. [Clinical experiences of RUAN's needling method for insomnia].

    PubMed

    Jiang, Ling-Zhen; Ruan, Bu-Qing

    2013-07-01

    The theoretical basis and needling techniques of RUAN's needling method in treatment of insomnia are introduced in this paper. Ruan's needling method follows the theory of traditional Chinese medicine and acupuncture, stresses the theory of taking brain as the marrow sea in treatment of insomnia acupuncture. The characteristics of his needling method are that emphasis on acupoints, including positioning accuracy and proper compatibility; think highly of needling method that combines with perpendicular needling, oblique needling, parallel needling, deep needling and shallow needling; emphasis on manipulation and identify qi under the needle to decide reinforcing or reducing method by arrival of qi, excess or deficiency. And the clinical observation of RUAN' s needling method on 30 cases of insomnia is attached. PMID:24032204

  8. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    MedlinePlus

    ... Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy ... Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration ...

  9. Estimating needle-tissue interaction forces for hollow needles using fiber Bragg grating sensors

    NASA Astrophysics Data System (ADS)

    Kumar, Saurabh; Shrikanth, V.; Bharadwaj, Amrutur; Asokan, Sundarrajan; Bobji, M. S.

    2016-03-01

    Brachytherapy and neurological procedures can benefit from real-time estimation of needle-tissue interaction forces, specifically for robotic or robot-assisted procedures. Fiber Bragg Grating Sensors provide advantages of very small size and electromagnetic immunity for use in measurement of the forces directly at the needle tip. This has advantages compared to measurements at the needle shaft which require extensive models of the friction between needle and tissues with varying depth. This paper presents the measurement of tip forces for a hollow needle and compensation for bending when encountering regions of varying stiffness in phantoms with multiple layers prepared using Polydimethylsiloxane.

  10. Needle Exchange Programs and Drug Injection Behavior

    ERIC Educational Resources Information Center

    DeSimone, Jeff

    2005-01-01

    This study examines how drug injection and needle sharing propensities respond when a needle exchange program (NEP) is introduced into a city. I analyze 1989-1995 Drug Use Forecasting data on adult male arrestees from 24 large U.S. cities, in nine of which NEPs opened during the sample period. After controlling for cocaine and heroin prices, AIDS…

  11. [Textual research on the fire needle and the fire needle therapy].

    PubMed

    Liu, T; Zhu, J P; Zhang, Q C

    2016-03-01

    There are different names of the fire needle therapy in the Huang di nei jing (Inner Canon of Huangdi) such as Zu-zhen (), Cui-zhen (,), Fan-zhen (), Huo-cui (), Cui (,,), Cuici ,), Fan zhen jie ci (). It is claimed that the lance needle, the round sharp needle and the long needle recorded in this Classic are puncturing tools for the fire needle therapy. In the Eastern Han Dynasty, Zhang Zhongjing expanded the indications for the fire needle therapy and Huo-zhen () firstly appeared in the Jin kui yu han jing(Classic of the Jade Box and Golden Chamber). The application of the fire needle therapy had been further expanded to a lot of internal and external disorders form the Wei-Jin-Southern and Northern Dynasties to the Ming and Qing Dynasties. There are more detailed records on the manipulation and the tools of the fire needle therapy during this period. In the 1970s, Huo zhen liao fa () was proposed and still in use today. However the Bai-zhen (plain needle) in ancient literature is equal to the filiform needle and should not be regarded as the former name of the fire needle. PMID:27255194

  12. Precipitation of Oriented Rutile and Ilmenite Needles in Garnet, Northeastern Connecticut, USA: Evidence for Extreme Metamorphic Conditions?

    NASA Astrophysics Data System (ADS)

    Ague, J. J.; Eckert, J. O.

    2011-12-01

    We report the discovery of oriented needles of rutile and, less commonly, ilmenite in the cores of garnets from northeastern CT, USA. The rocks preserve granulite facies mineral assemblages, form part of the Merrimack Synclinorium, and underwent metamorphism and deformation during the Acadian orogeny. The needles appear identical to those reported from a number of extreme P-T environments worldwide, including UHP metamorphic rocks, high-P granulites, and garnet peridotites. The needles are predominantly oriented along <111> directions in garnet. The long axes of the rutile needles commonly do not go extinct parallel to the cross hairs under cross-polarized light (e.g., Griffin et al., 1971). This anomalous extinction indicates that the needles do not preserve a specific crystallographic relationship with their garnet hosts (e.g., Hwang et al., 2007). The needles range from a few hundred nm to a few um in diameter, and can be mm-scale in length. Micrometer-scale plates of rutile, srilankite and crichtonite have also been observed in some garnets together with the Fe-Ti oxide needles. Several origins for the needles have been proposed in the literature; we investigate the hypothesis that they precipitated in situ from originally Ti-rich garnet. Chemical profiles across garnets indicate that some retain Ti zoning, with elevated-Ti concentrations in the cores dropping to low values in the rims. For these zoned garnets, high-resolution, 2-D chemical mapping using the JEOL JXA-8530F field emission gun electron microprobe at Yale University reveals that the needles are surrounded by well-defined Ti-depletion halos. Chemical profiles also document strong depletions of Cr (which is present in both rutile and ilmenite) directly adjacent to needles. The observed Ti-depletions demonstrate that the needles precipitated from Ti-bearing garnet, probably during cooling and/or decompression associated with exhumation. The rutile precipitates must be largely incoherent with respect

  13. The inner rod protein controls substrate switching and needle length in a Salmonella type III secretion system

    PubMed Central

    Lefebre, Matthew D.; Galán, Jorge E.

    2014-01-01

    Type III secretion machines are essential for the biology of many bacteria that are pathogenic or symbiotic for animals, plants, or insects. They exert their function by delivering bacterial effector proteins into target eukaryotic cells. The core component of these machines is the needle complex, a multiprotein structure that spans the bacterial envelope and serves as a conduit for proteins that transit this secretion pathway. The needle complex is composed of a multiring base embedded in the bacterial envelope and a filament-like structure, the needle, that projects from the bacterial surface and is linked to the base by the inner rod. Assembly of the needle complex proceeds in a step-wise fashion that is initiated by the assembly of the base and is followed by the export of the building subunits for the needle and inner rod substructures. Once assembled, the needle complex reprograms its specificity and becomes competent for the secretion of effector proteins. Here through genetic, biochemical, and electron microscopy analyses of the Salmonella inner rod protein subunit PrgJ we present evidence that the assembly of the inner rod dictates the timing of substrate switching and needle length. Furthermore, the identification of mutations in PrgJ that specifically alter the hierarchy of protein secretion provides additional support for a complex role of the inner rod substructure in type III secretion. PMID:24379359

  14. Needle-Tissue Interaction Forces for Bevel-Tip Steerable Needles

    PubMed Central

    Misra, Sarthak; Reed, Kyle B.; Douglas, Andrew S.; Ramesh, K. T.; Okamura, Allison M.

    2010-01-01

    The asymmetry of a bevel-tip needle results in the needle naturally bending when it is inserted into soft tissue. As a first step toward modeling the mechanics of deflection of the needle, we determine the forces at the bevel tip. In order to find the forces acting at the needle tip, we measure rupture toughness and nonlinear material elasticity parameters of several soft tissue simulant gels and chicken tissue. We incorporate these physical parameters into a finite element model that includes both contact and cohesive zone models to simulate tissue cleavage. We investigate the sensitivity of the tip forces to tissue rupture toughness, linear and nonlinear tissue elasticity, and needle tip bevel angle. The model shows that the tip forces are sensitive to the rupture toughness. The results from these studies contribute to a mechanics-based model of bevel-tip needle steering, extending previous work on kinematic models. PMID:22020139

  15. [Discussion on needling sensation, arrival of qi and needling response (Deqi)].

    PubMed

    Zhang, Fang; Wang, Hong-Du

    2012-12-01

    The current appointed teaching material of Science of Acupuncture and Moxibustion holds that there is no difference among the needling sensation, arrival of qi and needling response. However, the author has a different understanding. Therefore, Neijing (Internal Classic), its annotation, exposition and understandings of ancient and modern famous experts are cited to analyze their meanings. And the result indicates that the needling sensation is subjective feelings and perceived responses of doctors and patients. Arrival of qi is the healing process of the organ through activating the anti-pathogenic qi to expel the pathogens. The needling response is the final aim of acupuncture therapy. Thus, the meaning of needling sensation, arrival of qi, and needling response are different. And an accurate understanding can better guide acupuncture treatment.

  16. Pine needle abortion biomarker detected in bovine fetal fluids

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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...

  17. 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...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle. (a) Identification. A neurosurgical suture needle is a needle used in suturing during...

  18. 21 CFR 880.6920 - Syringe needle introducer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Syringe needle introducer. 880.6920 Section 880... Devices § 880.6920 Syringe needle introducer. (a) Identification. A syringe needle introducer is a device that uses a spring-loaded mechanism to drive a hypodermic needle into a patient to a...

  19. 21 CFR 880.6920 - Syringe needle introducer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Syringe needle introducer. 880.6920 Section 880... Devices § 880.6920 Syringe needle introducer. (a) Identification. A syringe needle introducer is a device that uses a spring-loaded mechanism to drive a hypodermic needle into a patient to a...

  20. 21 CFR 880.6920 - Syringe needle introducer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Syringe needle introducer. 880.6920 Section 880... Devices § 880.6920 Syringe needle introducer. (a) Identification. A syringe needle introducer is a device that uses a spring-loaded mechanism to drive a hypodermic needle into a patient to a...

  1. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Neurosurgical suture needle. 882.4650 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle. (a) Identification. A neurosurgical suture needle is a needle used in suturing during...

  2. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Neurosurgical suture needle. 882.4650 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle. (a) Identification. A neurosurgical suture needle is a needle used in suturing during...

  3. 21 CFR 880.6920 - Syringe needle introducer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Syringe needle introducer. 880.6920 Section 880... Devices § 880.6920 Syringe needle introducer. (a) Identification. A syringe needle introducer is a device that uses a spring-loaded mechanism to drive a hypodermic needle into a patient to a...

  4. 21 CFR 880.6920 - Syringe needle introducer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Syringe needle introducer. 880.6920 Section 880... Devices § 880.6920 Syringe needle introducer. (a) Identification. A syringe needle introducer is a device that uses a spring-loaded mechanism to drive a hypodermic needle into a patient to a...

  5. 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...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle. (a) Identification. A neurosurgical suture needle is a needle used in suturing during...

  6. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Neurosurgical suture needle. 882.4650 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle. (a) Identification. A neurosurgical suture needle is a needle used in suturing during...

  7. Biopsy needle detection in transrectal ultrasound.

    PubMed

    Ayvaci, Alper; Yan, Pingkun; Xu, Sheng; Soatto, Stefano; Kruecker, Jochen

    2011-01-01

    Using the fusion of pre-operative MRI and real time intra-procedural transrectal ultrasound (TRUS) to guide prostate biopsy has been shown as a very promising approach to yield better clinical outcome than the routinely performed TRUS only guided biopsy. In several situations of the MRI/TRUS fusion guided biopsy, it is important to know the exact location of the deployed biopsy needle, which is imaged in the TRUS video. In this paper, we present a method to automatically detect and segment the biopsy needle in TRUS. To achieve this goal, we propose to combine information from multiple resources, including ultrasound probe stability, TRUS video background model, and the prior knowledge of needle orientation and position. The proposed algorithm was tested on TRUS video sequences which have in total more than 25,000 frames. The needle deployments were successfully detected and segmented in the sequences with high accuracy and low false-positive detection rate.

  8. Demand for superpremium needle cokes on upswing

    SciTech Connect

    Acciarri, J.A.; Stockman, G.H. )

    1989-12-01

    The authors discuss how recent supply shortages of super-premium quality needle cokes, plus the expectation of increased shortfalls in the future, indicate that refiners should consider upgrading their operations to fill these demands. Calcined, super-premium needle cokes are currently selling for as much as $550/metric ton, fob producer, and increasing demand will continue the upward push of the past year. Needle coke, in its calcined form, is the major raw material in the manufacture of graphite electrodes. Used in steelmaking, graphite electrodes are the electrical conductors that supply the heat source, through arcing electrode column tips, to electric arc steel furnaces. Needle coke is commercially available in three grades - super premium, premium, and intermediate. Super premium is used to produce electrodes for the most severe electric arc furnace steelmaking applications, premium for electrodes destined to less severe operations, and intermediate for even less critical needs.

  9. An illuminated flute needle for vitreoretinal surgery.

    PubMed

    Davison, C N; Rosen, P H

    1994-06-01

    We have developed a simple self-illuminated flute needle for internal drainage of subretinal fluid during three-port vitrectomy. This instrument facilitates visualization and drainage through peripheral retinal breaks.

  10. A Multi-Layered Needle Injection Simulator.

    PubMed

    Laufer, Shlomi; Kempton, Steve J; Maciolek, Kimberly; Terry, Aliyya; Ray, Rebeca D; Pugh, Carla M; Afifi, Ahmed M

    2016-01-01

    Insuring correct needle location is crucial in many medical procedures. This can be even more challenging for physicians injecting in a new location for the first time. Since they do not necessarily know how the tissue is supposed to feel, finding the correct location and correct depth can be difficult. In this study we designed a simulator for training needle injection. The simulator was fabricated to give a realistic feeling of injecting Botox® in the temporalis and the semispinalis muscles as part of migraine treatment. In addition the simulator provided real-time feedback of correct needle location. Nine residents and medical students evaluated the simulator. They made several errors that were corrected real time using the real time feedback provided. They found the simulator to be very useful and that the training significantly improved their confidence. The methods described in this study can easily be implemented for developing needle injection simulators for other anatomical locations.

  11. Sliding Mode Control of Steerable Needles

    PubMed Central

    Rucker, D. Caleb; Das, Jadav; Gilbert, Hunter B.; Swaney, Philip J.; Miga, Michael I.; Sarkar, Nilanjan; Webster, Robert J.

    2014-01-01

    Steerable needles can potentially increase the accuracy of needle-based diagnosis and therapy delivery, provided they can be adequately controlled based on medical image information. We propose a novel sliding mode control law that can be used to deliver the tip of a flexible asymmetric-tipped needle to a desired point, or to track a desired trajectory within tissue. The proposed control strategy requires no a priori knowledge of model parameters, has bounded input speeds, and requires little computational resources. We show that if the standard nonholonomic model for tip-steered needles holds, then the control law will converge to desired targets in a reachable workspace, within a tolerance that can be defined by the control parameters. Experimental results validate the control law for target points and trajectory following in phantom tissue and ex vivo liver. Experiments with targets that move during insertion illustrate robustness to disturbances caused by tissue deformation. PMID:25400527

  12. Science off the Sphere: Knitting Needles

    NASA Video Gallery

    International Space Station Expedition 30 astronaut Don Pettit uses knitting needles and water droplets to demonstrate physics in space for 'Science off the Sphere.' Through a partnership between N...

  13. Sliding Mode Control of Steerable Needles.

    PubMed

    Rucker, D Caleb; Das, Jadav; Gilbert, Hunter B; Swaney, Philip J; Miga, Michael I; Sarkar, Nilanjan; Webster, Robert J

    2013-10-01

    Steerable needles can potentially increase the accuracy of needle-based diagnosis and therapy delivery, provided they can be adequately controlled based on medical image information. We propose a novel sliding mode control law that can be used to deliver the tip of a flexible asymmetric-tipped needle to a desired point, or to track a desired trajectory within tissue. The proposed control strategy requires no a priori knowledge of model parameters, has bounded input speeds, and requires little computational resources. We show that if the standard nonholonomic model for tip-steered needles holds, then the control law will converge to desired targets in a reachable workspace, within a tolerance that can be defined by the control parameters. Experimental results validate the control law for target points and trajectory following in phantom tissue and ex vivo liver. Experiments with targets that move during insertion illustrate robustness to disturbances caused by tissue deformation.

  14. Effect of thinning on anatomical adaptations of Norway spruce needles.

    PubMed

    Gebauer, Roman; Volarík, Daniel; Urban, Josef; Børja, Isabella; Nagy, Nina Elisabeth; Eldhuset, Toril Drabløs; Krokene, Paal

    2011-10-01

    Conifers and other trees are constantly adapting to changes in light conditions, water/nutrient supply and temperatures by physiological and morphological modifications of their foliage. However, the relationship between physiological processes and anatomical characteristics of foliage has been little explored in trees. In this study we evaluated needle structure and function in Norway spruce families exposed to different light conditions and transpiration regimes. We compared needle characteristics of sun-exposed and shaded current-year needles in a control plot and a thinned plot with 50% reduction in stand density. Whole-tree transpiration rates remained similar across plots, but increased transpiration of lower branches after thinning implies that sun-exposed needles in the thinned plot were subjected to higher water stress than sun-exposed needles in the control plot. In general, morphological and anatomical needle parameters increased with increasing tree height and light intensity. Needle width, needle cross-section area, needle stele area and needle flatness (the ratio of needle thickness to needle width) differed most between the upper and lower canopy. The parameters that were most sensitive to the altered needle water status of the upper canopy after thinning were needle thickness, needle flatness and percentage of stele area in needle area. These results show that studies comparing needle structure or function between tree species should consider not only tree height and light gradients, but also needle water status. Unaccounted for differences in needle water status may have contributed to the variable relationship between needle structure and irradiance that has been observed among conifers. PMID:21891783

  15. Dry needling versus acupuncture: the ongoing debate.

    PubMed

    Zhou, Kehua; Ma, Yan; Brogan, Michael S

    2015-12-01

    Although Western medical acupuncture (WMA) is commonly practised in the UK, a particular approach called dry needling (DN) is becoming increasingly popular in other countries. The legitimacy of the use of DN by conventional non-physician healthcare professionals is questioned by acupuncturists. This article describes the ongoing debate over the practice of DN between physical therapists and acupuncturists, with a particular emphasis on the USA. DN and acupuncture share many similarities but may differ in certain aspects. Currently, little information is available from the literature regarding the relationship between the two needling techniques. Through reviewing their origins, theory, and practice, we found that DN and acupuncture overlap in terms of needling technique with solid filiform needles as well as some fundamental theories. Both WMA and DN are based on modern biomedical understandings of the human body, although DN arguably represents only one subcategory of WMA. The increasing volume of research into needling therapy explains its growing popularity in the musculoskeletal field including sports medicine. To resolve the debate over DN practice, we call for the establishment of a regulatory body to accredit DN courses and a formal, comprehensive educational component and training for healthcare professionals who are not physicians or acupuncturists. Because of the close relationship between DN and acupuncture, collaboration rather than dispute between acupuncturists and other healthcare professionals should be encouraged with respect to education, research, and practice for the benefit of patients with musculoskeletal conditions who require needling therapy. PMID:26546163

  16. Dry needling versus acupuncture: the ongoing debate.

    PubMed

    Zhou, Kehua; Ma, Yan; Brogan, Michael S

    2015-12-01

    Although Western medical acupuncture (WMA) is commonly practised in the UK, a particular approach called dry needling (DN) is becoming increasingly popular in other countries. The legitimacy of the use of DN by conventional non-physician healthcare professionals is questioned by acupuncturists. This article describes the ongoing debate over the practice of DN between physical therapists and acupuncturists, with a particular emphasis on the USA. DN and acupuncture share many similarities but may differ in certain aspects. Currently, little information is available from the literature regarding the relationship between the two needling techniques. Through reviewing their origins, theory, and practice, we found that DN and acupuncture overlap in terms of needling technique with solid filiform needles as well as some fundamental theories. Both WMA and DN are based on modern biomedical understandings of the human body, although DN arguably represents only one subcategory of WMA. The increasing volume of research into needling therapy explains its growing popularity in the musculoskeletal field including sports medicine. To resolve the debate over DN practice, we call for the establishment of a regulatory body to accredit DN courses and a formal, comprehensive educational component and training for healthcare professionals who are not physicians or acupuncturists. Because of the close relationship between DN and acupuncture, collaboration rather than dispute between acupuncturists and other healthcare professionals should be encouraged with respect to education, research, and practice for the benefit of patients with musculoskeletal conditions who require needling therapy.

  17. Trigger point needling: techniques and outcome.

    PubMed

    Vulfsons, Simon; Ratmansky, Motti; Kalichman, Leonid

    2012-10-01

    In this review we provide the updates on last years' advancements in basic science, imaging methods, efficacy, and safety of dry needling of myofascial trigger points (MTrPs). The latest studies confirmed that dry needling is an effective and safe method for the treatment of MTrPs when provided by adequately trained physicians or physical therapists. Recent basic studies have confirmed that at the site of an active MTrP there are elevated levels of inflammatory mediators, known to be associated with persistent pain states and myofascial tenderness and that this local milieu changes with the occurrence of local twitch response. Two new modalities, sonoelastography and magnetic resonance elastography, were recently introduced allowing noninvasive imaging of MTrPs. MTrP dry needling, at least partially, involves supraspinal pain control via midbrain periaqueductal gray matter activation. A recent study demonstrated that distal muscle needling reduces proximal pain by means of the diffuse noxious inhibitory control. Therefore, in a patient too sensitive to be needled in the area of the primary pain source, the treatment can be initiated with distal needling.

  18. Methods for segmenting curved needles in ultrasound images.

    PubMed

    Okazawa, Stephen H; Ebrahimi, Richelle; Chuang, Jason; Rohling, Robert N; Salcudean, Septimiu E

    2006-06-01

    Ultrasound-guided percutaneous needle insertions are widely used techniques in current clinical practice. Some of these procedures have a high degree of difficulty because of poor observability of the needle in the ultrasound image. There have been recent efforts to improve guidance by computer assisted needle detection. These software techniques are often limited by not representing needle curvature. We present two methods to detect the needle in 2D ultrasound that specifically address needle curvature. Firstly, we demonstrate a real-time needle segmentation algorithm based on the Hough transform which detects the needle and represents its curved shape. Secondly, we demonstrate how a new coordinate transformation can transform detection of a curved needle to a linear fit. These methods are demonstrated on ultrasound and photographic images.

  19. Biomineralized vaccine nanohybrid for needle-free intranasal immunization.

    PubMed

    Wang, Xiaoyu; Yang, Dong; Li, Shihua; Xu, Xurong; Qin, Cheng-Feng; Tang, Ruikang

    2016-11-01

    Frequent outbreaks and the rapid global spread of infectious diseases have increased the urgent need for massive vaccination especially in countries with limited resources. Intranasal vaccination facilitates the mass vaccination via needle-free delivery of vaccine through nasal mucosal surfaces. Inspired by the strong capability of calcium phosphate (CaP) materials to adhere to cells and tissues, we propose to improve nasal vaccination by using a biomineralization-based strategy. The vaccine nanohybrid was obtained by covering the viral surface with CaP nanoshell, which changed the physiochemical properties of original vaccine, resulting in the increase of mucosal adhesion to the nasal tissues. The core-shell structure was beneficial for the receptor-independent uptake and the induction of elevated local IgA response within the nasal cavity. Moreover, the vaccine complex elicited enhanced systemic antibody response that neutralized wild type of dengue virus and promoted the systemic cellular immune responses. This achievement presents the potential of CaP based vaccine biomineralization for the fabrication of needle-free vaccine formulation. PMID:27575530

  20. Needle exchange: how the meanings ascribed to needles impact exchange practices and policies.

    PubMed

    Strike, Carol J; Myers, Ted; Millson, Margaret

    2002-04-01

    The consistency among needle exchange practices, HIV prevention, harm reduction goals, and potential program effectiveness are analyzed. Using a modified ethnographic approach, qualitative interviews were conducted with staff (n = 59) of needle exchange programs (NEPs; n = 15). Interviews addressed operational policies; funding and challenges. An iterative, inductive analytic process was used. Differences in exchange practices are traced to differences in how workers define needles as objects of "risk" and/or "prevention." The weight accorded to each definition has implications for service delivery. Among NEPs that ascribe a "risk" meaning, workers enforce a strict one-for-one exchange, encourage clients to take fewer needles, and penalize clients. Programs that focus on the "prevention" meaning of needles work towards improving access, problem solving about proper disposal and do not penalize clients. Operational policies that restrict access to sterile equipment or discourage attendance need to be reconsidered if HIV prevention goals are to be realized. PMID:12000231

  1. Medically relevant ElectroNeedle technology development.

    SciTech Connect

    Schmidt, Carrie Frances; Thomas, Michael Loren; McClain, Jaime L.; Harper, Jason C.; Achyuthan, Komandoor E.; Ten Eyck, Gregory A.

    2008-11-01

    ElectroNeedles technology was developed as part of an earlier Grand Challenge effort on Bio-Micro Fuel Cell project. During this earlier work, the fabrication of the ElectroNeedles was accomplished along with proof-of-concept work on several electrochemically active analytes such as glucose, quinone and ferricyanide. Additionally, earlier work demonstrated technology potential in the field of immunosensors by specifically detecting Troponin, a cardiac biomarker. The current work focused upon fabrication process reproducibility of the ElectroNeedles and then using the devices to sensitively detect p-cresol, a biomarker for kidney failure or nephrotoxicity. Valuable lessons were learned regarding fabrication assurance and quality. The detection of p-cresol was accomplished by electrochemistry as well as using fluorescence to benchmark ElectroNeedles performance. Results from these studies will serve as a guide for the future fabrication processes involving ElectroNeedles as well as provide the groundwork necessary to expand technology applications. One paper has been accepted for publication acknowledging LDRD funding (K. E. Achyuthan et al, Comb. Chem. & HTS, 2008). We are exploring the scope for a second paper describing the applications potential of this technology.

  2. Optical Coherence Tomography in a Needle Format

    NASA Astrophysics Data System (ADS)

    Lorenser, Dirk; McLaughlin, Robert A.; Sampson, David D.

    In this chapter, we review the technology and applications of needle probes for optical coherence tomography (OCT). Needle probes are miniaturized fiber-optic probes that can be mounted inside hypodermic needles, allowing them to be inserted deep into the body during OCT imaging. This overcomes the very limited imaging depth of OCT of only 2-3 mm in biological tissue, enabling access to deep-tissue locations that are beyond the reach of free-space optical scan heads or catheters. This chapter provides an in-depth review of the current state-of-the art in needle probe technology, including optical design and fabrication, scan mechanisms (including three-dimensional scanning), and integration into OCT systems. It also provides an overview of emerging applications of this fascinating new imaging tool in areas such as cancer diagnosis, pulmonary imaging, imaging of the eye and imaging of the brain. Finally, two case studies are presented, illustrating needle-based OCT imaging in breast cancer and lungs.

  3. Structure of Phage P22 Cell Envelope-Penetrating Needle

    SciTech Connect

    Olia,A.; Casjens, S.; Cingolani, G.

    2007-01-01

    Bacteriophage P22 infects Salmonella enterica by injecting its genetic material through the cell envelope. During infection, a specialized tail needle, gp26, is injected into the host, likely piercing a hole in the host cell envelope. The 2.1-Angstroms crystal structure of gp26 reveals a 240-Angstroms elongated protein fiber formed by two trimeric coiled-coil domains interrupted by a triple beta-helix. The N terminus of gp26 plugs the portal protein channel, retaining the genetic material inside the virion. The C-terminal tip of the fiber exposes beta-hairpins with hydrophobic tips similar to those seen in class II fusion peptides. The alpha-helical core connecting these two functionally polarized tips presents four trimerization octads with consensus sequence IXXLXXXV. The slender conformation of the gp26 fiber minimizes the surface exposed to solvent, which is consistent with the idea that gp26 traverses the cell envelope lipid bilayers.

  4. Structure of Phage P22 Cell Envelope-Penetrating Needle

    SciTech Connect

    Olia, A.S.; Casjens, S.; Cingolani, G.

    2009-06-02

    Bacteriophage P22 infects Salmonella enterica by injecting its genetic material through the cell envelope. During infection, a specialized tail needle, gp26, is injected into the host, likely piercing a hole in the host cell envelope. The 2.1-{angstrom} crystal structure of gp26 reveals a 240-{angstrom} elongated protein fiber formed by two trimeric coiled-coil domains interrupted by a triple {beta}-helix. The N terminus of gp26 plugs the portal protein channel, retaining the genetic material inside the virion. The C-terminal tip of the fiber exposes {beta}-hairpins with hydrophobic tips similar to those seen in class II fusion peptides. The {alpha}-helical core connecting these two functionally polarized tips presents four trimerization octads with consensus sequence IXXLXXXV. The slender conformation of the gp26 fiber minimizes the surface exposed to solvent, which is consistent with the idea that gp26 traverses the cell envelope lipid bilayers.

  5. Solution structure of monomeric BsaL, the type III secretion needle protein of Burkholderia pseudomallei.

    PubMed

    Zhang, Lingling; Wang, Yu; Picking, Wendy L; Picking, William D; De Guzman, Roberto N

    2006-06-01

    Many gram-negative bacteria that are important human pathogens possess type III secretion systems as part of their required virulence factor repertoire. During the establishment of infection, these pathogens coordinately assemble greater than 20 different proteins into a macromolecular structure that spans the bacterial inner and outer membranes and, in many respects, resembles and functions like a syringe. This type III secretion apparatus (TTSA) is used to inject proteins into a host cell's membrane and cytoplasm to subvert normal cellular processes. The external portion of the TTSA is a needle that is composed of a single type of protein that is polymerized in a helical fashion to form an elongated tube with a central channel of 2-3 nm in diameter. TTSA needle proteins from a variety of bacterial pathogens share sequence conservation; however, no atomic structure for any TTSA needle protein is yet available. Here, we report the structure of a TTSA needle protein called BsaL from Burkholderia pseudomallei determined by nuclear magnetic resonance (NMR) spectroscopy. The central part of the protein assumes a helix-turn-helix core domain with two well-defined alpha-helices that are joined by an ordered, four-residue linker. This forms a two-helix bundle that is stabilized by interhelix hydrophobic contacts. Residues that flank this presumably exposed core region are not completely disordered, but adopt a partial helical conformation. The atomic structure of BsaL and its sequence homology with other TTSA needle proteins suggest potentially unique structural dynamics that could be linked with a universal mechanism for control of type III secretion in diverse gram-negative bacterial pathogens.

  6. Mechanics of Flexible Needles Robotically Steered through Soft Tissue

    PubMed Central

    Misra, S.; Reed, K. B.; Schafer, B. W.; Ramesh, K. T.; Okamura, A. M.

    2010-01-01

    The tip asymmetry of a bevel-tip needle results in the needle naturally bending when it is inserted into soft tissue. This enables robotic needle steering, which can be used in medical procedures to reach subsurface targets inaccessible by straight-line trajectories. However, accurate path planning and control of needle steering requires models of needle-tissue interaction. Previous kinematic models required empirical observations of each needle and tissue combination in order to fit model parameters. This study describes a mechanics-based model of robotic needle steering, which can be used to predict needle behavior and optimize system design based on fundamental mechanical and geometrical properties of the needle and tissue. We first present an analytical model for the loads developed at the tip, based on the geometry of the bevel edge and material properties of soft-tissue simulants (gels). We then present a mechanics-based model that calculates the deflection of a bevel-tipped needle inserted through a soft elastic medium. The model design is guided by microscopic observations of needle-gel interactions. The energy-based formulation incorporates tissue-specific parameters, and the geometry and material properties of the needle. Simulation results follow similar trends (deflection and radius of curvature) to those observed in experimental studies of robotic needle insertion. PMID:21170164

  7. Needle aspiration of peritonsillar abscess in children.

    PubMed

    Weinberg, E; Brodsky, L; Stanievich, J; Volk, M

    1993-02-01

    Needle aspiration for the treatment of peritonsillar abscess was assessed in 43 consecutive children aged 7 to 18 years (mean age, 13.9 +/- 2.5 years) during the 3-year period from 1988 through 1991. A positive aspirate was obtained in 31 (76%) of the 41 patients who cooperated for needle aspiration; a mean of 2.9 +/- 1.9 mL of pus was withdrawn. Of the 31 children with a positive aspirate, in 27 (87%) the abscess resolved, two (6%) required a second aspiration for resolution, and two (6%) underwent immediate tonsillectomy for persistent abscess. Of the 10 children (24%) with negative aspirations, in six (60%) the abscess resolved with antibiotic treatment alone, three (30%) underwent immediate (quinsy) tonsillectomy, and in one (10%) the abscess spontaneously drained. No bleeding, airway obstruction, or anesthetic complications occurred. Needle aspiration of peritonsillar abscess in children, with tonsillectomy reserved for nonresponders, appears to be an efficacious and safe method of treatment.

  8. Needle enzyme electrodes for biological studies.

    PubMed

    Churchouse, S J; Battersby, C M; Mullen, W H; Vadgama, P M

    1986-01-01

    Needle enzyme electrodes have been produced for measurement of glucose and lactate. They comprise glutaraldehyde-crosslinked oxidases immobilised over less than 1.1 mm od needle-type sensors for H2O2. To obtain selectivity in blood, an underlying polyethersulphone membrane was used which excluded electrochemical interferents from the working (Pt) electrode. Linearity for the systems was extended to cover the clinical range by the use of outer low permeability polyurethane membranes. This type of external membrane also reduced the stirring dependence of electrodes. The glucose needle electrode was used in unstirred whole blood samples and gave an acceptable correlation with the routine spectrophotometric method (y = 0.954x + 0.202, r = 0.991, n = 48). PMID:3632730

  9. Structural changes in spruce and fir needles.

    PubMed

    Schmitt, U; Ruetze, M

    1990-01-01

    Needles from spruce and fir trees were analyzed for histological changes induced by long-term exposure in open-top chambers to SO(2) and/or O(3) combined with acid rain. Light and electron microscopical evaluation revealed initial structural changes in the vascular bundle of fir needles, with an increased number of crushed sieve cells in the phloem. In addition the walls of young, adaxial sieve cells lacked the typical thickening usually observed in naturally aged needles. These findings may indicate restricted assimilate translocation. The presence of SO(2) in any treatment led to thylakoidal swellings and membrane reductions in the chloroplasts of mesophyll cells near the vascular bundle. This damage pattern resembled alterations caused by nutrient deficiency rather than by the direct action of gaseous pollutants. In general, fir appears to be more sensitive to environmental stress than spruce; this substantiates the findings of previous studies.

  10. ["Sham Needle"--Design and Application of A Double-blind Placebo Needle Assembly].

    PubMed

    Yan, Liu; Ma, Li-hong

    2016-02-01

    The blind study design, particularly the double-blind study design is a very important method for diminishing placebo effect and reducing bias in clinical medical trial. Enlightened by Streitberger's and Park's sham needle design, the authors of the present paper introduce a newly designed sham needle device (Yan's sham-needle) for controlled double-blind trials of acupuncture. This sham needle device consists of needle, tube and base. The bottom of the tube is completely sealed and it can never arouse any invasive stimulation on the subject's skin when the sham needle is downward pressed on the body surface. Meanwhile, this sham device is filled with sponge which is able to simulate soft tissues of the acupoint area. By combining words suggestions or hints before trials and the same shape as verum device, this sham-needle device reduces the risk of blind-breaking and makes it possible to conduct controlled double-blind trials. Primary practice showed that this device may provide a new and practical tool for researching the placebo effect of acupuncture therapy. PMID:27141628

  11. 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

  12. Needle free injection technology: A complete insight.

    PubMed

    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.

  13. Needle free injection technology: A complete insight.

    PubMed

    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

  14. Syringe and Needle Size, Syringe Type, Vacuum Generation, and Needle Control in Aspiration Procedures

    SciTech Connect

    Haseler, Luke J.; Sibbitt, Randy R.; Sibbitt, Wilmer L.; Michael, Adrian A.; Gasparovic, Charles M.; Bankhurst, Arthur D.

    2011-06-15

    Purpose: Syringes are used for diagnostic fluid aspiration and fine-needle aspiration biopsy in interventional procedures. We determined the benefits, disadvantages, and patient safety implications of syringe and needle size on vacuum generation, hand force requirements, biopsy/fluid yield, and needle control during aspiration procedures. Materials and Methods: Different sizes (1, 3, 5, 10, and 20 ml) of the conventional syringe and aspirating mechanical safety syringe, the reciprocating procedure device, were studied. Twenty operators performed aspiration procedures with the following outcomes measured: (1) vacuum (torr), (2) time to vacuum (s), (3) hand force to generate vacuum (torr-cm{sup 2}), (4) operator difficulty during aspiration, (5) biopsy yield (mg), and (6) operator control of the needle tip position (mm). Results: Vacuum increased tissue biopsy yield at all needle diameters (P < 0.002). Twenty-milliliter syringes achieved a vacuum of -517 torr but required far more strength to aspirate, and resulted in significant loss of needle control (P < 0.002). The 10-ml syringe generated only 15% less vacuum (-435 torr) than the 20-ml device and required much less hand strength. The mechanical syringe generated identical vacuum at all syringe sizes with less hand force (P < 0.002) and provided significantly enhanced needle control (P < 0.002). Conclusions: To optimize patient safety and control of the needle, and to maximize fluid and tissue yield during aspiration procedures, a two-handed technique and the smallest syringe size adequate for the procedure should be used. If precise needle control or one-handed operation is required, a mechanical safety syringe should be considered.

  15. PET-Based Percutaneous Needle Biopsy.

    PubMed

    El-Haddad, Ghassan

    2016-07-01

    PET can be used to guide percutaneous needle biopsy to the most metabolic lesion, improving diagnostic yield. PET biopsy guidance can be performed using visual or software coregistration, electromagnetic needle tracking, cone-beam computed tomography (CT), and intraprocedural PET/CT guidance. PET/CT-guided biopsies allow the sampling of lesions that may not be clearly visible on anatomic imaging, or of lesions that are morphologically normal. PET can identify suspicious locations within complex tumors that are most likely to contain important diagnostic and prognostic information. PMID:27321036

  16. 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.

  17. The needle effect in the relief of myofascial pain.

    PubMed

    Lewit, K

    1979-02-01

    In reviewing techniques for therapeutic local anaesthesia of pain spots, it appeared that the common denominator was puncture by the needle and not the anaesthetic employed. The present study examines short- and long-term effects of dry needling in the treatment of chronic myofascial pain. 241 patients and 312 pain sites were treated by needling. When the most painful spot was touched by the needle, immediate analgesia without hypesthesia was observed in 86.8% of cases. Permanent relief of tenderness in the needled structure was obtained for 92 structures; relief for several months in 58; for several weeks in 63; and for several days in 32 out of 288 pain sites followed up. The effectiveness of treatment was related to the intensity of pain produced at the trigger zone, and to the precision with which the site of maximal tenderness was located by the needle. The immediate analgesia produced by needling the pain spot has been called the "needle effect".

  18. 21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... needle electrode is a monopolar or bipolar needle intended to be inserted into muscle or nerve tissue to... electromyography (recording the intrinsic electrical properties of skeletal muscle). (b) Classification. Class...

  19. 21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... needle electrode is a monopolar or bipolar needle intended to be inserted into muscle or nerve tissue to... electromyography (recording the intrinsic electrical properties of skeletal muscle). (b) Classification. Class...

  20. 21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... needle electrode is a monopolar or bipolar needle intended to be inserted into muscle or nerve tissue to... electromyography (recording the intrinsic electrical properties of skeletal muscle). (b) Classification. Class...

  1. 21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... needle electrode is a monopolar or bipolar needle intended to be inserted into muscle or nerve tissue to... electromyography (recording the intrinsic electrical properties of skeletal muscle). (b) Classification. Class...

  2. 21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... needle electrode is a monopolar or bipolar needle intended to be inserted into muscle or nerve tissue to... electromyography (recording the intrinsic electrical properties of skeletal muscle). (b) Classification. Class...

  3. 41. VALVEHOUSE FOR NEEDLE VALVE OUTLET WORKS ON GALLERY 2, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    41. VALVEHOUSE FOR NEEDLE VALVE OUTLET WORKS ON GALLERY 2, SHOWING NEEDLE VALVE CONTROL PEDESTALS (MANUFACTURED BY AMERICAN LOCOMOTIVE COMPANY) IN LEFT FOREGROUND AND RIGHT BACKGROUND. VIEW TO NORTHEAST. - Owyhee Dam, Across Owyhee River, Nyssa, Malheur County, OR

  4. An Evolutionarily Conserved Family of Virion Tail Needles Related to Bacteriophage P22 gp26: Correlation between Structural Stability and Length of the -Helical Trimeric Coiled Coil

    SciTech Connect

    Bhardwaj, A.; Walker-Kopp, N; Casjens, S; Cingolani, G

    2009-01-01

    Bacteriophages of the Podoviridae family use short noncontractile tails to inject their genetic material into Gram-negative bacteria. In phage P22, the tail contains a thin needle, encoded by the phage gene 26, which is essential both for stabilization and for ejection of the packaged viral genome. Bioinformatic analysis of the N-terminal domain of gp26 (residues 1-60) led us to identify a family of genes encoding putative homologues of the tail needle gp26. To validate this idea experimentally and to explore their diversity, we cloned the gp26-like gene from phages HK620, Sf6 and HS1, and characterized these gene products in solution. All gp26-like factors contain an elongated {alpha}-helical coiled-coil core consisting of repeating, adjacent trimerization heptads and form trimeric fibers with length ranging between about 240 to 300 {angstrom}. gp26 tail needles display a high level of structural stability in solution, with Tm (temperature of melting) between 85 and 95 C. To determine how the structural stability of these phage fibers correlates with the length of the {alpha}-helical core, we investigated the effect of insertions and deletions in the helical core. In the P22 tail needle, we identified an 85-residue-long helical domain, termed MiCRU (minimal coiled-coil repeat unit), that can be inserted in-frame inside the gp26 helical core, preserving the straight morphology of the fiber. Likewise, we were able to remove three quarters of the helical core of the HS1 tail needle, minimally decreasing the stability of the fiber. We conclude that in the gp26 family of tail needles, structural stability increases nonlinearly with the length of the {alpha}-helical core. Thus, the overall stability of these bacteriophage fibers is not solely dependent on the number of trimerization repeats in the {alpha}-helical core.

  5. Acoustic Radiation Force Impulse (ARFI) Imaging-Based Needle Visualization

    PubMed Central

    Rotemberg, Veronica; Palmeri, Mark; Rosenzweig, Stephen; Grant, Stuart; Macleod, David; Nightingale, Kathryn

    2011-01-01

    Ultrasound-guided needle placement is widely used in the clinical setting, particularly for central venous catheter placement, tissue biopsy and regional anesthesia. Difficulties with ultrasound guidance in these areas often result from steep needle insertion angles and spatial offsets between the imaging plane and the needle. Acoustic Radiation Force Impulse (ARFI) imaging leads to improved needle visualization because it uses a standard diagnostic scanner to perform radiation force based elasticity imaging, creating a displacement map that displays tissue stiffness variations. The needle visualization in ARFI images is independent of needle-insertion angle and also extends needle visibility out of plane. Although ARFI images portray needles well, they often do not contain the usual B-mode landmarks. Therefore, a three-step segmentation algorithm has been developed to identify a needle in an ARFI image and overlay the needle prediction on a coregistered B-mode image. The steps are: (1) contrast enhancement by median filtration and Laplacian operator filtration, (2) noise suppression through displacement estimate correlation coefficient thresholding and (3) smoothing by removal of outliers and best-fit line prediction. The algorithm was applied to data sets from horizontal 18, 21 and 25 gauge needles between 0–4 mm offset in elevation from the transducer imaging plane and to 18G needles on the transducer axis (in plane) between 10° and 35° from the horizontal. Needle tips were visualized within 2 mm of their actual position for both horizontal needle orientations up to 1.5 mm off set in elevation from the transducer imaging plane and on-axis angled needles between 10°–35° above the horizontal orientation. We conclude that segmented ARFI images overlaid on matched B-mode images hold promise for improved needle visibility in many clinical applications. PMID:21608445

  6. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures.

    PubMed

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C; Leblond, Frédéric

    2015-11-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue.

  7. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures.

    PubMed

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C; Leblond, Frédéric

    2015-11-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue. PMID:26600990

  8. Use of Electromagnetic Navigational Transthoracic Needle Aspiration (E-TTNA) for Sampling of Lung Nodules.

    PubMed

    Arias, Sixto; Lee, Hans; Semaan, Roy; Frimpong, Bernice; Ortiz, Ricardo; Feller-Kopman, David; Oakjones-Burgess, Karen; Yarmus, Lonny

    2015-05-23

    Lung nodule evaluation represents a clinical challenge especially in patients with intermediate risk for malignancy. Multiple technologies are presently available to sample nodules for pathological diagnosis. Those technologies can be divided into bronchoscopic and non-bronchoscopic interventions. Electromagnetic navigational bronchoscopy is being extensively used for the endobronchial approach to peripheral lung nodules but has been hindered by anatomic challenges resulting in a 70% diagnostic yield. Electromagnetic navigational guided transthoracic needle lung biopsy is novel non-bronchoscopic method that uses a percutaneous electromagnetic tip tracked needle to obtain core biopsy specimens. Electromagnetic navigational transthoracic needle aspiration complements bronchoscopic techniques potentially allowing the provider to maximize the diagnostic yield during one single procedure. This article describes a novel integrated diagnostic approach to pulmonary lung nodules. We propose the use of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) for mediastinal staging; radial EBUS, navigational bronchoscopy and E-TTNA during one single procedure to maximize diagnostic yield and minimize the number of invasive procedures needed to obtain a diagnosis. This manuscript describes in detail how the navigation transthoracic procedure is performed. Additional clinical studies are needed to determine the clinical utility of this novel technology.

  9. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures

    PubMed Central

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C.; Leblond, Frédéric

    2015-01-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue. PMID:26600990

  10. 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...

  11. 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...

  12. 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...

  13. 21 CFR 884.6100 - Assisted reproduction needles.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Assisted reproduction needles. 884.6100 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6100 Assisted reproduction needles. (a) Identification. Assisted reproduction needles are devices used in...

  14. 21 CFR 884.6100 - Assisted reproduction needles.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Assisted reproduction needles. 884.6100 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6100 Assisted reproduction needles. (a) Identification. Assisted reproduction needles are devices used in...

  15. 21 CFR 884.6100 - Assisted reproduction needles.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Assisted reproduction needles. 884.6100 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6100 Assisted reproduction needles. (a) Identification. Assisted reproduction needles are devices used in...

  16. 21 CFR 884.6100 - Assisted reproduction needles.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction needles. 884.6100 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6100 Assisted reproduction needles. (a) Identification. Assisted reproduction needles are devices used in...

  17. 21 CFR 884.6100 - Assisted reproduction needles.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Assisted reproduction needles. 884.6100 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6100 Assisted reproduction needles. (a) Identification. Assisted reproduction needles are devices used in...

  18. The Double-Needle Felling Machine. Module 17.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    This module on the double-needle felling machine, one in a series dealing with industrial sewing machines, their attachments, and operation, covers two topics: performing special operations on the double-needle felling machine (straight seams) and performing special operations on the double-needle felling machine (curved flat-felled seams). For…

  19. 21 CFR 880.5570 - Hypodermic single lumen needle.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hypodermic single lumen needle. 880.5570 Section... Therapeutic Devices § 880.5570 Hypodermic single lumen needle. (a) Identification. A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below...

  20. 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...

  1. Hollow needle used to cut metal honeycomb structures

    NASA Technical Reports Server (NTRS)

    Gregg, E. A.

    1966-01-01

    Hollow needle tool cuts metal honeycomb structures without damaging adjacent material. The hollow needle combines an electrostatic discharge and a stream of oxygen at a common point to effect rapid, accurate metal cutting. The tool design can be varied to use the hollow needle principle for cutting a variety of shapes.

  2. 21 CFR 880.5570 - Hypodermic single lumen needle.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hypodermic single lumen needle. 880.5570 Section... Therapeutic Devices § 880.5570 Hypodermic single lumen needle. (a) Identification. A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below...

  3. 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...

  4. 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

  5. Ciliated cells in abdominal or pelvic fine needle aspirations: a case report and review of the literature.

    PubMed

    Perry, Kyle D; Cheng, Ning Li; Eberts, Paul; Yang, Jack

    2013-01-01

    Ciliated cells encountered outside of an expected anatomical location (e.g., the respiratory tract, fallopian tube, etc) can represent a diagnostic difficulty for the cytopathologist, especially during preliminary assessment of a fine needle aspiration (FNA) for adequacy or malignancy. We present the cytologic and histologic features of a FNA and needle core biopsy, respectively, of an abdominal mass, likely from a gastrointestinal duplication cyst, foregut cyst or a bronchogenic cyst. We also briefly review the differential diagnosis for ciliated cells encountered in abdominal or pelvic FNAs.

  6. Composite Cores

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Spang & Company's new configuration of converter transformer cores is a composite of gapped and ungapped cores assembled together in concentric relationship. The net effect of the composite design is to combine the protection from saturation offered by the gapped core with the lower magnetizing requirement of the ungapped core. The uncut core functions under normal operating conditions and the cut core takes over during abnormal operation to prevent power surges and their potentially destructive effect on transistors. Principal customers are aerospace and defense manufacturers. Cores also have applicability in commercial products where precise power regulation is required, as in the power supplies for large mainframe computers.

  7. Vocational Home Economics Education. Needle Trades.

    ERIC Educational Resources Information Center

    Halmes, Ellen; Sawatzky, Joyce

    This instructional package, designed for use in secondary and adult education, focuses on the vocational area of needle trades. Section A of this document contains three units of instruction; "Securing a Job,""Career Success," and "The Free Enterprise System." Section B contains four units on sewn products operations: "Sewing Machine Maintenance…

  8. A Modification to Maxwell's Needle Apparatus

    ERIC Educational Resources Information Center

    Soorya, Tribhuvan N.

    2015-01-01

    Maxwell's needle apparatus is used to determine the shear modulus (?) of the material of a wire of uniform cylindrical cross section. Conventionally, a single observation is taken for each observable, and the value of ? is calculated in a single shot. A modification to the above apparatus is made by varying one of the observables, namely the mass…

  9. Genetics Home Reference: Melnick-Needles syndrome

    MedlinePlus

    ... or buccal smear. Am J Med Genet. 2002 Mar 1;108(2):120-7. Citation on PubMed OMIM: ... 2003 Apr;33(4):487-91. Epub 2003 Mar 3. Citation on ... syndrome types 1 and 2, frontometaphyseal dysplasia and Melnick-Needles syndrome. ...

  10. Needle aspiration biopsy in salivary gland lesions.

    PubMed

    Shaha, A R; Webber, C; DiMaio, T; Jaffe, B M

    1990-10-01

    The value of needle aspiration biopsy in the evaluation and management of salivary gland pathology is controversial. The major reasons for this controversy are the difficulty in cytologic evaluation and the fact that the extent of surgery can be easily defined based on clinical judgement. However, a preoperative diagnosis is helpful in discussions with patients regarding the extent and type of surgery. Apart from the fact that needle biopsy can distinguish benign from malignant conditions, it is also very useful in distinguishing between salivary and other nonsalivary pathology. Over the past 7 1/2 years, we have performed 160 needle aspirations of parotid, submandibular, and submucosal lesions. Adequate specimens for cytologic evaluation were obtained in 155 patients (97%). A total of 84 parotid lesions, 70 submandibular lumps, and 6 submucosal abnormalities were detected. A cytologic diagnosis of benign pathology was made in 120 patients. Twelve patients had lymphoma and the diagnosis was suspected based on needle aspiration. There were 10 patients with tuberculosis and 30 patients with hyperplastic lymph nodes or benign lymphoepithelial disease of the parotid. There were three false-positive and two false-negative reports. No complications such as hematoma, nerve injury, or infection developed. The major difficulty was in distinguishing between malignancy and obstructive sialadenitis in the submandibular region. Needle aspiration was helpful in evaluating lesions in the tail of the parotid and submandibular area. The cytologic distinction between salivary and nonsalivary pathology was useful in planning the appropriate surgery and the extent of surgical resection. From a clinical standpoint, the distinction between benign and malignant salivary and nonsalivary pathology was very helpful. Preoperative diagnosis of Warthin's tumor, lymphoma, or benign lymphoepithelial disease was essential to the correct management of these patients.

  11. Kinematics Analysis of an Aided Robot for Needle Insertion

    NASA Astrophysics Data System (ADS)

    Li, Qiang; Gao, Dedong; Wang, Shan; Bai, Huiquan; Zheng, Haojun

    The kinematic relationship between the needle base and the robot's joints is analyzed. The analysis process is based on the aided needle-insertion robot built by our group. The thinking of needle-inserting procedure is confirming the needle base's posture before the needle inserted into tissue. The method of Denavit-Hartenberg (D-H) parameters is used to establish a link robot body-frames with the structural characteristics of the robot. After analysing kinematics, the kinematics equation is presented. The kinematics inverse solutions are obtained with the analytical method and geometry analysis method.

  12. Pine needle holders for use in gas exchange measurements.

    PubMed

    Edwards, N T

    1989-12-01

    Simple holders for positioning pine needles in a gas exchange cuvette are described. The holders make it easy to enclose a standard length of needles in the cuvette in a single plane without mutual shading. The holders also make it possible, following gas exchange measurements, to harvest for further analysis just those needle portions that were enclosed in the leaf chamber. Field observations, which were made with a gas exchange cuvette incorporating the needle holders, on the relationship between carbon exchange rate and photon flux density in loblolly pine (Pinus taeda L.) needles are reported.

  13. 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.

  14. Extranodal Rosai–Dorfman Disease as Isolated Lesion of the Tibia Diagnosed by Fine-Needle Aspiration Cytology

    PubMed Central

    Xu, Jie; Liu, Chun-Hua; Wang, Yan-Si; Chen, Chang-Xian

    2015-01-01

    Abstract Few studies have used fine-needle aspiration cytology for the purpose of isolated skeletal Rosai–Dorfman diseases (RDDs) diagnosis. Herein, we described an extremely rare case of a 56-year-old woman who presented to our hospital with an insidious onset of pain in the right proximal tibia. The provisional cytologic diagnosis of RDDs was confirmed by a computer tomography-guided core needle biopsy of the lesion. Subsequently, curettage and autogenous iliac crest bone graft were performed successfully. At the 4th year of follow-up her clinical symptoms disappeared, and there was no clinical evidence of lesion recurrence. Our case highlighted the role of fine-needle aspiration cytology with immunohistochemical studies in the diagnosis of RDDs and the characteristic features of isolated skeletal RDDs in an unusual location, the knowledge of which would help avoid missed or delayed diagnosis in the future. PMID:26632704

  15. 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.

  16. 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.

  17. Tip-holed spinal needle: a new design concept.

    PubMed

    Jahangir, S M

    2000-01-01

    Dura-arachnoid puncture for spinal anesthesia is associated with several complications. Postdural puncture headache (PDPH) and needle bending are significant among these. The incidence of PDPH has been reduced significantly with the advent of pencil-point needles. However, these needles also have their limitations, such as obstruction of the delivery port by tissues affecting both cerebrospinal fluid flash back and drug delivery. Increasing the size of the lateral hole has led to mechanical complications, such as tip bending. A new spreading beveled spinal needle tip has been designed to overcome the disadvantages of all the currently used spinal needles. To assess the feasibility, a 26-gauge Quincke spinal needle (B. Braun, Melsungen, Germany) has been modified manually. The new tip-holed design seems to be sound both from theoretical and practical point of view. Searching Medline Plus through their Internet Web site (www.nlm.nih.com) did not reveal the existence of any such spinal needle. PMID:10925938

  18. Needle Insertion with Duty-Cycled Rotation into Multiple Media

    PubMed Central

    Lehocky, Craig A.; Riviere, Cameron N.

    2012-01-01

    Thin, flexible needles can be steered along nonlinear paths to reach deep anatomical structures within the human body. This study builds upon previous work involving steering of bevel-tipped needles by inserting while rotating in a duty-cycled fashion. Here we investigate how needle material and radius, duty cycle, and tissue stiffness affect needle curvature. Needles were inserted into media while rotated at a specified duty cycle and the curvature was measured. A linear relationship between duty cycle and curvature was observed across all needle materials and radii, and tissue stiffnesses. Following these observations, we developed a model that encapsulates needle and tissue parameters in order to predict the duty cycle needed to achieve a desired curvature. PMID:23366042

  19. Low-loss polymer optical waveguides with graded-index perfect circular cores for on-board interconnection

    NASA Astrophysics Data System (ADS)

    Saito, Yuki; Fukagata, Koji; Ishigure, Takaaki

    2016-02-01

    Using the Mosquito method, we fabricate low-loss multimode polymer optical waveguides with graded-index (GI) perfect circular cores for the applications to on-board optical interconnection. We already developed the Mosquito method utilizing a microdispenser, as a fabrication technique for GI circular core polymer waveguides. In the Mosquito method, a liquid-state core monomer is dispensed from a syringe needle into a liquid-state cladding monomer while the needle horizontally scans. Originally we used siloxane based monomers. In this paper, novel organic-inorganic hybrid materials (SUNCONNECT®) are selected to confirm the applicability of wide-range polymers to the Mosquito method. Here, a dip is observed on the upper perimeter of the obtained core cross-sections particularly when using a straight needle. Such a core-shape deformation increases the coupling loss with circular-core optical fibers. So, the flow of core and cladding monomers while dispensing the core with the needle scan is visually observed. It is confirmed that the edge of the straight needle chips off the upper perimeter of the core when the core monomer is dispensed, leading to the dip. Therefore, the straight needle is replaced for a curved one to change the dispensing direction for eliminating the dip. It is experimentally found that an almost circular core (50-μm diameter with 1.09 vertical to horizontal ratio of diameter) is formed when a curved needle is used. Finally, we successfully demonstrate a 1.73-dB lower loss in a 5-cm long waveguide compared to the one having the core with a dip.

  20. [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

  1. An Exploration of the Needling Depth in Acupuncture: The Safe Needling Depth and the Needling Depth of Clinical Efficacy

    PubMed Central

    Lin, Jaung-Geng; Chou, Pei-Chi; Chu, Heng-Yi

    2013-01-01

    Objective. To explore the existing scientific information regarding safe needling depth of acupuncture points and the needling depth of clinical efficacy. Methods. We searched the PubMed, EMBASE, Cochrane, Allied and Complementary Medicine (AMED), The National Center for Complementary and Alternative Medicine (NCCAM), and China National Knowledge Infrastructure (CNKI) databases to identify relevant monographs and related references from 1991 to 2013. Chinese journals and theses/dissertations were hand searched. Results. 47 studies were recruited and divided into 6 groups by measuring tools, that is, MRI, in vivo evaluation, CT, ultrasound, dissected specimen of cadavers, and another group with clinical efficacy. Each research was analyzed for study design, definition of safe depth, and factors that would affect the measured depths. Depths of clinical efficacy were discussed from the perspective of de-qi and other clinical observations. Conclusions. Great inconsistency in depth of each point measured from different subject groups and tools exists. The definition of safe depth should be established through standardization. There is also lack of researches to compare the clinical efficacy. A well-designed clinical trial selecting proper measuring tools to decide the actual and advisable needling depth for each point, to avoid adverse effects or complications and promote optimal clinical efficacy, is a top priority. PMID:23935678

  2. 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.

  3. Molecular ruler determines needle length for the Salmonella Spi-1 injectisome.

    PubMed

    Wee, Daniel H; Hughes, Kelly T

    2015-03-31

    The type-III secretion (T3S) systems of bacteria are part of self-assembling nanomachines: the bacterial flagellum that enables cells to propel themselves through liquid and across hydrated surfaces, and the injectisome that delivers pathogenic effector proteins into eukaryotic host cells. Although the flagellum and injectisome serve different purposes, they are evolutionarily related and share many structural similarities. Core features to these T3S systems are intrinsic length control mechanisms for external cellular projections: the hook of the flagellum and the injectisome needle. We present evidence that the Spi-1 injectisome, like the Salmonella flagellar hook, uses a secreted molecular ruler, InvJ, to determine needle length. This result supports a universal length control mechanism using molecular rulers for T3S systems. PMID:25775540

  4. Molecular ruler determines needle length for the Salmonella Spi-1 injectisome.

    PubMed

    Wee, Daniel H; Hughes, Kelly T

    2015-03-31

    The type-III secretion (T3S) systems of bacteria are part of self-assembling nanomachines: the bacterial flagellum that enables cells to propel themselves through liquid and across hydrated surfaces, and the injectisome that delivers pathogenic effector proteins into eukaryotic host cells. Although the flagellum and injectisome serve different purposes, they are evolutionarily related and share many structural similarities. Core features to these T3S systems are intrinsic length control mechanisms for external cellular projections: the hook of the flagellum and the injectisome needle. We present evidence that the Spi-1 injectisome, like the Salmonella flagellar hook, uses a secreted molecular ruler, InvJ, to determine needle length. This result supports a universal length control mechanism using molecular rulers for T3S systems.

  5. Maxillofacial Changes in Melnick-Needles Syndrome

    PubMed Central

    Albuquerque do Nascimento, Leilane Larissa; Salgueiro, Monica da Consolação Canuto; Quintela, Mariana; Mota, Ana Carolina Costa

    2016-01-01

    Background. Melnick-Needles Syndrome is rare congenital hereditary skeletal dysplasia caused by mutations in the FLNA gene, which codifies the protein filamin A. This condition leads to serious skeletal abnormalities, including the stomatognathic region. Case Presentation. This paper describes the case of a 13-year-old girl diagnosed with Melnick-Needles Syndrome presenting with different forms of skeletal dysplasia, such as cranial hyperostosis, short upper limbs, bowed long bones, metaphyseal thickening, genu valgum (knock-knee), shortened distal phalanges, narrow pelvis and shoulders, rib tapering and irregularities, elongation of the vertebrae, kyphoscoliosis, micrognathia, hypoplastic coronoid processes of the mandible, left stylohyoid ligament suggesting ossification, and dental development anomalies. Conclusion. Knowledge of this rare syndrome on the part of dentists is important due to the fact that this condition involves severe abnormalities of the stomatognathic system that cause an impact on the development of the entire face as well as functional and esthetic impairments. PMID:27478655

  6. Susuks: charm needles in facial soft tissues.

    PubMed

    Shanmuhasuntharam, P; Ghani, S H

    1991-04-20

    Susuks or charm needles are a form of talisman inserted and worn subcutaneously, in the face and other parts of the body, in the belief that they will enhance or preserve the wearer's beauty, youth, charisma, strength or health, or bring success in business. This mystic practice is found among some south-east Asian people, especially Malayan and Muslim females. Most susuk wearers are secretive about their hidden talismans, but these gold or silver needles are being discovered with increasing frequency now that radiographs are used more widely. An understanding of this practice and an awareness of its existence is important to avoid misdiagnosis and mismanagement of these patients. The practice of susuk wearing and its relevance to dentistry is discussed. Nine cases of facial susuk wearers are presented and previous reports are reviewed.

  7. Maxillofacial Changes in Melnick-Needles Syndrome.

    PubMed

    Albuquerque do Nascimento, Leilane Larissa; Salgueiro, Monica da Consolação Canuto; Quintela, Mariana; Teixeira, Victor Perez; Mota, Ana Carolina Costa; de Godoy, Camila Haddad Leal; Bussadori, Sandra Kalil

    2016-01-01

    Background. Melnick-Needles Syndrome is rare congenital hereditary skeletal dysplasia caused by mutations in the FLNA gene, which codifies the protein filamin A. This condition leads to serious skeletal abnormalities, including the stomatognathic region. Case Presentation. This paper describes the case of a 13-year-old girl diagnosed with Melnick-Needles Syndrome presenting with different forms of skeletal dysplasia, such as cranial hyperostosis, short upper limbs, bowed long bones, metaphyseal thickening, genu valgum (knock-knee), shortened distal phalanges, narrow pelvis and shoulders, rib tapering and irregularities, elongation of the vertebrae, kyphoscoliosis, micrognathia, hypoplastic coronoid processes of the mandible, left stylohyoid ligament suggesting ossification, and dental development anomalies. Conclusion. Knowledge of this rare syndrome on the part of dentists is important due to the fact that this condition involves severe abnormalities of the stomatognathic system that cause an impact on the development of the entire face as well as functional and esthetic impairments. PMID:27478655

  8. West Needle Wilderness study area, Colorado

    SciTech Connect

    Van Loenen, R.E.; Scott, D.C.

    1984-01-01

    The West Needle Wilderness study area, southwestern Colorado, was evaluated for mineral-resource potential in 1982. An area extending westward into the wilderness near the Elk Park mine, has a probable mineral-resource potential for uranium. Uranium resources, and associated silver, nickel, cobalt, and copper, are located at the Elk Park mine, directly adjacent to the eastern study area boundary. No potential for other mineral or energy resources was identified in this study.

  9. Fine needle aspiration of salivary gland tumors.

    PubMed

    Shintani, S; Matsuura, H; Hasegawa, Y

    1997-08-01

    The usefulness of fine needle aspiration (FNA) as a preoperative diagnostic procedure was studied in 43 patients with salivary gland tumors. Nine of the tumors were malignant and 34 benign. The diagnostic sensitivity of FNA was 88.9% (8/9), the specificity 94.1% (32/34) and the accuracy 93.0% (40/43). These results indicate that FNA is a highly sensitive and specific screening procedure.

  10. 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.

  11. Exploration of new electroacupuncture needle material.

    PubMed

    Lee, Sanghun; Choi, Gwang-Ho; Lee, Chang Hoon; Kim, Yu Kyoung; Lee, Saebhom; Cho, Sungjin; Yeon, Sunhee; Choi, Sun-Mi; Ryu, Yeon-Hee

    2012-01-01

    Background. Electro Acupuncture (EA) uses the acupuncture needle as an electrode to apply low-frequency stimulation. For its safe operation, it is essential to prevent any corrosion of the acupuncture needle. Objective. The aim of this study is to find an available material and determine the possibility of producing a standard EA needle that is biocompatible. Methods. Biocompatibility was tested by an MTT assay and cytotoxicity testing. Corrosion was observed with a scanning electron microscope (SEM) after 0.5 mA, 60 min stimulation. The straightness was measured using a gap length of 100 mm, and tensile testing was performed by imposing a maximum tensile load. Results. Phosphor bronze, Ni coated SS304, were deemed inappropriate materials because of mild-to-moderate cytotoxicity and corrosion. Ti-6Al-4V and SS316 showed no cytotoxicity or corrosion. Ti-6Al-4V has a 70 times higher cost and 2.5 times lower conductivity than SS316. The results of both straightness and tensile testing confirmed that SS316 can be manufactured as a standard product. Conclusion. As a result, we confirmed that SS316 can be used a new EA electrode material. We hope that a further study of the maximum capacity of low-frequency stimulation using an SS316 for safe operation. PMID:22675386

  12. Exploration of New Electroacupuncture Needle Material

    PubMed Central

    Lee, Sanghun; Choi, Gwang-Ho; Lee, Chang Hoon; Kim, Yu Kyoung; Lee, Saebhom; Cho, Sungjin; Yeon, Sunhee; Choi, Sun-Mi; Ryu, Yeon-Hee

    2012-01-01

    Background. Electro Acupuncture (EA) uses the acupuncture needle as an electrode to apply low-frequency stimulation. For its safe operation, it is essential to prevent any corrosion of the acupuncture needle. Objective. The aim of this study is to find an available material and determine the possibility of producing a standard EA needle that is biocompatible. Methods. Biocompatibility was tested by an MTT assay and cytotoxicity testing. Corrosion was observed with a scanning electron microscope (SEM) after 0.5 mA, 60 min stimulation. The straightness was measured using a gap length of 100 mm, and tensile testing was performed by imposing a maximum tensile load. Results. Phosphor bronze, Ni coated SS304, were deemed inappropriate materials because of mild-to-moderate cytotoxicity and corrosion. Ti-6Al-4V and SS316 showed no cytotoxicity or corrosion. Ti-6Al-4V has a 70 times higher cost and 2.5 times lower conductivity than SS316. The results of both straightness and tensile testing confirmed that SS316 can be manufactured as a standard product. Conclusion. As a result, we confirmed that SS316 can be used a new EA electrode material. We hope that a further study of the maximum capacity of low-frequency stimulation using an SS316 for safe operation. PMID:22675386

  13. 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

  14. 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. PMID:26841375

  15. 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.

  16. Fluoroscopically guided transforaminal epidural dry needling for lumbar spinal stenosis using a specially designed needle

    PubMed Central

    2010-01-01

    Background This report describes the methodological approach and clinical application of a minimally invasive intervention to treat lumbar spinal stenosis (LSS). Methods Thirty-four patients with LSS underwent fluoroscopically guided transforaminal epidural dry needling using a specially designed flexed Round Needle. The needle was inserted 8-12 cm lateral to the midline at the level of the stenosis and advanced to a position between the anterior side of the facet joint and pedicle up to the outer-third of the pedicle. The needle was advanced medially and backed laterally within a few millimetres along the canal side of the inferior articular process between the facet joint and pedicle. The procedure was completed when a marked reduction in resistance was felt at the tip of the needle. The procedure was performed bilaterally at the level of the stenosis. Results The average follow-up period was 12.9 ± 1.1 months. The visual analogue scale (VAS) pain score was reduced from 7.3 ± 2.0 to 4.6 ± 2.5 points, the Oswestry Disability Index (ODI) score decreased from 41.4 ± 17.2 to 25.5 ± 12.6% and the average self-rated improvement was 52.6 ± 33.1%. The VAS scores indicated that 14 (41.2%) patients reported a "good" to "excellent" treatment response, while 11 (32.4%) had a "good" to "excellent" treatment response on the ODI and 22 (64.7%) had a "good" to "excellent" treatment response on the self-rated improvement scale. Conclusions These results suggest that fluoroscopically guided transforaminal epidural dry needling is effective for managing LSS. PMID:20698999

  17. Needle Fracture during Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspicious Thoracic Lymph Nodes.

    PubMed

    Adamowicz, Bartosz; Manière, Thibaut; Déry, Vincent; Désilets, Étienne

    2016-01-01

    Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is used to make a cytopathologic diagnosis of suspicious lesions located around the gastrointestinal tract. It is a safe technique with few complications. The most common complications of EUS-FNA are related to pancreatic lesions (pancreatitis, bleeding, and abdominal pain). Rare complications have been noted such as stent malfunction, air embolism, infection, neural and vascular injuries, and tumor cell seeding. There are very few studies examining equipment malfunctions. We report a case of needle fracture during the EUS-FNA of suspicious thoracic lymph nodes in a 79-year-old man investigated for unexplained weight loss. PMID:27555874

  18. Needle Fracture during Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspicious Thoracic Lymph Nodes

    PubMed Central

    Manière, Thibaut; Déry, Vincent

    2016-01-01

    Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is used to make a cytopathologic diagnosis of suspicious lesions located around the gastrointestinal tract. It is a safe technique with few complications. The most common complications of EUS-FNA are related to pancreatic lesions (pancreatitis, bleeding, and abdominal pain). Rare complications have been noted such as stent malfunction, air embolism, infection, neural and vascular injuries, and tumor cell seeding. There are very few studies examining equipment malfunctions. We report a case of needle fracture during the EUS-FNA of suspicious thoracic lymph nodes in a 79-year-old man investigated for unexplained weight loss. PMID:27555874

  19. MR-compatible biopsy needle with enhanced tip force sensing

    PubMed Central

    Elayaperumal, Santhi; Bae, Jung Hwa; Christensen, David; Cutkosky, Mark R.; Daniel, Bruce L.; Costa, Joannes M.; Black, Richard J.; Faridian, Fereydoun; Moslehi, Behzad

    2015-01-01

    We describe an instrumented biopsy needle that provides physicians the capability to sense interaction forces directly at the tip of the needle’s inner stylet. The sensors consist of optical fiber Bragg gratings (FBGs), and are unaffected by electromagnetic fields; hence the needle is suitable for MR-guided procedures. In comparison to previous instrumented needles that measure bending strains, the new design has additional sensors and a series of micro-machined holes at the tip. The holes increase strain sensitivity, especially to axial forces, without significantly reducing the stiffness or strength. A comparison of the dynamic forces measured with the new needle and those obtained using a force/torque sensor at the needle base shows that the enhanced tip sensitivity is particularly noticeable when there is significant friction along the needle sleeve. PMID:26509189

  20. 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.

  1. Chest Wall Dissemination of Nocardiosis after Percutaneous Transthoracic Needle Biopsy

    SciTech Connect

    Shimamoto, Hiroshi Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kamiya, Mika; Miyazaki, Masaya; Arai, Yasuaki; Horio, Yoshitsugu

    2007-07-15

    We described a case of chest wall dissemination after percutaneous transthoracic needle biopsy. A 65-year-old man had a lung nodule which was suspected to be lung carcinoma. He underwent percutaneous transthoracic needle biopsy using an 18G semiautomated biopsy needle and pathologic diagnosis showed organizing pneumonia. Two months after the biopsy, chest wall dissemination occurred. Implantation of carcinoma along the biopsy route was suspected, but the mass was actually due to pulmonary nocardiosis.

  2. Hollow metallic micromachined needles with multiple output ports

    NASA Astrophysics Data System (ADS)

    Brazzle, John D.; Mohanty, Swomitra K.; Frazier, A. Bruno

    1999-08-01

    In this paper, hollow metallic micromachined needles with multiple output ports are designed, fabricated, characterized, and packaged. The hollow metallic needles include design features such as tapered needle tips and multiple output ports on the bottom and top of each needle. The needle tip and shaft are formed by microelectroformed metal. The flow characteristics of the needles are currently being experimentally investigated and modeled using a finite element numerical model. The experimental results and theoretical models will be presented as part of this paper. The micromachined needles can be fabricated on a variety of substrates and can use micro-electroformed palladium as the structural material. The use of palladium as a structural material provides high mechanical strength and durability, as well as, biocompatibility for use in biomedical applications. The cross-sectional dimensions of individual needle tips begin at less than 10 micrometers in width and 15 micrometers in height and then taper to 200 micrometers in width and 60 micrometers in height. The significance of this work includes the development of hollow metallic micromachined needles for biomedical applications, as well as, a discussion of structural, fluidic, and packaging design considerations.

  3. Comparing ease of intraosseous needle placement: Jamshidi versus cook.

    PubMed

    Halm, B; Yamamoto, L G

    1998-07-01

    In a sample of 34 study subjects, Cook and Jamshidi intraosseous (IO) needles were compared for ease of insertion into turkey bones. The averaged lapsed time of insertion was significantly shorter using the Jamshidi needle (25.5 v 56.2 seconds, P < .0001). The mean difficulty of insertion score was lower using the Jamshidi needle (3.0 v 7.1 on a 10-cm visual analog scale, P < .0001). The less costly Jamshidi needle is easier to use in IO insertion in this turkey bone model.

  4. Serrated needle design facilitates precise round window membrane perforation.

    PubMed

    Stevens, James P; Watanabe, Hirobumi; Kysar, Jeffrey W; Lalwani, Anil K

    2016-07-01

    The round window membrane (RWM) has become the preferred route, over cochleostomy, for the introduction of cochlear implant electrodes as it minimizes inner ear trauma. However, in the absence of a tool designed for creating precise perforation, current practices lead to tearing of the RWM and significant intracochlear pressure fluctuations. On the basis of RWM mechanical properties, we have designed a multi-serrated needle to create consistent holes without membrane tearing or damaging inner ear structures. Four and eight-serrated needles were designed and produced with wire electrical discharge machining (EDM). The needle's ability to create RWM perforations was tested in deidentified, commercially acquired temporal bones with the assistance of a micromanipulator. Subsequently, specimens were imaged under light and scanning electron microscopy (SEM). The needles created consistent, appropriately sized holes in the membrane with minimal tearing. While a four-serrated crown needle made rectangular/trapezoid perforations, the octagonal crown formed smooth oval holes within the membrane. Though designed for single use, the needle tolerated repeated use without significant damage. The serrated needles formed precise perforations in the RWM while minimizing damage during cochlear implantation. The octagonal needle design created the preferred oval perforation better than the quad needle. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1633-1637, 2016. PMID:26914984

  5. Lab in a needle for epidural space identification

    NASA Astrophysics Data System (ADS)

    Carotenuto, B.; Micco, A.; Ricciardi, A.; Amorizzo, E.; Mercieri, M.; Cutolo, A.; Cusano, A.

    2016-05-01

    This work relies on the development of a sensorized medical needle with an all-optical guidance (Lab in a Needle) system for epidural space identification. The device is based on the judicious integration of a Fiber Bragg grating sensor inside the lumen of an epidural needle to discriminate between different types of tissue and thus providing continuous and real time measurements of the pressure experienced by the needle tip during its advancement. Experiments carried out on an epidural training phantom demonstrate the validity of our approach for the correct and effective identification of the epidural space.

  6. 49 CFR 178.337-14 - Gauging devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... See § 173.315(h) of this subchapter. (b) Pressure gauges. (1) See § 173.315(h) of this subchapter. (2... service must be provided with a suitable pressure gauge. A shut-off valve must be installed between the pressure gauge and the cargo tank. (c) Orifices. See § 173.315(h) (3) and (4) of this subchapter....

  7. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure, in... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... filling. (2) The design pressure of each liquid level gauging device must be at least that of the tank....

  8. Evolution of transbronchial needle aspiration technique

    PubMed Central

    Liu, Qing-Hua; Ben, Su-Qin; Xia, Yang

    2015-01-01

    Transbronchial needle aspiration (TBNA) is an established technique to collect cell and tissue specimens from lesions outside the airway wall, generally guided by flexible bronchoscope under the direct visualization of the puncture site. TBNA has been utilized for 30 years, and now there is renewed interest in utilizing it in conjunction with endobronchial ultrasound. Although the basic operational principles have remained the same, conventional TBNA (cTBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) have been greatly improved over the years with the increased application in clinic and the advance of new technology. In this article we briefly discussed the evolution of TBNA technique and its future. PMID:26807269

  9. Transurethral needle biopsy: a novel technique for pathologic diagnosis of bladder tumors in children.

    PubMed

    Lightfoot, Michelle; Li, Roger; Alsyouf, Muhannad; Nicolay, Lesli; Chamberlin, David

    2014-12-01

    Although rare, both benign and malignant bladder tumors are occasionally encountered in the pediatric population. In the present article, the technique of transurethral needle biopsy, which utilizes an 18-gauge core biopsy instrument inserted through a 9.5 French offset pediatric cystoscope to obtain diagnostic biopsies, is described. This technique has been used successfully in two patients, both of whom had an inflammatory myofibroblastic tumor on biopsy and on final pathology from partial cystectomy. This provides an alternative technique, which may be used when a pediatric resectoscope is not available or in patients with a small caliber urethra.

  10. Multimodal optical biopsy probe to improve the safety and diagnostic yield of brain needle biopsies (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Desroches, Joannie; Pichette, Julien; Goyette, Andréanne; Tremblay, Marie-Andrée.; Jermyn, Michael; Petrecca, Kevin; Leblond, Frédéric

    2016-03-01

    Brain needle biopsy (BNB) is performed to collect tissue when precise neuropathological diagnosis is required to provide information about tumor type, grade, and growth patterns. The principal risks associated with this procedure are intracranial hemorrhage (due to clipping blood vessels during tissue extraction), incorrect tumor typing/grading due to non-representative or non-diagnostic samples (e.g. necrotic tissue), and missing the lesion. We present an innovative device using sub-diffuse optical tomography to detect blood vessels and Raman spectroscopy to detect molecular differences between tissue types, in order to reduce the risks of misdiagnosis, incorrect tumour grading, and non-diagnostic samples. The needle probe integrates optical fibers directly onto the external cannula of a commercial BNB needle, and can perform measurements for both optical techniques through the same fibers. This integrated optical spectroscopy system uses diffuse reflectance signals to perform a 360-degree reconstruction of the tissue adjacent to the biopsy needle, based on the optical contrast associated with hemoglobin light absorption, thereby localizing blood vessels. Raman spectra measurements are also performed interstitially for tissue characterization. A detailed sensitivity of the system is presented to demonstrate that it can detect absorbers with diameters <300 µm located up to ˜2 mm from the biopsy needle core, for bulk optical properties consistent with brain tissue. Results from animal experiments are presented to validate blood vessel detection and Raman spectrum measurement without disruption of the surgical workflow. We also present phantom measurements of Raman spectra with the needle probe and a comparison with a clinically validated Raman spectroscopy probe.

  11. An Endovascular Cannulation Needle with an Internal Wire for the Fragmentation of Thrombi in Retinal Vein Occlusion

    PubMed Central

    Asami, Tetsu; Kaneko, Hiroki; Miyake, Kensaku; Ota, Ichiro; Miyake, Goichiro; Kato, Seiichi; Yasuda, Shunsuke; Iwase, Takeshi; Ito, Yasuki; Terasaki, Hiroko

    2016-01-01

    Purpose We report a newly developed device to fragment thrombi in retinal vein occlusion. Methods The new instrument consists of a 23-gauge (G) pipe and a 37-G needle with an internal wire. A total of 40 porcine eyes were used; 20 eyes for experiments in the branch retinal vein (BRV group) and 20 eyes for experiments in the central retinal vein (CRV group). We placed 25-G 3-port trocars, and core vitrectomy was performed. Another 23-G scleral incision was performed for insertion of the needle. The needle pierced the retinal vein at a distance of three- to four- or one-disc diameters from the optic disc (BRV or CRV group, respectively), and the internal wire was advanced toward the disc. The success rates of needle piercing and cannulation of the internal wire were recorded in each group. In the CRV group, the cannulation was deemed successful when the tip reached inside the optic disc. Real-time optical coherence tomography imaging also was performed using the Zeiss Rescan 700 device in porcine eyes. Histologic examination of the retinal vessel inserted with the internal wire was performed. Results The success rates of needle piercing into the BRV and CRV were 85% and 95%, respectively. The success rates of cannulation of the internal wire into the BRV and CRV were 85% and 0%, respectively. The process of cannulation was recorded successfully with the Rescan 700. Histologic examination showed no damages to the endothelial cell layer. Conclusions The needle and internal wire intended to be used for recanalization of BRV occlusion were successfully pierced and cannulated into the BRV. Translational Relevance This newly developed device could become a treatment modality for retinal vein occlusion to fragment thrombi that present treatment methods cannot reach and remove directly. PMID:27730009

  12. Three-dimensional needle-tip localization by electric field potential and camera hybridization for needle electromyography exam robotic simulator.

    PubMed

    He, Siyu; Gomez-Tames, Jose; Yu, Wenwei

    2016-01-01

    As one of neurological tests, needle electromygraphy exam (NEE) plays an important role to evaluate the conditions of nerves and muscles. Neurology interns and novice medical staff need repetitive training to improve their skills in performing the exam. However, no training systems are able to reproduce multiple pathological conditions to simulate real needle electromyogram exam. For the development of a robotic simulator, three components need to be realized: physical modeling of upper limb morphological features, position-dependent electromyogram generation, and needle localization; the latter is the focus of this study. Our idea is to couple two types of sensing mechanism in order to acquire the needle-tip position with high accuracy. One is to segment the needle from camera images and calculate its insertion point on the skin surface by a top-hat transform algorithm. The other is voltage-based depth measurement, in which a conductive tissue-like phantom was used to realize both needle-tip localization and physical sense of needle insertion. For that, a pair of electrodes was designed to generate a near-linear voltage distribution along the depth direction of the tissue-like phantom. The accuracy of the needle-tip position was investigated by the electric field potential and camera hybridization. The results showed that the needle tip could be detected with an accuracy of 1.05±0.57 mm. PMID:27382339

  13. Three-dimensional needle-tip localization by electric field potential and camera hybridization for needle electromyography exam robotic simulator

    PubMed Central

    He, Siyu; Gomez-Tames, Jose; Yu, Wenwei

    2016-01-01

    As one of neurological tests, needle electromygraphy exam (NEE) plays an important role to evaluate the conditions of nerves and muscles. Neurology interns and novice medical staff need repetitive training to improve their skills in performing the exam. However, no training systems are able to reproduce multiple pathological conditions to simulate real needle electromyogram exam. For the development of a robotic simulator, three components need to be realized: physical modeling of upper limb morphological features, position-dependent electromyogram generation, and needle localization; the latter is the focus of this study. Our idea is to couple two types of sensing mechanism in order to acquire the needle-tip position with high accuracy. One is to segment the needle from camera images and calculate its insertion point on the skin surface by a top-hat transform algorithm. The other is voltage-based depth measurement, in which a conductive tissue-like phantom was used to realize both needle-tip localization and physical sense of needle insertion. For that, a pair of electrodes was designed to generate a near-linear voltage distribution along the depth direction of the tissue-like phantom. The accuracy of the needle-tip position was investigated by the electric field potential and camera hybridization. The results showed that the needle tip could be detected with an accuracy of 1.05±0.57 mm. PMID:27382339

  14. A Needle-Free Injection System (INJEX™) with lidocaine for epidural needle insertion: A randomized controlled trial

    PubMed Central

    Gozdemir, Muhammet; Demircioglu, Ruveyda Irem; Karabayirli, Safinaz; Sert, Huseyin; Muslu, Bunyamin; Usta, Burhanettin; Yazici, Ummugulsum

    2016-01-01

    Objectives: Local anesthetic infiltration is also a process of a painful process itself. INJEX™ technology, known as “Needle-free” drug delivery system, was designed for reducing the pain associated with cutaneous procedures. We conducted a prospective, randomized trial to evaluate the application of lidocaine with INJEX™ system and 27-gauge needle. Methods: A total of 60 consecutive patients were allocated to receive either INJEX group or 27-gauge needle group. Local anesthetic infiltration was applied two minutes before epidural needle insertion. Results: Mean VAS, at the time of local anesthetic injection was 0 for group I and 2 for group II. When the effect of epidural needle insertion was compared, the mean VAS score was one versus two for Group-I versus Group-II, respectively. Lidocaine applied with the INJEX™ system before epidural needle insertion significantly reduced the intensity of pain during that procedure and was least effective the lidocaine applied with the 27-gauge needle and patients felt less pain during at the time of local anesthetic injection in Group-I. Conclusion: Needle-free delivery of lidocaine is an effective, easy to-use and noninvasive method of providing local anesthesia for the epidural needle insertion. PMID:27375728

  15. Gas flow dependence of atmospheric pressure plasma needle discharge characteristics

    NASA Astrophysics Data System (ADS)

    Qian, Muyang; Yang, Congying; Liu, Sanqiu; Chen, Xiaochang; Ni, Gengsong; Wang, Dezhen

    2016-04-01

    In this paper, a two-dimensional coupled model of neutral gas flow and plasma dynamics is presented to explain the gas flow dependence of discharge characteristics in helium plasma needle at atmospherics pressure. The diffusional mixing layer between the helium jet core and the ambient air has a moderate effect on the streamer propagation. The obtained simulation results present that the streamer shows the ring-shaped emission profile at a moderate gas flow rate. The key chemical reactions which drive the streamer propagation are electron-impact ionization of helium neutral, nitrogen and oxygen molecules. At a moderate gas flow rate of 0.5 slm, a significant increase in propagation velocity of the streamer is observed due to appropriate quantity of impurities air diffuse into the helium. Besides, when the gas flow rate is below 0.35 slm, the radial density of ground-state atomic oxygen peaks along the axis of symmetry. However, when the gas flow rate is above 0.5 slm, a ring-shaped density distribution appears. The peak density is on the order of 1020 m-3 at 10 ns in our work.

  16. Percolation in suspensions of hard nanoparticles: From spheres to needles

    NASA Astrophysics Data System (ADS)

    Schilling, Tanja; Miller, Mark A.; van der Schoot, Paul

    2015-09-01

    We investigate geometric percolation and scaling relations in suspensions of nanorods, covering the entire range of aspect ratios from spheres to extremely slender needles. A new version of connectedness percolation theory is introduced and tested against specialised Monte Carlo simulations. The theory accurately predicts percolation thresholds for aspect ratios of rod length to width as low as 10. The percolation threshold for rod-like particles of aspect ratios below 1000 deviates significantly from the inverse aspect ratio scaling prediction, thought to be valid in the limit of infinitely slender rods and often used as a rule of thumb for nanofibres in composite materials. Hence, most fibres that are currently used as fillers in composite materials cannot be regarded as practically infinitely slender for the purposes of percolation theory. Comparing percolation thresholds of hard rods and new benchmark results for ideal rods, we find that i) for large aspect ratios, they differ by a factor that is inversely proportional to the connectivity distance between the hard cores, and ii) they approach the slender rod limit differently.

  17. Improving Door to Needle time in Patients for Thrombolysis.

    PubMed

    Fernandes, Darren; Umasankar, Udayaraj

    2016-01-01

    Ischaemic stroke can result in approximately 2 million brain neurones being damaged for each minute that it is left untreated. Various trials and studies such as the National Institute of Neurologic Disorders (NINDS) trial, the European Cooperative Acute Stroke Study (ECASS), ECASS II, and the Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke (ATLANTIS) study have clearly demonstrated the beneficial effects of intravenous tissue plasminogen activator (tPA) for treatment of acute stroke. Therefore to minimise damage and improve clinical outcome, we need to identify patients who present within 4.5 hours of symptom onset and reduce the time taken to adminster a thrombolytic agent. This time is commonly referred to as the 'door to needle' (DTN) time. Our standard, set by the Clinical Commissioning Group (CCG) is to achieve a median time of scanning and thrombolysis within 55 minutes from the time that the patient enters the hospital. The aim of our QIP was to collect data on what the DTN time was during November 2015, December 2015, and January 2016 and to evaluate how this can be improved after each month. This Quality Improvement Project in the DTN time in patients for thrombolysis has identified areas in the pathway that leads to delays. One major contributing factor is the time for a doctor to come and assess and administer the thrombolytic agent to the patient. Change was implemented by ensuring that the core medical trainee on call is allocated to respond as a priority to all possible thrombolysis calls. This has resulted in a reduction of mean DTN time, from 74 minutes in November to 43 minutes in January. As well as improving patient outcomes, it is proposed that the implementation of change has benefitted the training experience and development of key skills of the core medical trainees. PMID:27559475

  18. Scaling of hemolysis in needles and catheters.

    PubMed

    Sharp, M K; Mohammad, S F

    1998-01-01

    Hemolysis in clinical blood samples leads to inaccurate assay results and often to the need for repeated blood draws. In vitro experiments were conducted to determine the influence on hemolysis in phlebotomy needles and catheters of pressure difference, cannula diameter, and cannula material. Fresh blood from five human volunteers was forced from a syringe inside a pressurized chamber through 14, 18, and 22 gauge 304 stainless steel needles and polyurethane and Teflon catheters, all 40 mm long. Hemolysis was measured in the samples by a spectrophotometer. It was found that hemolysis increased with increases in pressure difference and cannula diameter and no consistent trend could be identified with regard to cannula material. The pressure differences required for significant hemolysis were above those typical of clinical venipuncture blood draws. While there was substantial variability among individuals, the hemolysis values scaled with exponent S = (t/t0)[(tau/tau0)-1]2, where t is the characteristic duration of shear, t0 is a time constant, tau is the wall shear stress, and tau0 is the wall shear stress threshold below which no hemolysis occurs. A hemolysis threshold including both time and shear stress was also defined for S = constant. The threshold implies that a threshold shear stress exists below which erythrocytes are not damaged for any length of exposure time, but that red cells may be damaged by an arbitrarily short period of exposure to sufficiently large shear stress.

  19. Design of a Slender Tuned Ultrasonic Needle for Bone Penetration

    NASA Astrophysics Data System (ADS)

    Cleary, Rebecca; Mathieson, Andrew; Wallace, Robert; Simpson, Hamish; Lucas, Margaret

    This paper reports on an ultrasonic bone biopsy needle, particularly focusing on design guidelines applicable for any slender tuned ultrasonic device component. Ultrasonic surgical devices are routinely used to cut a range of biological tissues, such as bone. However the realisation of an ultrasonic bone biopsy needle is particularly challenging. This is due to the requirement to generate sufficient vibrational amplitude capable of penetrating mineralised tissue, while avoiding flexural vibrational responses, which are known to reduce the performance and reliability of slender ultrasonic devices. This investigation uses finite element analysis (FEA) to predict the vibrational behaviour of a resonant needle which has dimensions that match closely to an 8Gx4inch bone marrow biopsy needle. Features of the needle, including changes in material and repeated changes in diameter, have been included and systematically altered to demonstrate that the location of and geometry of these features can significantly affect the resonant frequency of bending and torsional modes of vibration while having a limited effect on the frequency and shape of the tuned longitudinal mode. Experimental modal analysis was used to identify the modal parameters of the selected needle design, validating the FEA model predictions of the longitudinal mode and the close flexural modes. This verifies that modal coupling can be avoided by judicious small geometry modifications. Finally, the tuned needle assembly was driven under typical operational excitation conditions to demonstrate that an ultrasonic biopsy needle can be designed to operate in a purely longitudinal motion.

  20. 21 CFR 868.5090 - Emergency airway needle.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 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....

  1. 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....

  2. 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....

  3. 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 868.5150 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....

  4. 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....

  5. 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....

  6. 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....

  7. 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....

  8. Observations on rotating needle insertions using a brachytherapy robot

    NASA Astrophysics Data System (ADS)

    Meltsner, M. A.; Ferrier, N. J.; Thomadsen, B. R.

    2007-09-01

    A robot designed for prostate brachytherapy implantations has the potential to greatly improve treatment success. Much of the research in robotic surgery focuses on measuring accuracy. However, there exist many factors that must be optimized before an analysis of needle placement accuracy can be determined. Some of these parameters include choice of the needle type, insertion velocity, usefulness of the rotating needle and rotation speed. These parameters may affect the force at which the needle interacts with the tissue. A reduction in force has been shown to decrease the compression of the prostate and potentially increase the accuracy of seed position. Rotating the needle as it is inserted may reduce frictional forces while increasing accuracy. However, needle rotations are considered to increase tissue damage due to the drilling nature of the insertion. We explore many of the factors involved in optimizing a brachytherapy robot, and the potential effects each parameter may have on the procedure. We also investigate the interaction of rotating needles in gel and suggest the rotate-cannula-only method of conical needle insertion to minimize any tissue damage while still maintaining the benefits of reduced force and increased accuracy.

  9. 21 CFR 880.5570 - Hypodermic single lumen needle.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hypodermic single lumen needle. 880.5570 Section 880.5570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Therapeutic Devices § 880.5570 Hypodermic single lumen needle. (a) Identification. A hypodermic single...

  10. Needle and Syringe Cleaning Practices among Injection Drug Users.

    ERIC Educational Resources Information Center

    Fisher, Dennis G.; Harbke, Colin R.; Canty, John R.; Reynolds, Grace L.

    2002-01-01

    Evaluates the effect of needle exchange on the bleach-mediated disinfection (BMD) practices of 176 needle and syringe sharing injection drug users (IDUs). Results reveal that IDUs who traded sex for money or drugs were less likely to practice BMD, and IDUs who reported a reduced number of sex partners were more likely to practice BMD. (Contains 36…

  11. 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

  12. Minimally disruptive needle insertion: a biologically inspired solution.

    PubMed

    Leibinger, Alexander; Oldfield, Matthew J; Rodriguez Y Baena, Ferdinando

    2016-06-01

    The mobility of soft tissue can cause inaccurate needle insertions. Particularly in steering applications that employ thin and flexible needles, large deviations can occur between pre-operative images of the patient, from which a procedure is planned, and the intra-operative scene, where a procedure is executed. Although many approaches for reducing tissue motion focus on external constraining or manipulation, little attention has been paid to the way the needle is inserted and actuated within soft tissue. Using our biologically inspired steerable needle, we present a method of reducing the disruptiveness of insertions by mimicking the burrowing mechanism of ovipositing wasps. Internal displacements and strains in three dimensions within a soft tissue phantom are measured at the needle interface, using a scanning laser-based image correlation technique. Compared to a conventional insertion method with an equally sized needle, overall displacements and strains in the needle vicinity are reduced by 30% and 41%, respectively. The results show that, for a given net speed, needle insertion can be made significantly less disruptive with respect to its surroundings by employing our biologically inspired solution. This will have significant impact on both the safety and targeting accuracy of percutaneous interventions along both straight and curved trajectories. PMID:27274797

  13. 42. VALVEHOUSE FOR NEEDLE VALVE OUTLET WORKS ON GALLERY 2, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    42. VALVEHOUSE FOR NEEDLE VALVE OUTLET WORKS ON GALLERY 2, SHOWING OVERHEAD SERVICE CRANE AT CENTER. NOTE NEEDLE VALVE AIR VENTS AND GAUGES AT RIGHT, NEXT TO CONTROL PEDESTAL. VIEW TO EAST. - Owyhee Dam, Across Owyhee River, Nyssa, Malheur County, OR

  14. Synthesis of nano-crystalline multifibrous zirconia needle

    SciTech Connect

    Biswas, Mridula; Bandyopadhyay, Siddhartha

    2013-06-01

    Graphical abstract: - Highlights: • Zirconia needles have been successfully prepared by simple inorganic sol–gel route. • The shape of the needles was retained after firing with aspect ratio > 400. • Needles are composed of multiple fibres. • Fibres are composed of nano crystals. - Abstract: Zirconia needles have been successfully synthesized using a simple inorganic sol–gel process without using any template. The method employs mixture of zirconium oxychloride octahydrate and sulphuric acid in aqueous medium. This process requires heat treatment at 40 °C for 2 h in an oven for nucleus formation. Complete formation of needle occurs after 17 days. The green needle retained its original shape after calcination at 1200 °C. Fired needles were of 1–2 cm in length and 5–50 μm in diameter and possess monoclinic phase. Needles are composed of multiple fibres. Depending on the heat treatment temperature, crystallite size varies in the range of 8 to around 300 nm.

  15. An evolutionarily conserved family of virion tail needles related to bacteriophage P22 gp26: correlation between structural stability and length of the α-helical trimeric coiled-coil

    PubMed Central

    Bhardwaj, Anshul; Walker-Kopp, Nancy; Casjens, Sherwood R.; Cingolani, Gino

    2009-01-01

    Bacteriophages of the Podoviridae family use short non-contractile tails to inject their genetic material into Gram-negative bacteria. In phage P22, the tail contains a thin needle, encoded by the phage gene 26, which is essential both for stabilization and ejection of the packaged viral genome. Bio-informatic analysis of the N-terminal domain of gp26 (residues 1–60) led us to identify a family of genes encoding putative homologues of the tail needle gp26. To validate this idea experimentally and to explore their diversity, we cloned the gp26-like gene from phages HK620, Sf6, HS1, and characterized these gene products in solution. All gp26-like factors contain an elongated α-helical coiled-coil core consisting of repeating, adjacent trimerization heptads and form trimeric fibers with length ranging between about 240Å to 300Å. Gp26-tail needles display high structural stability in solution, with Tm (temperature of melting) between 85–95°C. To determine how the structural stability of these phage fibers correlates with the length of the α-helical core, we investigated the effect of insertions and deletions in the helical core. In P22 tail needle, we identified an 85-residue long helical domain, termed MiCRU (Minimal Coiled-coil Repeat Unit), that can be inserted in frame inside gp26 helical core, preserving the straight morphology of the fiber. Likewise, we were able to remove three quarters of the helical core of HS1 tail needle minimally decreasing the stability of the fiber. We conclude that in the gp26 family of tail needles, structural stability increases non-linearly with the length of the α-helical core. Thus, the overall stability of these bacteriophage fibers is not solely dependent on the number of trimerization repeats in the α-helical core. PMID:19482036

  16. Modeling Electric Fields of Peripheral Nerve Block Needles.

    NASA Astrophysics Data System (ADS)

    Davis, James Ch.; Anderson, Norman E.; Meisel, Mark W.; Ramirez, Jason G.; Kayser Enneking, F.

    2006-03-01

    Peripheral nerve blocks present an alternative to general anesthesia in certain surgical procedures and a means of acute pain relief through continuous blockades. They have been shown to decrease the incidence of postoperative nausea and vomiting, reduce oral narcotic side effects, and improve sleep quality. Injecting needles, which carry small stimulating currents, are often used to aid in locating the target nerve bundle. With this technique, muscle responses indicate needle proximity to the corresponding nerve bundle. Failure rates in first injection attempts prompted our study of electric field distributions. Finite difference methods were used to solve for the electric fields generated by two widely used needles. Geometric differences in the needles effect variations in their electric field and current distributions. Further investigations may suggest needle modifications that result in a reduction of initial probing failures.

  17. Modeling Electric Fields of Peripheral Nerve Block Needles.

    NASA Astrophysics Data System (ADS)

    Davis, James Ch.; Ramirez, Jason G.

    2005-11-01

    Peripheral nerve blocks present an alternative to general anesthesia in certain surgical procedures and a means of acute pain relief through continuous blockades. They have been shown to decrease the incidence of postoperative nausea and vomiting, reduce oral narcotic side effects, and improve sleep quality. Injecting needles, which carry small stimulating currents, are often used to aid in locating the target nerve bundle. With this technique, muscle responses indicate needle proximity to the corresponding nerve bundle. Failure rates in first injection attempts prompted our study of electric field distributions. Finite difference methods were used to solve for the electric fields generated by two widely used needles. Differences in geometry between needles are seen to effect changes in electric field and current distributions. Further investigations may suggest needle modifications that result in a reduction of initial probing failures.

  18. Needle targeting under C-arm fluoroscopy servoing

    NASA Astrophysics Data System (ADS)

    Mihaescu, Cristian; Ibanez, Luis; Mocanu, Mihai; Cleary, Kevin R.

    2005-04-01

    This paper describes a method for translational and orientational alignment of a robotic needle driver based on image servoing and x-ray fluoroscopy. The translational process works by segmenting the needle in a frame-grabbed fluoroscopic image and then commanding the robot to automatically move the needle tip to the skin entry point. The orientational alignment is then completed based on five different positions of the needle tip. Previously reported fluoroscopy servoing methods use complex robot-image registration algorithms, fiducial markers, and two or more dissimilar views that included moving the fluoroscope. Our method aligns the needle using one setting of the fluoroscope so that it does not need to be moved during the alignment process. Sample results from both the translational and orientational steps are included.

  19. 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.

  20. Removal of an embedded crochet needle in the mouth.

    PubMed

    Klovenski, Victoria; Juergens, Andrew; Lappo, Kyla; Marshall, Kyle

    2016-01-01

    A 3-year-old child presented to the emergency department with a crochet needle lodged in her posterior oral cavity. To localize the needle and significant surrounding anatomic structures, bedside transcavitary ultrasound was employed. After careful localization, the needle was removed using a modified needle cover technique. A review of barbed foreign object removal techniques, including advance-and-cut, retrograde, string-yank, and needle cover techniques, is presented. Important considerations while planning any procedure include risk, benefit, availability of staff, and availability of equipment. Proper anesthesia is paramount to the success of these procedures, and sedation in pediatric patients may prove necessary. Postprocedure wound care and follow-up must also be arranged. This case demonstrates the importance of adaptation of well-documented techniques to remain flexible for any situation that may present to the emergency department.

  1. Removal of an embedded crochet needle in the mouth

    PubMed Central

    Juergens, Andrew; Lappo, Kyla; Marshall, Kyle

    2016-01-01

    A 3-year-old child presented to the emergency department with a crochet needle lodged in her posterior oral cavity. To localize the needle and significant surrounding anatomic structures, bedside transcavitary ultrasound was employed. After careful localization, the needle was removed using a modified needle cover technique. A review of barbed foreign object removal techniques, including advance-and-cut, retrograde, string-yank, and needle cover techniques, is presented. Important considerations while planning any procedure include risk, benefit, availability of staff, and availability of equipment. Proper anesthesia is paramount to the success of these procedures, and sedation in pediatric patients may prove necessary. Postprocedure wound care and follow-up must also be arranged. This case demonstrates the importance of adaptation of well-documented techniques to remain flexible for any situation that may present to the emergency department. PMID:26722162

  2. 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

  3. The Detection of Cold Dust in Cassiopeia A: Evidence for the Formation of Metallic Needles in the Ejecta

    NASA Astrophysics Data System (ADS)

    Dwek, Eli

    2004-06-01

    Ejecta from core-collapse supernovae contain a few solar masses of refractory elements and therefore can be the most important source of interstellar dust if these elements condense efficiently into solids. However, infrared observations of young supernova remnants, such as Cas A or Kepler, and observations of SN 1987A have detected only ~10-3 Msolar of hot dust in these objects. Recently, Dunne et al. obtained 450 and 850 μm SCUBA images of Cas A and reported the detection of 2-4 Msolar of cold (18 K) dust in the remnant. Here we show that their interpretation of the observations faces serious difficulties. Their inferred dust mass ignores the effect of grain destruction by sputtering and is larger than the mass of refractory material in the ejecta of a 10-30 Msolar star. The cold dust model faces even more difficulties if the 170 μm observations of the remnant are included in the analysis, which decreases the cold dust temperature to ~ 8 K and increases its mass to >~ 20 Msolar. We offer here a more plausible interpretation of their observation, in which the cold dust emission is generated by conducting needles in the ejecta. The needle properties are completely determined by the combined submillimeter and X-ray observations of the remnant. The needles are collisionally heated by the shocked gas. They are very efficient emitters at submillimeter wavelengths and, with a resistivity of a few μΩ cm, can readily attain a temperature of 8 K. Taking the destruction of needles into account, a dust mass of only 10-4 to 10-3 Msolar is needed to account for the observed SCUBA emission. The needles consist of metallic whiskers with <~1% of embedded impurities, which may have condensed out of blobs of material that were expelled at high velocities from the inner metal-rich layers of the star in an asymmetric explosion. Conductive needles may also be the source of the cold dust emission detected by Morgan et al. in Kepler. When aligned in the magnetic field, needles may

  4. Soft tissue navigation using needle-shaped markers: Evaluation of navigation aid tracking accuracy and CT registration

    NASA Astrophysics Data System (ADS)

    Maier-Hein, L.; Maleike, D.; Neuhaus, J.; Franz, A.; Wolf, I.; Meinzer, H.-P.

    2007-03-01

    We evaluate two core modules of a novel soft tissue navigation system. The system estimates the position of a hidden target (e.g. a tumor) during a minimally invasive intervention from the location of a set of optically tracked needle-shaped navigation aids which are placed in the vicinity of the target. The initial position of the target relative to the navigation aids is obtained from a CT scan. The accuracy of the entire system depends on (a) the accuracy for locating a set of navigation aids in a CT image, (b) the accuracy for determining the positions of the navigation aids during the intervention by means of optical tracking, (c) the accuracy for tracking the applicator (e.g. the biopsy needle), and (d) the accuracy of the real-time deformation model which continuously computes the location of the initially determined target point from the current positions of the navigation aids. In this paper, we focus on the first two aspects. We introduce the navigation aids we constructed for our system and show that the needle tips can be tracked with submillimeter accuracy. Furthermore, we present and evaluate three methods for registering a set of navigation aid models with a given CT image. The fully-automatic algorithm outperforms both the manual method and the semi-automatic algorithm, yielding an average distance of 0.27 +/- 0.08 mm between the estimated needle tip position and the reference position.

  5. Optical Flow-Based Tracking of Needles and Needle-Tip Localization Using Circular Hough Transform in Ultrasound Images

    PubMed Central

    Ayvali, Elif; Desai, Jaydev P.

    2014-01-01

    Image-guided interventions have become the standard of care for needle-based procedures. The success of the image-guided procedures depends on the ability to precisely locate and track the needle. This work is primarily focused on 2D ultrasound-based tracking of a hollow needle (cannula) that is composed of straight segments connected by shape memory alloy actuators. An in-plane tracking algorithm based on optical flow was proposed to track the cannula configuration in real-time. Optical flow is a robust tracking algorithm that can easily run on a CPU. However, the algorithm does not perform well when it is applied to the ultrasound images directly due to the intensity variation in the images. The method presented in this work enables using the optical flow algorithm on ultrasound images to track features of the needle. By taking advantage of the bevel tip, Circular Hough transform was used to accurately locate the needle tip when the imaging is out-of-plane. Through experiments inside tissue phantom and ex-vivo experiments in bovine kidney, the success of the proposed tracking methods were demonstrated. Using the methods presented in this work, quantitative information about the needle configuration is obtained in real-time which is crucial for generating control inputs for the needle and automating the needle insertion. PMID:25503523

  6. 24. A CORE WORKER DISPLAYS THE CORE BOX AND CORES ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. A CORE WORKER DISPLAYS THE CORE BOX AND CORES FOR A BRASS GATE VALVE BODY MADE ON A CORE BOX, CA. 1950. - Stockham Pipe & Fittings Company, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL

  7. [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.

  8. Remote Electromagnetic Vibration of Steerable Needles for Imaging in Power Doppler Ultrasound

    PubMed Central

    Cabreros, Sarah S.; Jimenez, Nina M.; Greer, Joseph D.; Adebar, Troy K.; Okamura, Allison M.

    2015-01-01

    Robotic needle steering systems for minimally invasive medical procedures require complementary medical imaging systems to track the needles in real time. Ultrasound is a promising imaging modality because it offers relatively low-cost, real-time imaging of the needle. Previous methods applied vibration to the base of the needle using a voice coil actuator, in order to make the needle visible in power Doppler ultrasound. We propose a new method for needle tip vibration, using electromagnetic actuation of small permanent magnets placed inside the needle to improve needle tip visibility in power Doppler imaging. Robotic needle insertion experiments using artificial tissue and ex vivo porcine liver showed that the electromagnetic tip vibration method can generate a stronger Doppler response compared to the previous base vibration method, resulting in better imaging at greater needle depth in tissue. It also eliminates previous issues with vibration damping along the shaft of the needle. PMID:26413379

  9. Shikimate dehydrogenase from Pinu sylvestris L. needles

    SciTech Connect

    Osipov, V.I.; Shein, I.V.

    1986-07-10

    Shikimate dehydrogenase was isolated by extraction from pine needles and partially purified by fractionation with ammonium sulfate. In conifers, in contrast to other plants, all three isoenzymes of shikimate dehydrogenase exhibit activity not only with NADP/sup +/, but also with NAD/sup +/. The values of K/sub m/ for shikimate, when NADP/sup +/ and NAD/sup +/ are used as cofactors, are 0.22 and 1.13 mM, respectively. The enzyme is maximally active at pH 10 with both cofactors. It is suggested that NAD-dependent shikimate dehydrogenase catalyzes the initial reaction of the alternative pathway of the conversion of shikimic acid to hydroxybenzoic acid. The peculiarities of the organization and regulation of the initial reactions of the shikimate pathway in conifers and in plants with shikimate dehydrogenase absolutely specific for NADP are discussed.

  10. Shear modulus estimation with vibrating needle stimulation.

    PubMed

    Orescanin, Marko; Insana, Michael

    2010-06-01

    An ultrasonic shear wave imaging technique is being developed for estimating the complex shear modulus of biphasic hydropolymers including soft biological tissues. A needle placed in the medium is vibrated along its axis to generate harmonic shear waves. Doppler pulses synchronously track particle motion to estimate shear wave propagation speed. Velocity estimation is improved by implementing a k-lag phase estimator. Fitting shear-wave speed estimates to the predicted dispersion relation curves obtained from two rheological models, we estimate the elastic and viscous components of the complex shear modulus. The dispersion equation estimated using the standard linear solid-body (Zener) model is compared with that from the Kelvin-Voigt model to estimate moduli in gelatin gels in the 50 to 450 Hz shear wave frequency bandwidth. Both models give comparable estimates that agree with independent shear rheometer measurements obtained at lower strain rates. PMID:20529711

  11. [Design of acupoint electric characteristic sensing needle].

    PubMed

    Liu, Tang-yi; Yang, Hua-yuan; Kuai, Le; Gao, Ming

    2007-09-01

    The electric characteristics of acupoints have been confirmed by researchers at home and abroad. Because the traditional detection methods are various (mainly are different positions of the reference electrode), and they are influenced by many affective factors, with unstable results and bad repeatability, so the studies of the electric characteristics of acupoints are limited. The acupoint electric characteristic sensing needle is introduced in detail from its design, detection methods and so on, which can detects changes of the acupoint electric characteristics of channels and acupoints in different healthy states real-timely, dynamically and continuously. It not only can avoid those affective factors, and also the detective results are relatively stable and the repeatability is also better.

  12. Fine-needle aspiration cytology in fibromatoses.

    PubMed

    Zaharopoulos, P; Wong, J Y

    1992-01-01

    Fine-needle aspiration (FNA) cytology was performed in seven cases of fibromatosis of variable types with tumorous clinical presentation. These included: four cases of musculoaponeurotic fibromatosis, two in posterior neck muscles, one in anterior neck muscles and one in intercostal muscles; one case of fibromatosis of the breast; and two cases of fibromatosis colli in neonates. In all cases the specimens contained connective tissue with many fibroblast-like cells, lacking features which could indicate a malignant lesion. The findings in these cases indicate that, although by FNA cytology in fibromatoses a specific diagnosis for each pathologic entity may not be easily reached, in the proper clinical setting the cytologic findings can be of sufficient relevance to offset the need for an open tissue biopsy, where there are valid reasons against a surgical intervention.

  13. NEP advocates urged: set up needle exchange.

    PubMed

    1995-12-01

    The Point Defiance AIDS Projects, founded in 1988, is a successful needle exchange program (NEP) in Tacoma, WA. Program director David Purchase's approach to potential community resistance is based on the theory that it is better to seek forgiveness than to beg permission. Since its inception, the program has faced two legal battles that have been resolved in favor of Point Defiance. The Washington State Supreme Court ruled that exchange programs should be exempted from state paraphernalia laws. Point Defiance employs three full-time staff members experienced with the drug-using community to conduct on-site exchanges. HIV seroprevalence among injection drug users has remained below five percent over the last five years. PMID:11362933

  14. Needle-based confocal laser endomicroscopy

    PubMed Central

    Giovannini, Marc

    2015-01-01

    New applications of confocal laser endomicroscopy were developed as pCLE in the bile duct and nCLE for pancreatic cystic tumors, pancreatic masses and lymph nodes. The aim of this paper would be to give you an update in this new technology and to try to define its place in the diagnosis of cystic and solid pancreatic masses. The material used was a 19G EUS-needle in which the stylet was replaced by the Confocal mini-probe. The mini-probe (0.632 mm of diameter) is pre-loaded and screwed by a locking device in the EUS-Needle and guided endosonographically in the target. Regarding pancreatic cystic lesion, the presence of epithelial villous structures based on nCLE was associated with pancreatic cystic neoplasm (IPMN) (P = 0.004) and provided a sensitivity of 59%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 50%. A superficial vascular network pattern visualized on nCLE was identified in serous cystadenomas. It corresponded on pathological specimen to a dense and subepithelial capillary vascularization. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of this sign for the diagnosis of SCA were 87%, 69%, 100%, 100%, and 82%, respectively. In pancreatic adenocarcinomas, nCLE found vascular leakage with irregular vessels with leakage of fluorescein into the tumor, large dark clumps which correspond to humps of malignant cells. These criteria correlate with the histological structure of those tumors which are characterized by tumoral glands, surrounded by fibrosis in case of fibrous stroma tumor. Neuroendocrine tumors showed a dense network of small vessels on a dark background, which fits with the histological structure based on cord of cells surrounded by vessels and by fibrosis. nCLE is feasible during a EUS examination; these preliminary results are very encouraging and may be used in the future in case of inconclusive EUS-FNA. PMID:26643694

  15. 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.

  16. In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle.

    PubMed

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

    2016-06-15

    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.

  17. Return Rates for Needle Exchange Programs: A Common Criticism Answered

    PubMed Central

    Ksobiech, Kate

    2004-01-01

    This study searched the available needle exchange program (NEP) literature for return rate data. A total of 26 articles were found. The overall worldwide return rate was 90%, although this ranged from a low of 15% to a high of 112%. U.S. NEP return rates were gathered from only eight studies, indicating a clear need for more data, although U.S. return rates were comparable to those from NEPs outside of the U.S. One underlying assumption made by opponents of NEPs is that IDUs will not return needles to the distribution site, thereby potentially increasing the risk of health problems to the surrounding community from exposure to contaminated needles. This study's results suggest that NEPs are relatively successful in taking in used needles, although it is generally unclear where the needles were originally acquired, and if IDUs return their own needles, or are returning needles for a social network. Ways for AIDS Service Organizations to capitalize on these brief encounters with IDUs, as well as public policy implications of the findings, are discussed. PMID:15169545

  18. Development of plasma needle to be used for biomedical applications

    NASA Astrophysics Data System (ADS)

    Bora, B.; Jain, J.; Inestrosa-Izurieta, M. J.; Avaria, G.; Moreno, J.; Pavez, C.; Marcelain, K.; Armisen, R.; Soto, L.

    2016-05-01

    Plasma needle is a novel design of a plasma source at atmospheric pressure to achieve a non-thermal plasma jet. The advantage of the plasma needle is that it can be operated in open air, outside a vessel. The plasma that is generated with the plasma needle is small (about one millimetre) and non-thermal, the temperature of the neutral particles and ions is in about room temperature and suitably can interact with living biological cell without damaging the cell. In this work, we report the development of a plasma needle, which is operated by a dc power source and produced a stable plasma jet on water surface. Argon gas is used to operate the plasma needle. The preliminary electrical diagnostics of the plasma needle shows that the discharge is filamentary in nature. For diagnostic of the plasma jet produced by the developed plasma needle, the produced plasma jet is directed to water surface and characterization are carried out by means of electrical discharge characteristics and optical emission spectroscopy. In this work, preliminary results of the diagnostic will be presented.

  19. In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle

    PubMed Central

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

    2016-01-01

    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. PMID:27301303

  20. Endobronchial ultrasound transbronchial needle aspiration: a hybrid method

    PubMed Central

    Ben, Suqin

    2015-01-01

    Background Conventional transbronchial needle aspiration (cTBNA) was first performed approximately 30 years ago; however TBNA was not widely adopted until the development of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA). Current EBUS-TBNA needle sizes are limited to 21- and 22-gauge. In order to determine whether a 19-gauge (19G) needle in EBUS-TBNA can further improve the diagnostic yield and simplify the methodology of EBUS-TBNA we developed a hybrid method. Here we report our initial experience in assessing the feasibility of performing EBUS-TBNA using a conventional 19G TBNA needle. Methods Ten patients with diagnosed or suspected lung cancer with or without lymphadenopathy (LAD) were sampled for diagnostic and/or staging purposes. Patients with suspected benign processes were sampled only for diagnosis. A 19G cTBNA needle was deployed through the working channel of the EBUS bronchoscope. Samples obtained were evaluated for cyto- and histopathologic adequacy. Results All 10 patients successfully underwent hybrid 19G EBUS-TBNA. All samples were considered adequate for cyto- and histopathologic evaluation. Conclusions Hybrid EBUS-TBNA utilizing a 19G cTBNA needle through an EBUS scope is feasible and may be able to reliably acquire histologic specimens. PMID:26807276

  1. Determination of Optimum Formalin Fixation Duration for Prostate Needle Biopsies for Immunohistochemistry and Quantum Dot FISH Analysis.

    PubMed

    Sathyanarayana, Ubaradka G; Birch, Chandler; Nagle, Raymond B; Tomlins, Scott A; Palanisamy, Nallasivam; Zhang, Wenjun; Hubbard, Antony; Brunhoeber, Patrick; Wang, Yixin; Tang, Lei

    2015-01-01

    Prostate biopsy is the key clinical specimen for disease diagnosis. However, various conditions used during biopsy processing for histologic analysis may affect the performance of diagnostic tests, such as hematoxylin and eosin (H&E) staining, immunohistochemistry (IHC), or in situ hybridization (ISH). One such condition that may affect diagnostic test performance is fixation duration in 10% neutral buffered formalin (NBF). For example, prostate needle biopsies are often <1 mm in diameter and thus overfixed. It is important to understand the impact of tissue fixation duration on diagnostic test performance to enable optimized assay procedures. This study was designed to study the effect of 10% NBF fixation duration of prostate needle biopsy on multiplexed quantum dot (QD) ISH assay of ERG and PTEN, 2 genes commonly altered in prostate cancer. The samples were also evaluated for H&E staining and ERG and PTEN IHC. H&E staining and ERG and PTEN IHC were acceptable for all the durations of fixation tested. For QD ISH, we observed good signals with biopsy samples fixed from 4 to 120 hours. Biopsy specimens fixed between 8 and 72 hours gave the best signal as scored by the study pathologist. In a separate cohort of 18 routinely processed prostate biopsy cores, all cores were stained successfully with the QD ISH assay, and results were 100% concordant to ERG and PTEN IHC. We conclude that 8 to 72 hours duration of fixation for prostate needle biopsies in 10% NBF results in optimal QD ISH assay performance.

  2. Do active safety-needle devices cause spatter contamination?

    PubMed

    Roff, M; Basu, S; Adisesh, A

    2014-03-01

    Exposure to blood and body fluids is an occupational hazard in healthcare. Although the potential for blood-borne virus transmission through needlestick injury has been widely studied, the risk of this occurring through spatter contamination from safety-needle syringes is not well understood. This report examines this risk from three commonly used safety needles and suggests that this presents a new and significant hazard. Further work should be commissioned to quantify this hazard and determine which type of safety needle would minimize spatter contamination following syringe discharge and safety activation.

  3. Robotic Image-Guided Needle Interventions of the Prostate

    PubMed Central

    Mozer, Pierre C; Partin, Alan W; Stoianovici, Dan

    2009-01-01

    Prostate biopsy and needle-directed prostate therapies are currently performed free-handed or with needle external templates under ultrasound guidance. Direct image-guided intervention robots are modern instruments that have the potential to substantially enhance these procedures. These may increase the accuracy and repeatability with which needles are placed in the gland. The authors’ group has developed a robot for precise prostate targeting that operates remotely alongside the patient in the magnetic resonance imaging scanner, as guided according to the image. PMID:19390670

  4. 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.

  5. 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.

  6. Determination of the Stoichiometry of the Complete Bacterial Type III Secretion Needle Complex Using a Combined Quantitative Proteomic Approach.

    PubMed

    Zilkenat, Susann; Franz-Wachtel, Mirita; Stierhof, York-Dieter; Galán, Jorge E; Macek, Boris; Wagner, Samuel

    2016-05-01

    Precisely knowing the stoichiometry of their components is critical for investigating structure, assembly, and function of macromolecular machines. This has remained a technical challenge in particular for large, hydrophobic membrane-spanning protein complexes. Here, we determined the stoichiometry of a type III secretion system of Salmonella enterica serovar Typhimurium using two complementary protocols of gentle complex purification combined with peptide concatenated standard and synthetic stable isotope-labeled peptide-based mass spectrometry. Bacterial type III secretion systems are cell envelope-spanning effector protein-delivery machines essential for colonization and survival of many Gram-negative pathogens and symbionts. The membrane-embedded core unit of these secretion systems, termed the needle complex, is composed of a base that anchors the machinery to the inner and outer membranes, a hollow filament formed by inner rod and needle subunits that serves as conduit for substrate proteins, and a membrane-embedded export apparatus facilitating substrate translocation. Structural analyses have revealed the stoichiometry of the components of the base, but the stoichiometry of the essential hydrophobic export apparatus components and of the inner rod protein remain unknown. Here, we provide evidence that the export apparatus of type III secretion systems contains five SpaP, one SpaQ, one SpaR, and one SpaS. We confirmed that the previously suggested stoichiometry of nine InvA is valid for assembled needle complexes and describe a loose association of InvA with other needle complex components that may reflect its function. Furthermore, we present evidence that not more than six PrgJ form the inner rod of the needle complex. Providing this structural information will facilitate efforts to obtain an atomic view of type III secretion systems and foster our understanding of the function of these and related flagellar machines. Given that other virulence

  7. Core layering

    NASA Astrophysics Data System (ADS)

    Jacobson, S. A.; Rubie, D. C.; Hernlund, J. W.; Morbidelli, A.

    2015-12-01

    We have created a planetary accretion and differentiation model that self-consistently builds and evolves Earth's core. From this model, we show that the core grows stably stratified as the result of rising metal-silicate equilibration temperatures and pressures, which increases the concentrations of light element impurities into each newer core addition. This stable stratification would naturally resist convection and frustrate the onset of a geodynamo, however, late giant impacts could mechanically mix the distinct accreted core layers creating large homogenous regions. Within these regions, a geodynamo may operate. From this model, we interpret the difference between the planetary magnetic fields of Earth and Venus as a difference in giant impact histories. Our planetary accretion model is a numerical N-body integration of the Grand Tack scenario [1]—the most successful terrestrial planet formation model to date [2,3]. Then, we take the accretion histories of Earth-like and Venus-like planets from this model and post-process the growth of each terrestrial planet according to a well-tested planetary differentiation model [4,5]. This model fits Earth's mantle by modifying the oxygen content of the pre-cursor planetesimals and embryos as well as the conditions of metal-silicate equilibration. Other non-volatile major, minor and trace elements included in the model are assumed to be in CI chondrite proportions. The results from this model across many simulated terrestrial planet growth histories are robust. If the kinetic energy delivered by larger impacts is neglected, the core of each planet grows with a strong stable stratification that would significantly impede convection. However, if giant impact mixing is very efficient or if the impact history delivers large impacts late, than the stable stratification can be removed. [1] Walsh et al. Nature 475 (2011) [2] O'Brien et al. Icarus 223 (2014) [3] Jacobson & Morbidelli PTRSA 372 (2014) [4] Rubie et al. EPSL 301

  8. Quantification of prostate deformation due to needle insertion during TRUS-guided biopsy: comparison of hand-held and mechanically stabilized systems

    NASA Astrophysics Data System (ADS)

    De Silva, Tharindu; Bax, Jeffrey; Fenster, Aaron; Samarabandu, Jagath; Ward, Aaron D.

    2011-03-01

    Prostate biopsy is the clinical standard for the definitive diagnosis of prostate cancer. To overcome the limitations of 2D TRUS-guided biopsy systems when targeting pre-planned locations, systems have been developed with 3D guidance to improve the accuracy of cancer detection. Prostate deformation due to needle insertion and biopsy gun firing is a potential source of error that can cause target misalignments during biopsies. We use non-rigid registration of 2D TRUS images to quantify the deformation during the needle insertion and the biopsy gun firing procedure, and compare this effect in biopsies performed using a handheld TRUS probe with those performed using a mechanically assisted 3D TRUS guided biopsy system. Although the mechanically assisted biopsy system had a mean deformation approximately 0.2 mm greater than that of the handheld approach, it yielded a lower relative increase of deformation near the needle axis during the needle insertion stage and greater deformational stability of the prostate during the biopsy gun firing stage. We also analyzed the axial and lateral components of the tissue motion; our results indicated that the motion is weakly biased in the direction orthogonal to the needle, which is less than ideal from a targeting standpoint given the long, narrow cylindrical shape of the biopsy core.

  9. Clinical management of needle-phobia patients requiring acupuncture therapy.

    PubMed

    Lu, D P; Lu, G P

    1999-01-01

    Both acupuncture and hypnosis have their distinct applications in the health profession, but combining acupuncture therapy with hypnosis has rarely been done for the purpose of therapeutic treatment, perhaps because few clinicians have proper training in both disciplines. For needle phobic patients, acupuncture treatment can be a dreadful experience, as multiple needles are usually used. It is stressful for both clinicians and patients when the patients are put in an extremely apprehensive state. Our research for combining both acupuncture and hypnosis has revealed that synergy does exist in both, and that hypnosis does augment the effect of acupuncture, resulting in better treatment outcomes. Since many acupuncture patients who are needle phobic do not return for further treatment even though acupuncture has rendered good therapeutic results for them, stress reduction with hypnosis is, therefore, a welcome complimentary adjunct that would enable them to return for further needed acupuncture treatment if and when the factor of fear of the needle is removed. PMID:10768416

  10. NEEDLE ANATOMY CHANGES WITH INCREASING TREE AGE IN DOUGLAS FIR

    EPA Science Inventory

    Morphological differences between old growth and sapling (Pseudotsuga menziesii, (Mirb.) Franco) Douglas fir trees may extend to differences in needle anatomy. We used microscopy with image analysis to compare and quantify anatomical parameters in cross-sections of previous year...

  11. [Doctor HUANG Shi-ping's acupuncture with golden needles].

    PubMed

    Chen, Teng-Fei; Ma, Zeng-Bin; Xin, Si-Yuan; Zhu, Jiang

    2013-08-01

    Taking Doctor HUANG Shi-ping as the representative, the school of Huang's golden needle is based on Chinese martial art. Golden needles are adopted as main tool. Attaching great importance on the combination of acupuncture and moxibustioin, it is also characterized with penetrating needling with long needles. Through the development of three generations, it once outshone other schools in the field of acupuncture, and became famous all over the world. It made great contribution to the development of the course of acupuncture. However, with the development of the history, the form of acupuncture education as well as apparatus were all undergone an unified reform. Therefore, Doctor HUANG Shi-ping's acupuncture school be lost gradually.

  12. [Infection of a hip prosthesis after dry needling].

    PubMed

    Steentjes, Koen; de Vries, Lieke M A; Ridwan, Ben U; Wijgman, A J Jurgen

    2016-01-01

    A 57-year-old patient presented to the orthopaedic department with hip pain 7 months after hip replacement and two weeks after dry needling by a physiotherapist. Dry needling is used by physiotherapists to treat pain and stiffness. In the Netherlands, there are no clear guidelines or contra-indications described for this treatment. The surgical scar of our patient showed signs of inflammation for which debridement and irrigation were performed. Tissue samples showed positive bacterial cultures and the patient was treated with antibiotics. One week after completing this treatment, the infection returned. Debridement and irrigation were repeated and antibiotic treatment was recommenced. Three months later, the patient showed no signs of infection with the prosthesis still in situ. Although there is no strong evidence for a causal relationship between dry needling and the infection, dry needling should be used carefully in patients with a joint replacement, due to the increased risk of infection. PMID:26786794

  13. 10. NEEDLE SHOWER IN COOLING ROOM. Hot Springs National ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. NEEDLE SHOWER IN COOLING ROOM. - Hot Springs National Park, Bathhouse Row, Fordyce Bathhouse: Mechanical & Piping Systems, State Highway 7, 1 mile north of U.S. Highway 70, Hot Springs, Garland County, AR

  14. 9. NEEDLE SHOWER IN MEN'S PACK ROOM. Hot Springs ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. NEEDLE SHOWER IN MEN'S PACK ROOM. - Hot Springs National Park Bathhouse Row, Maurice Bathhouse: Mechanical & Piping Systems, State Highway 7, 1 mile north of U.S. Highway 70, Hot Springs, Garland County, AR

  15. 64. Penstock housing with outlet needle valve at lower left. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    64. Penstock housing with outlet needle valve at lower left. Roadway support work is visible at top. Photographer Mark Durben. Source: Salt River Project. - Waddell Dam, On Agua Fria River, 35 miles northwest of Phoenix, Phoenix, Maricopa County, AZ

  16. 21 CFR 880.5570 - Hypodermic single lumen needle.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below the... an intravascular administration set. (b) Classification. Class II (performance standards)....

  17. CT-guided percutaneous needle placement in forensic medicine.

    PubMed

    Hyodoh, Hideki; Shimizu, Jyunya; Mizuo, Keisuke; Okazaki, Shunichiro; Watanabe, Satoshi; Inoue, Hiromasa

    2015-03-01

    We have developed a technique of CT-guided needle placement in the destructed human body in forensic practice. A sixty-year-old male was found in a burned car and he was also destructed severely. Although blood was needed for the external examination, it was difficult to approach the vessels because of the severely burned condition of the cadaver. Thus, we attempted to obtain a blood sample from a vessel using a CT-guided technique. Postmortem CT demonstrated the presence of blood-containing vessels in the pelvis. Indeed, CT-guided needle placement had no difficulty with surface markers, table location, or depth measurement from the surface. CT-guide needle placement is a feasible and reliable technique, so that when the tissue/blood sample is at risk of being spoiled, CT-guided needle placement could be a substitute for conventional sampling techniques.

  18. 24. DETAIL VIEW OF NEEDLE BEAM. NOTE THE WIRE ROPE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. DETAIL VIEW OF NEEDLE BEAM. NOTE THE WIRE ROPE TIED AROUND THE HANGER CABLE AND THE RAILING POST. March 1987 - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  19. Ralph L. Huber, DMD: forgotten inventor of the "Tuohy" needle.

    PubMed

    Lubisich, Josef W

    2004-07-01

    The hypodermic needle popularized by Edward Tuohy, MD for use in his method of continuous spinal anesthesia has been incorrectly called the "Tuohy needle" since he first popularized it in 1945. It was recently determined that Ralph L. Huber, a Seattle dentist, was the inventor of this widely used needle. However, very little is known about Huber. There is no mention of him in the medical literature, and until recently, he was forgotten. Through the location of various primary sources, including the original needle point invented by Dr. Huber, this essay introduces the fascinating life of Dr. Huber, and also his personal notes about his inventions. Not only was he a prominent Seattle dentist, but also a prolific inventor.

  20. Dry needling as a method of tendinopathy treatment.

    PubMed

    Nagraba, Łukasz; Tuchalska, Julia; Mitek, Tomasz; Stolarczyk, Artur; Deszczyński, Jarosław

    2013-01-01

    Tendinopathy is a broad concept that describes any painful condition that occurs in or around a tendon.The ideal treatment for tendinopathy is still nebulous. Dry needling is a treatment method in which a special needle is placed into the focus of tendinosis. The aim of this procedure is to form fenestrations which may initiateadvantageous bleeding and thus bring about the influx of growth factors (activating healing and regeneration). Relevant clinical studies have often combineddry needling with autologous blood injection therapy. Results from these studies are encouraging. This review of English-language literature aims to present this noteworthy method of tendino- and enthesopathytreatmentm by describing the results of several trials, hypotheses explaining the underlying mechanism and the application of dry needling in other fields of medicine.

  1. 20. GENERATOR #1 NEEDLE VALVE CONTROL WHEEL, WATERWHEEL GOVERNOR, PENSTOCK ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    20. GENERATOR #1 NEEDLE VALVE CONTROL WHEEL, WATERWHEEL GOVERNOR, PENSTOCK PRESSURE GAUGE, AND GOVERNOR OIL SET. VIEW TO EAST. - Santa Ana River Hydroelectric System, SAR-2 Powerhouse, Redlands, San Bernardino County, CA

  2. Pressure valve for needle gate valve control. June 13, 1913. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Pressure valve for needle gate valve control. June 13, 1913. Photocopy of original drawing. Drawing on file at the Salt River Project Archives. Phoenix, Arizona - Cross Cut Hydro Plant, North Side of Salt River, Tempe, Maricopa County, AZ

  3. 60. NEEDLE AND NOZZLE TIP, SANTA ANA NO. 1, SOUTHERN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    60. NEEDLE AND NOZZLE TIP, SANTA ANA NO. 1, SOUTHERN CALIFORNIA EDISON CO., APR. 28, 1910, REVISED MAY 12, 1910. SCE drawing no. 4500. - Santa Ana River Hydroelectric System, SAR-1 Powerhouse, Redlands, San Bernardino County, CA

  4. 10. NEEDLE SHOWER IN WOMEN'S PACK ROOM. Hot Springs ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. NEEDLE SHOWER IN WOMEN'S PACK ROOM. - Hot Springs National Park, Bathhouse Row, Lamar Bathhouse: Mechanical & Piping Systems, State Highway 7, 1 mile north of U.S. Highway 70, Hot Springs, Garland County, AR

  5. 8. DETAIL VIEW OF NEEDLE BEAMGUY CONNECTION AND PIVOTS, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. DETAIL VIEW OF NEEDLE BEAM-GUY CONNECTION AND PIVOTS, LOOKING NORTHWEST - Mystic River Drawbridge No. 7, Spanning Mystic River at Boston & Maine Railroad Eastern Route, Somerville, Middlesex County, MA

  6. 48. AUTOMATIC WATER CONTROL MOTOR DRIVE FOR NEEDLES CONSTRUCTION DETAILS, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    48. AUTOMATIC WATER CONTROL MOTOR DRIVE FOR NEEDLES CONSTRUCTION DETAILS, SANTA ANA RIVER NO. 2, JAN. 24, 1977. SCE drawing no. 455667-0. - Santa Ana River Hydroelectric System, SAR-2 Powerhouse, Redlands, San Bernardino County, CA

  7. 10. DETAIL VIEW OF NEEDLE BEAMGUY CONNECTIONS, EAST ELEVATION, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. DETAIL VIEW OF NEEDLE BEAM-GUY CONNECTIONS, EAST ELEVATION, LOOKING SOUTHWEST - Mystic River Drawbridge No. 7, Spanning Mystic River at Boston & Maine Railroad Eastern Route, Somerville, Middlesex County, MA

  8. Miniature oxygen-hydrogen cutting torch constructed from hypodermic needle

    NASA Technical Reports Server (NTRS)

    Shlichta, P.

    1964-01-01

    A miniature cutting torch consisting of a main body member, upon which the hydrogen and oxygen containers are mounted, valves for controlling gas flow, and a hypodermic needle that acts as a mixing tube and flame tip is constructed.

  9. Enterobacter aerogenes Needle Stick Leads to Improved Biological Management System

    SciTech Connect

    Johanson, Richard E.

    2004-08-01

    A laboratory worker who received a needle stick from a contaminated needle while working with a culture containing Enterobactor aerogenes developed a laboratory acquired infection. Although this organism has been shown to cause community and nosocomial infections, there have been no documented cases of a laboratory acquired infections. Lessons learned from the event led to corrective actions which included modification of lab procedures, development of a biological inventory tracking and risk identification system and the establishment of an effective biological safety program.

  10. Electrochemical corrosion of STS304 acupuncture needles by electrical stimulation.

    PubMed

    Hwang, Hye Suk; Yang, Eun Jin; Ryu, Yeon Hee; Lee, Myeong Soo; Choi, Sun-Mi

    2010-06-01

    We present the first investigation of electrical corrosion in acupuncture needles after electrical stimulation. Using scanning electron microscopy, we observed the occurrence of electrochemical corrosion on the surface of stainless steel 304 acupuncture needles after electrical stimulation in the tibial muscles of rats. Biphasic pulse electrical stimuli with 10-Hz frequency, 1-mA intensity and 1-ms pulse width were applied to the needles. The terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method labels fragmented DNA. Positive staining using this test indicates apoptotic cells in electrically stimulated tissues. The risk of electrical corrosion was found to be less in bipolar, short-duration, low-current or voltage and short-period stimulation than in monopolar, long-duration, high-current or voltage and long-period stimulation. Evaluation with a scanning electron microscope revealed that electrical stimulation can increase the electrical corrosion of stainless steel 304 acupuncture needles. In biocompatibility studies of stainless steel 304 acupuncture needles for electrical stimulation, TUNEL-positive cells were detected in the tibial muscle within 5 days after electrical stimulation. The results of this study demonstrate that the corrosion products of stainless steel 304 acupuncture needles might affect the post-electrical stimulation tissue response. PMID:20633521

  11. Nursing and safety of silver needle diathermy treating ankylosing spondylitis.

    PubMed

    Ning, Huaxiu; Wang, Yun; Yuan, Yiwen; Ning, Huaying

    2015-03-01

    This paper aims to discuss the nursing and safety of silver needle diathermy in the treatment for ankylosing spondylitis. We nursed 46 patients with ankylosing spondylitis treated with silver needle diathermy. Specific nursing was focused on physical condition evaluation and mental nursing before treatment, observation during and after treatment, diet nursing, needle eye nursing, functional training and propaganda and education when discharged. The result suggested that all the patients received mental nursing, diet guide, skin care, health education, functional training and follow-up visit from the nurse and all of them could endure silver needle diathermy as discomfort or drug allergy was barely found, so were slight scald and skin infection nearby the needle eye caused by fainting during acupuncture, accidental puncture or overheat. Follow-up visit showed that no patient suffered obvious untoward effect and the pain, joint range of motion and living condition were distinctly improved a week after discharging. In conclusion, during the treatment for ankylosing spondylitis applying silver needle diathermy, the nursing before, during and after the treatment can obviously reduce the complication, accelerate the recovery, which is highly safe.

  12. Neuromuscular Damage and Repair after Dry Needling in Mice

    PubMed Central

    Domingo, Ares; Mayoral, Orlando; Monterde, Sonia; Santafé, Manel M.

    2013-01-01

    Objective. Some dry needling treatments involve repetitive and rapid needle insertions into myofascial trigger points. This type of treatment causes muscle injury and can also damage nerve fibers. The aim of this study is to determine the injury caused by 15 repetitive punctures in the muscle and the intramuscular nerves in healthy mouse muscle and its ulterior regeneration. Methods. We repeatedly needled the levator auris longus muscle of mice, and then the muscles were processed with immunohistochemistry, methylene blue, and electron microscopy techniques. Results. Three hours after the dry needling procedure, the muscle fibers showed some signs of an inflammatory response, which progressed to greater intensity 24 hours after the procedure. Some inflammatory cells could still be seen when the muscle regeneration was almost complete seven days after the treatment. One day after the treatment, some changes in the distribution of receptors could be observed in the denervated postsynaptic component. Reinnervation was complete by the third day after the dry needling procedure. We also saw very fine axonal branches reinnervating all the postsynaptic components and some residual sprouts the same day. Conclusion. Repeated dry needling punctures in muscle do not perturb the different stages of muscle regeneration and reinnervation. PMID:23662122

  13. Improvement of needle type applicator made of shape memory alloy.

    PubMed

    Kanazawa, Y; Kato, K; Yabuhara, T; Uzuka, T; Takahashi, H; Fujii, Y

    2008-01-01

    This paper discusses radio frequency (RF) interstitial hyperthermia for brain tumors with a developed needle type applicator made of a shape memory alloy (SMA). The problem with the heating method of interstitial hyperthermia is the small heating area. So, we proposed a new heating method using a needle type electrode made of SMA which consists of nickel (Ni), copper (Cu) and titanium (Ti) for expanding the heating area. Here, we proposed the heating method that the leading end of needle type electrode was divided into four parts and the leading end spreads in four directions with a temperature rise. First, the proposed RF interstitial hyperthermia system with the SMA needle was presented. Second, the results obtained by the experimental heating of the agar phantom by using the developed SMA needle type applicator were presented. Third, comparing experimental results, we discussed the heating properties of the developed system. Finally, from these results, it is confirmed that the developed needle type applicator made of SMA is useful for wide heating by invasive hyperthermia.

  14. 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. PMID:17474862

  15. Fine needle aspiration biopsy of thyroid nodules

    PubMed Central

    Arda, I; Yildirim, S; Demirhan, B; Firat, S

    2001-01-01

    BACKGROUND—Fine needle aspiration biopsy (FNA) is a routine diagnostic technique for evaluating thyroid nodules. Many reports in adults consider that FNA is superior to thyroid ultrasonography (USG) and radionuclide scanning (RS). Only five studies have been published on FNA of childhood thyroid nodules.
AIMS—To investigate the reliability of FNA in the evaluation and management of thyroid nodules, and compare the results of FNA, USG, and RS with regard to final histopathological diagnosis.
METHODS—FNA was performed in 46 children with thyroid nodules after USG and RS examination. We investigated the sensitivity, specificity, accuracy, and positive and negative predictive values of USG, RS, and FNA in their management.
RESULTS—Six patients who had malignant or suspicious cells on FNA examination underwent immediate surgery. The other 40 patients received medical treatment according to their hormonal status. Fifteen of these nodules either disappeared or decreased in number and/or size. Surgery was performed in 25 patients who did not respond to therapy. Statistical analysis revealed sensitivity, specificity, accuracy, and positive and negative predictive values respectively as follows: 60%, 59%, 59%, 15%, and 92% for USG; 30%, 42%, 39%, 12%, and 68% for SC; 100%, 95%, 95%, 67%, and 100% for FNAB.
CONCLUSION—FNAB is as reliable in children as in adults for definitive diagnosis of thyroid nodules. Using this technique avoids unnecessary thyroid surgery in children.

 PMID:11567941

  16. Hollow needle cataract aspiration in antiquity.

    PubMed

    Pérez-Cambrodí, Rafael J; Ascaso, Francisco J; Diab, Fathi; Alzamora-Rodríguez, Antonio; Grzybowski, Andrzej

    2015-12-01

    The dislocation of the crystalline lens or couching technique was the predominant procedure to surgically remove cataracts until the 18th century A.D. However, in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis. Some literary sources attributed the origins of this technique to Antyllus of Alexandria, a Greek surgeon who lived in the 2nd century A.D. in the Roman Empire. Nevertheless, this statement remains unclear and is probably the consequence of posterior interpretations or incorrect translations of the manuscripts. In recent years, the discovery of the hollow needles from Montbellet (France) and Viladamat (Spain), in archaeological settlements dated between the 1st century and 3rd century A.D., has reopened the possibility of cataract extraction as an option in the surgical management of soft cataracts in the antiquity. In any case, these findings are exceptional, and thus, probably this technique was not widely practised and very likely disparaged by the medical community. PMID:26385516

  17. Micro-needle electro-tactile display.

    PubMed

    Tezuka, Mayuko; Kitamura, Norihide; Miki, Norihisa

    2015-08-01

    Haptic feedback is strongly demanded for high-precision robot-assisted surgery and teleoperation. The haptic feedback consists of force and tactile feedback, however tactile feedback has been little studied and the size and weight of the system poses challenges for practical applications. In this paper we propose a sheet-type wearable electro-tactile display which provides tactile sensations to the user as the feedback at a low voltage and power consumption. The display possesses needle-shaped electrodes, which can penetrate through the high-impedance stratum corneum. We developed the fabrication process and, as the first step, we investigated the tactile sensation that can be created to the fingertip by the display. Rough and smooth surfaces were successfully presented to the user. Then, we characterized the tactile display when used on the forearm, in particular, with respect to the spatial resolution. These tactile displays can be used to inform the user of the surface property of the parts of interest, such as tumor tissues, and to guide him in the manipulation of surgery robots. PMID:26737606

  18. Micro-needle electro-tactile display.

    PubMed

    Tezuka, Mayuko; Kitamura, Norihide; Miki, Norihisa

    2015-08-01

    Haptic feedback is strongly demanded for high-precision robot-assisted surgery and teleoperation. The haptic feedback consists of force and tactile feedback, however tactile feedback has been little studied and the size and weight of the system poses challenges for practical applications. In this paper we propose a sheet-type wearable electro-tactile display which provides tactile sensations to the user as the feedback at a low voltage and power consumption. The display possesses needle-shaped electrodes, which can penetrate through the high-impedance stratum corneum. We developed the fabrication process and, as the first step, we investigated the tactile sensation that can be created to the fingertip by the display. Rough and smooth surfaces were successfully presented to the user. Then, we characterized the tactile display when used on the forearm, in particular, with respect to the spatial resolution. These tactile displays can be used to inform the user of the surface property of the parts of interest, such as tumor tissues, and to guide him in the manipulation of surgery robots.

  19. Hollow needle cataract aspiration in antiquity.

    PubMed

    Pérez-Cambrodí, Rafael J; Ascaso, Francisco J; Diab, Fathi; Alzamora-Rodríguez, Antonio; Grzybowski, Andrzej

    2015-12-01

    The dislocation of the crystalline lens or couching technique was the predominant procedure to surgically remove cataracts until the 18th century A.D. However, in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis. Some literary sources attributed the origins of this technique to Antyllus of Alexandria, a Greek surgeon who lived in the 2nd century A.D. in the Roman Empire. Nevertheless, this statement remains unclear and is probably the consequence of posterior interpretations or incorrect translations of the manuscripts. In recent years, the discovery of the hollow needles from Montbellet (France) and Viladamat (Spain), in archaeological settlements dated between the 1st century and 3rd century A.D., has reopened the possibility of cataract extraction as an option in the surgical management of soft cataracts in the antiquity. In any case, these findings are exceptional, and thus, probably this technique was not widely practised and very likely disparaged by the medical community.

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

    PubMed Central

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

    2014-01-01

    Objectives 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. Methods 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. Results 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. Conclusions 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. PMID:24522003

  1. 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.

  2. Impact of Needle Diameter on Long-Term Dry Needling Treatment of Chronic Lumbar Myofascial Pain Syndrome

    PubMed Central

    Wang, Gang; Gao, Qian; Li, Jun; Tian, Yuling; Hou, Jingshan

    2016-01-01

    ABSTRACT Objective To investigate the impact of diameter of needles on the effect of dry needling treatment of chronic lumbar myofascial pain syndrome. Design Forty-eight patients with chronic lumbar myofascial pain syndrome were randomly allocated to 3 groups. They received dry needling with needles of diameter 0.25 (group A), 0.5 (group B), and 0.9 mm (group C). Visual analog scale evaluation and health survey were conducted at baseline and 3 months after the treatment. Results Visual analog scale scores were significantly different in all groups from baseline to 3 months. Visual analog scale scores at 3 months showed differences between group C and the other 2 groups. When baseline and 3 months after treatment (0 day and 3 months) in each of the 3 groups was compared, there was a difference between group C and group B. The Short Form (36) Health Survey scores from baseline to 3 months were different within the treatment groups. Conclusions Visual analog scale score evaluations at 3 months showed efficacy in all groups. Results of 3 months showed that efficacy of treatment with larger needles (0.9-mm diameter) was better than that of smaller ones (0.5-mm diameter). The Short Form (36) Health Survey scores at 3 months indicated that treatments with needles of varying diameters were all effective, and when the results of 3 months were compared, there was no difference between the 3 groups. PMID:27333534

  3. 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. PMID:1467102

  4. Processing of needle rinse material from fine-needle aspirations rarely detects malignancy not identified in smears.

    PubMed

    Henry-Stanley, M J; Stanley, M W

    1992-01-01

    When preparing FNA smears, we recover material left in the needle hub by forcefully striking the open hub against a slide. Material in the syringe tip is expressed by repeated forceful blasts of air (needle unattached). We investigated the utility of recovering additional material by rinsing the needle and syringe. Saline was used to flush the needle and syringe tip repeatedly. All material was processed by cytocentrifugation. We studied 159 needle rinse (NR) specimens from 152 patients (breast = 70, lymph node = 30, lung = 15, soft tissue = 14, salivary gland = 12, thyroid = 12, liver = 5, branchial cleft cyst = 1). Malignancy was identified in 21 FNAs (13%) from 21 patients (14%). All were diagnosed in smears (9 lung, 5 liver, 4 lymph node, 2 breast, 1 soft tissue). NR material identified 16 of these (76%). No case with benign smears (n = 138) showed malignancy in NR material. We conclude that if good technique is applied to preparation of smears and recovery of material from the needle hub and syringe tip, NR material will rarely identify additional malignancies. It thus represents an inefficient allocation of technical and human resources within the laboratory. However, NR may provide additional slides for special stains and may be useful for clinicians who do not always prepare high quality smears. Furthermore, the ease with which FNA of palpable masses can be repeated suggests that in the small number of cases requiring special stains, additional material can be readily obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Modeling Cryotherapy Ice Ball Dimensions and Isotherms in a Novel Gel-based Model to Determine Optimal Cryo-needle Configurations and Settings for Potential Use in Clinical Practice

    PubMed Central

    Shah, Taimur T.; Arbel, Uri; Foss, Sonja; Zachman, Andrew; Rodney, Simon; Ahmed, Hashim U.; Arya, Manit

    2016-01-01

    Objective To gain a better understanding of ice ball dimensions and temperature isotherms relevant for cell kill when using combinations of cryo-needles we set out to answer 4 questions: (1) what type of cryo-needle? (2) how many needles? (3) best spatial configuration? and (4) correct duty cycle percentage? Methods We conducted laboratory experiments to monitor ice ball dimensions and create multi-needle planar isotherm maps for 17G and 10G cryo-needles using a novel multi-needle thermocouple fixture within gel at body temperature. We tested configurations of 1-4 cryo-needles at duty cycles of 20%-100% with 1-2.5 cm spacing. Results Analysis of various combinations shows that a central core of ≤−40°C develops at a distance of ~1 cm around the cryo-needles. Temperature increases linearly from this point to the ice ball leading edge (0°C), which is a further ≈1 cm away. Thus, the −40°C isotherm is approximately 1 cm inside the leading edge of the ice ball. The optimum distance between cryo-needles was 1.5-2 cm, at duty cycle settings of 70%-100%. At distances further apart or with lower duty cycle settings, ice balls either had a central core >−40°C or had an hourglass shape. Conclusion In answer to questions 1-3, tumor length, diameter, and shape will ultimately determine the number of needles and their configuration. However, we propose a conservative distance for cryo-needle placement between 1 and 1.5 cm should be adopted for clinical practice. In answer to question 4, using low duty cycle settings runs the risk of incomplete −40°C isotherm coverage of the tumor, and thus in routine practice we suggest that settings of 70%-100% are most appropriate. PMID:26902833

  6. Fine needle aspiration biopsy of fibromatoses.

    PubMed

    Raab, S S; Silverman, J F; McLeod, D L; Benning, T L; Geisinger, K R

    1993-01-01

    Fibromatoses form a spectrum of clinicopathologic entities characterized by the infiltrative proliferation of fibroblasts that lack malignant cytologic features. Fibromatoses present as nodular soft tissue masses almost anywhere in the body and thus are often amenable to fine needle aspiration (FNA). This report describes the FNA cytologic findings of fibromatosis in six patients ranging in age from 7 1/2 weeks to 36 years. Two of the lesions arose in the abdominal wall (musculoaponeurotic fibromatosis or extra-abdominal desmoid), and one each involved the plantar surface (Ledderhose's disease), the shoulder and the sternocleidomastoid muscle (Fibromatosis coli). The FNA of the shoulder was initially interpreted as nodular fasciitis due to the clinical presentation of a rapidly growing mass; an aspirate from the deep musculoaponeurotic region was believed to reveal a low grade sarcoma. The FNA diagnosis of musculoaponeurotic fibromatosis in a patient with familial polyposis coli suggested the diagnosis of Gardner's syndrome. Cytologically the aspirates consisted of groups of loosely cohesive, bland-appearing, spindle-shaped cells having oval to elongated nuclei and cytoplasmic tags. Individual spindle cells and rare inflammatory cells were also present. The aspirate of fibromatosis coli also contained degenerating skeletal muscle cells. Tissue confirmation was obtained in four cases. We believe that FNA is a useful procedure for the initial and recurrent diagnosis of fibromatoses and in the separation of fibromatoses from other benign and malignant soft tissue lesions. A discussion of other entities that enter into the cytologic differential diagnosis, such as mesenchymal repair, fasciitis and spindle cell types of sarcoma, is presented. From our experience we believe that the clinicopathologic features can suggest the diagnosis of fibromatosis, but histologic confirmation is recommended.

  7. Syringe and needle exchange programs: Part I.

    PubMed

    Schwartz, R H

    1993-03-01

    Syringe and needle exchange (SANE) programs appear to be a pragmatic approach to reducing the rising incidence of human immunodeficiency virus (HIV) infection among intravenous drug users (IVDUs). One purported indication of the effectiveness of SANE programs is lower prevalence rates of cases of AIDS or of HIV seropositivity in cities with SANE programs than in cities without such programs. In each positive comparison cited, however, the lower levels of HIV seropositivity were already present before the establishment of SANE programs. A second indicator of SANE effectiveness is a reduction in prevalence of hepatitis B in SANE program participants. Multiple factors working in concert, not simply the SANE programs, however, account for such progress; such factors include reductions in sharing of uncleaned injection equipment; legal exchange or sale of syringes at pharmacies; regular rinsing of used "works" with bleach; and epidemiologic fluctuations in the prevalence or a saturation level of the hepatitis B virus in IVDUs. A third indicator of the value of SANE programs is that they enable some otherwise unreachable IVDUs to make contact with a social or health facility. SANE programs do not facilitate the induction of new IVDUs or increase the frequency of injection by older addicts. From 60% to 90% of SANE attenders will return borrowed used injection equipment. Most participants reported that they reduced the frequency of lending or borrowing unclean injection equipment. Counterbalancing the above, SANE programs attract only a minority of all IVDUs in most cities, and they fail to attract the youngest subset of IVDUs. The attrition rate is high; only a small percentage of attenders remain with the program for more than a few months. Although many of the initial concerns about SANE programs have not been realized and there have been important public health gains to those who continue to attend them, SANE programs deserve more careful, unbiased, longitudinal

  8. Transthoracic needle biopsy of the lung

    PubMed Central

    DiBardino, David M.; Yarmus, Lonny B.

    2015-01-01

    Background Image guided transthoracic needle aspiration (TTNA) is a valuable tool used for the diagnosis of countless thoracic diseases. Computed tomography (CT) is the most common imaging modality used for guidance followed by ultrasound (US) for lesions abutting the pleural surface. Novel approaches using virtual CT guidance have recently been introduced. The objective of this review is to examine the current literature for TTNA biopsy of the lung focusing on diagnostic accuracy and safety. Methods MEDLINE was searched from inception to October 2015 for all case series examining image guided TTNA. Articles focusing on fluoroscopic guidance as well as influence of rapid on-site evaluation (ROSE) on yield were excluded. The diagnostic accuracy, defined as the number of true positives divided by the number of biopsies done, as well as the complication rate [pneumothorax (PTX), bleeding] was examined for CT guided TTNA, US guided TTNA as well as CT guided electromagnetic navigational-TTNA (E-TTNA). Of the 490 articles recovered 75 were included in our analysis. Results The overall pooled diagnostic accuracy for CT guided TTNA using 48 articles that met the inclusion and exclusion criteria was 92.1% (9,567/10,383). A similar yield was obtained examining ten articles using US guided TTNA of 88.7% (446/503). E-TTNA, being a new modality, only had one pilot study citing a diagnostic accuracy of 83% (19/23). Pooled PTX and hemorrhage rates were 20.5% and 2.8% respectively for CT guided TTNA. The PTX rate was lower in US guided TTNA at a pooled rate of 4.4%. E-TTNA showed a similar rate of PTX at 20% with no incidence of bleeding in a single pilot study available. Conclusions Image guided TTNA is a safe and accurate modality for the biopsy of lung pathology. This study found similar yield and safety profiles with the three imaging modalities examined. PMID:26807279

  9. Atomic model of the type III secretion system needle.

    PubMed

    Loquet, Antoine; Sgourakis, Nikolaos G; Gupta, Rashmi; Giller, Karin; Riedel, Dietmar; Goosmann, Christian; Griesinger, Christian; Kolbe, Michael; Baker, David; Becker, Stefan; Lange, Adam

    2012-05-20

    Pathogenic bacteria using a type III secretion system (T3SS) to manipulate host cells cause many different infections including Shigella dysentery, typhoid fever, enterohaemorrhagic colitis and bubonic plague. An essential part of the T3SS is a hollow needle-like protein filament through which effector proteins are injected into eukaryotic host cells. Currently, the three-dimensional structure of the needle is unknown because it is not amenable to X-ray crystallography and solution NMR, as a result of its inherent non-crystallinity and insolubility. Cryo-electron microscopy combined with crystal or solution NMR subunit structures has recently provided a powerful hybrid approach for studying supramolecular assemblies, resulting in low-resolution and medium-resolution models. However, such approaches cannot deliver atomic details, especially of the crucial subunit-subunit interfaces, because of the limited cryo-electron microscopic resolution obtained in these studies. Here we report an alternative approach combining recombinant wild-type needle production, solid-state NMR, electron microscopy and Rosetta modelling to reveal the supramolecular interfaces and ultimately the complete atomic structure of the Salmonella typhimurium T3SS needle. We show that the 80-residue subunits form a right-handed helical assembly with roughly 11 subunits per two turns, similar to that of the flagellar filament of S. typhimurium. In contrast to established models of the needle in which the amino terminus of the protein subunit was assumed to be α-helical and positioned inside the needle, our model reveals an extended amino-terminal domain that is positioned on the surface of the needle, while the highly conserved carboxy terminus points towards the lumen.

  10. 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. PMID:7382928

  11. Changing the needle when inoculating blood cultures. A no-benefit and high-risk procedure.

    PubMed

    Leisure, M K; Moore, D M; Schwartzman, J D; Hayden, G F; Donowitz, L G

    Although the Centers for Disease Control recommends that needles should never be recapped, many phlebotomists routinely recap and change needles before blood culture inoculation. This study compared the extrinsic contamination rate in blood cultures when the needle was and was not changed. One hundred eight medical students obtained 182 blood specimens from each other by means of standard methods. Each specimen was inoculated into two culture bottles. The first bottle was inoculated with the needle used for phlebotomy, and the second was inoculated after needle change. Four (2.2%) of 182 bottles were contaminated when the needle was not changed, compared with one (0.6%) when the needle was changed. This small difference was not statistically significant, and the likelihood of having failed to detect a 5% difference in contamination rate was small. The risk of needle-stick injury incurred by changing the needle before inoculation of blood culture bottles seems to be unjustified. PMID:2170700

  12. Fine needle aspirate flow cytometric phenotyping characterizes immunosuppressive nature of the mesothelioma microenvironment.

    PubMed

    Lizotte, Patrick H; Jones, Robert E; Keogh, Lauren; Ivanova, Elena; Liu, Hongye; Awad, Mark M; Hammerman, Peter S; Gill, Ritu R; Richards, William G; Barbie, David A; Bass, Adam J; Bueno, Raphael; English, Jessie M; Bittinger, Mark; Wong, Kwok-Kin

    2016-01-01

    With the emergence of checkpoint blockade and other immunotherapeutic drugs, and the growing adoption of smaller, more flexible adaptive clinical trial designs, there is an unmet need to develop diagnostics that can rapidly immunophenotype patient tumors. The ability to longitudinally profile the tumor immune infiltrate in response to immunotherapy also presents a window of opportunity to illuminate mechanisms of resistance. We have developed a fine needle aspirate biopsy (FNA) platform to perform immune profiling on thoracic malignancies. Matching peripheral blood, bulk resected tumor, and FNA were analyzed from 13 mesothelioma patients. FNA samples yielded greater numbers of viable cells when compared to core needle biopsies. Cell numbers were adequate to perform flow cytometric analyses on T cell lineage, T cell activation and inhibitory receptor expression, and myeloid immunosuppressive checkpoint markers. FNA samples were representative of the tumor as a whole as assessed by head-to-head comparison to single cell suspensions of dissociated whole tumor. Parallel analysis of matched patient blood enabled us to establish quality assurance criteria to determine the accuracy of FNA procedures to sample tumor tissue. FNA biopsies provide a diagnostic to rapidly phenotype the tumor immune microenvironment that may be of great relevance to clinical trials. PMID:27539742

  13. Fine needle aspirate flow cytometric phenotyping characterizes immunosuppressive nature of the mesothelioma microenvironment

    PubMed Central

    Lizotte, Patrick H.; Jones, Robert E.; Keogh, Lauren; Ivanova, Elena; Liu, Hongye; Awad, Mark M.; Hammerman, Peter S.; Gill, Ritu R.; Richards, William G.; Barbie, David A.; Bass, Adam J.; Bueno, Raphael; English, Jessie M.; Bittinger, Mark; Wong, Kwok-Kin

    2016-01-01

    With the emergence of checkpoint blockade and other immunotherapeutic drugs, and the growing adoption of smaller, more flexible adaptive clinical trial designs, there is an unmet need to develop diagnostics that can rapidly immunophenotype patient tumors. The ability to longitudinally profile the tumor immune infiltrate in response to immunotherapy also presents a window of opportunity to illuminate mechanisms of resistance. We have developed a fine needle aspirate biopsy (FNA) platform to perform immune profiling on thoracic malignancies. Matching peripheral blood, bulk resected tumor, and FNA were analyzed from 13 mesothelioma patients. FNA samples yielded greater numbers of viable cells when compared to core needle biopsies. Cell numbers were adequate to perform flow cytometric analyses on T cell lineage, T cell activation and inhibitory receptor expression, and myeloid immunosuppressive checkpoint markers. FNA samples were representative of the tumor as a whole as assessed by head-to-head comparison to single cell suspensions of dissociated whole tumor. Parallel analysis of matched patient blood enabled us to establish quality assurance criteria to determine the accuracy of FNA procedures to sample tumor tissue. FNA biopsies provide a diagnostic to rapidly phenotype the tumor immune microenvironment that may be of great relevance to clinical trials. PMID:27539742

  14. Study of salivary gland lesions with fine needle aspiration cytology and histopothology along with immunohistochemistry.

    PubMed

    Chakrabarti, Srabani; Bera, Moumita; Bhattacharya, Pranab Kumar; Chakrabarty, Debasish; Manna, Asim Kumar; Pathak, Swapan; Maiti, Krishnendu

    2010-12-01

    Salivary gland swelling is a common and important problem. Acute and chronic sialadenitis, different benign and malignant neoplasms are the common causes which present with salivary gland swelling. Imaging technique is not so helpful in pre-operative diagnosis; microscopical examination is required for diagnosis. Pre-operative core needle biopsy is hazardous and may damage facial nerve, lead to fistula formation or associated with tumour seeding. Fine needle aspiration cytology (FNAC) is however virtually risk-free. The study was done to assess the utility of FNAC and its accuracy and pitfalls with respect to histopathology and advantages of immunohistochemistry. The study was done with 40 cases of salivary gland swelling. After clinical examination, FNAC and histopathological examination along with immunohistochemistry was done and the results were correlated. Out of 40 cases, 25 involved the parotid gland, most common age group affected was 20 - 40 years and male: female ratio was 5: 3. Out of 40 cases 37 cases were cytologically and histopathologically correlated and rest 3 cases were different. Among these 3 cases, 2 were adenoid cystic carcinoma which was cytologically diagnosed as benign neoplasm (monomorphic adenoma). One case of Warthin's tumour was cytologically diagnosed as pleomorphic adenoma. The sensitivity of this study was found to be 71.43%, specificity 100% and accuracy was 93.10%. This study corroborates well with other studies including immunohistochemical findings. p53 expression was found to be related with nature of the neoplasm. FNAC is an important tool for early diagnosis of salivary gland lesions.

  15. Dependence of needle architecture and chemical composition on canopy light availability in three North American Pinus species with contrasting needle length.

    PubMed

    Niinemets, Ulo; Ellsworth, David S; Lukjanova, Aljona; Tobias, Mari

    2002-08-01

    Morphology and chemical composition of needles of shade-intolerant southern conifers (Pinus palustris Mill. (mean needle length +/- SD = 29.1 +/- 4.1 cm), P. taeda L. (12.3 +/- 2.9 cm) and P. virginiana Mill. (5.1 +/- 0.8 cm)) were studied to test the hypothesis that foliage acclimation potential to canopy light gradients is generally low for shade-intolerant species, and in particular, because of mechanical limitations, in species with longer needles. Plasticity for each needle variable was defined as the slope of the foliar characteristic versus irradiance relationship. A novel geometrical model for needle area and volume calculation was employed for the three-needled species P. palustris and P. taeda. Needle thickness (T) strongly increased, but width (W) was less variable with increasing daily integrated quantum flux density averaged over the season (Q(int)), resulting in changes in cross-sectional needle shape that were manifested in a positive relationship between the total to projected needle area ratio (A(T)/A(P)) and Q(int) in the three-needled species. In contrast, cross-sectional needle geometry was only slightly modified by irradiance in the two-needled conifer P. virginiana. Needle dry mass per unit total needle area (M(T)) was positively related to Q(int) in all species, leading to greater foliar nitrogen contents per unit area at higher irradiances. Separate examination of the components of M(T) (density (D) and the volume (V) to A(T) ratio; M(T) = DV/A(T)) indicated that the positive effect of light on M(T) resulted solely from increases in V/A(T), i.e., from increases in the thickness of foliage elements. Foliar chlorophyll content per unit mass increased with increasing Q(int), allowing an improvement in light-harvesting efficiency in low light. The variables characterizing needle material properties (D, the dry to fresh mass ratio, and needle carbon content per unit mass) were generally independent of Q(int), suggesting that needles were less

  16. Method for fabricating arrays of micro-needles

    DOEpatents

    Kenney, Christopher J.

    2003-04-22

    An array of micro-needles is created by forming an array pattern on the upper surface of a silicon wafer and etching through openings in the pattern to define micro-needle sized cavities having a desired depth. The mold thus formed may be filled with electrically conductive material, after which a desired fraction of the silicon wafer bulk is removed from the bottom-up by etching, to expose an array of projecting micro-needles. The mold may instead be filled with a flexible material to form a substrate useful in gene cell probing. An array of hollow micro-needles may be formed by coating the lower wafer surface with SiN, and etching through pattern openings in the upper surface down to the SiN layer, and then conformally coating the upper surface with thermal silicon dioxide. The SiN layer is then stripped away and a desired fraction of the bulk of the wafer removed from the bottom-up to expose an array of projecting hollow micro-needles.

  17. 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.

  18. Numerical description of discharge characteristics of the plasma needle

    SciTech Connect

    Brok, W.J.M.; Bowden, M.D.; Dijk, J. van; Mullen, J.J.A.M. van der; Kroesen, G.M.W.

    2005-07-01

    The plasma needle is a small atmospheric, nonthermal, radio-frequency discharge, generated at the tip of a needle, which can be used for localized disinfection of biological tissues. Although several experiments have characterized various qualities of the plasma needle, discharge characteristics and electrical properties are still not well known. In order to provide initial estimates on electrical properties and quantities such as particle densities, we employed a two-dimensional, time-dependent fluid model to describe the plasma needle. In this model the balance equation is solved in the drift-diffusion approach for various species and the electron energy, as well as Poisson's equation. We found that the plasma production occurs in the sheath region and results in a steady flux of reactive species outwards. Even at small (<0.1%) admixtures of N{sub 2} to the He background, N{sub 2}{sup +} is the dominant ion. The electron density is typically 10{sup 11} cm{sup -3} and the dissipated power is in the order of 10 mW. These results are consistent with the experimental data available and can give direction to the practical development of the plasma needle.

  19. 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

  20. 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.

  1. Dry needling in the management of musculoskeletal pain.

    PubMed

    Kalichman, Leonid; Vulfsons, Simon

    2010-01-01

    Myofascial pain is a common syndrome seen by family practitioners worldwide. It can affect up to 10% of the adult population and can account for acute and chronic pain complaints. In this clinical narrative review we have attempted to introduce dry needling, a relatively new method for the management of musculoskeletal pain, to the general medical community. Different methods of dry needling, its effectiveness, and physiologic and adverse effects are discussed. Dry needling is a treatment modality that is minimally invasive, cheap, easy to learn with appropriate training, and carries a low risk. Its effectiveness has been confirmed in numerous studies and 2 comprehensive systematic reviews. The deep method of dry needling has been shown to be more effective than the superficial one for the treatment of pain associated with myofascial trigger points. However, over areas with potential risk of significant adverse events, such as lungs and large blood vessels, we suggest using the superficial technique, which has also been shown to be effective, albeit to a lesser extent. Additional studies are needed to evaluate the effectiveness of dry needling. There also is a great need for further investigation into the development of pain at myofascial trigger points.

  2. NPIP: A skew line needle configuration optimization system for HDR brachytherapy

    SciTech Connect

    Siauw, Timmy; Cunha, Adam; Berenson, Dmitry; Atamtuerk, Alper; Hsu, I-Chow; Goldberg, Ken; Pouliot, Jean

    2012-07-15

    Purpose: In this study, the authors introduce skew line needle configurations for high dose rate (HDR) brachytherapy and needle planning by integer program (NPIP), a computational method for generating these configurations. NPIP generates needle configurations that are specific to the anatomy of the patient, avoid critical structures near the penile bulb and other healthy structures, and avoid needle collisions inside the body. Methods: NPIP consisted of three major components: a method for generating a set of candidate needles, a needle selection component that chose a candidate needle subset to be inserted, and a dose planner for verifying that the final needle configuration could meet dose objectives. NPIP was used to compute needle configurations for prostate cancer data sets from patients previously treated at our clinic. NPIP took two user-parameters: a number of candidate needles, and needle coverage radius, {delta}. The candidate needle set consisted of 5000 needles, and a range of {delta} values was used to compute different needle configurations for each patient. Dose plans were computed for each needle configuration. The number of needles generated and dosimetry were analyzed and compared to the physician implant. Results: NPIP computed at least one needle configuration for every patient that met dose objectives, avoided healthy structures and needle collisions, and used as many or fewer needles than standard practice. These needle configurations corresponded to a narrow range of {delta} values, which could be used as default values if this system is used in practice. The average end-to-end runtime for this implementation of NPIP was 286 s, but there was a wide variation from case to case. Conclusions: The authors have shown that NPIP can automatically generate skew line needle configurations with the aforementioned properties, and that given the correct input parameters, NPIP can generate needle configurations which meet dose objectives and use as many

  3. Mercury's Core

    NASA Astrophysics Data System (ADS)

    Peale, S. J.

    2005-05-01

    In determining Mercury's core structure from its rotational properties, the location of Cassini state 1 is crucial. Convincing radar evidence indicates that the mantle rests on a liquid layer (Margot et al. 2005), but there are no empirical constraints on the moment of inertia C/MR2, which constraints must wait for the determination of the gravitational coefficients J2 and C22 from the MESSENGER orbiting spacecraft, and an accurate determination of the obliquity of the Cassini state. Tidal and core-mantle dissipation drive the spin to the Cassini state with a time scale O(105) years, so the spin should occupy the Cassini state and thereby define its obliquity---unless there has been a recent excitation of a free precession of the spin. Another way the spin might be displaced from the Cassini state is if the variations in the orbital elements, which change the position of the Cassini state, cause the spin axis to lag behind as it attempts to follow the state. Fortunately, the solid angle the spin axis encloses as it precesses around the Cassini state is an adiabatic invariant, and it is conserved if the orbital element variations are slow compared to the precession rate. As the precession period is O(1000) years, and the time scales of orbital parameter variations are O(105) years, the spin axis should remain very close to the Cassini state if it were ever close. But how close is close? The increasing precision of the radar and eventual spacecraft measurements warrants a check on the likely proximity of the spin axis to the Cassini state. By numerically following the positions of the spin axis and Cassini state with orbital parameters varying with time scales and amplitudes comparable to the real variations, we show that the spin should remain within 1″ of the Cassini state once dissipative torques bring it there. The current spin axis position should thus define the Cassini state sufficiently to put reasonably tight constraints on the core structure

  4. Fine Needle Aspiration Cytology versus Fine Needle Capillary Sampling in Cytological Diagnosis of Thyroid Lesions

    PubMed Central

    Pinki, Pandey; Alok, Dixit; Ranjan, Aggarwal; Nanak Chand, Mahajan

    2015-01-01

    Background and Objectives: Fine needle aspiration cytology (FNAC) is an established out- patient procedure used in primary diagnosis of palpable thyroid lesions. A modified technique fine needle capillary sampling (FNCS) obviates the need of suction, is less painful, patient friendly and reported to overcome the problem of inadequate and bloody specimens. The aim of our study was to compare the efficacy and quality of FNCS with that of conventional FNAC in the lesions of thyroid. Methods: One hundred patients, presenting between January 2011 to December 2012 at Cytopathology Department of M M Institute of Medical Sciences and Research, Mullana, with diffuse and nodular thyroid lesions were enrolled with both the techniques being executed on the patients, beginning with FNA followed by FNCS. The smears were scored using five objective parameters i.e. background blood, cellular material, cellular degeneration, cellular trauma, and retention of appropriate architecture, in a single blind setting by a cyto-pathologist. The results were analyzed using Student’s test for paired data and chi- square analysis. Results: A highly significant differences (P<0.001) in favor of FNCS was observed for the background blood, cellular material and retention of architecture while total score favored FNA for cellular degeneration and degree of cellular trauma. Total scores and average score per case for FNCS was significantly better (P<0.001) than FNA. FNCS technique yielded more diagnostically superior and lesser number of unsatisfactory smears whereas greater number of diagnostically adequate samples was obtained by FNA technique. Conclusion: FNCS offers more number of diagnostically better quality smears. Both techniques could be supplementary on many occasions and substitutive on a few. Combination of the two techniques could offer better diagnostic accuracy. PMID:26516325

  5. Surface-blended texturing of medical needles for friction reduction using a picosecond laser

    NASA Astrophysics Data System (ADS)

    Wang, Xingsheng; Han, Peidong; Kang, Min; Ehmann, Kornel

    2016-04-01

    The success of percutaneous procedures depends on the accuracy of the medical needle insertion. Reducing the insertion force and using better needle visualization during needle insertion can reduce needle placement errors. Surface texturing is frequently used to create micro-features on medical needle's tip portion to improve the visibility in ultrasound-guided percutaneous procedures. However, these micro-features usually increase the friction between the needle and tissue because of stress concentrations. This paper explores a method for creating micro-features with blended edges on echogenic needles and studies the friction behavior between textured echogenic needles and phantom tissue to identify blended texture patterns that would minimize the friction during needle insertion. Laser surface texturing was used to create regular micro-circumferential channels and micro-corner-cube-like dimples along the needle's axial direction. Variations of the overlap in the feed direction were used to blend the edges of micro-channels and micro-dimples with different fillet radii. Both needles with regular and blended surface textures were experimentally investigated through needle extraction experiments from phantom tissue. It was found that the blended textured needles with large fillet radii exhibit a much better friction behavior.

  6. Electrostatic Droplet Ejection Using Planar Needle Inkjet Head

    NASA Astrophysics Data System (ADS)

    Hakiai, Kazunori; Ishida, Yuji; Baba, Akiyoshi; Asano, Tanemasa

    2005-07-01

    For the purpose of investigating the electrostatic droplet ejection event, a planar needle inkjet head with a projected cone-shaped needle (3-D head) was prepared to observe the phenomenon of droplet ejection. As the initial approach to developing a liquid ejection monitoring method, electric current was also measured. The ejection was found to take place as a series of single events that are composed of fine droplet ejections forming the Taylor cone and the subsequent swing back of the liquid front owing to the relationship between surface tension and electrostatic force. The critical factors for ejecting fine droplets in the case of using the inkjet head having a protruding needle were back pressure from the reservoir and the wetting control of the structures. The fast Fourier transform of electric current revealed the appearance of periodic signals during ejection, which may be used in developing a technique of sensing droplet ejection.

  7. Treatment of supraspinatus tendinopathy with ultrasound guided dry needling

    PubMed Central

    Settergren, Roy

    2013-01-01

    Objective 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. Clinical Features 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. Intervention and Outcome 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. Conclusions Sonographically guided dry needling was shown to be beneficial for this patient as evident by sonographic changes pre- and postprocedure. PMID:23997721

  8. Surgical Removal of an Unrecognized Tapestry Needle from the Urethra.

    PubMed

    Temiz, Mustafa Zafer; Yuruk, Emrah; Teberik, Kutlu; Kandirali, Engin

    2015-04-24

    The variety of intraurethral foreign bodies has been reported in literature. Most of them tend to be self-inserted because of sexual or erotic reasons. We report a 23-year old male patient who had tapestry needle into his urethra, which was not self-inserted. The patient was referred to our institution with dysuria and hematuria. There was microscopic hematuria in urine analysis and no pathologic sign in sonography. The needle was detected in proximal urethra in pelvic X-ray and endoscopic visualization revealed that it was trapped in mucosa. The needle was successfully removed by open surgery. Main treatment for the removal of urethral foreign bodies is usually endoscopic but open surgery may be required in some cases especially cutting foreign bodies. PMID:26236453

  9. Understanding the Physiology of Postharvest Needle Abscission in Balsam Fir.

    PubMed

    Lada, Rajasekaran R; MacDonald, Mason T

    2015-01-01

    Balsam fir (Abies balsamea) trees are commonly used as a specialty horticultural species for Christmas trees and associated greenery in eastern Canada and United States. Postharvest needle abscission has always been a problem, but is becoming an even bigger challenge in recent years presumably due to increased autumn temperatures and earlier harvesting practices. An increased understanding of postharvest abscission physiology in balsam fir may benefit the Christmas tree industry while simultaneously advancing our knowledge in senescence and abscission of conifers in general. Our paper describes the dynamics of needle abscission in balsam fir while identifying key factors that modify abscission patterns. Concepts such as genotypic abscission resistance, nutrition, environmental factors, and postharvest changes in water conductance and hormone evolution are discussed as they relate to our understanding of the balsam fir abscission physiology. Our paper ultimately proposes a pathway for needle abscission via ethylene and also suggests other potential alternative pathways based on our current understanding. PMID:26635863

  10. Surgical Removal of an Unrecognized Tapestry Needle from the Urethra

    PubMed Central

    Temiz, Mustafa Zafer; Yuruk, Emrah; Teberik, Kutlu; Kandirali, Engin

    2015-01-01

    The variety of intraurethral foreign bodies has been reported in literature. Most of them tend to be self-inserted because of sexual or erotic reasons. We report a 23-year old male patient who had tapestry needle into his urethra, which was not self-inserted. The patient was referred to our institution with dysuria and hematuria. There was microscopic hematuria in urine analysis and no pathologic sign in sonography. The needle was detected in proximal urethra in pelvic X-ray and endoscopic visualization revealed that it was trapped in mucosa. The needle was successfully removed by open surgery. Main treatment for the removal of urethral foreign bodies is usually endoscopic but open surgery may be required in some cases especially cutting foreign bodies. PMID:26236453

  11. Understanding the Physiology of Postharvest Needle Abscission in Balsam Fir

    PubMed Central

    Lada, Rajasekaran R.; MacDonald, Mason T.

    2015-01-01

    Balsam fir (Abies balsamea) trees are commonly used as a specialty horticultural species for Christmas trees and associated greenery in eastern Canada and United States. Postharvest needle abscission has always been a problem, but is becoming an even bigger challenge in recent years presumably due to increased autumn temperatures and earlier harvesting practices. An increased understanding of postharvest abscission physiology in balsam fir may benefit the Christmas tree industry while simultaneously advancing our knowledge in senescence and abscission of conifers in general. Our paper describes the dynamics of needle abscission in balsam fir while identifying key factors that modify abscission patterns. Concepts such as genotypic abscission resistance, nutrition, environmental factors, and postharvest changes in water conductance and hormone evolution are discussed as they relate to our understanding of the balsam fir abscission physiology. Our paper ultimately proposes a pathway for needle abscission via ethylene and also suggests other potential alternative pathways based on our current understanding. PMID:26635863

  12. Fine needle aspiration biopsy in salivary gland tumours.

    PubMed

    Lau, T; Balle, V H; Bretlau, P

    1986-04-01

    Of 105 tumours of the major salivary glands, 90 were benign and 15 malignant. In benign tumours a correct preoperative diagnosis was made by fine needle aspiration biopsy in 84%, and none were falsely classed as malignant. In the malignant tumours, only 8 out of 15 (53%) were correctly diagnosed as malignant while 7 were misdiagnosed as benign. It is concluded that in benign salivary gland tumours there is good accordance between fine needle aspiration biopsy and the final histological report, in contrast to the malignant tumours where this is less convincing. Fine needle aspiration biopsy is a valuable diagnostic tool, but the result should be carefully evaluated, regarded as only part of the clinical picture and not solely relied on.

  13. Understanding the Physiology of Postharvest Needle Abscission in Balsam Fir.

    PubMed

    Lada, Rajasekaran R; MacDonald, Mason T

    2015-01-01

    Balsam fir (Abies balsamea) trees are commonly used as a specialty horticultural species for Christmas trees and associated greenery in eastern Canada and United States. Postharvest needle abscission has always been a problem, but is becoming an even bigger challenge in recent years presumably due to increased autumn temperatures and earlier harvesting practices. An increased understanding of postharvest abscission physiology in balsam fir may benefit the Christmas tree industry while simultaneously advancing our knowledge in senescence and abscission of conifers in general. Our paper describes the dynamics of needle abscission in balsam fir while identifying key factors that modify abscission patterns. Concepts such as genotypic abscission resistance, nutrition, environmental factors, and postharvest changes in water conductance and hormone evolution are discussed as they relate to our understanding of the balsam fir abscission physiology. Our paper ultimately proposes a pathway for needle abscission via ethylene and also suggests other potential alternative pathways based on our current understanding.

  14. Structural Plasticity of the Phage P22 Tail Needle gp26 Probed with Xenon Gas

    SciTech Connect

    Olia, A.; Casjens, S; Cingolani, G

    2009-01-01

    The tail needle, gp26, is a highly stable homo-trimeric fiber found in the tail apparatus of bacteriophage P22. In the mature virion, gp26 is responsible for plugging the DNA exit channel, and likely plays an important role in penetrating the host cell envelope. In this article, we have determined the 1.98 A resolution crystal structure of gp26 bound to xenon gas. The structure led us to identify a calcium and a chloride ion intimately bound at the interior of alpha-helical core, as well as seven small cavities occupied by xenon atoms. The two ions engage in buried polar interactions with gp26 side chains that provide specificity and register to gp26 helical core, thus enhancing its stability. Conversely, the distribution of xenon accessible cavities correlates well with the flexibility of the fiber observed in solution and in the crystal structure. We suggest that small internal cavities in gp26 between the helical core and the C-terminal tip allow for flexible swinging of the latter, without affecting the overall stability of the protein. The C-terminal tip may be important in scanning the bacterial surface in search of a cell-envelope penetration site, or for recognition of a yet unidentified receptor on the surface of the host.

  15. Electromagnetic needle tracking during simulated right internal jugular cannulation.

    PubMed

    Faulke, D J; Hall, T H; Nixon, C

    2015-07-01

    This study used three-dimensional information from Stealth navigation technology during simulated right internal jugular vein cannulation to define the initial needle trajectory taken when using three approaches: landmark (LM), short-axis (SAX) ultrasound and long-axis (LAX) ultrasound. Nineteen volunteers indicated the entry site and needle direction (track) they would use in performing right internal jugular vein cannulation by the three approaches. The likelihood of cannulation success, arterial puncture and needle direction were recorded. Volunteers were asked to assess the suitability of the simulation system for validity and educational benefit. The SAX track crossed the jugular vein more frequently than the LAX and LM tracks (SAX: 94%; LAX: 80%; LM: 47% [SAX versus LM, P <0.01]). The mean indicated needle direction in the coronal plane for LM, SAX and LAX were -4, 13 and 11 degrees, respectively. The track associated with the LAX technique would have entered the carotid artery by 16% of volunteers. At needle depths of over 40 mm, the track crossed the vertebral artery at the following rates (LM: 11%; SAX: 16%; LAX: 16%). The use of Stealth technology to provide three-dimensional feedback of the needle path taken during simulated right internal jugular cannulation was considered realistic (16/19) and of benefit for 18 of 19 (95%) respondents. The SAX track was associated with the highest likelihood of successful jugular cannulation and the lowest cross rate of the carotid artery. The simulation model using Stealth was considered to be valuable and realistic by participants despite some limitations.

  16. Midwinter needle temperature and winter injury of montane red spruce.

    PubMed

    Strimbeck, G R; Johnson, A H; Vann, D R

    1993-09-01

    To assess the role of solar warming and associated temperature fluctuations in the winter injury of sun-exposed red spruce foliage, we used fine wire thermocouples to monitor midwinter needle temperature in the upper canopy of mature red spruce trees over two winters. In 1989-1990, 15-min mean temperatures were recorded for six needles in a single tree. In 1990-1991, 10-min mean temperatures of six needles in one tree, and 1-min mean temperatures of seven needles in a second tree were recorded during rapid temperature changes. Warming was more frequent and greatest on terminal shoots of branches with a south to southwest aspect. The maximum rise above ambient air temperature exceeded 20 degrees C, and the maximum one minute decrease in temperature was 9 degrees C, with maximum rates of 0.8 and 0.6 degrees C min(-1) sustained over 10- and 15-min intervals, respectively. These data demonstrate that red spruce is subject to rapid temperature fluctuations similar to those known to produce visible injury in American aborvitae, a much hardier species. We concluded that solar warming to temperatures above the freezing point was unlikely to result in dehardening and subsequent freezing injury, because warming was infrequent, of short duration, and did not always raise needle temperature above the freezing point. Parts of branches and some individual shoots were frequently covered by snow or rime that may have prevented injury by reducing the frequency or intensity of needle temperature fluctuations. Radiation load on exposed shoots may have been increased by reflection of short wave radiation from snow and rime deposits on surrounding surfaces, which would exacerbate temperature fluctuations. PMID:14969891

  17. Electromagnetic needle tracking during simulated right internal jugular cannulation.

    PubMed

    Faulke, D J; Hall, T H; Nixon, C

    2015-07-01

    This study used three-dimensional information from Stealth navigation technology during simulated right internal jugular vein cannulation to define the initial needle trajectory taken when using three approaches: landmark (LM), short-axis (SAX) ultrasound and long-axis (LAX) ultrasound. Nineteen volunteers indicated the entry site and needle direction (track) they would use in performing right internal jugular vein cannulation by the three approaches. The likelihood of cannulation success, arterial puncture and needle direction were recorded. Volunteers were asked to assess the suitability of the simulation system for validity and educational benefit. The SAX track crossed the jugular vein more frequently than the LAX and LM tracks (SAX: 94%; LAX: 80%; LM: 47% [SAX versus LM, P <0.01]). The mean indicated needle direction in the coronal plane for LM, SAX and LAX were -4, 13 and 11 degrees, respectively. The track associated with the LAX technique would have entered the carotid artery by 16% of volunteers. At needle depths of over 40 mm, the track crossed the vertebral artery at the following rates (LM: 11%; SAX: 16%; LAX: 16%). The use of Stealth technology to provide three-dimensional feedback of the needle path taken during simulated right internal jugular cannulation was considered realistic (16/19) and of benefit for 18 of 19 (95%) respondents. The SAX track was associated with the highest likelihood of successful jugular cannulation and the lowest cross rate of the carotid artery. The simulation model using Stealth was considered to be valuable and realistic by participants despite some limitations. PMID:26099763

  18. Two cases of uterine malignant lymphoma diagnosed by needle biopsy

    PubMed Central

    Ichimura, Tomoyuki; Murakami, Makoto; Matsuda, Makiko; Kawamura, Naoki; Sumi, Toshiyuki

    2015-01-01

    Abstract The incidence of primary malignant lymphoma arising in the female genital tract is extremely rare and constitutes approximately 0.05% of malignant tumors. Uterine malignant lymphoma develops in the endometrial stroma, causing minimal necrosis. It is therefore difficult to diagnose malignant lymphoma, as it does not involve genital bleeding or epithelial defects. We have performed transcervical needle biopsies from deep in the myometrium, with the purpose of diagnosing uterine muscle layer lesions, such as leiomyosarcoma, but this is an unusual method. In this report, we suggest that transcervical needle biopsy is useful in the diagnosis of uterine malignant lymphoma. PMID:26370331

  19. Fine-needle aspiration biopsy with a vacuum test tube.

    PubMed

    Fornage, B D

    1988-11-01

    A simple, low-cost, automatic aspiration system that makes use of vacuum test tubes designed for the drawing of venous blood has been used for real-time ultrasound (US)-guided fine-needle aspiration biopsy of 13 cysts (breast), an abscess (liver), and five solid (breast, liver, thyroid) masses. Because it allows the operator to perform aspiration with one hand while holding the real-time US transducer with the other, and because creation of the suction is associated with no significant displacement of the needle, this approach has allowed sampling of lesions less than 1 cm in diameter. No complications have occurred.

  20. Complications of needle thoracostomy: A comprehensive clinical review

    PubMed Central

    Wernick, Brian; Hon, Heidi H; Mubang, Ronnie N; Cipriano, Anthony; Hughes, Ronson; Rankin, Demicha D; Evans, David C; Burfeind, William R; Hoey, Brian A; Cipolla, James; Galwankar, Sagar C; Papadimos, Thomas J; Stawicki, Stanislaw P; Firstenberg, Michael S

    2015-01-01

    Needle thoracostomy (NT) is a valuable adjunct in the management of tension pneumothorax (tPTX), a life-threatening condition encountered mainly in trauma and critical care environments. Most commonly, needle thoracostomies are used in the prehospital setting and during acute trauma resuscitation to temporize the affected individuals prior to the placement of definitive tube thoracostomy (TT). Because it is both an invasive and emergent maneuver, NT can be associated with a number of potential complications, some of which may be life-threatening. Due to relatively common use of this procedure, it is important that healthcare providers are familiar, and ready to deal with, potential complications of NT. PMID:26557486

  1. Use of Additional Needle Pulses Using Electrical Discharge Machining

    NASA Astrophysics Data System (ADS)

    Schulze, Hans-Peter; Juhr, Henrik; Haas, Rüdiger

    2011-05-01

    The influence exerted by the longer rectangular pulses with additional Needle Pulses. Needle pulses for the spark erosion are the fundamental of the erosion pulses with pulse durations smaller 1 μs and high current-rise-velocity (ramp unit). In this shorter pulse-duration it is possible to use higher current densities; without composition of the thermal-affected zones. The technological advantage is a higher productivity because the higher pulse energy and parallel a better quality of the processing area exist; an additional factor for the higher productivity is the smaller number of back-cuts for the finish quality of the cut.

  2. Diagnosis of salivary gland tumors by fine needle aspiration biopsy.

    PubMed

    Sismanis, A; Merriam, J M; Kline, T S; Davis, R K; Shapshay, S M; Strong, M S

    1981-01-01

    The cytologic findings of 51 smears obtained by fine needle aspiration biopsy from salivary gland masses were compared with the histologic findings of permanent sections. The overall concurrence rate between cytologic and histologic findings for being and malignant lesions was 91%. The diagnostic accuracy (exact histologic diagnosis) for the benign lesions was 87% and for the malignant tumors 60%. One case showed false-positive results and 1 case false-negative results. Fine needle aspiration biopsy has been found to be safe, free of complications, and helpful in the planning of treatment.

  3. Fine needle aspiration biopsy diagnosis of neck masses.

    PubMed

    Sismanis, A; Strong, M S; Merriam, J

    1980-01-01

    The cytologic findings in 107 aspiration smears obtained with the fine needle technique from head and neck masses were compared with the histologic findings in permanent sections. The overall concurrence rate between cytologic and histologic findings in benign and malignant tumors was 82.2 per cent. There was a 5.6 per cent incidence of false negative findings. There were no false positive results. Fine needle aspiration was found to be safe, complication free, and most helpful in planning treatment. We recommend the technique to others who deal with head and neck masses.

  4. Scattering by single ice needles and plates at 30 GHz

    NASA Technical Reports Server (NTRS)

    Yeh, C.; Woo, R.; Armstrong, J.; Ishimaru, A.

    1982-01-01

    Because of the small loss tangent of ice at 30-50 GHz, significant depolarization of satellite-to-ground communication signals could occur due to the presence of cirrus clouds in their paths. It is known that cirrus clouds basically consist of ice needles and plates. Extensive calculations have been performed for the problem of scattering by a family of ice needles and plates for various length-to-width ratios ranging from 1 to 10. Scattering results with special attention to induced cross-polarized fields will be presented.

  5. Transcaval migration of an acupuncture needle from the abdominal cavity to the heart.

    PubMed

    Neely, David; Jeganathan, Reubendra; Campalani, Gianfranco

    2010-11-01

    We report the case of a patient who was noted to have inserted an acupuncture needle into his abdomen. The needle migrated to the heart and was removed from the right ventricle using cardiopulmonary bypass.

  6. MRI-guided core needle biopsy of the prostate: acceptance and side effects

    PubMed Central

    Egbers, Nina; Schwenke, Carsten; Maxeiner, Andreas; Teichgräber, Ulf; Franiel, Tobias

    2015-01-01

    PURPOSE We aimed to study side effects, complications, and patient acceptance of magnetic resonance imaging-guided real-time biopsy (MRI-GB) of the prostate. METHODS Fifty-four men (49–78 years) with elevated prostate-specific antigen after at least one negative systematic transrectal ultrasound-guided biopsy (TRUS-GB) were included in a prospective clinical study. Suspicious areas on images were selectively sampled by obtaining a median of four specimens (range, 1–9 specimens) using MRI-GB. In TRUS-GB, a median of 10 specimens (range, 6–14 specimens) were obtained. Telephone interviews were conducted one week after outpatient MRI-GB, asking patients about pain and side effects (hematuria, hemospermia, rectal bleeding, fever, and chills) of the two biopsy procedures and which of the two procedures they preferred. Multinomial regression analysis and Fisher’s exact test was used to test for differences. RESULTS MRI-GB was preferred by 65% (35/54), and 82% (44/54) would undergo MRI-GB again. Pain intensity (P = 0.005) and bleeding duration (P = 0.004) were significantly lower for MRI-GB compared with TRUS-GB. Hematuria was less common after MRI-GB compared with TRUS-GB (P = 0.006). A high correlation was given between bleeding intensity and bleeding duration for TRUS-GB (r=0.77) and pain intensity and pain duration for MRI-GB (r=0.65). Although hemospermia, rectal hemorrhage, fever, and chills were less common in MRI, they showed no statistically significant difference. CONCLUSION MRI-GB of the prostate seems to have fewer side effects and less pain intensity than TRUS-GB and was preferred by the majority of patients. PMID:25858525

  7. 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.

  8. Computational design optimization of an SMA-based active steerable needle

    NASA Astrophysics Data System (ADS)

    Konh, Bardia; Hutapea, Parsaoran

    2015-04-01

    Shape memory alloy (SMA) actuated needle is currently being developed to assist surgeons/physicians in their percutaneous interventional procedures. The proposed active surgical needle can potentially compensate the possible misplacements of the needle tip in the tissue benefiting from the improved navigation provided by the attached SMA actuators. In this study finite element tools have been utilized in order to maintain an optimum design of the active needle configuration. There are several parameters involved in the design affecting the active needle's applicability and maneuverability; among them are the length, diameter and the maximum residual strain of the SMA wires, the stiffness and diameters of the surgical needle and the offset distance between the needle and the actuator. For analyzing the response of the active needle structure a parametric model was developed in ANSYS. This model was linked to the automated optimization tools for an improved design of the active needle. The most sensitive parameters affecting the active needle's steerability were found to be the offset distance and the length of the needle. Considering the results and the clinical limitations, an improved design of the active needle was presented.

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

    SciTech Connect

    McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.; McLaughlin, Patrick W.; Shih, Albert J.

    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 parameters 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.

  10. Development and evaluation of optical needle depth sensor for percutaneous diagnosis and therapies

    NASA Astrophysics Data System (ADS)

    Palmer, Keryn; Alelyunas, David; McCann, Connor; Yoshimitsu, Kitaro; Kato, Takahisa; Song, Sang-Eun; Hata, Nobuhiko

    2014-03-01

    Current methods of needle insertion during percutaneous CT and MRI guided procedures lack precision in needle depth sensing. The depth of the needle insertion is currently monitored through depth markers drawn on the needle and later confirmed by intra-procedural imaging; until this confirmation, the physicians' judgment that the target is reached is solely based on the depth markers, which are not always clearly visible. We have therefore designed an optical sensing device which provides continuous feedback of needle insertion depth and degree of rotation throughout insertion. An optical mouse sensor was used in conjunction with a microcontroller board, Arduino Due, to acquire needle position information. The device is designed to be attached to a needle guidance robot developed for MRI-guided prostate biopsy in order to aid the manual insertion. An LCD screen and three LEDs were employed with the Arduino Due to form a hand-held device displaying needle depth and rotation. Accuracy of the device was tested to evaluate the impact of insertion speed and rotation. Unlike single dimensional needle depth sensing developed by other researchers, this two dimensional sensing device can also detect the rotation around the needle axis. The combination of depth and rotation sensing would be greatly beneficial for the needle steering approaches that require both depth and rotation information. Our preliminary results indicate that this sensing device can be useful in detecting needle motion when using an appropriate speed and range of motion.

  11. 41 CFR 109-27.5009 - Control of hypodermic needles and syringes.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... needles and syringes. 109-27.5009 Section 109-27.5009 Public Contracts and Property Management Federal... Guidelines § 109-27.5009 Control of hypodermic needles and syringes. Effective procedures and practices shall provide for the management and physical security of hypodermic needles and syringes to prevent illegal...

  12. Ankylosing spondylitis and central core disease: case report.

    PubMed

    Scola, Rosana Herminia; Lin, Kátia; Iwamoto, Fãbio Massaiti; Arruda, Walter Oleschko; Werneck, Lineu Cesar

    2003-09-01

    Ankylosing spondylitis (AS) is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD) is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

  13. Needle sharing in The Netherlands: an ethnographic analysis.

    PubMed Central

    Grund, J P; Kaplan, C D; Adriaans, N F

    1991-01-01

    BACKGROUND. Needle sharing has been reported to be the main cause of the rapid spread of the human immunodeficiency virus (HIV) among injecting drug users. Risk behaviors such as needle sharing are, however, the end result of complicated interaction patterns in drug user networks, which have their specific rules and rituals, and larger social structures and official drug policy. METHODS. To study these interaction patterns we examined the drug administration rituals of heroin addicts in Rotterdam, The Netherlands. Intensive ethnographic descriptions were collected by participant observation. RESULTS. In less than 10% of the observed self-injections unsafe syringes were used. In 68% of the self-injections new, sterile syringes were used. Needle sharing as a planned sequence was not observed. Sharing was determined primarily by the availability of syringes, experience with the injecting ritual, and drug craving. In all observed needle-sharing events, subjects were aware of the risks involved and undertook efforts to clean the injection equipment. CONCLUSIONS. In contrast to psychological approaches aimed at reducing individual "risk behavior," these findings suggest that HIV prevention can be made more effective if active drug injectors are organized to help themselves and their peers prevent high-risk exchange situations. PMID:1746657

  14. The Single Needle Lockstitch Machine. [Sewing Seams.] Module 4.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    This module on sewing seams, one in a series on the single needle lockstitch sewing machine for student self-study, contains three sections. Each section includes the following parts: an introduction, directions, an objective, learning activities, student information, student self-check, check-out activities, and an instructor's final checklist.…

  15. Failed needle decompression of bilateral spontaneous tension pneumothorax.

    PubMed

    Bach, P T; Sølling, C

    2015-07-01

    This case report presents a young male admitted with primary bilateral spontaneous tension pneumothorax and severe respiratory distress. This is an extremely rare condition. The patient was on the verge of hypoxic cardiac arrest and the attempted needle thoracocentesis was unsuccessful. Needle thoracocentesis in the midclavicular line of the second intercostal space is widely used and recommended as first-line treatment of tension pneumothorax. Reviewing the literature, the procedure is not based on solid evidence. It has high failure rates and potentially serious complications. Alternatives to this approach are perhaps more appropriate. Correctly done, needle thoracocentesis has its place in the presence of a diagnosed or suspected tension pneumothorax when no other options are available. If needle thoracocentesis is chosen, then insertion in the mid-anterior axillary line of the 3rd-5th intercostal space is an appropriate alternative site. Otherwise, lateral thoracostomy, with or without chest tube insertion, is a safe procedure with a high success rate. It should be considered as the first-line treatment of tension pneumothorax, particularly in the unstable patient.

  16. 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.

  17. The effects of diesel injector needle motion on spray structure.

    SciTech Connect

    Powell, C. F.; Kastengren, A. L.; Liu, Z.; Fezzaa, K.

    2011-01-01

    The internal structure of diesel fuel injectors is known to have a significant impact on the steady-state fuel distribution within the spray. However, little experimental or computational work has been performed on the dynamics of fuel injectors. Recent studies have shown that it is possible to measure the three-dimensional geometry of the injector nozzle, and to track changes in that geometry as the needle opens and closes in real time. This has enabled the dynamics of the injector to be compared with the dynamics of the spray, and allows computational fluid dynamics (CFD) simulations to use realistic time-dependent flow passage geometries. In this study, X-ray phase-enhanced imaging has been used to perform time-resolved imaging of the needle seat area in several common-rail diesel injection nozzles. The fuel distributions of the sprays emitted by these injectors were also studied with fast X-ray radiography. Correlations between eccentric motions of the injector needle valve and oscillations in the fuel density as it emerges from the nozzle are examined. CFD modeling is used to interpret the effect of needle motion on fuel flow.

  18. 21 CFR 878.5350 - Needle-type epilator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... hair by applying electric current at the tip of a fine needle that has been inserted close to the hair shaft, under the skin, and into the dermal papilla. The electric current may be high-frequency AC current, high-frequency AC combined with DC current, or DC current only. (b) Classification. Class...

  19. 21 CFR 878.5350 - Needle-type epilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... hair by applying electric current at the tip of a fine needle that has been inserted close to the hair shaft, under the skin, and into the dermal papilla. The electric current may be high-frequency AC current, high-frequency AC combined with DC current, or DC current only. (b) Classification. Class...

  20. 21 CFR 878.5350 - Needle-type epilator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... hair by applying electric current at the tip of a fine needle that has been inserted close to the hair shaft, under the skin, and into the dermal papilla. The electric current may be high-frequency AC current, high-frequency AC combined with DC current, or DC current only. (b) Classification. Class...

  1. 21 CFR 878.5350 - Needle-type epilator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... hair by applying electric current at the tip of a fine needle that has been inserted close to the hair shaft, under the skin, and into the dermal papilla. The electric current may be high-frequency AC current, high-frequency AC combined with DC current, or DC current only. (b) Classification. Class...

  2. 21 CFR 878.5350 - Needle-type epilator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... hair by applying electric current at the tip of a fine needle that has been inserted close to the hair shaft, under the skin, and into the dermal papilla. The electric current may be high-frequency AC current, high-frequency AC combined with DC current, or DC current only. (b) Classification. Class...

  3. 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 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... syringe to inject local anesthetics and other drugs. (b) Classification. Class I (general controls)....

  4. 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 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... syringe to inject local anesthetics and other drugs. (b) Classification. Class I (general controls)....

  5. Randomized interventions for needle procedures in children with cancer.

    PubMed

    Hedén, L; VON Essen, L; Ljungman, G

    2009-07-01

    The aim of this study was to examine whether children experience less fear, distress and pain connected to a routine needle insertion in an intravenous port when subjected to an intervention: blowing soap bubbles or having a heated pillow vs. standard care. Twenty-eight children, 2-7 years, cared for at a paediatric oncology unit, undergoing a routine needle insertion in an intravenous port were included consecutively. All children were subjected to two needle insertions; at the first they received standard care, and at the second standard care + a randomized intervention. Parents and nurses assessed children's fear, distress and pain on 0-100 mm visual analogue scales. According to parents' report, children experienced less fear when subjected to intervention vs. standard care reported by parents (P < 0.001). Children also experienced less fear (P < 0.05) and distress (P < 0.05) when subjected to standard care + blowing soap bubbles vs. standard care (n = 14), and less fear when subjected to standard care + heated pillow vs. standard care (P < 0.05). Nurses' reports did not show any differences for standard care + intervention vs. standard care. Blowing soap bubbles or having a heated pillow is more effective than standard care in reducing children's fear and distress in needle procedures, according to parents' report. PMID:19040458

  6. 21 CFR 880.5570 - Hypodermic single lumen needle.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hypodermic single lumen needle. 880.5570 Section 880.5570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... joined to a female connector (hub) designed to mate with a male connector (nozzle) of a piston syringe...

  7. Randomized interventions for needle procedures in children with cancer.

    PubMed

    Hedén, L; VON Essen, L; Ljungman, G

    2009-07-01

    The aim of this study was to examine whether children experience less fear, distress and pain connected to a routine needle insertion in an intravenous port when subjected to an intervention: blowing soap bubbles or having a heated pillow vs. standard care. Twenty-eight children, 2-7 years, cared for at a paediatric oncology unit, undergoing a routine needle insertion in an intravenous port were included consecutively. All children were subjected to two needle insertions; at the first they received standard care, and at the second standard care + a randomized intervention. Parents and nurses assessed children's fear, distress and pain on 0-100 mm visual analogue scales. According to parents' report, children experienced less fear when subjected to intervention vs. standard care reported by parents (P < 0.001). Children also experienced less fear (P < 0.05) and distress (P < 0.05) when subjected to standard care + blowing soap bubbles vs. standard care (n = 14), and less fear when subjected to standard care + heated pillow vs. standard care (P < 0.05). Nurses' reports did not show any differences for standard care + intervention vs. standard care. Blowing soap bubbles or having a heated pillow is more effective than standard care in reducing children's fear and distress in needle procedures, according to parents' report.

  8. Clinton said to be serious about vetoing ban on needles.

    PubMed

    1999-09-01

    Congress is ready to pass an appropriations bill barring the District of Columbia from using its own funds for needle-exchange programs. The Clinton administration appears ready to veto, if the bill passes. D.C. representative, Eleanor Holmes Norton, is asking that the bill be voted down when Congress returns in September.

  9. Structural peculiarities of single crystal diamond needles of nanometer thickness

    NASA Astrophysics Data System (ADS)

    Orekhov, Andrey S.; Tuyakova, Feruza T.; Obraztsova, Ekaterina A.; Loginov, Artem B.; Chuvilin, Andrey L.; Obraztsov, Alexander N.

    2016-11-01

    Diamond is attractive for various applications due to its unique mechanical and optical properties. In particular, single crystal diamond needles with high aspect ratios and sharp apexes of nanometer size are demanded for different types of optical sensors including optically sensing tip probes for scanning microscopy. This paper reports on electron microscopy and Raman spectroscopy characterization of the diamond needles having geometrically perfect pyramidal shapes with rectangular atomically flat bases with (001) crystallography orientation, 2–200 nm sharp apexes, and with lengths from about 10–160 μm. The needles were produced by selective oxidation of (001) textured polycrystalline diamond films grown by chemical vapor deposition. Here we study the types and distribution of defects inside and on the surface of the single crystal diamond needles. We show that sp3 type point defects are incorporated into the volume of the diamond crystal during growth, while the surface of the lateral facets is enriched by multiple extended defects. Nitrogen addition to the reaction mixture results in increase of the growth rate on {001} facets correlated with the rise in the concentration of sp3 type defects.

  10. Removing Phosphorus from Aqueous Solutions Using Lanthanum Modified Pine Needles

    PubMed Central

    Wang, Xianze; Liu, Zhongmou; Liu, Jiancong; Huo, Mingxin; Huo, Hongliang; Yang, Wu

    2015-01-01

    The renewable pine needles was used as an adsorbent to remove phosphorus from aqueous solutions. Using batch experiments, pine needles pretreated with alkali-isopropanol (AI) failed to effectively remove phosphorus, while pine needles modified with lanthanum hydroxide (LH) showed relatively high removal efficiency. LH pine needles were effective at a wide pH ranges, with the highest removal efficiency reaching approximately 85% at a pH of 3. The removal efficiency was kept above 65% using 10 mg/L phosphorus solutions at desired pH values. There was no apparent significant competitive behavior between co-existing anions of sulfate, nitrate, and chloride (SO42-, NO3- and Cl-); however, CO32- exhibited increased interfering behavior as concentrations increased. An intraparticle diffusion model showed that the adsorption process occurred in three phases, suggesting that a boundary layer adsorption phenomena slightly affected the adsorption process, and that intraparticle diffusion was dominant. The adsorption process was thermodynamically unfavorable and non-spontaneous; temperature increases improved phosphorus removal. Total organic carbon (TOC) assays indicated that chemical modification reduced the release of soluble organic compounds from 135.6 mg/L to 7.76 mg/L. This new information about adsorption performances provides valuable information, and can inform future technological applications designed to remove phosphorus from aqueous solutions. PMID:26630014

  11. 26. VIEW SHOWING NEEDLE VALVE TRASH RACK NEARING COMPLETION. ARCHES ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. VIEW SHOWING NEEDLE VALVE TRASH RACK NEARING COMPLETION. ARCHES VISIBLE IN THIS PICTURE ARE 8, 9, 10, AND 11, WHICH HAVE BEEN COMPLETED TO SPRINGING LINE ELEVATIONS 1700, 1744, 1766 AND 1766 RESPECTIVELY. January 1, 1939 - Bartlett Dam, Verde River, Phoenix, Maricopa County, AZ

  12. Robotic systems for percutaneous needle-guided interventions.

    PubMed

    Kettenbach, Joachim; Kronreif, Gernot

    2015-02-01

    Several groups have developed robotic systems for invasive medical procedures. In this article we will focus on selected robotic systems for percutaneous needle-guided interventions using CT or MR imaging. We present six interventional robotic systems designed to work with imaging modalities such as CT, Cone-beam CT and MRI. The details of each system are given along with any phantom, animal, or human trials performed with each particular robot. Although each of these systems has specific features, they are all of great clinical value since they provide very stable needle guidance -- even for angulated approaches, they may allow access to lesions when the width of the CT- or MR- gantry would limit the access for a biopsy needle or other interventional tools such as thermal ablation probes. Then, such a robot may be able to guide the needle into the most promising region of the lesion without the need for a second contrast injection. Thus, more efficacious characterization and treatment, particularly for lesions that are difficult to target, can be anticipated. Although more research and clinical trials are certainly needed, it is, however, our belief that robotic systems will be an important part of future interventions.

  13. Fine-needle aspiration of the salivary glands.

    PubMed

    Zarka, M A

    1996-01-01

    Fine-needle aspiration is increasingly used in community practices for the diagnosis of salivary gland lesions, and it often renders an unequivocal diagnosis. This chapter discusses in detail the technical considerations of FNA, non-neoplastic and inflammatory conditions, benign neoplasms, common malignant neoplasms, and rare malignant neoplasms.

  14. [Fine-needle puncture of salivary gland tumors].

    PubMed

    Hustin, J; Lejuste, P

    1989-12-01

    Fine needle aspiration cytology of major salivary glands is easy to perform at a low cost. Its predictive value is 100% for malignancy. Its main indications are: the diagnosis of inflammatory lesions, of malignant growths (either epithelial or lymphoma or metastases) and the follow-up of benign lesions which are not immediately amenable to surgery.

  15. New real time needle segmentation technique using grayscale Hough transformation

    NASA Astrophysics Data System (ADS)

    Qiu, Wu; Zhou, Hua; Ding, Mingyue; Zhang, Songgeng

    2007-12-01

    Real-time needle segmentation and tracking is very important in image-guided surgery, biopsy, and therapy. In this paper, we described an automated technique to provide real-time needle segmentation from a sequence of 2-D ultrasound images for the use of guidance of a needle to the target in soft tissues. The Hough transform is used to find straight lines or analytic curves in binary image. Hough transform is applied usually to binary images. Hence one needs to convert, initially, the gray level image to a binary one (through thresholding, edge detection, or thinning) in order to apply the HT. While in the process of binarization, some information about line segments in the image may be lost when an inappropriate threshold is used. Gray-Scale Hough Transform can detect the line without binarization. Unfortunately, its high computational cost often prevents it from being applied in real-time applications without the help of specially designed hardware. In this paper, we proposed a needle segmentation technique based on a real-time gray-scale Hough transform. It is composed of an improved Gray Hough Transformation and a coarse-fine search strategy. Furthermore, the RTGHT (Real-Time Gray-Scale Hough Transform) technique is evaluated by patient breast biopsy images. Experiments with patient breast biopsy ultrasound (US) image sequences showed that our approach can segment the biopsy needle in real time (i.e., less than 60 ms) with the angular rms error of about 1° and the position rms error of about 0.5 mm an affordable PC computer without the help of specially designed hardware.

  16. Needle Migration to the Heart: An Unusual Association of Hemodialysis and Cardiovascular Morbidity.

    PubMed

    Honikman, Rafael; Chikwe, Joanna; Tokita, Joji Erik; Mittnacht, Alexander J C

    2015-10-15

    In this report, we present a unique complication of hemodialysis: the hemodialysis access needle was lost into an arteriovenous fistula. The event went unnoticed for several months. The needle eventually migrated into the right ventricle, requiring an operative retrieval. Loss of the needle was likely unrecognized because of the use of a retracting safety cannula that conceals the needle within a sheath after removal. This case highlights a rare and potentially serious complication of hemodialysis access, demonstrates a possible hazard of retracting safety needles, and reviews the management of foreign bodies that have migrated into the heart.

  17. Scattering from a random layer embedded with dielectric needles. [for applications to coniferous vegetation

    NASA Technical Reports Server (NTRS)

    Eom, H. J.; Fung, A. K.

    1986-01-01

    Intensity scattering from a random layer imbedded with small dielectric needles is studied for applications to coniferous vegetation. The phase matrix of a thin needle whose length may be appreciable compared to the incident wavelength is presented. The effects of needle orientation on scattering is taken into account by averaging the phase function over angles of orientation. The backscattering coefficient from the layer is computed by solving the radiative transfer equation. The effects of operating frequency, orientation and size of a needle on like- and cross-backscattering are demonstrated. It was found that in backscattering angular trends are mainly controlled by the orientation of the needles.

  18. Dual-core antiresonant hollow core fibers.

    PubMed

    Liu, Xuesong; Fan, Zhongwei; Shi, Zhaohui; Ma, Yunfeng; Yu, Jin; Zhang, Jing

    2016-07-25

    In this work, dual-core antiresonant hollow core fibers (AR-HCFs) are numerically demonstrated, based on our knowledge, for the first time. Two fiber structures are proposed. One is a composite of two single-core nested nodeless AR-HCFs, exhibiting low confinement loss and a circular mode profile in each core. The other has a relatively simple structure, with a whole elliptical outer jacket, presenting a uniform and wide transmission band. The modal couplings of the dual-core AR-HCFs rely on a unique mechanism that transfers power through the air. The core separation and the gap between the two cores influence the modal coupling strength. With proper designs, both of the dual-core fibers can have low phase birefringence and short modal coupling lengths of several centimeters.

  19. Precision grid and hand motion for accurate needle insertion in brachytherapy

    SciTech Connect

    McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.; McLaughlin, Patrick W.; Shih, Albert J.

    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 the 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.

  20. In vivo motion and force measurement of surgical needle intervention during prostate brachytherapy

    SciTech Connect

    Podder, Tarun; Clark, Douglas; Sherman, Jason; Fuller, Dave; Messing, Edward; Rubens, Deborah; Strang, John; Brasacchio, Ralph; Liao, Lydia; Ng, W.-S.; Yu Yan

    2006-08-15

    In this paper, we present needle insertion forces and motion trajectories measured during actual brachytherapy needle insertion while implanting radioactive seeds in the prostate glands of 20 different patients. The needle motion was captured using ultrasound images and a 6 degree-of-freedom electromagnetic-based position sensor. Needle velocity was computed from the position information and the corresponding time stamps. From in vivo data we found the maximum needle insertion forces to be about 15.6 and 8.9 N for 17 gauge (1.47 mm) and 18 gauge (1.27 mm) needles, respectively. Part of this difference in insertion forces is due to the needle size difference (17G and 18G) and the other part is due to the difference in tissue properties that are specific to the individual patient. Some transverse forces were observed, which are attributed to several factors such as tissue heterogeneity, organ movement, human factors in surgery, and the interaction between the template and the needle. However, theses insertion forces are significantly responsible for needle deviation from the desired trajectory and target movement. Therefore, a proper selection of needle and modulated velocity (translational and rotational) may reduce the tissue deformation and target movement by reducing insertion forces and thereby improve the seed delivery accuracy. The knowledge gleaned from this study promises to be useful for not only designing mechanical/robotic systems but also developing a predictive deformation model of the prostate and real-time adaptive controlling of the needle.

  1. [Research thoughts and methodology on efficacy specificity of needling and moxibustion methods based upon data mining].

    PubMed

    Jia, Chun-sheng; Li, Xiao-feng; Wang, Jian-ling; Xu, Jing

    2011-02-01

    The method for needling and moxibustion is an indispensable component of acupuncturology. In clinical practice of acupuncture and moxibustion, efficacy specificity of different needling and moxibustion methods for different clinical conditions or different phases of a disease exists objectively, which is in a close relation with the results of clinical interventions. Starting with the correlation between the efficacy specificity of different needling and moxibustion methods and different clinical conditions or syndromes, the authors of the present paper put forward to collect abundant literature on needling and moxibustion methods, extract and analyze standard formats of information, establish literature database on needling and moxibustion methods and then design literature data application platform. On the basis of those mentioned above, a data mining model of needling and moxibustion methods will be established for revealing the potential knowledge and regularities about application of needling and moxibustion methods from the related abundant fuzzy and incomplete literature data according to data analysis and designed research program on efficacy specificity.

  2. Toward robotic needle steering in lung biopsy: a tendon-actuated approach

    NASA Astrophysics Data System (ADS)

    Kratchman, Louis B.; Rahman, Mohammed M.; Saunders, Justin R.; Swaney, Philip J.; Webster, Robert J., III

    2011-03-01

    Needle tip dexterity is advantageous for transthoracic lung biopsies, which are typically performed with rigid, straight biopsy needles. By providing intraoperative compensation for trajectory error and lesion motion, tendon-driven biopsy needles may reach smaller or deeper nodules in fewer attempts, thereby reducing trauma. An image-guided robotic system that uses these needles also has the potential to reduce radiation exposure to the patient and physician. In this paper, we discuss the design, workflow, kinematic modeling, and control of both the needle and a compact and inexpensive robotic prototype that can actuate the tendon-driven needle for transthoracic lung biopsy. The system is designed to insert and steer the needle under Computed Tomography (CT) guidance. In a free-space targeting experiment using a discrete proportional control law with digital camera feedback, we show a position error of less than 1 mm achieved using an average of 8.3 images (n=3).

  3. The Path-of-Probability Algorithm for Steering and Feedback Control of Flexible Needles

    PubMed Central

    Park, Wooram; Wang, Yunfeng; Chirikjian, Gregory S.

    2010-01-01

    In this paper we develop a new framework for path planning of flexible needles with bevel tips. Based on a stochastic model of needle steering, the probability density function for the needle tip pose is approximated as a Gaussian. The means and covariances are estimated using an error propagation algorithm which has second order accuracy. Then we adapt the path-of-probability (POP) algorithm to path planning of flexible needles with bevel tips. We demonstrate how our planning algorithm can be used for feedback control of flexible needles. We also derive a closed-form solution for the port placement problem for finding good insertion locations for flexible needles in the case when there are no obstacles. Furthermore, we propose a new method using reference splines with the POP algorithm to solve the path planning problem for flexible needles in more general cases that include obstacles. PMID:21151708

  4. Silicon Needles Fabricated by Highly Selective Anisotropic Dry Etching and Their Field Emission Current Characteristics

    NASA Astrophysics Data System (ADS)

    Kanechika, Masakazu; Mitsushima, Yasuichi

    2000-12-01

    A new process to fabricate a silicon needle, whose tip radius is about 5 nm and aspect ratio is about 7, was developed. The silicon needles were fabricated by highly selective anisotropic dry etching. The etching mask was oxygen precipitation, which was formed by nitrogen ion implantation and the subsequent oxidation. The process is simple enough to be integrated with complementary metal-oxide-semiconductor (CMOS) circuits. The density of the silicon needle can be controlled by adjusting the dose for nitrogen ion implantation. The position of the silicon needle can be controlled by adjusting the position for nitrogen ion implantation, because silicon needles are formed only in the nitrogen ion implantation area. Furthermore, using these silicon needles as micro emitters, a field emission diode was fabricated. The Fowler-Nordheim plot shows that the field around the tip of the silicon needles was highly enhanced.

  5. Effects of vibration excitation methodology and configuration of an acoustic needle on its tip vibration.

    PubMed

    Li, Ning; Hu, Junhui

    2013-04-01

    One of design purposes of an acoustic needle is to obtain a big vibration displacement at its tip. In this paper, vibration characteristics of the tip of the acoustic needle driven by a sandwich type ultrasonic transducer, is investigated to obtain the guidelines for increasing the tip vibration. It is found that the tip vibration can be increased by employing acoustic needles with proper vibration excitation structure and configuration. The effective measures include using a sandwich type piezoelectric transducer with flexurally vibrating end plates and an acoustic needle with conical tip section, decreasing the length of vibration excitation section at the needle root, bonding the needle root at a proper location of the transducer end plate, and tuning the length ratio of the conical tip section to the whole needle. PMID:23294988

  6. Cancer cell profiling by barcoding allows multiplexed protein analysis in fine needle aspirates

    PubMed Central

    Ullal, Adeeti V.; Peterson, Vanessa; Agasti, Sarit S.; Tuang, Suan; Juric, Dejan; Castro, Cesar M.; Weissleder, Ralph

    2014-01-01

    Immunohistochemistry-based clinical diagnoses require invasive core biopsies and use a limited number of protein stains to identify and classify cancers. Here, we introduce a technology that allows analysis of hundreds of proteins from minimally invasive fine needle aspirates (FNA), which contain much smaller numbers of cells than core biopsies. The method capitalizes on DNA-barcoded antibody sensing where barcodes can be photo-cleaved and digitally detected without any amplification steps. Following extensive benchmarking in cell lines, this method showed high reproducibility and achieved single cell sensitivity. We used this approach to profile ~90 proteins in cells from FNAs and subsequently map patient heterogeneity at the protein level. Additionally, we demonstrate how the method could be used as a clinical tool to identify pathway responses to molecularly targeted drugs and to predict drug response in patient samples. This technique combines specificity with ease of use to offer a new tool for understanding human cancers and designing future clinical trials. PMID:24431113

  7. Temporal Isotopic Variations of Leaf Water in Pine Needles

    NASA Astrophysics Data System (ADS)

    Shu, Y.; Feng, X.; Faiia, A. M.

    2005-05-01

    Understanding the isotopic variations in a plant's leaf water is important for a number of climatological and biogeochemical studies. Leaf water isotopic composition is affected by the isotopic composition of the source water and the relative humidity of the air, both of which are related to climate. This dependency is the basis for climate reconstruction using isotopic compositions of tree-ring cellulose. The isotopic composition of leaf water is also important for the assessment of terrestrial biological productivity and the quantification of the Dole effect. We have studied the oxygen and hydrogen isotopic variations in leaf water of biennial needles from red pine (Pinus resinosa) and white pine (Pinus strobes) in Hanover, New Hampshire, USA. We have examined the leaf water δD and δ18O values along pine needles from base to tip, and the isotopic differences between young and old leaves. Within a needle, progressive enrichments of both oxygen-18 and deuterium were observed toward the tip, ranging for δD from -60.1 to 9.4 permil in white pine and -67.1 to -34.9 permil in red pine, and for δ18O from -3.1 to 19.1 for white pine and -7.3 to 5.5 permil in red pine. For both species, δD and δ18O were higher in old leaves than in young leaves. The isotopic difference between old and young leaves was most pronounced earlier in the growing season; the gap narrowed with time and finally disappeared in early fall. Early in the growing season, the δD values of young needles were -21 and -30 permil in white and red pine, respectively, and that of old needles were -3.0 and -8.0 permil, respectively. The δ18O values showed similar trends, and the δD vs. δ18O slope for the young leaves decreased from 3.6 in spring to ~1 in early autumn. Our observations can be simulated using the progressive isotopic enrichment model proposed by Barnes and Farquhar for monocotyledoneous leaves. Two variables, the transpiration rate and length of the needle, can explain the observed

  8. Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance

    PubMed Central

    Braak, S J; Fütterer, J J; van Strijen, M J L; Hoogeveen, Y L; de Lange, F; Schultze Kool, L J

    2013-01-01

    Objective: To determine the accuracy of cone beam CT (CBCT) guidance and CT guidance in reaching small targets in relation to needle path complexity in a phantom. Methods: CBCT guidance combines three-dimensional CBCT imaging with fluoroscopy overlay and needle planning software to provide real-time needle guidance. The accuracy of needle positioning, quantified as deviation from a target, was assessed for inplane, angulated and double angulated needle paths. Four interventional radiologists reached four targets along the three paths using CBCT and CT guidance. Accuracies were compared between CBCT and CT for each needle path and between the three approaches within both modalities. The effect of user experience in CBCT guidance was also assessed. Results: Accuracies for CBCT were significantly better than CT for the double angulated needle path (2.2 vs 6.7 mm, p<0.001) for all radiologists. CBCT guidance showed no significant differences between the three approaches. For CT, deviations increased with increasing needle path complexity from 3.3 mm for the inplane placements to 4.4 mm (p=0.007) and 6.7 mm (p<0.001) for the angulated and double angulated CT-guided needle placements, respectively. For double angulated needle paths, experienced CBCT users showed consistently higher accuracies than trained users [1.8 mm (range 1.2–2.2) vs 3.3 mm (range 2.1–7.2) deviation from target, respectively; p=0.003]. Conclusion: In terms of accuracy, CBCT is the preferred modality, irrespective of the level of user experience, for more difficult guidance procedures requiring double angulated needle paths as in oncological interventions. Advances in knowledge: Accuracy of CBCT guidance has not been discussed before. CBCT guidance allows accurate needle placement irrespective of needle path complexity. For angulated and double-angulated needle paths, CBCT is more accurate than CT guidance. PMID:23913308

  9. A case of matrix-producing metaplastic carcinoma of the breast exhibiting similarities to pleomorphic adenoma on fine-needle aspiration cytology.

    PubMed

    Tajima, Shogo; Koda, Kenji; Ishii, Yumie; Hasegawa, Satoshi; Yokoyama, Hidetarou

    2015-01-01

    The distinction between matrix-producing metaplastic carcinoma (MPMC) and pleomorphic adenoma (PA) is sometimes unclear in breast pathology, especially on core needle biopsy. Herein, we presented a 66-year-old woman with MPMC of the breast that looked like PA on fine-needle aspiration cytology (FNAC). On FNAC, the appearance of abundant myxoid matrix along with cellular clusters composed of monotonous cellular populations looked like salivary PA, which we were familiar with owing to the frequency in routine pathological practice. Thus, the possibility of breast PA, the counterpart of salivary PA, was considered. However, the tumor location was different from where breast PA frequently occurs, i.e. the retroareolar region. Therefore, we eliminated the possibility of breast PA and avoided the erroneous cytological diagnosis. It is should be kept in mind that MPMC can look like PA on FNAC.

  10. Atrial fibrillation and pneumothorax after transthoracic needle lung biopsy

    PubMed Central

    Liu, Alexander; Southern, Iain; Nicol, Edward

    2012-01-01

    An obese 65-year-old male smoker with chronic obstructive pulmonary disease developed an iatrogenic pneumothorax with pulmonary haemorrhage during an elective transthoracic needle biopsy of a pulmonary lesion. Successful re-inflation was achieved with a chest drain which was then removed before transfer to the medical ward. He later developed persistent atrial fibrillation with breathlessness and haemoptysis. He was treated empirically for a pulmonary embolus, which was subsequently ruled out with CT pulmonary angiogram. Serial chest radiographs demonstrated recurrence of his pneumothorax and a chest drain was re-inserted. His atrial fibrillation was erroneously managed as supraventricular tachycardia, which was resistant to vagal manoeuvres and adenosine but later responded to intravenous amiodarone before a further relapse. Upon successful management of the pneumothorax, his atrial fibrillation terminated. This case highlighted the persistent and serious nature of complications posttransthoracic needle biopsy. PMID:22665868

  11. A thousand points ... needle exchange around the country.

    PubMed

    Sorge, R

    1990-01-01

    Needle exchange in the United States is a part of the AIDS direct action movement. Activists around the country, refusing to wait for health officials to create AIDS interventions for drug users, have taken the task upon themselves. Prevention Point in San Francisco, the National AIDS Brigade in Boston, and ACT UP/New York all run illegal programs in their locales, and member of all three groups have been arrested for their work. Tacoma, Seattle, and New Haven now have authorized programs, but only after Dave Purchase in Tacoma, ACT UP Seattle, and the National AIDS Brigade and ACES in New Haven demonstrated that needle exchange was a viable and necessary public health intervention. Health/PAC here presents some of the stories from this citizen's health action movement.

  12. A Wrist for Needle-Sized Surgical Robots

    PubMed Central

    York, Peter A.; Swaney, Philip J.; Gilbert, Hunter B.; Webster, Robert J.

    2015-01-01

    The needle-sized surgical tools used in arthroscopy, otolaryngology, and other surgical fields could become even more valuable to surgeons if endowed with the ability to navigate around sharp corners to manipulate or visualize tissue. We present a needle-sized wrist design that grants this ability. It can be easily interfaced with manual tools or concentric tube robots and is straightforward and inexpensive to manufacture. The wrist consists of a nitinol tube with several asymmetric cutouts, actuated by a tendon. Perhaps counter-intuitively, within this seemingly simple design concept, design optimization is challenging due to the number of parameters available and nonlinearities in material properties. In this paper, we examine a subset of possible geometries and derive kinematic and static models. Experimental results with a 1.16 mm diameter prototype validate the models. Lastly, we provide a discussion summarizing the lessons learned in our early experience designing and fabricating wrists of this type. PMID:26405562

  13. Needles of Pinus halepensis as Biomonitors of Bioaerosol Emissions

    PubMed Central

    Galès, Amandine; Latrille, Eric; Wéry, Nathalie; Steyer, Jean-Philippe; Godon, Jean-Jacques

    2014-01-01

    We propose using the surface of pine trees needles to biomonitor the bioaerosol emissions at a composting plant. Measurements were based on 16S rRNA gene copy numbers of Saccharopolyspora rectivirgula, a bioindicator of composting plant emissions. A sampling plan was established based on 29 samples around the emission source. The abundance of 16S rRNA gene copies of S. rectivirgula per gram of Pinus halepensis needles varied from 104 to 102 as a function of the distance. The signal reached the background level at distances around the composting plant ranging from 2 km to more than 5.4 km, depending on the local topography and average wind directions. From these values, the impacted area around the source of bioaerosols was mapped. PMID:25379901

  14. Silica needle template fabrication of metal hollow microneedle arrays

    NASA Astrophysics Data System (ADS)

    Zhu, M. W.; Li, H. W.; Chen, X. L.; Tang, Y. F.; Lu, M. H.; Chen, Y. F.

    2009-11-01

    Drug delivery through hollow microneedle (HMN) arrays has now been recognized as one of the most promising techniques because it minimizes the shortcomings of the traditional drug delivery methods and has many exciting advantages—pain free and tunable release rates, for example. However, this drug delivery method has been hindered greatly from mass clinical application because of the high fabrication cost of HMN arrays. Hence, we developed a simple and cost-effective procedure using silica needles as templates to massively fabricate HMN arrays by using popular materials and industrially applicable processes of micro- imprint, hot embossing, electroplating and polishing. Metal HMN arrays with high quality are prepared with great flexibility with tunable parameters of area, length of needle, size of hollow and array dimension. This efficient and cost-effective fabrication method can also be applied to other applications after minor alterations, such as preparation of optic, acoustic and solar harvesting materials and devices.

  15. Ultrasound-guided needle aspiration of amoebic liver abscess.

    PubMed Central

    Ramani, A.; Ramani, R.; Kumar, M. S.; Lakhkar, B. N.; Kundaje, G. N.

    1993-01-01

    This prospective study was carried out on 200 patients with clinically, ultrasonographically and serologically confirmed amoebic liver abscess. The role of ultrasound-guided needle aspiration in addition to medications was evaluated compared to drug treatment alone. Both the groups were monitored clinically and sonographically for up to 6 months after diagnosis. The initial response (after 15 days) was better in the aspirated group (P < 0.05) but resolution of abscess after 6 months were similar. There was a more rapid clinical response in the aspirated group, particularly in those with larger (> 6 cm) abscesses and there were no complications. Percutaneous ultrasound-guided needle aspiration is a safe diagnostic and therapeutic approach which enhances clinical recovery, accelerates resolution, especially in large abscesses, and prevents complications. PMID:8346134

  16. Study of benign superficial cysts by fine needle aspiration cytology.

    PubMed

    Roy, M; Bhattacharyya, A; Sanyal, S; Dasgupta, S

    1995-01-01

    Fine needle aspiration cytology of 213 cases of different cystic lesions from various regions of body and different superficial organs was analysed in an attempt to present the experience of the authors in the diagnosis of such lesions. The predominant lesion diagnosed by fine needle aspiration cytology was adnexal cyst/sebaceous cyst (41 cases) followed by vascular hamartoma (40 cases) and thyroglossal cyst (9 cases). One hundred fifty-eight (74.2%) out 213 cases were confirmed histopathologically. There was false negative diagnosis in 14 cases (6.6%). The remaining 41 (19.2%) cases did not turn up for further treatment. The fallacies that have been recorded in the diagnosis of thyroid cysts, salivary gland cysts and breast cysts in respect of papillary cystic thyroid carcinoma, muco-epidermoid carcinoma of salivary gland and intraductal carcinoma with fibrocystic disease of breast respectively have been highlighted in the present study.

  17. Fine needle aspiration biopsy cytology of major salivary glands.

    PubMed

    Qizilbash, A H; Sianos, J; Young, J E; Archibald, S D

    1985-01-01

    Fine needle aspiration biopsy of the major salivary glands was performed on 160 patients. In 146 patients with satisfactory samples, the cytologic diagnosis was correlated with clinical follow-up and histologic findings. There were 122 benign lesions, including 47 tumors. There were 24 malignant lesions, 10 of which were primary and 14 metastatic. The overall accuracy was 98%. The sensitivity of the technique was 87.5%. There was no false-positive diagnosis. There were three false-negative diagnoses due to sampling errors and inexperience during the initial period of the study. This study documents that needle aspiration biopsy cytology of the salivary glands is accurate, simple, rapid, inexpensive, well tolerated and harmless to the patient.

  18. Existence of needle crystals in local models of solidification

    NASA Technical Reports Server (NTRS)

    Langer, J. S.

    1986-01-01

    The way in which surface tension acts as a singular perturbation to destroy the continuous family of needle-crystal solutions of the steady-state growth equations is analyzed in detail for two local models of solidification. All calculations are performed in the limit of small surface tension or, equivalently, small velocity. The basic mathematical ideas are introduced in connection with a quasilinear, isotropic version of the geometrical model of Brower et al., in which case the continuous family of solutions dissappears completely. The formalism is then applied to a simplified boundary-layer model with an anisotropic kinetic attachment coefficient. In the latter case, the solvability condition for the existence of needle crystals can be satisfied whenever the coefficient of anisotropy is arbitrarily small but nonzero.

  19. [The enlightenment of Fu's subcutaneous needling on pain medicine].

    PubMed

    Li, Gui-Feng; Fu, Zhong-Hua

    2014-06-01

    Fu's subcutaneous needling (FSN) is a modern approach developed from traditional Chinese acupuncture. It could give some stimulation in the subcutaneous region that has a quick and long-lasting effect on soft tissue injuries and some of the internal medicine diseases. It is a safe approach without adverse reaction. Through analysis of the features and possible mechanism of FSN, it is believed that research on mechanism of FSN is beneficial to the development of modern medicine, especially to pain management.

  20. Needle placement for piriformis injection using 3-D imaging.

    PubMed

    Clendenen, Steven R; Candler, Shawn A; Osborne, Michael D; Palmer, Scott C; Duench, Stephanie; Glynn, Laura; Ghazi, Salim M

    2013-01-01

    Piriformis syndrome is a pain syndrome originating in the buttock and is attributed to 6% - 8% of patients referred for the treatment of back and leg pain. The treatment for piriformis syndrome using fluoroscopy, computed tomography (CT), electromyography (EMG), and ultrasound (US) has become standard practice. The treatment of Piriformis Syndrome has evolved to include fluoroscopy and EMG with CT guidance. We present a case study of 5 successful piriformis injections using 3-D computer-assisted electromagnet needle tracking coupled with ultrasound. A 6-degree of freedom electromagnetic position tracker was attached to the ultrasound probe that allowed the system to detect the position and orientation of the probe in the magnetic field. The tracked ultrasound probe was used to find the posterior superior iliac spine. Subsequently, 3 points were captured to register the ultrasound image with the CT or magnetic resonance image scan. Moreover, after the registration was obtained, the navigation system visualized the tracked needle relative to the CT scan in real-time using 2 orthogonal multi-planar reconstructions centered at the tracked needle tip. Conversely, a recent study revealed that fluoroscopically guided injections had 30% accuracy compared to ultrasound guided injections, which tripled the accuracy percentage. This novel technique exhibited an accurate needle guidance injection precision of 98% while advancing to the piriformis muscle and avoiding the sciatic nerve. The mean (± SD) procedure time was 19.08 (± 4.9) minutes. This technique allows for electromagnetic instrument tip tracking with real-time 3-D guidance to the selected target. As with any new technique, a learning curve is expected; however, this technique could offer an alternative, minimizing radiation exposure. PMID:23703429

  1. Solitary fibrous tumour of the prostate identified on needle biopsy.

    PubMed

    Galosi, Andrea B; Mazzucchelli, Roberta; Scarpelli, Marina; Lopez-Beltran, Antonio; Cheng, Liang; Muzzonigro, Giovanni; Montironi, Rodolfo

    2009-09-01

    The clinical and radical prostatectomy features of a case of solitary fibrous tumour (SFT) of the prostate identified on needle biopsy are presented. The main differential diagnoses are discussed. SFTs involving the prostate are relatively uncommon, with only isolated cases reported in the literature. Owing to their relative rarity and lack of long-term follow-up, the clinical behaviour of prostatic SFTs is difficult to predict. Complete resection of the tumour is currently the single main prognostic factor.

  2. Low coherence interferometry approach for aiding fine needle aspiration biopsies

    NASA Astrophysics Data System (ADS)

    Chang, Ernest W.; Gardecki, Joseph; Pitman, Martha; Wilsterman, Eric J.; Patel, Ankit; Tearney, Guillermo J.; Iftimia, Nicusor

    2014-11-01

    We present portable preclinical low-coherence interference (LCI) instrumentation for aiding fine needle aspiration biopsies featuring the second-generation LCI-based biopsy probe and an improved scoring algorithm for tissue differentiation. Our instrument and algorithm were tested on 38 mice with cultured tumor mass and we show the specificity, sensitivity, and positive predictive value of tumor detection of over 0.89, 0.88, and 0.96, respectively.

  3. Efficacy of needle biopsy in postradiation thyroid disease

    SciTech Connect

    Rosen, I.B.; Palmer, J.A.; Bain, J.; Strawbridge, H.; Walfish, P.G.

    1983-12-01

    Retrospective review was carried out of 124 patients with nodular disease of the thyroid gland and a history of radiation exposure who had undergone needle aspiration biopsy. Latency period from time of radiation varied from 2 to 50 years; but in 92 patients it exceeded 2 decades. Our patient group included those with occupational exposure and a past history of radiation for cancer. Incidence of cancer in the entire group was 49% but, for solitary lesions, this was increased to 56%, while only a 30% incidence of cancer was found in cases of multinodular goiters. Accuracy of needle aspiration biopsy overall was 74%: for the group with cancer--90%, for the group with adenomas--65%, and for the group with ''benign'' tumors--83%. Further assessment of needle technique indicated a sensitivity of 70%, specificity of 90%, positive predictive value of 90%, and negative predictive value of 83% to 65%. The accuracy could be increased to 84% if all adenomas were considered as possible malignancies. Eighteen percent of our patients had second tumors in the head and neck or breast area. Near-total thyroidectomy was considered to be the preferred procedure without accidental nerve injury and was done in one case of hypoparathyroidism after excision of an extensive tracheal invasive cancer. No evidence of death, recurrence, or metastasis as a result of thyroid cancer has been noted. While needle biopsy is indispensable to intelligent management, the history of radiation to the head and neck area must be preeminent in the selection of patients for surgical treatment. Conservative management appears to be reasonable in those patients with ''benign'' cytology, a less than 1 cm nodule, multinodularity, a functioning thyroid scan result, but persistence in the face of a lack of response to conservative management does not appear to be warranted.

  4. Radio frequency needle hyperthermia of normal and cancerous animal tissue

    NASA Astrophysics Data System (ADS)

    Shalhav, Arieh; Ramon, J.; Goldwasser, Benad; Nativ, Ofer; Cherniack, Ramy; Zajdel, Liliana

    1994-12-01

    Capacitative radio frequency (RF) was met with little success when used to treat human cancer. Conductive rf needle hyperthermia (RFNH) is used successfully for human tissue ablation in neurosurgery, cardiology, and recently in urology. RFNH ablates tissue by causing thermal damage limited to the vicinity of the rf needle. We conducted a series of studies to evaluate the effect of RFNH on cancerous and normal tissue. RFNH was applied to normal porcine livers during open surgery. Liver function tests were elevated two days post treatment, then returned to normal. Pigs were sequentially sacrificed. RFNH induced lesions were found to be maximal in size on days 2 - 4 post treatment and later became smaller as liver regenerated. Phase 2 included mice bearing two subcutaneous murine bladder tumors (MBT2). The rf needle was inserted into both tumors of each mouse, but rf current was applied to one tumor only. Energies of 3 to 7.5 watts were applied for 30 seconds to 5 minutes using a 0.02 inch needle. Mice were sacrificed 0, 1, and 3 days after treatment. Necrotic lesions 0.5 - 1.2 cm in diameter were found within the treated tumors. In phase 3, mice bearing a single 8 - 18 mm subcutaneous tumor were treated by RFNH aiming for complete tumor destruction. All control mice died of huge tumors within 31 days. Treated mice were alive with no signs of tumor when sacrificed 60 days after treatment. In phase 3 RFNH is capable of complete tumor eradication with little damage to surrounding normal tissue. It may have clinical applications for percutaneous endoscopic and laparoscopic treatment of tumors.

  5. Low coherence interferometry approach for aiding fine needle aspiration biopsies

    PubMed Central

    Chang, Ernest W.; Gardecki, Joseph; Pitman, Martha; Wilsterman, Eric J.; Patel, Ankit; Tearney, Guillermo J.; Iftimia, Nicusor

    2014-01-01

    Abstract. We present portable preclinical low-coherence interference (LCI) instrumentation for aiding fine needle aspiration biopsies featuring the second-generation LCI-based biopsy probe and an improved scoring algorithm for tissue differentiation. Our instrument and algorithm were tested on 38 mice with cultured tumor mass and we show the specificity, sensitivity, and positive predictive value of tumor detection of over 0.89, 0.88, and 0.96, respectively. PMID:25375634

  6. Growth of Ferrite Needles in Compacted Graphite Cast Iron

    NASA Astrophysics Data System (ADS)

    Durán, G. A.; Perez, T.; Gregorutti, R. W.; Mercader, R. C.; Desimoni, J.

    2005-04-01

    The austempering kinetics transformation of compacted graphite cast irons austempered at 623K is studied. The length (l) and the number per unit volume (N) of ferrite needles were followed by Scanning Electron Microscopy (SEM), while Mössbauer spectroscopy (MS) was used to determine the austenite relative areas. The SEM results are compared with theoretical calculations available in the literature and indicate that the diffusion of C atoms in austenite controls the transformation, confirming the indirect MS determinations.

  7. Growth of Ferrite Needles in Compacted Graphite Cast Iron

    SciTech Connect

    Duran, G.A.; Mercader, R.C.; Desimoni, J.; Perez, T.; Gregorutti, R.W.

    2005-04-26

    The austempering kinetics transformation of compacted graphite cast irons austempered at 623K is studied. The length (l) and the number per unit volume (N) of ferrite needles were followed by Scanning Electron Microscopy (SEM), while Moessbauer spectroscopy (MS) was used to determine the austenite relative areas. The SEM results are compared with theoretical calculations available in the literature and indicate that the diffusion of C atoms in austenite controls the transformation, confirming the indirect MS determinations.

  8. Fine needle aspiration cytology of salivary gland lesions.

    PubMed

    Young, J A; Smallman, L A; Thompson, H; Proops, D W; Johnson, A P

    1990-01-01

    Eighty-eight fine needle aspirates from 79 salivary gland lesions in 77 patients were examined. The overall diagnostic sensitivity was 84% and the specificity 98.41%. When the 14 unsatisfactory specimens were excluded the sensitivity rose to 95.45%. Correct identification of the disease process was possible in nearly 80% of cases with a final benign diagnosis. The histological tumour type was correctly predicted in 75% of the malignancies. In the others the cytological diagnosis was anaplastic malignant neoplasm.

  9. Core-core and core-valence correlation

    NASA Technical Reports Server (NTRS)

    Bauschlicher, Charles W., Jr.; Langhoff, Stephen R.; Taylor, Peter R.

    1988-01-01

    The effect of (1s) core correlation on properties and energy separations was analyzed using full configuration-interaction (FCI) calculations. The Be 1 S - 1 P, the C 3 P - 5 S and CH+ 1 Sigma + or - 1 Pi separations, and CH+ spectroscopic constants, dipole moment and 1 Sigma + - 1 Pi transition dipole moment were studied. The results of the FCI calculations are compared to those obtained using approximate methods. In addition, the generation of atomic natural orbital (ANO) basis sets, as a method for contracting a primitive basis set for both valence and core correlation, is discussed. When both core-core and core-valence correlation are included in the calculation, no suitable truncated CI approach consistently reproduces the FCI, and contraction of the basis set is very difficult. If the (nearly constant) core-core correlation is eliminated, and only the core-valence correlation is included, CASSCF/MRCI approached reproduce the FCI results and basis set contraction is significantly easier.

  10. Serological response to administration of Brucella abortus strain RB51 vaccine in beef and dairy heifers, using needle-free and standard needle-based injection systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to compare immunologic responses of heifers vaccinated with 10**10 colony-forming units (CFU) of Brucella abortus strain RB51 (SRB51) by standard needle-and-syringe system or a needle-free injection system. Heifers were randomly assigned to control and vaccination gro...

  11. Needle catheter duodenostomy: a technique for duodenal alimentation of birds.

    PubMed

    Goring, R L; Goldman, A; Kaufman, K J; Roberts, C; Quesenberry, K E; Kollias, G V

    1986-11-01

    A technique for duodenal alimentation (needle catheter duodenostomy) of birds was developed, using the domestic pigeon (Columba livia) as the experimental model. A needle catheter was inserted into the descending duodenum of 5 pigeons and was secured to the body wall and dorsum of each bird. A liquid diet was administered daily (in equal amounts of 0, 4, 8, 12, and 16 hours) for 14 days without adverse effects. On day 15, the catheters were removed, and the birds immediately resumed normal consumption of a pigeon ration and water diet. Although 4 of the 5 birds had minor weight loss, dietary alterations probably could be used on an individual basis to alleviate this problem. After oral alimentation was resumed, the 5 birds exceeded their initial body weight within 7 days. Four weeks after catheter removal, positive-contrast radiographic evaluations indicated that the duodenum of each pigeon appeared normal. Needle catheter duodenostomy was a viable method of alimentation in the domestic pigeon. This technique should be applicable for other avian species requiring bypass of the upper gastrointestinal tract proximal to the region of catheter insertion in the duodenum.

  12. Assessing cellular DNA damage from a helium plasma needle.

    PubMed

    Morales-Ramírez, P; Cruz-Vallejo, V; Peña-Eguiluz, R; López-Callejas, R; Rodríguez-Méndez, B G; Valencia-Alvarado, R; Mercado-Cabrera, A; Muñoz-Castro, A E

    2013-06-01

    The aim of the present study is to determine the deoxyribonucleic acid (DNA) damage by cells exposed to atmospheric pressure non-thermal plasma (APNTP). Mouse leukocytes embedded in agarose were exposed to the plasma at two different distances from a helium plasma needle outlet and during three different exposure periods. Damage was assessed by the single cell gel electrophoresis assay. The results indicate that, at 0.1 cm from the plasma needle, the exposure caused complete DNA fragmentation determined by the presence of so called "clouds". Samples exposed at 0.5 cm from the slide sample surface presented damage proportional to the exposure periods in terms of tail intensity, tail moment and "clouds" frequency. Studies performed with alkaline single cell gel electrophoresis assay to determine DNA breaks and alkali-labile sites, indicates that DNA damage produced by exposure to APNTP was caused mainly by oxidative radicals, rather than by UV light which causes cyclobutane pyrimidine dimers. These results allow us to conclude that plasma needle induced DNA breaks in mice leukocytes proportionally to exposure time.

  13. Satellite exchange in the Baltimore Needle Exchange Program.

    PubMed Central

    Valente, T W; Foreman, R K; Junge, B; Vlahov, D

    1998-01-01

    OBJECTIVE: Our first objective was to develop an index of satellite exchange and then determine whether satellite exchangers (SEs) differed demographically or behaviorally from other injecting drug users (IDUs). Our second objective was to determine the degree that SEs contributed to needle exchange program (NEP) effectiveness. METHODS: We collected data from approximately 5000 Baltimore Needle Exchange Program (BNEP) participants on the number of syringes acquired and returned over the two-year period February 1995 to February 1997. We then conducted one-way ANOVAs and logistic regressions to determine if SEs were different from other IDUs. RESULTS: We classified 9.35% of the IDUs and SEs and showed that SEs reported levels of drug use and risk behavior similar to other BNEP participants. Although SEs represented less than 10% of all BNEP clients, they accounted for more than 64% of all needles distributed by the BNEP. We showed that SEs accessed more wide-ranging drug use networks than non-SE IDUs and thus can act as potential bridges for human immunodeficiency virus (HIV) prevention materials and messages to larger numbers of drug injectors. CONCLUSIONS: SEs can be expressly targeted with specific prevention messages and encouraged to be "ambassadors" for HIV prevention messages. Efforts to curtail the activities of SEs may detract from the effectiveness of NEPs. PMID:9722814

  14. Canine lymphoma: immunocytochemical analysis of fine-needle aspiration biopsy.

    PubMed

    Caniatti, M; Roccabianca, P; Scanziani, E; Paltrinieri, S; Moore, P F

    1996-03-01

    Cytospin preparations of fine-needle aspirates from 21 dogs with peripheral lymphadenopathy (18 with lymphoma and three with lymph node hyperplasia) were studied by combining morphologic and immunocytochemical analysis. Fine-needle aspirates were taken from at least two enlarged lymph nodes, and the diagnosis was based on air-dried smears stained with May-Grünwald Giemsa. Fine-needle aspiration biopsy always provided an adequate quality and quantity of cells to perform morphologic and immunologic studies. Immunophenotyping was performed on cytospin preparations with a panel of eight monoclonal antibodies specific for canine cell surface antigens and one rabbit polyclonal antibody (A452) against human CD3, which cross-reacts with dog antigen. The immunocytochemical study resulted in the diagnosis of 14 B-cell lymphomas (CD21+, CD3-) and three T-cell lymphomas (all CD3+, two CD8+). One lymphoma lacked surface antigens specific for the B- or T-cell lineage and was classified as non-B-non-T lymphoma (CD21-, CD3-, CD4-, CD8-). The monoclonal antibodies CA12.10C12, CA4.1D3, and CA1D6 and the polyclonal antibody A452, used as a group, appeared to be the most useful reagents to suggest lymphoid origin and to discriminate between T-and B-cell phenotype. Cytospin preparations in combination with immunocytochemistry provided a practical, economical, and accurate method for the diagnosis and phenotyping of canine lymphoma.

  15. Effects of Rotational Motion in Robotic Needle Insertion

    PubMed Central

    Ramezanpour, H.; Yousefi, H.; Rezaei, M.; Rostami, M.

    2015-01-01

    Background Robotic needle insertion in biological tissues has been known as one the most applicable procedures in sampling, robotic injection and different medical therapies and operations. Objective In this paper, we would like to investigate the effects of angular velocity in soft tissue insertion procedure by considering force-displacement diagram. Non-homogenous camel liver can be exploited as a tissue sample under standard compression test with Zwick/Roell device employing 1-D axial load-cell. Methods Effects of rotational motion were studied by running needle insertion experiments in 5, 50 and 200 mm/min in two types of with or without rotational velocity of 50, 150 and 300 rpm. On further steps with deeper penetrations, friction force of the insertion procedure in needle shaft was acquired by a definite thickness of the tissue. Results Designed mechanism of fixture for providing different frequencies of rotational motion is available in this work. Results for comparison of different force graphs were also provided. Conclusion Derived force-displacement graphs showed a significant difference between two procedures; however, tissue bleeding and disorganized micro-structure would be among unavoidable results. PMID:26688800

  16. Efficacy of dry needling for treatment of myofascial pain syndrome.

    PubMed

    Fogelman, Yacov; Kent, John

    2015-01-01

    Myofascial pain is a major cause of musculoskeletal regional pain. Myofascial pain, which is a high-prevalence but eminently treatable condition, is almost universally underdiagnosed by physicians and undertreated by physical therapy modalities. Large numbers of patients can be left suffering in chronic pain for years. Dry needling, also referred to as Intramuscular Stimulation, is a method in the arsenal of pain management which has been known for almost 200 years in Western medicine, yet has been almost completely ignored. With the increase in research in this field over the past two decades, there are many high-quality studies that demonstrate dry needling to be an effective and safe method for the treatment of myofascial pain when diagnosed and treated by adequately-trained physicians or physical therapists. This article provides an overview of recent literature regarding the treatment of myofascial pain syndrome, evidence for the efficacy of dry needling as a central component of its management, and a glimpse at developments in recent imaging methods to aid in the treatment of these problems.

  17. Xylem Wall Collapse in Water-Stressed Pine Needles

    PubMed Central

    Cochard, Hervé; Froux, Fabienne; Mayr, Stefan; Coutand, Catherine

    2004-01-01

    Wall reinforcement in xylem conduits is thought to prevent wall implosion by negative pressures, but direct observations of xylem geometry during water stress are still largely lacking. In this study, we have analyzed the changes in xylem geometry during water stress in needles of four pine species (Pinus spp.). Dehydrated needles were frozen with liquid nitrogen, and xylem cross sections were observed, still frozen, with a cryo-scanning electron microscope and an epifluorescent microscope. Decrease in xylem pressure during drought provoked a progressive collapse of tracheids below a specific threshold pressure (Pcollapse) that correlates with the onset of cavitation in the stems. Pcollapse was more negative for species with smaller tracheid diameter and thicker walls, suggesting a tradeoff between xylem efficiency, xylem vulnerability to collapse, and the cost of wall stiffening. Upon severe dehydration, tracheid walls were completely collapsed, but lumens still appeared filled with sap. When dehydration proceeded further, tracheids embolized and walls relaxed. Wall collapse in dehydrated needles was rapidly reversed upon rehydration. We discuss the implications of this novel hydraulic trait on the xylem function and on the understanding of pine water relations. PMID:14657404

  18. [Recurrent breast haematoma after fine needle aspiration biopsy of angiosarcoma].

    PubMed

    Ortiz Mendoza, Carlos Manuel

    2007-03-01

    It is reported a rare complication after a fine needle aspiration biopsy of a breast angiosarcoma. A 30-years-old female presented with a right breast lump. An ovoid, hypoecoic lesion of 39 x 13 mm was detect by ultrasonography. A fine needle aspiration biopsy was carried out for diagnosis, but only blood was report. After the biopsy the skin showed a violaceous color, the lump was tender, reappeared in three instances and increased its size (15 cm). In spite of conservative management the pain and the mass did not disappear, then surgical management was decided. A soft, violaceous mass of 13 x 6 x 4 cm, with well demarcated boundaries was removed. A capillary and cavernous breast hemangioma was diagnosed. Four months later a recurrence presented, and a new excision was carried out with a resulting moderately differentiated angiosarcoma, then a simple mastectomy was performed for definitive treatment. On a literature search only one similar case was found. A recurrent haematoma after a fine needle aspiration biopsy of a breast tumor mandates to rule out an angiosarcoma.

  19. Treatment of temporomandibular myofascial pain with deep dry needling

    PubMed Central

    Gonzalez-Perez, Luis M.; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco J.

    2012-01-01

    Objectives: The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. Study Design: We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6,5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. Results: We found a statistically significant relationship (p<0,01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Conclusions: Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle. Key words:Temporomandibular joint, myofascial pain, external pterygoid muscle, trigger point, deep dry needling. PMID:22549679

  20. Interrater reliability of the needle examination in lumbosacral radiculopathy.

    PubMed

    Kendall, Richard; Werner, Robert A

    2006-08-01

    Low back pain and lumbar radiculopathy are among the most common painful disorders affecting the adult population. This study hypothesizes that there is good correlation between the diagnostic impression of an unblinded electromyographer, using clinical and electromyographic information, and an independent electromyographer, who uses the needle examination only to assess for lumbar radiculopathy. This is a prospective, single-blinded, observational pilot study. The needle examination was electronically recorded, reproduced, and shown to a second examiner, blinded to all clinical data. Diagnostic impressions from both examiners were recorded and evaluated for agreement. Six recorded cases were reviewed by 66 blinded examiners. Overall diagnostic agreement was 46.9% (60.5% faculty level, 28.5% resident level). Logistic regression shows a strong association between training level and agreement on diagnostic impression (odds ratio, 1.9; 95% confidence interval, 1.12-3.22; P = 0.019). This study shows that there is fair interrater reliability between faculty-level examiners and poor reliability among resident-level examiners when the needle examination is used to evaluate patients with lumbar radiculopathy.

  1. Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants.

    PubMed

    Thompson, S A; Fung, A Y C; Zaider, M

    2002-08-21

    One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with 1-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results. PMID:12222865

  2. NOTE: Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

    NASA Astrophysics Data System (ADS)

    Thompson, S. A.; Fung, A. Y. C.; Zaider, M.

    2002-08-01

    One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results.

  3. Closed-loop asymmetric-tip needle steering under continuous intraoperative MRI guidance.

    PubMed

    Patel, Niravkumar A; van Katwijk, Tim; Li, Gang; Moreira, Pedro; Shang, Weijian; Misra, Sarthak; Fischer, Gregory S

    2015-08-01

    Magnetic resonance imaging (MRI) provides excellent image contrast for various types of tissues, making it a suitable choice over other imaging modalities for various image-guided needle interventions. Furthermore, robot-assistance is maturing for surgical procedures such as percutaneous prostate and brain interventions. Although MRI-guided, robot-assisted needle interventions are approaching clinical usage, they are still typically open-loop in nature due to the lack of continuous intraoperative needle tracking. Closed-loop needle-based procedures can improve the accuracy of needle tip placement by correcting the needle trajectory during insertion. This paper proposes a system for robot-assisted, flexible asymmetric-tipped needle interventions under continuous intraoperative MRI guidance. A flexible needle's insertion depth and rotation angle are manipulated by an MRI-compatible robot in the bore of the MRI scanner during continuous multi-planar image acquisition to reach a desired target location. Experiments are performed on gelatin phantoms to assess the accuracy of needle placement into the target location. The system was able to successfully utilize live MR imaging to guide the path of the needle, and results show an average total targeting error of 2.5±0.47mm, with an average in-plane error of 2.09±0.33mm. PMID:26737384

  4. Local gene expression and immune responses of vaginal DNA vaccination using a needle-free injector.

    PubMed

    Kanazawa, Takanori; Takashima, Yuuki; Tamura, Toshiaki; Tsuchiya, Miki; Shibata, Yasunori; Udagawa, Haruhide; Okada, Hiroaki

    2010-08-30

    The vaginal mucosa is the most common site of initiation of virus infections that are transmitted through heterosexual intercourse, including HIV and papillomavirus. Thus, in order to prevent or treat these infections, strong vaginal immunity is required as the first line of defense. In this study, to establish a less invasive, safe, convenient and effective immunization method, we examined the local (skin and vagina) gene transfection efficiency of a non-needle jet injector for daily insulin injection. In the skin experiment, the needle-free injector resulted in a marked increase in marker gene expression, compared to the conventional needle-syringe injection. In addition, intradermal DNA vaccination using the needle-free injector dramatically induced IFN-gamma and antibody systemic responses in mice. Furthermore, we investigated the applicability of the needle-free injector as a vaginal vaccination tool in rabbits. Vaginal gene expression using the needle-free injector was significantly greater than that using needle-syringe injection. Moreover, intravaginal vaccination by the needle-free injector promoted vaginal IgA secretion and IFN-gamma mRNA expression in the blood lymphocytes, to a degree significantly higher than that by needle-syringe injection. In conclusion, local vaginal DNA vaccination using a needle-free jet injector is a promising approach for the prevention and treatment of mucosal infectious diseases.

  5. Comparison of 19-gauge eXcelon and WANG MW-319 transbronchial aspiration needles.

    PubMed

    Hsu, Li-Han; Liu, Chia-Chuan; Ko, Jen-Sheng; Feng, An-Chen; Chu, Nei-Min

    2016-03-01

    Conventional transbronchial needle aspiration (TBNA) using 19-gauge needles can obtain larger histological specimens for hilar-mediastinal diagnosis. A new 19-gauge eXcelon needle was introduced in Taiwan in July 2012. We prospectively enrolled patients with hilar-mediastinal lesions and pathology results of suspected benign origin or lymphoproliferative processes, to perform TBNA using a 19-gauge eXcelon needle, between July 2012 and December 2012. The results were compared with historical control of TBNA using a WANG MW-319 needle between January 2011 and June 2012. The procedure was performed by the same pulmonologist, and rapid on-site cytologic evaluation was used. The 19-gauge eXcelon needle was used in nine patients with 15 lymph nodes aspirated, with a mean diameter of 23.3 ± 10.7 mm. The mean number of needle passes was 2.7 ± 1.4, with a diagnostic accuracy of 77.8%. The MW-319 needle was used in 12 patients with 18 lymph nodes aspirated, with a mean diameter of 21.3 ± 5.7 mm. The mean number of needle passes was 2.2 ± 0.4, with a diagnostic accuracy of 75.0%. Neither technical nor major clinical complications were noted in either group. We concluded that the 19-gauge eXcelon needle was as safe and effective as the MW-319 needle. A more adequate specimen could be obtained and fewer needle passes were required with the MW-319 needle, although the difference did not reach significance. PMID:27042234

  6. Effects of prolonged drought on the anatomy of sun and shade needles in young Norway spruce trees.

    PubMed

    Gebauer, Roman; Volařík, Daniel; Urban, Josef; Børja, Isabella; Nagy, Nina Elisabeth; Eldhuset, Toril Drabløs; Krokene, Paal

    2015-11-01

    Predicted increases in the frequency and duration of drought are expected to negatively affect tree vitality, but we know little about how water shortage will influence needle anatomy and thereby the trees' photosynthetic and hydraulic capacity. In this study, we evaluated anatomical changes in sun and shade needles of 20-year-old Norway spruce trees exposed to artificial drought stress. Canopy position was found to be important for needle structure, as sun needles had significantly higher values than shade needles for all anatomical traits (i.e., cross-sectional needle area, number of tracheids in needle, needle hydraulic conductivity, and tracheid lumen area), except proportion of xylem area per cross-sectional needle area. In sun needles, drought reduced all trait values by 10-40%, whereas in shade needles, only tracheid maximum diameter was reduced by drought. Due to the relatively weaker response of shade needles than sun needles in drought-stressed trees, the difference between the two needle types was reduced by 25% in the drought-stressed trees compared to the control trees. The observed changes in needle anatomy provide new understanding of how Norway spruce adapts to drought stress and may improve predictions of how forests will respond to global climate change. PMID:26640676

  7. Effects of prolonged drought on the anatomy of sun and shade needles in young Norway spruce trees.

    PubMed

    Gebauer, Roman; Volařík, Daniel; Urban, Josef; Børja, Isabella; Nagy, Nina Elisabeth; Eldhuset, Toril Drabløs; Krokene, Paal

    2015-11-01

    Predicted increases in the frequency and duration of drought are expected to negatively affect tree vitality, but we know little about how water shortage will influence needle anatomy and thereby the trees' photosynthetic and hydraulic capacity. In this study, we evaluated anatomical changes in sun and shade needles of 20-year-old Norway spruce trees exposed to artificial drought stress. Canopy position was found to be important for needle structure, as sun needles had significantly higher values than shade needles for all anatomical traits (i.e., cross-sectional needle area, number of tracheids in needle, needle hydraulic conductivity, and tracheid lumen area), except proportion of xylem area per cross-sectional needle area. In sun needles, drought reduced all trait values by 10-40%, whereas in shade needles, only tracheid maximum diameter was reduced by drought. Due to the relatively weaker response of shade needles than sun needles in drought-stressed trees, the difference between the two needle types was reduced by 25% in the drought-stressed trees compared to the control trees. The observed changes in needle anatomy provide new understanding of how Norway spruce adapts to drought stress and may improve predictions of how forests will respond to global climate change.

  8. Contraception and clean needles: feasibility of combining mobile reproductive health and needle exchange services for female exotic dancers.

    PubMed

    Moore, Eva; Han, Jennifer; Serio-Chapman, Christine; Mobley, Cynthia; Watson, Catherine; Terplan, Mishka

    2012-10-01

    Young women engaged in exotic dancing have a higher need for reproductive health services than women not in this profession, and many also use drugs or exchange sex for money or drugs. Few report receiving reproductive health services. We describe a public health, academic, and community partnership that provided reproductive health services on needle exchange mobile vans in the "red light district" in downtown Baltimore, Maryland. Women made 220 visits to the vans in the first 21 months of the program's operation, and 65% of these visits involved provision of contraception. Programmatic costs were feasible. Joint provision of needle exchange and reproductive health services targeting exotic dancers has the potential to reduce unintended pregnancies and link pregnant, substance-abusing women to reproductive care, and such programs should be implemented more widely.

  9. Needle puncture in rabbit functional spinal units alters rotational biomechanics

    PubMed Central

    Hartman, Robert A.; Bell, Kevin M.; Quan, Bichun; Nuzhao, Yao; Sowa, Gwendolyn A.; Kang, James D.

    2014-01-01

    Study Design An in vitro biomechanical study for rabbit lumbar functional spinal units (FSUs) using a robot-based spine testing system. Objective To elucidate the effect of annular puncture with a 16G needle on mechanical properties in flexion/extension, axial rotation, and lateral bending. Summary of Background Data Needle puncture of the intervertebral disc has been shown to alter mechanical properties of the disc in compression, torsion, and bending. The effect of needle puncture in FSUs, where intact spinal ligaments and facet joints may mitigate or amplify these changes in the disc, on spinal motion segment stability subject to physiological rotations remains unknown. Methods Rabbit FSUs were tested using a robot testing system whose force/moment and position precision were assessed to demonstrate system capability. Flexibility testing methods were developed by load-to-failure testing in flexion/extension, axial rotation, and lateral bending. Subsequent testing methods were used to examine a 16G needle disc puncture and No. 11 blade disc stab (positive control for mechanical disruption). Flexibility testing was used to assess segmental range-of-motion (°), neutral zone stiffness (Nm/°) and width (° and Nm), and elastic zone stiffness before and after annular injury. Results The robot-based system was capable of performing flexibility testing on FSUs—mean precision of force/moment measurements and robot system movements were less than 3% and 1%, respectively, of moment-rotation target values. Flexibility moment targets were 0.3 Nm for flexion and axial rotation and 0.15 Nm for extension and lateral bending. Needle puncture caused significant (p<0.05) changes only in flexion/extension range-of-motion and neutral zone stiffness and width (Nm) compared to pre-intervention. No.11 blade-stab significantly increased range-of-motion in all motions, decreased neutral zone stiffness and width (Nm) in flexion/extension, and increased elastic zone stiffness in

  10. [Re-evaluation of using acupuncture needle as sphenoidal electrode in temporal lobe epilepsy].

    PubMed

    Chu, Nai-Shin

    2009-06-01

    In 1965, Feng of the Peking Union Hospital published an article entitled "Innovation in electroencephalography: the use of acupuncture needles as sphenoidal electrodes". It was a preliminary report, but surprisingly EEG records in the figures did not show definite spikes or sharp waves in the sphenoidal leads. In 1983, Feng and his colleagues reported a summary of 2,000 cases studied with acupuncture needle sphenoidal electrodes. This time, spikes or sharp waves were shown in EEG recordings. However, cases studied were several "paroxysmal disorders", including psychomotor seizure (155 cases), generalized seizure (765 cases), epileptic cephalgia (101 cases), syncope (104 cases), abdominal epilepsy (24 cases), encephalopathy (135 cases), brain tumor (32 cases), hemiplegia of unknown cause (43 cases), psychosis (34 cases), and others (607 cases). Therefore, there were many unknown cases and many cases that were not related to temporal lobe epilepsy. Surprisingly, the increase in detection by acupuncture needle electrode was higher for hemiplegia of unknown cause, brain tumors, and encephalopathies than for the temporal lobe epilepsy. Furthermore, the issue of no insulation of the acupuncture needle was not addressed. Therefore, we began in 1988 to reinvestigate the usefulness of uninsulated acupuncture needles as sphenoidal electrodes. We also compared the efficacy of anterior temporal electrodes (T1, T2) with those of acupuncture needle and EMG needle. Our results showed that when compared to the routine EEG recordings, acupuncture needle sphenoidal electrodes increased the yield of detecting anterior temporal spikes from 41% to 70%. Our data further showed that when compared to the EMG needle recordings, acupuncture needle recordings had the same detection rate, but the spike amplitude was slightly smaller (129 microv vs. 135 microv). Interestingly, we also found that anterior temporal surface electrode recordings were nearly as good as those of acupuncture needle

  11. Dry needling for management of pain in the upper quarter and craniofacial region.

    PubMed

    Kietrys, David M; Palombaro, Kerstin M; Mannheimer, Jeffrey S

    2014-01-01

    Dry needling is a therapeutic intervention that has been growing in popularity. It is primarily used with patients that have pain of myofascial origin. This review provides background about dry needling, myofascial pain, and craniofacial pain. We summarize the evidence regarding the effectiveness of dry needling. For patients with upper quarter myofascial pain, a 2013 systematic review and meta-analysis of 12 randomized controlled studies reported that dry needling is effective in reducing pain (especially immediately after treatment) in patients with upper quarter pain. There have been fewer studies of patients with craniofacial pain and myofascial pain in other regions, but most of these studies report findings to suggest the dry needling may be helpful in reducing pain and improving other pain related variables such as the pain pressure threshold. More rigorous randomized controlled trials are clearly needed to more fully elucidate the effectiveness of dry needling.

  12. Christmas surprise: the unnoticed journey of a needle-from bronchus to intestine.

    PubMed

    Graffstädt, H; Dieckow, B; Grüber, C; Stöver, B; Niggemann, B

    2005-12-01

    We report on a 14-year-old Arabian girl who suddenly developed coughing after having aspirated a needle used for fixing her headscarf. The chest X-ray showed the needle located in the right main bronchus. However, subsequent flexible bronchoscopy could not detect any foreign body. A further X-ray of the abdomen showed the needle now behind the diaphragm. Gastro-oesophageal endoscopy was also uneventful. On the third day, the needle was excreted naturally. Astonishingly, this journey of the wandering needle from bronchus to intestine was not realised by the patient at any time. Our case highlights that children and adolescents should be warned repeatedly about the risks of putting needles between their teeth. It also reminds the physician to diagnose aspirated foreign bodies as early as possible to prevent wandering and migrating, which may induce new risks and unnecessary diagnostic and therapeutic procedures.

  13. Reaction of 5 and 6 year olds to dental injection after viewing the needle: pilot study.

    PubMed

    Maragakis, G M; Musselman, R J; Ho, C C

    2006-01-01

    The aim was to evaluate the practice of hiding the needle prior to dental anesthesia administration to children. Fourteen 5 and 6 year olds received dental treatment in two sessions. The needle was shown in one session and hidden in the other. Eleven children were cooperative and 3 uncooperative irrespective of approach. The children's behavior correlated with fears expressed by the mothers. Our initial fndintgs do not support the practice of hiding the needle. PMID:17091654

  14. A Rare Case of a Lost Suture Needle during Third Molar Surgery

    PubMed Central

    Aktop, Sertac; Gocmen, Gokhan; Özturk, M. Elif; Gonul, Onur; Varol, Altan

    2015-01-01

    The authors report a case that is started with a simple upper third molar's surgical extraction and a broken 3.0 suture needle tip incident occurred. Broken fragment's localization has been detected with 3D cone beam computed tomography (CBCT). Needle tip has been reached with the help of CBCT vision. CBCT's benefits have been discussed on these types of cases and further migration of the needle tip during surgical procedure is reported. PMID:26347829

  15. Academic Rigor: The Core of the Core

    ERIC Educational Resources Information Center

    Brunner, Judy

    2013-01-01

    Some educators see the Common Core State Standards as reason for stress, most recognize the positive possibilities associated with them and are willing to make the professional commitment to implementing them so that academic rigor for all students will increase. But business leaders, parents, and the authors of the Common Core are not the only…

  16. 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.

  17. 3-D ultrasound-guided robotic needle steering in biological tissue.

    PubMed

    Adebar, Troy K; Fletcher, Ashley E; Okamura, Allison M

    2014-12-01

    Robotic needle steering systems have the potential to greatly improve medical interventions, but they require new methods for medical image guidance. Three-dimensional (3-D) ultrasound is a widely available, low-cost imaging modality that may be used to provide real-time feedback to needle steering robots. Unfortunately, the poor visibility of steerable needles in standard grayscale ultrasound makes automatic segmentation of the needles impractical. A new imaging approach is proposed, in which high-frequency vibration of a steerable needle makes it visible in ultrasound Doppler images. Experiments demonstrate that segmentation from this Doppler data is accurate to within 1-2 mm. An image-guided control algorithm that incorporates the segmentation data as feedback is also described. In experimental tests in ex vivo bovine liver tissue, a robotic needle steering system implementing this control scheme was able to consistently steer a needle tip to a simulated target with an average error of 1.57 mm. Implementation of 3-D ultrasound-guided needle steering in biological tissue represents a significant step toward the clinical application of robotic needle steering.

  18. 78 FR 48631 - Descriptive Designation for Needle- or Blade-Tenderized (Mechanically Tenderized) Beef Products

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    ... published a proposed rule in the Federal Register (78 FR 34589), ``Descriptive Designation for Needle- or... race, color, national origin, gender, religion, age, disability, political beliefs, sexual...

  19. Benchmarking of state-of-the-art needle detection algorithms in 3D ultrasound data volumes

    NASA Astrophysics Data System (ADS)

    Pourtaherian, Arash; Zinger, Svitlana; de With, Peter H. N.; Korsten, Hendrikus H. M.; Mihajlovic, Nenad

    2015-03-01

    Ultrasound-guided needle interventions are widely practiced in medical diagnostics and therapy, i.e. for biopsy guidance, regional anesthesia or for brachytherapy. Needle guidance using 2D ultrasound can be very challenging due to the poor needle visibility and the limited field of view. Since 3D ultrasound transducers are becoming more widely used, needle guidance can be improved and simplified with appropriate computer-aided analyses. In this paper, we compare two state-of-the-art 3D needle detection techniques: a technique based on line filtering from literature and a system employing Gabor transformation. Both algorithms utilize supervised classification to pre-select candidate needle voxels in the volume and then fit a model of the needle on the selected voxels. The major differences between the two approaches are in extracting the feature vectors for classification and selecting the criterion for fitting. We evaluate the performance of the two techniques using manually-annotated ground truth in several ex-vivo situations of different complexities, containing three different needle types with various insertion angles. This extensive evaluation provides better understanding on the limitations and advantages of each technique under different acquisition conditions, which is leading to the development of improved techniques for more reliable and accurate localization. Benchmarking results that the Gabor features are better capable of distinguishing the needle voxels in all datasets. Moreover, it is shown that the complete processing chain of the Gabor-based method outperforms the line filtering in accuracy and stability of the detection results.

  20. Needle-tissue interaction forces--a survey of experimental data.

    PubMed

    van Gerwen, Dennis J; Dankelman, Jenny; van den Dobbelsteen, John J

    2012-07-01

    The development of needles, needle-insertion simulators, and needle-wielding robots for use in a clinical environment depends on a thorough understanding of the mechanics of needle-tissue interaction. It stands to reason that the forces arising from this interaction are influenced by numerous factors, such as needle type, insertion speed, and tissue characteristics. However, exactly how these factors influence the force is not clear. For this reason, the influence of various factors on needle insertion-force was investigated by searching literature for experimental data. This resulted in a comprehensive overview of experimental insertion-force data available in the literature, grouped by factor for quick reference. In total, 99 papers presenting such force data were found, with typical peak forces in the order of 1-10N. The data suggest, for example, that higher velocity tends to decrease puncture force and increase friction. Furthermore, increased needle diameter was found to increase peak forces, and conical needles were found to create higher peak forces than beveled needles. However, many questions remain open for investigation, especially those concerning the influence of tissue characteristics.