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Sample records for aspiration eus-fna experience

  1. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of mediastinal lymph nodes: experience from region with high prevalence of tuberculosis.

    PubMed

    Manucha, Varsha; Kaur, Gagandeep; Verma, Kusum

    2013-12-01

    Utility of EUS-FNA in diagnosing granulomatous lesions of mediastinum in regions with high prevalence of tuberculosis has not yet been evaluated. In the present study, utility and limitations of EUS-FNA of mediastinal lesions from a tertiary care center with high prevalence of tuberculosis were studied. All cases where EUS-FNA had been performed to diagnose mediastinal lymphadenopathy from January 2006 to December 2008 were retrieved from the files of cytopathology laboratory. These were reviewed by the cytopathologist. Two hundred and eighty one EUS-FNA aspirates from 269 patients were evaluated. Satisfactory aspirates were available in 259 cases. A cytological diagnosis of granulomatous lymphadenitis was rendered in 206 cases. Of these, tuberculosis could be established as an etiology in 76 cases and sarcoidosis in 7 cases only. In remaining 123 cases the etiology of granulomatous lymphadenitis could not be established and clinical correlation was suggested. Malignancies were diagnosed or suspected in 24 and 5 cases, respectively. The study highlights that the dilemma of tuberculosis versus sarcoidosis persists in regions with high prevalence of tuberculosis. However, EUS-FNA is useful in diagnosing unsuspected malignancies and confirming the presence of granulomatous lymphadenitis.

  2. Pancreatic Metastasis from Rectal Cancer that was Diagnosed by Endoscopic Ultrasonography-guided Fine Needle Aspiration (EUS-FNA)

    PubMed Central

    Sano, Itsuki; Katanuma, Akio; Yane, Kei; Kin, Toshifumi; Nagai, Kazumasa; Yamazaki, Hajime; Koga, Hideaki; Kitagawa, Koh; Yokoyama, Kensuke; Ikarashi, Satoshi; Takahashi, Kuniyuki; Maguchi, Hiroyuki; Omori, Yuko; Shinohara, Toshiya

    2017-01-01

    Pancreatic metastasis from colorectal cancer is rare, and there have been only a few reports of its preoperative diagnosis by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with immunohistochemical staining. We herein describe the case of a 77-year-old woman in whom a solitary mass in the pancreatic tail was detected 11 years after rectal cancer resection. The patient also had a history of pulmonary tumor resection. We performed EUS-FNA and a histopathological examination showed adenocarcinoma with CD20+, CD7-, and CDX2+ (similar to her rectal cancer). EUS-FNA enabled a histopathological examination, including immunohistochemical staining, which helped to confirm the diagnosis of pancreatic and pulmonary metastasis from rectal cancer. PMID:28154274

  3. Metastatic renal cell carcinoma from a native kidney of a renal transplant patient diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy

    PubMed Central

    Alastal, Yaseen; Hammad, Tariq A; Rafiq, Ehsan; Nawras, Mohamad; Alaradi, Osama

    2015-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy sampling of enlarged lymph nodes is increasingly used to diagnose metastatic tumors, especially of the gastrointestinal tract and the lungs. Herein, we describe the diagnosis of metastatic renal cell carcinoma from a native kidney of a 54 year-old male patient, who had a 5-years history of renal transplant, by EUS-FNA of mediastinal and celiac lymph nodes. Histological and immunohistochemical findings confirmed the origin of metastatic tumor. EUS-FNA with proper cytological evaluation can be useful in the diagnosis of metastatic renal cell carcinoma in renal transplant patients. PMID:28326261

  4. Learning curve for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic lesions in a novel ex-vivo simulation model

    PubMed Central

    Gonzalez, J. M.; Cohen, J.; Gromski, M. A.; Saito, K.; Loundou, A.; Matthes, K.

    2016-01-01

    Background: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is essential in the management of digestive cancers. However, teaching and learning this technique remain challenging due to the lack of cost-effective models. Material and methods: This was a prospective experimental study using a complete porcine upper gastrointestinal ex-vivo organ package, placed in an Erlangen Active Simulator for Interventional Endoscopy (EASIE-R), and prepared with one cyst and two solid masses (2 cm). Five fellows inexperienced in EUS-FNA were enrolled, performing 10 procedures on each lesion, alternatively. The total time, number of attempts for success, of needle view losses, and of scope handling were recorded, associated with an independent skills rating by procedure. We compared the first 15 procedures with the last 15 for each fellow. Results: The fellows successfully performed all procedures in 2 to 40 minutes, requiring 1 to 6 attempts. All (5/5) improved their total time taken (P < 0.001), number of times when the EUS view of the needle was lost (P < 0.05), scope handling (P < 0.005), and skills rating (P < 0.001), whereas 4/5 (80 %) improved their number of attempts. The overall evaluation showed a significant decrease (P < 0.001) in the total time taken (11.2 ± 7.8 vs 4.3 ± 2.2 minutes), number of attempts (2.6 ± 1.2 vs 1.2 ± 0.7), number of times when the EUS view of the needle was lost (2.3 ± 2 vs 0.5 ± 0.7), and need for scope handling (1.1 ± 1.7 vs 0.1 ± 0.2). We also observed an improvement in skills rating (5 ± 1.9 vs. 7.7 ± 1.1). Conclusion: This newly designed ex-vivo model seems to be an effective way to improve the initial learning of EUS-FNA, by performing 30 procedures. PMID:27995190

  5. The role of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in non small cell lung cancer (NSCLC) patients: SEED-SEPD-AEG Joint Guideline.

    PubMed

    Vázquez-Sequeiros, Enrique; González-Panizo-Tamargo, Fernando; Barturen, Ángel; Calderón, Ángel; Esteban, José Miguel; Fernández-Esparrach, Gloria; Gimeno-García, Antonio; Ginés, Angels; Lariño, José; Pérez-Carreras, Mercedes; Romero, Rafael; Súbtil, José Carlos; Vila, Juan

    2013-04-01

    Lung cancer is one of the most frequent neoplasms in our environment, and represents the first cause of cancer related death in western countries. Diagnostic and therapeutic approach to these patients may be complicated, with endoscopic ultrasound guided fine needle aspiration (EUS-FNA), classically performed by gastroenterologists, playing a very important role. As this disease is not closely related to the "digestive tract", gastroenterologists have been forced to update their knowledge on this field o adequately diagnose this significant group of patients. The recent advent of modern and promising techniques like endobronchial ultrasound guided fine needle aspiration (EBUS-FNA) have prompted new approaches for diagnosis and staging of this type of patients. In this clinical guideline, the "Sociedad Española de Endoscopia Digestiva" (SEED), "Sociedad Española de Patología Digestiva" (SEPD) and the "AsociaciónEspañola de Gastroenterología", have jointed efforts to update the existing knowledge on the field and provide their members with evidence based recommendations.

  6. Balanced Propofol Sedation in Patients Undergoing EUS-FNA: A Pilot Study to Assess Feasibility and Safety

    PubMed Central

    Pagano, N.; Arosio, M.; Romeo, F.; Rando, G.; Del Conte, G.; Carlino, A.; Strangio, G.; Vitetta, E.; Malesci, A.; Repici, A.

    2011-01-01

    Introduction and aims. Balanced propofol sedation (BPS) administered by gastroenterologists has gained popularity in endoscopic procedures. Few studies exist about the safety of this approach during endosonography with fine needle aspiration (EUS-FNA). We assessed the safety of BPS in EUS-FNA. Materials and methods. 112 consecutive patients, referred to our unit to perform EUS-FNA, from February 2008 to December 2009, were sedated with BPS. A second gastroenterologist administered the drugs and monitorized the patient. Results. All the 112 patients (62 males, mean age 58.35) completed the examination. The mean dose of midazolam and propofol was, respectively, of 2.1 mg (range 1–4 mg) and 350 mg (range 180–400). All patients received oxygen with a mean flux of 4 liter/minute (range 2–6 liters/minute). The mean recovery time after procedure was 25 minutes (range 18–45 minutes). No major complications related to sedation were registered during all procedures. The oxygen saturation of all patients never reduced to less than 85%. Blood systolic pressure during and after the procedure never reduced to less than 100 mmHg. Conclusions. In our experience BPS administered by non-anaesthesiologists provided safe and successful sedation in patients undergoing EUS-FNA. PMID:21785561

  7. The integration of single fiber reflectance (SFR) spectroscopy during endoscopic ultrasound-guided fine needle aspirations (EUS-FNA) in pancreatic masses: a feasibility study

    NASA Astrophysics Data System (ADS)

    Stegehuis, Paulien L.; Boogerd, Leonora S. F.; Inderson, Akin; Veenendaal, Roeland A.; Bonsing, Bert A.; Amelink, Arjen; Vahrmeijer, Alexander L.; Dijkstra, Jouke; Robinson, Dominic J.

    2016-03-01

    EUS-FNA can be used for pathological confirmation of a suspicious pancreatic mass. However, performance depends on an on-site cytologist and time between punction and final pathology results can be long. SFR spectroscopy is capable of extracting biologically relevant parameters (e.g. oxygenation and blood volume) in real-time from a very small tissue volume at difficult locations. In this study we determined feasibility of the integration of SFR spectroscopy during EUSFNA procedures in pancreatic masses. Patients with benign and malignant pancreatic masses who were scheduled for an EUS-FNA were included. The working guide wire inside the 19 gauge endoscopic biopsy needle was removed and the sterile single fiber (300 μm core and 700 μm outer diameter, wide-angle beam, NA 0.22) inserted through the needle. Spectroscopy measurements in the visiblenear infrared wavelength region (400-900 nm) and autofluorescence measurements (excitation at 405 nm) were taken three times, and subsequently cytology was obtained. Wavelength dependent optical properties were compared to cytology results. We took measurements in 13 patients with corresponding cytology results (including mucinous tumor, ductal adenocarcinoma, neuroendocrine tumor, and pancreatitis). In this paper we show the first analyzed results comparing normal pancreatic tissue with cancerous tissue in the same patient. We found a large difference in blood volume fraction, and blood oxygenation was higher in normal tissue. Integration of SFR spectroscopy is feasible in EUS-FNA procedures, the workflow hardly requires changes and it takes little time. The first results differentiating normal from tumor tissue are promising.

  8. Endoscopic ultrasonography guided-fine needle aspiration for the diagnosis of solid pancreaticobiliary lesions: Clinical aspects to improve the diagnosis

    PubMed Central

    Matsubayashi, Hiroyuki; Matsui, Toru; Yabuuchi, Yohei; Imai, Kenichiro; Tanaka, Masaki; Kakushima, Naomi; Sasaki, Keiko; Ono, Hiroyuki

    2016-01-01

    Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has been applied to pancreaticobiliary lesions since the 1990s and is in widespread use throughout the world today. We used this method to confirm the pathological evidence of the pancreaticobiliary lesions and to perform suitable therapies. Complications of EUS-FNA are quite rare, but some of them are severe. Operators should master conventional EUS observation and experience a minimum of 20-30 cases of supervised EUS-FNA on non-pancreatic and pancreatic lesions before attempting solo EUS-FNA. Studies conducted on pancreaticobiliary EUS-FNA have focused on selection of suitable instruments (e.g., needle selection) and sampling techniques (e.g., fanning method, suction level, with or without a stylet, optimum number of passes). Today, the diagnostic ability of EUS-FNA is still improving; the detection of pancreatic cancer (PC) currently has a sensitivity of 90%-95% and specificity of 95%-100%. In addition to PC, a variety of rare pancreatic tumors can be discriminated by conducting immunohistochemistry on the FNA materials. A flexible, large caliber needle has been used to obtain a large piece of tissue, which can provide sufficient histological information to be helpful in classifying benign pancreatic lesions. EUS-FNA can supply high diagnostic yields even for biliary lesions or peri-pancreaticobiliary lymph nodes. This review focuses on the clinical aspects of EUS-FNA in the pancreaticobiliary field, with the aim of providing information that can enable more accurate and efficient diagnosis. PMID:26811612

  9. Validation of a realistic, simple, and inexpensive EUS-FNA training model using isolated porcine stomach

    PubMed Central

    Hoshi, Koki; Irisawa, Atsushi; Shibukawa, Goro; Yamabe, Akane; Fujisawa, Mariko; Igarashi, Ryo; Yoshida, Yoshitsugu; Abe, Yoko; Imbe, Koh

    2016-01-01

    Background and study aims: Trainees are required to learn EUS-FNA using a model before working with a patient. The aim of the current study was to validate a new training model developed for EUS-FNA. Patients and methods: Several fresh chicken tenderloins were embedded as target lesions in the submucosal layer of an isolated porcine stomach. The stomach was fixed to a plate with nails, and was placed in a tub filled with water. The primary endpoint was feasibility of the newly developed model for EUS-FNA training, evaluated as follows: 1) visualization of the target lesion with blinding for lesion location; 2) penetrability of the needle; 3) sampling rate of macroscopic specimen; and 4) ROSE capability. Secondary endpoints were its durability and utility for multiple EUS-FNA procedures during EUS-FNA training, and the ease and cost of preparing the model. Results: Six endoscopists (1 expert, 5 trainees) attempted EUS-FNA procedures using this model. The target lesion could be identified clearly, and EUS-FNA could be performed with realistic resistance felt. In addition, rapid on-site evaluation could be easily achieved. Based on 10 needlings by each endoscopist, adequate specimens for histology could be macroscopically taken with an average 85 % success rate. Visibility and maneuverability were maintained throughout all needlings. Preparation time for this model was less than 30 minutes with a total cost of $ 22. Conclusions: An easy-to-use and inexpensive training model with a realistic feel of needling was created. This model can potentially enable beginners to practice safe and effective EUS-FNA procedures. PMID:27652292

  10. Mucin (MUC) expression in EUS-FNA specimens is a useful prognostic factor in pancreatic ductal adenocarcinoma

    PubMed Central

    Higashi, Michiyo; Yokoyama, Seiya; Yamamoto, Takafumi; Goto, Yuko; Kitazono, Ikumi; Hiraki, Tsubasa; Taguchi, Hiroki; Hashimoto, Shinichi; Fukukura, Yoshihiko; Koriyama, Chihaya; Mataki, Yuko; Maemura, Kosei; Shinchi, Hiroyuki; Jain, Maneesh; Batra, Surinder K.; Yonezawa, Suguru

    2015-01-01

    Objectives The aim of this study was to further examine the utility of mucin expression profiles as prognostic factors in PDAC. Methods Mucin (MUC) expression was examined by immunohistochemistry (IHC) analysis in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimens obtained from 114 patients with PDAC. The rate of expression of each mucin was compared with clinicopathologic features. Results The expression rates of mucins in cancer lesions were MUC1, 87.7%; MUC2, 0.8%; MUC4, 93.0%; MUC5AC, 78.9%; MUC6, 24.6%; and MUC16, 67.5%. MUC1 and MUC4 were positive and MUC2 was negative in most PDACs. Patients with advanced stage of PDAC with MUC5AC expression had a significantly better outcome than those who were MUC5AC-negative (P=0.002).With increasing clinical stage, total MUC6 expression decreased (P for trend=0.001) and MUC16 cytoplasmic expression increased (P for trend=0.02). The prognosis of patients with MUC16 cytoplasmic expression was significantly poorer than those without this expression. Multivariate survival analysis revealed that MUC16 cytoplasmic expression was a significant independent predictor of a poor prognosis after adjusting for the effects of other prognostic factors (P=0.002). Conclusion Mucin expression profiles in EUS-FNA specimens have excellent diagnostic utility and are useful predictors of outcome in patients with PDAC. PMID:25906442

  11. Endoscopic Ultrasound-Guided Fine Needle Aspiration versus Percutaneous Ultrasound-Guided Fine Needle Aspiration in Diagnosis of Focal Pancreatic Masses

    PubMed Central

    Okasha, Hussein Hassan; Naga, Mazen Ibrahim; Esmat, Serag; Naguib, Mohamed; Hassanein, Mohamed; Hassani, Mohamed; El-Kassas, Mohamed; Mahdy, Reem Ezzat; El-Gemeie, Emad; Farag, Ali Hassan; Foda, Ayman Mohamed

    2013-01-01

    Objective: Pancreatic carcinoma is one of the leading cancer morbidity and mortality world-wide. Controversy has arisen about whether the percutaneous approach with computed tomography/ultrasonography-guidance fine needle aspiration (US-FNA) or endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the preferred method to obtain diagnostic tissue. Our purpose of this study is to compare between the diagnostic accuracy of EUS-FNA and percutaneous US-FNA in diagnosis of pancreatic cancer. Patients and Methods: A total of 197 patients with pancreatic masses were included in the study, 125 patients underwent US-FNA (Group 1) and 72 patients underwent EUS-FNA (Group 2). Results: EUS-FNA has nearly the same accuracy (88.9%) as US-FNA (87.2%) in diagnosis of pancreatic cancer. The sensitivity, specificity, positive predictive value and negative predictive value for EUS-FNA was 84%, 100%, 100%, 73.3% respectively. It was 85.5%, 90.4%, 94.7%, 76% respectively for US-FNA. EUS-FNA had a lower complication rate (1.38%) than US-FNA (5.6%). Conclusion: EUS-FNA has nearly the same accuracy as US-FNA of pancreatic masses with a lower complication rate. PMID:24949394

  12. Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions

    PubMed Central

    Sung, Hea Jung; Park, Eun Young; Moon, Sung Jin; Lim, Chul Hyun; Kim, Jin Su; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gyu; Choi, Kyu Yong

    2013-01-01

    Background/Aims We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions. Methods Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging. Results Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology. Conclusions EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA. PMID:24340255

  13. Endoscopic ultrasound-guided fine-needle aspiration diagnosis of secondary tumors involving the pancreas: An institution's experience

    PubMed Central

    Alomari, Almed K.; Ustun, Berrin; Aslanian, Harry R.; Ge, Xinquan; Chhieng, David; Cai, Guoping

    2016-01-01

    Background: Pancreatic masses may seldom represent a metastasis or secondary involvement by lymphoproliferative disorders. Recognition of this uncommon occurrence may help render an accurate diagnosis and avoid diagnostic pitfalls during endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In this study, we review our experience in diagnosing secondary tumors involving the pancreas. Materials and Methods: The electronic database of cytopathology archives was searched for cases of secondary tumors involving the pancreas at our institution and a total of 31 cases were identified. The corresponding clinical presentations, imaging study findings, cytological diagnoses, the results of ancillary studies, and surgical follow-up, if available, were reviewed. Results: Nineteen of the patients were male and 12 female, with a mean age of 66 years. Twenty-three patients (74%) had a prior history of malignancy, with the latency ranging from 6 months to 19 years. The secondary tumors involving the pancreas included metastatic carcinoma (24 cases), metastatic sarcoma (3 cases), diffuse large B-cell lymphoma (2 cases), and plasma cell neoplasm (2 cases). The most common metastatic tumors were renal cell carcinoma (8 cases) and lung carcinoma (7 cases). Correct diagnoses were rendered in 29 cases (94%). The remaining two cases were misclassified as primary pancreatic carcinoma. In both cases, the patients had no known history of malignancy, and no ancillary studies were performed. Conclusions: Secondary tumors involving the pancreas can be accurately diagnosed by EUS-FNA. Recognizing uncommon cytomorphologic features, knowing prior history of malignancy, and performing ancillary studies are the keys to improve diagnostic performance and avoid diagnostic pitfalls. PMID:26955395

  14. Repeat endoscopic ultrasound fine needle aspiration after a first negative procedure is useful in pancreatic lesions

    PubMed Central

    Téllez-Ávila, Félix I.; Martínez-Lozano, Jorge Adolfo; Rosales-Salinas, Anamaría; Bernal-Méndez, Ambrosio Rafael; Guerrero-Velásquez, Camilo; Ramírez-Luna, Miguel Ángel; Valdovinos-Andraca, Francisco

    2016-01-01

    Background and Objectives: There is no consensus about the ideal method for diagnosis in patients who have already undergone endoscopic ultrasound fine needle aspiration (EUS-FNA), and the inconclusive material is often obtained. The aim was to evaluate the diagnostic yield of the second EUS-FNA of pancreatic lesions. Materials and Methods: A retrospective analysis of prospectively collected data of patients with EUS-FNA of pancreatic lesions is performed. All patients who underwent more than one EUS-FNA for the evaluation of suspected pancreatic cancer over a 7-year period were included in the analysis. Results: A total of 296 EUS-FNAs of the pancreas were performed in 257 patients. The diagnostic yield with the first EUS-FNA was 78.6% (202/257). Thirty-nine (13.3%) FNAs were repeated in 34 patients; 17 (50%) patients were women. The mean ± standard deviation (SD) age was 58.8 ± 16.1 years. The location of the lesions in the pancreatic gland, from which the second biopsies were taken, was head of the pancreas, n = 28 (82.4%), body of the pancreas, n = 3 (8.8%), and tail, n = 3 (8.8%). The mean ± SD of the size of the lesion was 36.3 ± 14.6 mm. The second EUS-FNA was more likely to be positive for diagnosis in patients with an “atypical“ histological result in the first EUS-FNA (odds ratio [OR]: 4.04; 95% confidence interval [CI]: 0.9–18.3), in contrast to patients with a first EUS-FNA reported as “normal” (OR: 0.21; 95% CI: 0.06–0.71). Overall, the diagnostic yield of the second EUS-FNA was 58.8% (20/34) with an increase to 86.3% overall (222/257). Conclusion: Repeat EUS-FNA in pancreatic lesions is necessary in patients with a negative first EUS-FNA because it improves the diagnostic yield. PMID:27503159

  15. Accuracy of endoscopic ultrasound-guided fine-needle aspiration in the suspicion of pancreatic metastases

    PubMed Central

    2013-01-01

    Background Metastases to the pancreas are rare, and usually mistaken for primary pancreatic cancers. This study aimed to describe the histology results of solid pancreatic tumours obtained by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosis of metastases to the pancreas. Methods In a retrospective review, patients with pancreatic solid tumours and history of previous extrapancreatic cancer underwent EUS-FNA from January/1997 to December/2010. Most patients were followed-up until death and some of them were still alive at the end of the study. The performance of EUS-FNA for diagnosis of pancreatic metastases was analyzed. Symptoms, time frame between primary tumour diagnosis and the finding of metastases, and survival after diagnosis were also analyzed. Results 37 patients underwent EUS-FNA for probable pancreas metastases. Most cases (65%) presented with symptoms, especially upper abdominal pain (46%). Median time between detection of the first tumour and the finding of pancreatic metastases was 36 months. Metastases were confirmed in 32 (1.6%) cases, 30 of them by EUS-FNA, and 2 by surgery. Other 5 cases were non-metastatic. Most metastases were from lymphoma, colon, lung, and kidney. Twelve (32%) patients were submitted to surgery. Median survival after diagnosis of pancreatic metastases was 9 months, with no difference of survival between surgical and non-surgical cases. Sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA with histology analysis of the specimens for diagnosis of pancreatic metastases were, respectively, 93.8%, 60%, 93.8%, 60% and 89%. Conclusion EUS-FNA with histology of the specimens is a sensitive and accurate method for definitive diagnosis of metastatic disease in patients with a previous history of extrapancreatic malignancies. PMID:23578194

  16. High risk of acute pancreatitis after endoscopic ultrasound-guided fine needle aspiration of side branch intraductal papillary mucinous neoplasms

    PubMed Central

    Siddiqui, Ali A.; Shahid, Haroon; Shah, Apeksha; Khurana, Tanvi; Huntington, William; Ghumman, Saad S.; Loren, David E.; Kowalski, Thomas E.; Laique, Sobia; Hayat, Umar; Eloubeidi, Mohamad A.

    2015-01-01

    Background and Objectives: Data on the risk of acute pancreatitis following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions are limited. The aim of our study was to evaluate the frequency of acute pancreatitis after EUS-FNA of pancreatic cysts and solid lesions, and determine whether there was a difference in pancreatitis risk in patients with side branch intraductal papillary mucinous neoplasms (SB-IPMN). Patients and Methods: A retrospective review of patients who underwent EUS-FNA of pancreatic cysts and solid lesions was performed. The primary outcome measure was development of acute pancreatitis after EUS-FNA. Factors associated with acute pancreatitis were examined by statistical analysis to determine independent predictors of acute pancreatitis. Statistical significance was determined at a P ≤ 0.05. Results: We identified 186 patients with pancreatic cystic lesions and 557 with solid lesions in which EUS-FNA was performed. The median size of the cysts was 19 mm (range: 10-66 mm). There were 37 IPMNs, 33 mucinous cystic neoplasms, 58 serous cysts and 46 pseudocysts and 12 solid-cystic ductal carcinomas. The majority of patients (75%) with solid lesions were diagnosed with adenocarcinoma. Patients with pancreatic cysts had a statistically greater frequency of developing pancreatitis after EUS-FNA when compared to those with solid lesions (2.6% vs. 0.36% respectively; P = 0.13). In patients with cysts, there were no statistically significant differences between the two groups (with and without pancreatitis) with regard to a cyst location, size of the cyst, and number of needle passes or trainee involvement. Patients with SB-IPMN had a statistically higher frequency of pancreatitis after EUS-FNA compared to those with other cyst types (8% vs. 1.3% respectively; odds ratio = 6.4, 95% confidence intervals = 1.0-40.3, P = 0.05). Discussion: Patients with SB-IPMN are at a higher risk of developing acute pancreatitis after

  17. Pancreatic and Gastric Plasmacytoma Presenting with Obstructive Jaundice, Diagnosed with Endoscopic Ultrasound-Guided Fine Needle Aspiration.

    PubMed

    Padda, Manmeet S; Milless, Tiffani; Adeniran, Adebowale J; Mahooti, Sepi; Aslanian, Harry R

    2010-09-28

    Pancreatic plasmacytoma is a rare disorder which may present with obstructive jaundice. Only eighteen cases have been reported in the English language literature. We present the first case of pancreatic plasmacytoma and gastric plasmacytoma diagnosed with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). A 75-year-old male with a known history of multiple myeloma presented with obstructive jaundice and a pancreatic mass. A concomitant gastric mass due to gastric plasmacytoma was seen. The diagnosis was established via EUS-FNA of the pancreatic mass. Pancreatic plasmacytoma should be suspected in patients with a history of myeloma. EUS-FNA is a safe and effective modality in the diagnosis of pancreatic plasmacytoma. Radiation therapy should be the first-line of therapy in treating pancreatic plasmacytomas.

  18. Pancreatic and Gastric Plasmacytoma Presenting with Obstructive Jaundice, Diagnosed with Endoscopic Ultrasound-Guided Fine Needle Aspiration

    PubMed Central

    Padda, Manmeet S.; Milless, Tiffani; Adeniran, Adebowale J.; Mahooti, Sepi; Aslanian, Harry R.

    2010-01-01

    Pancreatic plasmacytoma is a rare disorder which may present with obstructive jaundice. Only eighteen cases have been reported in the English language literature. We present the first case of pancreatic plasmacytoma and gastric plasmacytoma diagnosed with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). A 75-year-old male with a known history of multiple myeloma presented with obstructive jaundice and a pancreatic mass. A concomitant gastric mass due to gastric plasmacytoma was seen. The diagnosis was established via EUS-FNA of the pancreatic mass. Pancreatic plasmacytoma should be suspected in patients with a history of myeloma. EUS-FNA is a safe and effective modality in the diagnosis of pancreatic plasmacytoma. Radiation therapy should be the first-line of therapy in treating pancreatic plasmacytomas. PMID:21060710

  19. Efficacy of endoscopic ultrasonography-guided fine needle aspiration for pancreatic neuroendocrine tumor grading

    PubMed Central

    Sugimoto, Mitsuru; Takagi, Tadayuki; Hikichi, Takuto; Suzuki, Rei; Watanabe, Ko; Nakamura, Jun; Kikuchi, Hitomi; Konno, Naoki; Waragai, Yuichi; Asama, Hiroyuki; Takasumi, Mika; Watanabe, Hiroshi; Obara, Katsutoshi; Ohira, Hiromasa

    2015-01-01

    AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) for grading pancreatic neuroendocrine tumors (PNETs). METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University Hospital. Among these cases, we targeted 10 PNET patients who were evaluated according to the World Health Organization (WHO) 2010 classification. Surgery was performed in eight patients, and chemotherapy was performed in two patients due to multiple liver metastases.Specimens obtained by EUS-FNA were first stained with hematoxylin and eosin and then stained with chromogranin, synaptophysin, CD56, and Ki-67. The specimens were graded by the Ki-67 index according to the WHO 2010 classification. Specimens obtained by surgery were graded by the Ki-67 index and mitotic count (WHO 2010 classification). For the eight specimens obtained by EUS-FNA, the Ki-67 index results were compared with those obtained by surgery. In the two cases treated with chemotherapy, the effects and prognoses were evaluated. RESULTS: The sampling rate for histological diagnosis by EUS-FNA was 100%. No adverse effects were observed. The concordance rate between specimens obtained by EUS-FNA and surgery was 87.5% (7/8). For the two cases treated with chemotherapy, case 1 received somatostatin analog therapy and transcatheter arterial infusion (TAI) targeting multiple liver metastases. Subsequent treatment consisted of everolimus. During chemotherapy, the primary tumor remained unconfirmed, although the multiple liver metastases diminished dramatically. Case 2 was classified as neuroendocrine carcinoma (NEC) according to the Ki-67 index of a specimen obtained by EUS-FNA; therefore, cisplatin and irinotecan therapy was started. However, severe adverse effects, including renal failure and diarrhea, were observed, and the therapy regimen was changed to cisplatin and etoposide. TAI targeting multiple liver

  20. Endosonography‑guided fine‑needle aspiration in the diagnosis of sarcoidosis: a randomized study.

    PubMed

    Kocoń, Piotr; Szlubowski, Artur; Kużdżał, Jarosław; Rudnicka-Sosin, Lucyna; Ćmiel, Adam; Soja, Jerzy; Włodarczyk, Janusz R; Talar, Piotr; Smęder, Tomasz; Gil, Tomasz; Warmus, Janusz; Tomaszewska, Romana

    2017-03-31

    INTRODUCTION    There are no widely accepted standards for the diagnosis of sarcoidosis. OBJECTIVES    The aim of this study was to assess the relative diagnostic yield of endobronchial ultrasound fine-needle aspiration (EBUS -FNA) and endoscopic ultrasound fine needle aspiration (EUS -FNA), and to compare them with standard diagnostic techniques such as endobronchial biopsy (EBB), transbronchial lung biopsy (TBLB), transbronchial needle aspiration (TBNA), and mediastinoscopy. PATIENTS AND METHODS    This was a prospective randomized study including consecutive patients with clinical diagnosis of stage I or II sarcoidosis. EBB, TBLB, and TBNA were performed at baseline in all patients. Subsequently, patients were randomized to group A (EBUS -FNA) or group B (EUS -FNA). Next, a crossover control test was performed: all patients with negative results in group A underwent EUS -FNA and all patients with negative results in group B underwent EBUS -FNA. If sarcoidosis was not confirmed, mediastinoscopy was performed. RESULTS    We enrolled 106 patients, of whom 100 were available for the final analysis. The overall sensitivity and accuracy of standard endoscopic methods were 64% each. When analyzing each of the standard endoscopic methods separately, the diagnosis was confirmed with EBB in 12 patients (12%), with TBLB in 42 patients (42%), and with TBNA in 44 patients (44%). The sensitivity and accuracy of each endosonographic technique were significantly higher than those of EBB+TBLB+TBNA (P = 0.0112 vs P = 0.0134). CONCLUSIONS    The sensitivity and accuracy of EBUS -FNA and EUS -FNA are significantly higher than those of standard endoscopic methods. Moreover, the sensitivity and accuracy of EUS -FNA tend to be higher than those of EBUS -FNA.

  1. Toward optical guidance during endoscopic ultrasound-guided fine needle aspirations of pancreatic masses using single fiber reflectance spectroscopy: a feasibility study

    NASA Astrophysics Data System (ADS)

    Stegehuis, Paulien L.; Boogerd, Leonora S. F.; Inderson, Akin; Veenendaal, Roeland A.; van Gerven, P.; Bonsing, Bert A.; Sven Mieog, J.; Amelink, Arjen; Veselic, Maud; Morreau, Hans; van de Velde, Cornelis J. H.; Lelieveldt, Boudewijn P. F.; Dijkstra, Jouke; Robinson, Dominic J.; Vahrmeijer, Alexander L.

    2017-02-01

    Endoscopic ultrasound-guided fine needle aspirations (EUS-FNA) of pancreatic masses suffer from sample errors and low-negative predictive values. Fiber-optic spectroscopy in the visible to near-infrared wavelength spectrum can noninvasively extract physiological parameters from tissue and has the potential to guide the sampling process and reduce sample errors. We assessed the feasibility of single fiber (SF) reflectance spectroscopy measurements during EUS-FNA of pancreatic masses and its ability to distinguish benign from malignant pancreatic tissue. A single optical fiber was placed inside a 19-gauge biopsy needle during EUS-FNA and at least three reflectance measurements were taken prior to FNA. Spectroscopy measurements did not cause any related adverse events and prolonged procedure time with ˜5 min. An accurate correlation between spectroscopy measurements and cytology could be made in nine patients (three benign and six malignant). The oxygen saturation and bilirubin concentration were significantly higher in benign tissue compared with malignant tissue (55% versus 21%, p=0.038; 166 μmol/L versus 17 μmol/L, p=0.039, respectively). To conclude, incorporation of SF spectroscopy during EUS-FNA was feasible, safe, and relatively quick to perform. The optical properties of benign and malignant pancreatic tissue are different, implying that SF spectroscopy can potentially guide the FNA sampling.

  2. Intraductal tubulopapillary neoplasm with expansile invasive carcinoma of the pancreas diagnosed by endoscopic ultrasonography-guided fine needle aspiration: a case report.

    PubMed

    Furuhata, Ayako; Minamiguchi, Sachiko; Mikami, Yoshiki; Kodama, Yuzo; Sumiyoshi, Shinji; Adachi, Souichi; Haga, Hironori

    2014-04-01

    Intraductal tubulopapillary neoplasm (ITPN) of the pancreas, a novel entity included in the World Health Organization 2010 classification, accounts for <1% of all pancreatic exocrine neoplasms and the number of reported cases is limited in the English literature. Herein we describe the cytologic features of ITPN with invasive carcinoma showing expansile growth on endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) cytology. A 74-year-old male patient is presented with a 6.2 cm irregular mass in the head of the pancreas. Microscopic examination of EUS-FNA material showed abundant branching clusters of cells, with some scattered discohesive cells. High power magnification revealed tubular and cribriform patterns with central lumina, containing mucinous or proteinaceous secretions. The constituent cells were relatively uniform and showed mild to intermediate nuclear atypia. Intracytoplasmic mucin was not identified. On cell-block preparation, luminal spaces of clusters contained wispy luminal mucin. Immunohistochemically, constituent cells were positive for MUC1 and MUC6, and were negative for MUC5AC. The large cribriform and tubular clusters with luminal spaces containing wispy mucin were considered to be diagnostic clues for the cytologic diagnosis of ITPN by EUS-FNA. MUC1, MUC6, and MUC5AC immunohistochemistry for cell-block preparation appears to be a useful adjunctive tool to confirm the diagnosis. On EUS-FNA, ITPN should be included in the differential diagnosis of a pancreatic mass lesion showing good circumscription.

  3. Diagnosis of pancreatic lesions collected by endoscopic ultrasound-guided fine-needle aspiration using next-generation sequencing

    PubMed Central

    Kameta, Eri; Sugimori, Kazuya; Kaneko, Takashi; Ishii, Tomohiro; Miwa, Haruo; Sato, Takeshi; Ishii, Yasuaki; Sue, Soichiro; Sasaki, Tomohiko; Yamashita, Yuki; Shibata, Wataru; Matsumoto, Naomichi; Maeda, Shin

    2016-01-01

    Endoscopic ultrasound-guided fine-needle aspiration (EUF-FNA) has improved the diagnosis of pancreatic lesions. Next-generation sequencing (NGS) facilitates the production of millions of sequences concurrently. Therefore, in the current study, to improve the detectability of oncogenic mutations in pancreatic lesions, an NGS system was used to diagnose EUS-FNA samples. A total of 38 patients with clinically diagnosed EUS-FNA specimens were analyzed; 27 patients had pancreatic ductal adenocarcinoma (PDAC) and 11 had non-PDAC lesions. DNA samples were isolated and sequenced by NGS using an Ion Personal Genome Machine system. The Cancer Hotspot Panel v2, which includes 50 cancer-related genes and 2,790 COSMIC mutations, was used. A >2% mutation frequency was defined as positive. KRAS mutations were detected in 26 of 27 PDAC aspirates (96%) and 0 of 11 non-PDAC lesions (0%). The G12, G13, and Q61 KRAS mutations were found in 25, 0, and 1 of the 27 PDAC samples, respectively. Mutations were confirmed by TaqMan® polymerase chain reaction analysis. TP53 mutations were detected in 12 of 27 PDAC aspirates (44%). SMAD4 was observed in 3 PDAC lesions and cyclin-dependent kinase inhibitor 2A in 4 PDAC lesions. Therefore, the current study was successfully able to develop an NGS assay with high clinical sensitivity for EUS-FNA samples. PMID:27895743

  4. Single-dose intra-procedural ceftriaxone during endoscopic ultrasound fine-needle aspiration of pancreatic cysts is safe and effective: results from a single tertiary center

    PubMed Central

    Klein, Amir; Qi, Rose; Nagubandi, Shyam; Lee, Eric; Kwan, Vu

    2017-01-01

    Background Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) is universally used for the investigation and diagnosis of pancreatic cystic lesions (PCL). Infectious complications following EUS-FNA of PCL are rare. Antibiotic prophylaxis to reduce the risk of infection is recommended; however, there is no consensus on the optimal regimen or route of administration. Potential advantages of a single-dose intravenous (IV) antibiotic over a prolonged oral regimen include simplicity, guaranteed delivery and fewer antibiotic related adverse events, but there are only limited data to support this. We aimed to investigate the safety and efficacy of a single 1 g dose of IV ceftriaxone in preventing infectious complications following EUS-FNA of PCL. Methods A retrospective analysis was conducted of EUS-FNA of PCL procedures performed at our center. We reviewed patient medical records for any presentation to a hospital in our district within 30 days of the procedure. An infectious complication was defined as fever/rigors, or bacteremia, or abdominal pain accompanied by imaging or laboratory results suggestive of infection, within 30 days of the procedure. Data collection included patient demographics, procedural data and outcome. Results EUS-FNA of 204 PCL (mean size 18.0 mm) was performed. Successful fluid aspiration was achieved in 94% of cases. Single-dose IV ceftriaxone was given in 146/204 (72%) cases. Four patients had a complication (pancreatitis n=1, post-procedural pain n=3). No infectious complications and no IV antibiotic-related adverse events were identified. Conclusion A single dose of IV ceftriaxone appears to be a safe, effective and convenient intervention for preventing infectious complications after FNA. PMID:28243046

  5. Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

    PubMed Central

    Han, Chaoqun; Lin, Rong; Zhang, Qin; Liu, Jun; Ding, Zhen; Hou, Xiaohua

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate technique for sampling the pancreas and mediastinum; however, limited data are available for other mass lesions. The aim of this study was to explore the value of EUS-FNA in the differential diagnosis of all mass lesions. Data from patients who underwent EUS-FNA for the diagnosis of mass lesions, including pancreatic, mediastinal, celiac and retroperitoneal lesions were retrospectively analyzed. The accuracy was calculated by comparing the results of FNA with the results of pathological examination or follow-up surveillances in non-operated cases. A total of 150 cases were included. The location of the mass varied from the pancreas (n=62) to the mediastinum (n=29), gastrointestinal tract (n=36), celiac cavity and retroperitoneum (n=23). The sensitivity and Youdens index of EUS-FNA in the diagnosis of all lesions were 92.97% and 0.93 respectively. The accuracy of diagnosis of pancreatic, mediastinal, gastrointestinal, celiac and retroperitoneal lesions was 85.48, 89.66, 83.33 and 78.23%, respectively. Masses were categorized into parenchymal organs (n=66), luminal organs (n=36) and enlarged lymph nodes (n=33). Lesions in parenchymal organs were likely to be bigger than those in luminal organs (P=0.03) and enlarged lymph nodes (P=0.01). For solid and cystic masses, which constituted 63.3 and 14.7% of the total masses, no significant difference in diagnostic accuracy was observed (P=0.56); however, lesion sizes were significantly different between these two groups (P=0.04) and the majority of cystic masses were identified in women (P=0.03). Malignant lesions were more common in older (P=0.01) and male (P=0.03) patients. In conclusion, EUS-FNA is an effective tool in the diagnosis of unexplained mass lesions; it influences the management of patients by enabling the appropriate treatment to be identified. PMID:27446324

  6. Endoscopic ultrasound-guided fine-needle aspirate-derived preclinical pancreatic cancer models reveal panitumumab sensitivity in KRAS wild-type tumors.

    PubMed

    Berry, William; Algar, Elizabeth; Kumar, Beena; Desmond, Christopher; Swan, Michael; Jenkins, Brendan J; Croagh, Daniel

    2017-05-15

    Pancreatic cancer (PC) is largely refractory to existing therapies used in unselected patient trials, thus emphasizing the pressing need for new approaches for patient selection in personalized medicine. KRAS mutations occur in 90% of PC patients and confer resistance to epidermal growth factor receptor (EGFR) inhibitors (e.g., panitumumab), suggesting that KRAS wild-type PC patients may benefit from targeted panitumumab therapy. Here, we use tumor tissue procured by endoscopic ultrasound-guided fine-needle aspirate (EUS-FNA) to compare the in vivo sensitivity in patient-derived xenografts (PDXs) of KRAS wild-type and mutant PC tumors to panitumumab, and to profile the molecular signature of these tumors in patients with metastatic or localized disease. Specifically, RNASeq of EUS-FNA-derived tumor RNA from localized (n = 20) and metastatic (n = 20) PC cases revealed a comparable transcriptome profile. Screening the KRAS mutation status of tumor genomic DNA obtained from EUS-FNAs stratified PC patients into either KRAS wild-type or mutant cohorts, and the engraftment of representative KRAS wild-type and mutant EUS-FNA tumor samples into NOD/SCID mice revealed that the growth of KRAS wild-type, but not mutant, PDXs was selectively suppressed with panitumumab. Furthermore, in silico transcriptome interrogation of The Cancer Genome Atlas (TCGA)-derived KRAS wild-type (n = 38) and mutant (n = 132) PC tumors revealed 391 differentially expressed genes. Taken together, our study validates EUS-FNA for the application of a novel translational pipeline comprising KRAS mutation screening and PDXs, applicable to all PC patients, to evaluate personalized anti-EGFR therapy in patients with KRAS wild-type tumors.

  7. Endoscopic ultrasound-guided fine-needle aspiration plus KRAS and GNAS mutation in malignant intraductal papillary mucinous neoplasm of the pancreas

    PubMed Central

    Bournet, Barbara; Vignolle-Vidoni, Alix; Grand, David; Roques, Céline; Breibach, Florence; Cros, Jérome; Muscari, Fabrice; Carrère, Nicolas; Selves, Janick; Cordelier, Pierre; Buscail, Louis

    2016-01-01

    Background: KRAS and GNAS mutations are common in intraductal papillary mucinous neoplasia of the pancreas (IPMN). The aims of this study were to assess the role of pre-therapeutic cytopathology combined with KRAS and GNAS mutation assays within cystic fluid sampled by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to predict malignancy of IPMN. Patients and methods: We prospectively included 37 IPMN patients with clinical and/or imaging predictors of malignancy (men: 24; mean age: 69.5 years). Cytopathology (performed on cystic fluid and/or IPMN nodules), KRAS (Exon 2, codon 12) and GNAS (Exon 8, codon 201) mutations assays (using TaqMan® allelic discrimination) were performed on EUS-FNA material. The final diagnosis was obtained from IPMN resections (n = 18); surgical biopsies, EUS-FNA analyses, and follow-up (n = 19): 10 and 27 IPMN were benign and malignant, respectively. Results: Sensitivity, specificity, positive and negative predictive values, and accuracy of cytopathology alone to diagnose IPMN malignancy were 55 %, 100 %, 100 %, 45 %, and 66 %, respectively. When KRAS-mutation analysis was combined with cytopathology these values were 92 %, 50 %, 83 %, 71 %, and 81 %, respectively. GNAS assays did not improve the performances of cytopathology alone or those of cytopathology plus a KRAS assay. Conclusions: In patients with a likelihood of malignant IPMN at pre-therapeutic investigation, testing for KRAS mutations in cystic fluid sampling by EUS-FNA improved the results of cytopathology for the diagnosis of malignancy whereas GNAS mutation assay did not. PMID:27995180

  8. Clinical utility of endoscopic ultrasound-guided fine-needle aspiration in mixed adenoneuroendocrine carcinoma with signet-ring cells of the pancreas: a case report and review of the literature.

    PubMed

    Kaji, Kiichiro; Seishima, Jun; Yamato, Masatoshi; Miyazawa, Masaki; Komura, Takuya; Marukawa, Yohei; Ohta, Hajime; Kasashima, Satomi; Kawashima, Atsuhiro; Yano, Masaaki; Unoura, Masashi

    2016-02-01

    A man in his 60s visited our hospital because of a pancreatic head tumor. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) revealed that the tumor consisted of a neuroendocrine carcinoma (NEC) and adenocarcinoma, including signet-ring cell carcinoma, and that the ratio of these components was approximately 50:50. Therefore, he was diagnosed with mixed adenoneuroendocrine carcinoma (MANEC). Because of liver and lymph node metastases, systemic chemotherapy was initiated using a regimen for the NEC component based on an increase in neuron-specific enolase (NSE). Although the patient achieved stable disease after two chemotherapy cycles, the tumor increased in size after three cycles, which was associated with a gradual increase in carcinoembryonic antigen and a decrease in NSE level. An EUS-FNA reexamination revealed that the adenocarcinoma component accounted for 90 % of the tumor. Thus, an adenocarcinoma chemotherapy regimen was started, and a slight reduction in tumor size was observed. Here, we report an extremely rare and remarkable case of MANEC of the pancreas that demonstrates the effectiveness of EUS-FNA for helping to decide the chemotherapy regimen.

  9. Dynamic telecytology compares favorably to rapid onsite evaluation of endoscopic ultrasound fine needle aspirates

    PubMed Central

    Buxbaum, James L.; Eloubeidi, Mohamad A.; Lane, Christianne J.; Varadarajulu, Shyam; Linder, Ami; Crowe, Amanda E.; Jhala, Darshana; Jhala, Nirag C.; Crowe, David R.; Eltoum, Isam A.

    2013-01-01

    Background and Aims Rapid onsite evaluation (ROSE) has been demonstrated to correlate with final cytologic interpretations and improves the diagnostic yield of EUS-FNA, however, its availability is variable across centers. The aim of this prospective study was to evaluate whether remote telecytology can substitute for ROSE. Methods Consecutive patients who underwent EUS-FNA for diverse indications at a high volume referral center were enrolled All samples were prospectively evaluated by three methods. ROSE was performed by a cytopathologist in the procedure room; simultaneously dynamic telecytology was done by a different cytopathologist in a remote location at our institution. The third method, final cytologic interpretation in the laboratory, was the gold standard. Telecytology was performed using an Olympus microscope system (BX) which broadcasts live images over the internet. Accuracy of telecytology and agreement with other methods were the principle outcome measurements. Results Twenty-five consecutive samples were obtained from participants 40–87 years (median age =63, 48% male). There was 88% agreement between telecytology and final cytology (p < 0.001) and 92% agreement between ROSE and final cytology (p <0.001). There was consistency between telecytology and ROSE (p-value for McNemar’s χ2 = 1.0). Cohen’s kappa for agreement for telecytology and ROSE was 0.80 (SE = 0.11), confirming favorable correlation. Conclusion Dynamic telecytology compares favorably to ROSE in the assessment of EUS acquired fine needle aspirates. If confirmed by larger trials, this system might obviate the need for onsite interpretation of EUS-FNA specimens. PMID:22729624

  10. Endoscopic ultrasound-guided fine-needle aspiration diagnosis of Merkel cell carcinoma metastatic to the pancreas.

    PubMed

    Bernstein, Jane; Adeniran, Adebowale J; Cai, Guoping; Theoharis, Constantine G A; Ustun, Berrin; Beckman, Danita; Aslanian, Harry R; Harigopal, Malini

    2014-03-01

    Merkel cell carcinoma (MCC) is a rare and highly aggressive primary neuroendocrine carcinoma of the skin with a high propensity for local, regional, and distant spread. Distant metastasis of MCC to the pancreas is uncommonly seen and may impose a diagnostic challenge cytologically. Here we report a case of MCC with pancreatic metastasis, which was diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The aspirates revealed both single and clustered epithelial cells with scant cytoplasm and round nuclei with stippled chromatin and inconspicuous nucleoli. Immunocytochemically, the tumor cells were positive for CK20, synaptophysin, CD56, and CD117. The neoplastic cells were also identified by flow cytometry as non-hematopoietic cells which were positive for CD56 and negative for CD45. To our knowledge, this is only the second case report of MCC metastatic to the pancreas diagnosed by EUS-FNA. There have been several reports of MCC metastatic to the pancreas diagnosed only at the time of surgical resection. However, a preoperative diagnosis allows for appropriate management while sparing a patient the morbidity of unnecessary procedures.

  11. Accuracy of diagnosis of solid pseudopapillary tumor of the pancreas on fine needle aspiration: A multi-institution experience of ten cases

    PubMed Central

    Jahangir, Sidra; Loya, Asif; Siddiqui, Momin T.; Akhter, Noreen; Yusuf, Muhammed Aasim

    2015-01-01

    Introduction: Solid pseudopapillary tumor of the pancreas (SPTP) is a neoplasm of uncertain origin and indolent biologic behavior with distinctive morphological features occurring predominantly in young women. This tumor has an excellent prognosis compared to neuroendocrine and acinar cell carcinoma, which are close differential diagnoses based on morphology, hence making it crucial to diagnose SPTP correctly. Objectives: To discuss the cytomorphological features of 10 cases of SPTP reported in two institutions and to evaluate the diagnostic accuracy of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) cytology in establishing the diagnosis of SPTP. Methods: Ten diagnosed cases of SPTP were retrieved from the computerized endoscopy and pathology databases of our two tertiary care institutions. Nine patients had subsequent histological follow-up available. Eight patients underwent EUS-FNA while one patient each had ultrasound and computed tomography-guided FNA. The rapid on-site evaluation was carried out in all 10 cases, and additional material was retained for cell block preparation. Immunohistochemical (IHC) stains ranging from synaptophysin, progesterone receptor, chromogranin, β-catenin, CD10, and NSE were applied on cell blocks. Histological sections of all resected specimens were reviewed, and findings were correlated with those obtained by FNA. Results: Adequate material was obtained in all ten cases. IHC stains helped to confirm the cytological impression of SPTP. Histological examination of resection specimens, available in 9/10 cases, confirmed the cytological diagnosis. Conclusions: FNA particularly that obtained with EUS guidance is an effective tool in the accurate diagnosis of SPTP. PMID:26884802

  12. Slow-pull and different conventional suction techniques in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid lesions using 22-gauge needles

    PubMed Central

    Chen, Jia-Ying; Ding, Qing-Yu; Lv, Yang; Guo, Wen; Zhi, Fa-Chao; Liu, Si-De; Cheng, Tian-Ming

    2016-01-01

    AIM To evaluate the cytological diagnostic capacity and sample quality of the slow-pull technique and compare them with different suction techniques. METHODS From July 2010 to December 2015, 102 patients with pancreatic solid lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with 22-gauge needles were retrospectively evaluated. EUS-FNA diagnosis was based on a cytological examination, and final diagnosis was based on a comprehensive standard of cytological diagnosis, surgical pathology and clinical or imaging follow-up. Cytological specimens were characterized for cellularity and blood contamination. The cytological diagnostic capacity and sample quality of the slow-pull technique and suction techniques with 5-mL/10-mL/20-mL syringes were analyzed. RESULTS Of all of the EUS-FNA procedures, the slow-pull technique and suction techniques with 5-mL/10-mL/20-mL syringes were used in 31, 19, 34 and 18 procedures, respectively. There were significant differences between these four suction techniques in terms of cytological diagnostic accuracy (90.3% vs 63.2% vs 58.8% vs 55.6%, P = 0.019), sensitivity (88.2% vs 41.7% vs 40.0% vs 36.4%, P = 0.009) and blood contamination (score ≥ 2 for 29.0% vs 52.6% vs 70.6% vs 72.2%, P = 0.003). The accuracy and sensitivity of the slow-pull technique were significantly higher than those of the suction techniques using 5-mL (P = 0.03, P = 0.014), 10-mL (P = 0.005; P = 0.006) and 20-mL syringes (P = 0.01, P = 0.01). Blood contamination was significantly lower in the slow-pull technique than in the suction techniques with 10-mL (P = 0.001) and 20-mL syringes (P = 0.007). CONCLUSION The slow-pull technique may increase the cytological diagnostic accuracy and sensitivity with slight blood contamination during EUS-FNA when using 22-gauge needles for solid pancreatic masses. PMID:27818594

  13. Eosinophilic esophageal myositis diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report.

    PubMed

    Igarashi, Ryo; Irisawa, Atsushi; Shibukawa, Goro; Yamabe, Akane; Fujisawa, Mariko; Sato, Ai; Maki, Takumi; Arakawa, Noriyuki; Yoshida, Yoshitsugu; Yamamoto, Shogo; Ikeda, Tsunehiko

    2016-10-01

    Eosinophilic esophagitis (EoE) is diagnosed by microscopic findings of eosinophilic infiltration into the squamous epithelium. In contrast, another disease concept termed "eosinophilic esophageal myositis (EoEM)" has been proposed, whereby there is eosinophilic infiltration into the muscularis propria instead. A 60-year-old man was referred to our hospital for chest pain, dysphagia, and several episodes of esophageal food impaction. Although EoE was suspected based on clinical features, biopsy specimens showed no mucosal eosinophilic infiltration. Endoscopic ultrasound (EUS) showed thickening of the muscularis propria layer and subsequent EUS-guided fine-needle aspiration biopsy (EUS-FNA) revealed eosinophilic infiltration into the muscularis propria. Although the patient's symptoms gradually improved after steroid administration, complete remission was not achieved after 1 year of treatment. This case may reflect a disorder distinct from typical EoE based on eosinophilic infiltration of the muscularis propria but not the squamous epithelium, and we, therefore, diagnosed it as EoEM using the EUS-FNA findings as reference.

  14. Differential diagnosis between pancreatic neuroendocrine and solid pseudopapillary neoplasms on endoscopic ultrasound-guided fine-needle aspiration

    PubMed Central

    Raddaoui, Emad M.; Almadi, Majid A.; Aljebreen, Abdulrahman M.; Alsaif, Faisal A.; AlShedoukhy, Ahlam A.; Al-Lehibi, Abed H.; Almohameed, Khalid A.; Tsolakis, Apostolos V.; AlAbbadi, Mousa A.; Almutrafi, Amna R.

    2016-01-01

    Objectives: To evaluate the role of applying a limited panel of immunohistochemical stains on the cellblock preparation from samples obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the aim of differentiating solid pseudopapillary neoplasms (SPNs) from neuroendocrine tumors (NETs). Methods: We retrospectively retrieved all the EUS-FNAs of the pancreas that have a diagnosis of NET or SPN that were performed at 2 tertiary care hospitals in Riyadh, Kingdom of Saudi Arabia from May 2004 to December 2014. Diff-Quik, Papanicolaou, and Immunohistochemistry stains on cellblock preparations were performed. Results: Twenty cases were available (16 pancreatic neuroendocrine tumors (pNETs) and 4 SPNs). The pNETs were immunoreactive for synaptophysin, chromogranin A and CD56 while E-cadherin was diffusely to focally cytoplasmic positive. β-catenin was negative or showed focal cytoplasmic immunoreactivity. In comparison, SPNs were positive for vimentin, CD10, CD-56, focally positive for progesterone receptors and synaptophysin, and revealed nuclear immunostaining for β-catenin. They were negative for chromogranin A and E-cadherin. Conclusion: Based on EUS-FNA samples, nuclear immunoreactivity for β-catenin with loss of membranous immunostaining for E-Cadherin can potentially facilitate differentiating SPNs from pNETs. PMID:27381533

  15. [Our experiences with early vacuum aspiration (miniinterruption)].

    PubMed

    Poradovský, K; Ondás, P; Posluch, J

    1982-07-01

    The authors report their experiences with 80 early vacuum aspirations (mini-interruptions) performed at the 1st Dept. of Gynecology and Obstetrics of the University Hospital in Kosice during 1980-81. The procedure was performed between days 36-42 in 15% of the women, between days 43-49 in 52.7% of the women, between days 50-56 in 27.5%, and between days 57-60 in 5% of the women. Interruption of pregnancy did not require general anesthesia or hospitalization of the patients. Complications occurred in 10% of the women, 6.25% due to residua and 2.5% to inflammation. Further experience should reduce the occurrence of complications. The authors consider the method to be advantageous and prospective. (author's modified)

  16. 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. PMID:27818598

  17. Aspiration.

    PubMed

    Hancocks, S

    2003-03-22

    Aspiration lands in the dictionary between aspidistra and aspirin - a Victorian parlour plant and an anti-inflammatory with new-found cardiac and DVT prevention qualities. What do we make of that as a sign of the times?

  18. Prospective validation of microRNA signatures for detecting pancreatic malignant transformation in endoscopic-ultrasound guided fine-needle aspiration biopsies

    PubMed Central

    Frampton, Adam E.; Krell, Jonathan; Prado, Mireia Mato; Gall, Tamara M.H.; Abbassi-Ghadi, Nima; Del Vecchio Blanco, Giovanna; Funel, Niccola; Giovannetti, Elisa; Castellano, Leandro; Basyouny, Mohamed; Habib, Nagy A.; Kaltsidis, Harry; Vlavianos, Panagiotis; Stebbing, Justin; Jiao, Long R.

    2016-01-01

    Background Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. Novel biomarkers are required to aid treatment decisions and improve patient outcomes. MicroRNAs (miRNAs) are potentially ideal diagnostic biomarkers, as they are stable molecules, and tumour and tissue specific. Results Logistic regression analysis revealed an endoscopic-ultrasound fine-needle aspiration (EUS-FNA) 2-miRNA classifier (miR-21 + miR-155) capable of distinguishing benign from malignant pancreatic lesions with a sensitivity of 81.5% and a specificity of 85.7% (AUC 0.930). Validation FNA cohorts confirmed both miRNAs were overexpressed in malignant disease, while circulating miRNAs performed poorly. Methods Fifty-five patients with a suspicious pancreatic lesion on cross-sectional imaging were evaluated by EUS-FNA. At echo-endoscopy, the first part of the FNA was sent for cytological assessment and the second part was used for total RNA extraction. Candidate miRNAs were selected after careful review of the literature and expression was quantified by qRT-PCR. Validation was performed on an independent cohort of EUS-FNAs, as well as formalin-fixed paraffin embedded (FFPE) and plasma samples. Conclusions We provide further evidence for using miRNAs as diagnostic biomarkers for pancreatic malignancy. We demonstrate the feasibility of using fresh EUS-FNAs to establish miRNA-based signatures unique to pancreatic malignant transformation and the potential to enhance risk stratification and selection for surgery. PMID:27086919

  19. Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: a case report and literature review.

    PubMed

    Salla, Charitini; Chatzipantelis, Paschalis; Konstantinou, Panagiotis; Karoumpalis, Ioannis; Pantazopoulou, Akrivi; Dappola, Victoria

    2007-10-14

    We describe the clinical, imaging and cytopathological features of solid pseudopapillary tumor of the pancreas (SPTP) diagnosed by endoscopic ultrasound-guided (EUS-guided) fine-needle aspiration (FNA). A 17-year-old woman was admitted to our hospital with complaints of an unexplained episodic abdominal pain for 2 mo and a short history of hypertension in the endocrinology clinic. Clinical laboratory examinations revealed polycystic ovary syndrome, splenomegaly and low serum amylase and carcinoembryonic antigen (CEA) levels. Computed tomography (CT) analysis revealed a mass of the pancreatic tail with solid and cystic consistency. EUS confirmed the mass, both in body and tail of the pancreas, with distinct borders, which caused dilation of the peripheral part of the pancreatic duct (major diameter 3.7 mm). The patient underwent EUS-FNA. EUS-FNA cytology specimens consisted of single cells and aggregates of uniform malignant cells, forming microadenoid structures, branching, papillary clusters with delicate fibrovascular cores and nuclear overlapping. Naked capillaries were also seen. The nuclei of malignant cells were round or oval, eccentric with fine granular chromatin, small nucleoli and nuclear grooves in some of them. The malignant cells were periodic acid Schiff (PAS)-Alcian blue (+) and immunocytochemically they were vimentin (+), CA 19.9 (+), synaptophysin (+), chromogranin (-), neuro-specific enolase (-), a1-antitrypsin and a1-antichymotrypsin focal positive. Cytologic findings were strongly suggestive of SPTP. Biopsy confirmed the above cytologic diagnosis. EUS-guided FNA diagnosis of SPTP is accurate. EUS findings, cytomorphologic features and immunostains of cell block help distinguish SPTP from pancreatic endocrine tumors, acinar cell carcinoma and papillary mucinous carcinoma.

  20. Transnational Experience, Aspiration and Family Language Policy

    ERIC Educational Resources Information Center

    Hua, Zhu; Wei, Li

    2016-01-01

    Transnational and multilingual families have become commonplace in the twenty-first century. Yet relatively few attempts have been made from applied and socio-linguistic perspectives to understand what is going on "within" such families; how their transnational and multilingual experiences impact on the family dynamics and their everyday…

  1. Lung cancer diagnosis and staging with endobronchial ultrasound-guided transbronchial needle aspiration compared with conventional approaches: an open-label, pragmatic, randomised controlled trial

    PubMed Central

    Navani, Neal; Nankivell, Matthew; Lawrence, David R; Lock, Sara; Makker, Himender; Baldwin, David R; Stephens, Richard J; Parmar, Mahesh K; Spiro, Stephen G; Morris, Stephen; Janes, Sam M

    2015-01-01

    Summary Background The diagnosis and staging of lung cancer is an important process that identifies treatment options and guides disease prognosis. We aimed to assess endobronchial ultrasound-guided transbronchial needle aspiration as an initial investigation technique for patients with suspected lung cancer. Methods In this open-label, multicentre, pragmatic, randomised controlled trial, we recruited patients who had undergone a CT scan and had suspected stage I to IIIA lung cancer, from six UK centres and randomly assigned them to either endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) or conventional diagnosis and staging (CDS), for further investigation and staging. If a target node could not be accessed by EBUS-TBNA, then endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was allowed as an alternative procedure. Randomisation was stratified according to the presence of mediastinal lymph nodes measuring 1 cm or more in the short axis and by recruiting centre. We used a telephone randomisation method with permuted blocks of four generated by a computer. Because of the nature of the intervention, masking of participants and consenting investigators was not possible. The primary endpoint was the time-to-treatment decision after completion of the diagnostic and staging investigations and analysis was by intention-to-diagnose. This trial is registered with ClinicalTrials.gov, number NCT00652769. Findings Between June 10, 2008, and July 4, 2011, we randomly allocated 133 patients to treatment: 66 to EBUS-TBNA and 67 to CDS (one later withdrew consent). Two patients from the EBUS-TBNA group underwent EUS-FNA. The median time to treatment decision was shorter with EBUS-TBNA (14 days; 95% CI 14–15) than with CDS (29 days; 23–35) resulting in a hazard ratio of 1·98, (1·39–2·82, p<0·0001). One patient in each group had a pneumothorax from a CT-guided biopsy sample; the patient from the CDS group needed intercostal drainage

  2. Links between Nonshared Friendship Experiences and Adolescent Siblings' Differences in Aspirations

    ERIC Educational Resources Information Center

    Kretschmer, Tina; Pike, Alison

    2010-01-01

    Using a sibling design, this study examined the association between adolescents' friendship experiences and their aspirations for self-acceptance, affiliation, and financial success. We hypothesized that adolescent siblings would differ in their aspirations and that unique experiences in friendships would be associated with these differences.…

  3. Links between nonshared friendship experiences and adolescent siblings' differences in aspirations.

    PubMed

    Kretschmer, Tina; Pike, Alison

    2010-02-01

    Using a sibling design, this study examined the association between adolescents' friendship experiences and their aspirations for self-acceptance, affiliation, and financial success. We hypothesized that adolescent siblings would differ in their aspirations and that unique experiences in friendships would be associated with these differences. Within our sample of 102 same-sex sibling pairs (mean age older sibling 16 years, younger sibling 14 years), only a small degree of sibling similarity was found for aspirations as well as friendship experiences. Self-acceptance and affiliation were positively linked to general friendship positivity as well as to positive features of the adolescents' closest friend. Bivariate model-fitting techniques revealed that nonshared processes (i.e., unique to each child in the family) explained these links between friendship experiences and aspirations. The results indicate that growing up in one home and being socialized by the same parents does not make adolescent siblings similar in their aspirations but rather that nonshared experiences like those with close friends are related to aspiration dissimilarity of siblings.

  4. Reaming Irrigator Aspirator system: early experience of its multipurpose use.

    PubMed

    Kanakaris, Nikolaos K; Morell, Dan; Gudipati, Suribabu; Britten, Simon; Giannoudis, Peter V

    2011-09-01

    The evolution of contemporary intramedullary reaming systems has recently generated the Reamer Irrigator Aspirator system (RIA-Synthes®), which has progressively gained in popularity as well as in indications. The preliminary results of its use over the initial period of 18 months ata single tertiary referral centre were prospectively collected and are presented. The wide spectrum of RIA's indications have been exploited, including 7 patients with polytrauma that underwent acute femoral nailing, 8 with femoral intramedullary osteomyelitis, 9 with pathological lesions of the femoral shaft, as well as 18 patients where the RIA system has been used to harvest morselised autologous bone graft in the presence of recalcitrant atrophie non-unions and bone defects. Overall its use was proven safe and efficient, achieving aggressive medullary canal debridement, collection of adequate samples for further analysis in the infected and oncology cases, as well as impressive volumes of the osteoinductive and osteogenic reaming debris for grafting purposes. No pulmonary complications or evidence of the second hit sequelae were recorded in the polytrauma patient subgroup despite the presence of a high ISS Further controlled clinical studies should follow focused in all different applications of this reliable, user-friendly and impressively versatile system, to validate these preliminary results.

  5. "Aspiration disease".

    PubMed

    Pradhan, D J; Ikins, P M

    1976-03-01

    Aspiration disease, a term used to define both an acute and chronic form of a disease entity, is described. Etiological factors, pathophysiology and therapy are discussed with emphasis on aspiration of gastric juice. A brief mention of a small clinical experience is included.

  6. Single Center Experience with the AngioVac Aspiration System

    SciTech Connect

    Salsamendi, Jason Doshi, Mehul Bhatia, Shivank; Narayanan, Govindarajan

    2015-08-15

    PurposeThe AngioVac catheter system is a mechanical suction device designed for removal of intravascular material using extracorporeal veno-venous bypass circuit. The purpose of this study is to present the outcomes in patients treated with the AngioVac aspiration system and to discuss its efficacy in different vascular beds.Materials and MethodsA retrospectively review was performed of seven patients treated with AngioVac between October 2013 and December 2014. In 6/7 cases, the AngioVac cannula was inserted percutaneously and the patient was placed on veno-venous bypass. In one of the cases, the cannula was inserted directly into the Fontan circuit after sternotomy and the patient was maintained on cardiopulmonary bypass. Thrombus location included iliocaval (2), SVC (1), pulmonary arteries (1), Fontan circuit and Glenn shunt with pulmonary artery extension (1), right atrium (1), and IVC with renal vein extension (1).ResultsThe majority of thrombus (50–95 %) was removed in 5/7 cases, and partial thrombus removal (<50 %) was confirmed in 2/7 cases. Mean follow-up was 205 days (range 64–403 days). All patients were alive at latest follow-up. Minor complications included three neck hematomas in two total patients. No major complications occurred.ConclusionAngioVac is a useful tool for acute thrombus removal in the large vessels. The setup and substantial cost may limit its application in straightforward cases. More studies are needed to establish the utility of AngioVac in treatment of intravascular and intracardiac material.

  7. Internship Experiences for Aspiring Principals: Student Perceptions and Effectiveness

    ERIC Educational Resources Information Center

    Christian, Ginger R.

    2011-01-01

    The purpose of this quantitative study was to investigate East Tennessee State University graduate student perceptions on the effectiveness of internship experiences as students explored the implementation of ISLLC Standards and the role of mentor support as they prepared for the principalship. The participating university for this study is…

  8. Educational Experiences and Aspirations of Older Youth in Foster Care.

    ERIC Educational Resources Information Center

    McMillen, Curtis; Auslander, Wendy; Elze, Diane; White, Tony; Thompson, Ronald

    2003-01-01

    Documented school experiences of youth referred for independent-living preparation from foster care system in one Midwestern county. Found that 73 percent had been suspended at least once, and 16 percent had been expelled. Fifty-eight percent had failed a class in the past year, and 29 percent had been in physical fights with students. Seventy…

  9. Female leadership raises aspirations and educational attainment for girls: a policy experiment in India.

    PubMed

    Beaman, Lori; Duflo, Esther; Pande, Rohini; Topalova, Petia

    2012-02-03

    Exploiting a randomized natural experiment in India, we show that female leadership influences adolescent girls' career aspirations and educational attainment. A 1993 law reserved leadership positions for women in randomly selected village councils. Using 8453 surveys of adolescents aged 11 to 15 and their parents in 495 villages, we found that, relative to villages in which such positions were never reserved, the gender gap in aspirations closed by 20% in parents and 32% in adolescents in villages assigned a female leader for two election cycles. The gender gap in adolescent educational attainment was erased, and girls spent less time on household chores. We found no evidence of changes in young women's labor market opportunities, which suggests that the impact of women leaders primarily reflects a role model effect.

  10. Early experiences with tachycardia-triggered vagus nerve stimulation using the AspireSR stimulator.

    PubMed

    El Tahry, Riëm; Hirsch, Martin; Van Rijckevorsel, Kenou; Santos, Susana Ferrao; de Tourtchaninoff, Marianne; Rooijakkers, Herbert; Coenen, Volker; Schulze-Bonhage, Andreas

    2016-06-01

    Many epilepsy patients treated with vagus nerve stimulation additionally use an "on-demand" function, triggering an extra stimulation to terminate a seizure or diminish its severity. Nevertheless, a substantial number of patients are not able to actively trigger stimulations by use of a magnet, due to the absence of an aura or inability for voluntary actions in the early phase of a seizure. To address this need, a novel implantable pulse generator, the AspireSR VNS system, was developed to provide automated ictal stimulation triggered by a seizure-detecting algorithm. We report our experience with three patients in assessing the functionality of ictal stimulation, illustrating the detection system in practice. Detection of ictal tachycardia and variable additional detections of physiological tachycardia depended on the individual seizure-detecting algorithm settings.

  11. Emergency bronchoscopy for foreign-body aspiration in a child with type I mucopolysaccharidosis: a challenging airway management experience.

    PubMed

    Kendigelen, Pinar; Tunali, Yusuf; Tutuncu, Ayse; Ashyralyyeva, Gulruh; Emre, Senol; Kaya, Guner

    2016-08-01

    The mucopolysaccharidosis (MPS) is a rare lysosomal storage disease. Glycosaminoglycans (GAG) accumulate in musculoskeletal system, connective tissues. Enlarged tongue, short immobile neck, and limited mobility of the cervical spine and temporomandibular joints render the airway management potentially risky. MPS children have high anesthetic risks, especially in airway management of emergency situations. The foreign-body aspiration requiring intervention with rigid bronchoscopy is an urgent and risky clinical situation. We present our experience with a challenging airway management with a three-year-old child with MPS who needed emergency bronchoscopy due to peanut aspiration.

  12. Research and Teaching: Understanding How Undergraduate Research Experiences Influence Student Aspirations for Research Careers and Graduate Education

    ERIC Educational Resources Information Center

    Adedokun, Omolola A.; Zhang, Dake; Parker, Loran Carleton; Bessenbacher, Ann; Childress, Amy; Burgess, Wilella Daniels

    2012-01-01

    Extant and emerging literature on undergraduate research experiences (UREs) focuses on the identification of their benefits to student participants. However, a notable limitation in these studies results from little or no examination of the processes through which UREs influence student career decisions and education aspirations. This study offers…

  13. Aspiration pneumonia

    MedlinePlus

    Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis ... The type of bacteria that caused the pneumonia depends on: Your ... facility, for example) Whether you were recently hospitalized ...

  14. Contrast-enhanced harmonic endoscopic ultrasound imaging: basic principles, present situation and future perspectives.

    PubMed

    Alvarez-Sánchez, María-Victoria; Napoléon, Bertrand

    2014-11-14

    Over the last decade, the development of stabilised microbubble contrast agents and improvements in available ultrasonic equipment, such as harmonic imaging, have enabled us to display microbubble enhancements on a greyscale with optimal contrast and spatial resolution. Recent technological advances made contrast harmonic technology available for endoscopic ultrasound (EUS) for the first time in 2008. Thus, the evaluation of microcirculation is now feasible with EUS, prompting the evolution of contrast-enhanced EUS from vascular imaging to images of the perfused tissue. Although the relevant experience is still preliminary, several reports have highlighted contrast-enhanced harmonic EUS (CH-EUS) as a promising noninvasive method to visualise and characterise lesions and to differentiate benign from malignant focal lesions. Even if histology remains the gold standard, the combination of CH-EUS and EUS fine needle aspiration (EUS-FNA) can not only render EUS more accurate but may also assist physicians in making decisions when EUS-FNA is inconclusive, increasing the yield of EUS-FNA by guiding the puncture with simultaneous imaging of the vascularity. The development of CH-EUS has also opened up exciting possibilities in other research areas, including monitoring responses to anticancer chemotherapy or to ethanol-induced pancreatic tissue ablation, anticancer therapies based on ultrasound-triggered drug and gene delivery, and therapeutic adjuvants by contrast ultrasound-induced apoptosis. Contrast harmonic imaging is gaining popularity because of its efficacy, simplicity and non-invasive nature, and many expectations are currently resting on this technique. If its potential is confirmed in the near future, contrast harmonic imaging will become a standard practice in EUS.

  15. Endobronchial Ultrasound-directed Transbronchial Needle Aspiration in Diagnosis of Mediastinal Lesions: Initial Egyptian Experience.

    PubMed

    Safwat, Tarek; Khattab, Adel; Haddad, Salwa El; Mostafa, Yasser; Korraa, Emad; Madkour, Ashraf; Fattah, Wael Abd El

    2009-01-01

    Mediastinal lesions represent a diagnostic challenge and often require invasive approaches. We evaluated the role of radial probe endobronchial ultrasound-directed transbronchial needle aspiration (EBUS-TBNA) in the evaluation of mediastinal lesions. Between March 2005 to February 2006, 30 consecutive patients with enlarged mediastinal lymph nodes from unknown etiologies or suspicious for metastatic bronchogenic carcinoma and mediastinal masses underwent EBUS-TBNA and were clinically followed up. EBUS-TBNA was applied under topical anesthesia, midazolam sedation with a mean dose of 4.6+1.7 mg and prolonged the examination by 14.7 minutes on average. EBUS-directed TBNA was performed in 17 lymph nodes and 13 mediastinal masses, achieving specific diagnosis in 82.3% (14/17) and 84.6% (11/13) of examined lesions, respectively, with an overall yield of 83%. The sensitivity, specificity, and accuracy of EBUS-TBNA in distinguishing benign from malignant mediastinal lesions were 89.4%, 100%, and 93.3%, respectively. EBUS was well tolerated by most of the patients with no TBNA-related complications. In conclusion, EBUS-TBNA of mediastinal lesions is a minimally invasive safe diagnostic technique with high yield, even in the hands of those with initial experience. This initial study is convincing and stimulating for widespread application of EBUS-TBNA in Egyptian bronchoscopy practice.

  16. Bone marrow aspiration

    MedlinePlus

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  17. Looking toward the Blue Sky: Environmental Education Researchers' Experience, Influences, and Aspirations

    ERIC Educational Resources Information Center

    Ardoin, Nicole M.; Clark, Charlotte R.; Wojcik, Deborah J.

    2016-01-01

    Environmental education (EE) researchers hail from diverse disciplines and sociocultural contexts, work in a range of settings, and envision various outcomes. Desiring to better understand their backgrounds, interests, and aspirations for the field, we surveyed EE researchers to explore their theoretical and educational influences and what they…

  18. Virtual School, Real Experience: Simulations Replicate the World of Practice for Aspiring Principals

    ERIC Educational Resources Information Center

    Mann, Dale; Shakeshaft, Charol

    2013-01-01

    A web-enabled computer simulation program presents real-world opportunities, problems, and challenges for aspiring principals. The simulation challenges areas that are not always covered in lectures, textbooks, or workshops. For example, using the simulation requires dealing--on-screen and in real time--with demanding parents, observing…

  19. FINE NEEDLE ASPIRATION CYTOLOGY OF ABDOMINAL ORGANS--TEN-YEAR SINGLE CENTER EXPERIENCE.

    PubMed

    Vasilj, Ankica; Katović, Sandra Kojić

    2016-03-01

    The aim of the study was to assess the role of fine needle aspiration cytology (FNAC) in the diagnosis of focal changes in solid abdominal organs. A total of 1084 aspirates from intra-abdominal organs including liver, spleen, pancreas and kidneys obtained by ultrasound (US) guidance during a 10-year period were included in the study. The smears were classified as benign, malignant or suspected of malignancy, and unsatisfactory for interpretation. The liver accounted for more than half of the US-guided FNA procedures, followed by the pancreas with 38%. Out of 1084 aspirations, 192 (17.7%) were inadequate for cytologic analysis. Over half of aspirated lesions in the pancreas were primary cancers, while one-third of pancreatic lesions were benign. In the majority of kidney lesions (83%), cytology found benign changes, mostly cysts. Spleen FNA was least likely; in most cases (59%) it showed lymphoid tissue hyperplasia; in four cases cytologic diagnosis was lymphoma and three lesions were suspected lymphoma. During the study, no major complications were observed on any US-guided FNAC procedure. In conclusion, intra-abdominal FNA is a reliable, sensitive and specific method with a high diagnostic accuracy for the diagnosis of malignant lesions. It can be utilized as a preoperative procedure for the management of all intra-abdominal lesions.

  20. Confronting Issues of Gender and Ethnicity: Women's Experiences as Aspiring Urban Principals

    ERIC Educational Resources Information Center

    Sperandio, Jill

    2009-01-01

    This article examines, from a female perspective, the complexities of gender and ethnicity embedded in successful urban school leadership. The authors use qualitative data, collected from female participants in two cohorts of aspiring urban principals in a yearlong experimental leadership preparation program, to discuss issues that arise during…

  1. Initial experience with endoscopic ultrasonic aspirator in purely neuroendoscopic removal of intraventricular tumors.

    PubMed

    Cinalli, Giuseppe; Imperato, Alessia; Mirone, Giuseppe; Di Martino, Giuliana; Nicosia, Giancarlo; Ruggiero, Claudio; Aliberti, Ferdinando; Spennato, Pietro

    2017-03-01

    OBJECTIVE Neuroendoscopic removal of intraventricular tumors is difficult and time consuming because of the lack of an effective decompression system that can be used through the working channel of the endoscope. The authors report on the utilization of an endoscopic ultrasonic aspirator in the resection of intraventricular tumors. METHODS Twelve pediatric patients (10 male, 2 female), ages 1-15 years old, underwent surgery via a purely endoscopic approach using a Gaab rigid endoscope and endoscopic ultrasonic aspirator. Two patients presented with intraventricular metastases from high-grade tumors (medulloblastoma, atypical teratoid rhabdoid tumor), 2 with subependymal giant cell astrocytomas (associated with tuberous sclerosis), 2 with low-grade intraparaventricular tumors, 4 with suprasellar tumors (2 craniopharyngiomas and 2 optic pathway gliomas), and 2 with pineal tumors (1 immature teratoma, 1 pineal anlage tumor). Hydrocephalus was present in 5 cases. In all patients, the endoscopic trajectory and ventricular access were guided by electromagnetic neuronavigation. Nine patients underwent surgery via a precoronal bur hole while supine. In 2 cases, surgery was performed through a frontal bur hole at the level of the hairline. One patient underwent surgery via a posterior parietal approach to the trigone while in a lateral position. The endoscopic technique consisted of visualization of the tumor, ventricular washing to dilate the ventricles and to control bleeding, obtaining a tumor specimen with biopsy forceps, and ultrasonic aspiration of the tumor. Bleeding was controlled with irrigation, monopolar coagulation, and a thulium laser. RESULTS In 7 cases, the resection was total or near total (more than 90% of lesion removed). In 5 cases, the resection was partial. Histological evaluation of the collected material (withdrawn using biopsy forceps and aspirated with an ultrasonic aspirator) was diagnostic in all cases. The duration of surgery ranged from 30 to

  2. Role of endoscopic ultrasound in the molecular diagnosis of pancreatic cancer

    PubMed Central

    Bournet, Barbara; Gayral, Marion; Torrisani, Jérôme; Selves, Janick; Cordelier, Pierre; Buscail, Louis

    2014-01-01

    Pancreatic ductal adenocarcinoma remains one of the most deadly types of tumor. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a safe, cost-effective, and accurate technique for evaluating and staging pancreatic tumors. However, EUS-FNA may be inconclusive or doubtful in up to 20% of cases. This review underlines the clinical interest of the molecular analysis of samples obtained by EUS-FNA in assessing diagnosis or prognosis of pancreatic cancer, especially in locally advanced tumors. On EUS-FNA materials DNA, mRNA and miRNA can be extracted, amplified, quantified and subjected to methylation assay. Kras mutation assay, improves diagnosis of pancreatic cancer. When facing to clinical and radiological presentations of pseudo-tumorous chronic pancreatitis, wild-type Kras is evocative of benignity. Conversely, in front of a pancreatic mass suspected of malignancy, a mutated Kras is highly evocative of pancreatic adenocarcinoma. This strategy can reduce false-negative diagnoses, avoids the delay of making decisions and reduces loss of surgical resectability. Similar approaches are conducted using analysis of miRNA expression as well as Mucin or markers of invasion (S100P, S100A6, PLAT or PLAU). Beyond the diagnosis approach, the prediction of response to treatment can be also investigated form biomarkers expression within EUS-FNA materials. PMID:25152579

  3. [The value of the triad: clinical examination, mammography and needle aspiration cytology in the diagnosis of breast carcinoma. Our experience].

    PubMed

    Cipolla, C; Amato, C; Di Lisi, G; Graceffa, G; Cassano, T; Salanitro, L; Bajardi, G; De Simone, G F; Barberi, G; Tomasino, R M

    1990-11-01

    Based on the authors' personal experience of the use of the triad, clinical examination, mammography and needle-aspiration cytology, in the strategic diagnosis of breast cancer, the paper emphasizes the importance of early diagnosis as the sole means of obtaining an improved outcome. Using this integrated methodology the authors have obtained a specificity of 99%, sensitivity of 97.8%, and a diagnostic accuracy and prognostic value for positive tests of 98%. In conclusion, the authors affirm that the comparative interpretation of clinical examination, mammography and cytology appears to be an extremely efficacious and reliable method for the diagnosis of the nature of breast nodules.

  4. Endoscopic Ultrasound-Guided Oncologic Therapy for Pancreatic Cancer

    PubMed Central

    Suzuki, Rei; Irisawa, Atsushi; Bhutani, Manoop S.

    2013-01-01

    Since the development of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the early 1990s, its application has been extended to various diseases. For pancreatic cancer, EUS-FNA can obtain specimens from the tumor itself with fewer complications than other methods. Interventional EUS enables various therapeutic options: local ablation, brachytherapy, placement of fiducial markers for radiotherapy, and direct injection of antitumor agents into cancer. This paper will focus on EUS-guided oncologic therapy for pancreatic cancer. PMID:23533319

  5. Solid Pseudopapillary Neoplasm of the Pancreas in Young Male Patients: Three Case Reports

    PubMed Central

    Aso, Akira; Nakamura, Kazuhiko; Sudovykh, Irina; Ito, Tetsuhide; Nakamura, Masafumi; Ikeda, Tetsuo; Takizawa, Nobuyoshi; Oda, Yoshinao; Shimizu, Shuji

    2017-01-01

    A preoperative diagnosis of solid pseudopapillary neoplasms (SPNs) in young male patients is difficult to achieve using radiological images. We herein present three cases of young male patients with relatively small SPNs. Endoscopic ultrasound (EUS) showed well-encapsulated, smooth-surfaced, heterogeneous solid lesions in all patients, and all preoperative diagnoses were achieved by EUS-guided fine needle aspiration (EUS-FNA). The final pathological diagnosis after surgery was an SPN with a Ki-67 labeling index of <2%. SPNs should be considered even in young male patients. EUS with EUS-FNA could be a useful diagnostic modality for SPNs even in young male patients. PMID:28255475

  6. School Characteristics and Experiences of African American, Hispanic/Latino, and Native American Youth in Rural Communities: Relation to Educational Aspirations

    ERIC Educational Resources Information Center

    Irvin, Matthew J.; Byun, Soo-yong; Meece, Judith L.; Reed, Karla S.; Farmer, Thomas W.

    2016-01-01

    The primary purpose of this study was to examine differences in the school characteristics and experiences of African American, Hispanic/Latino, and Native American youth in rural high schools as well as their relation to educational aspirations. We also investigated the characteristics and experiences of students and their families given that…

  7. Accuracy of fine needle aspiration cytology of salivary gland lesions: routine diagnostic experience in Bangkok, Thailand.

    PubMed

    Nguansangiam, Sudarat; Jesdapatarakul, Somnuek; Dhanarak, Nisarat; Sosrisakorn, Krittika

    2012-01-01

    Fine needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimal invasive and cost-effective method for diagnosis of salivary gland lesions. This study evaluated the accuracy and diagnostic performance of FNA cytology in Thailand. A consecutive series of 290 samples from 246 patients during January 2001-December 2009 were evaluated from the archive of the Anatomical Pathology Department of our institution and 133 specimens were verified by histopathologic diagnoses, obtained with material from surgical excision or biopsy. Cytologic diagnoses classified as unsatisfactory, benign, suspicious for malignancy and malignant were compared with the histopathological findings. Among the 133 satisfactory specimens, the anatomic sites were 70 (52.6%) parotid glands and 63 (47.4 %) submandibular glands. FNA cytological diagnoses showed benign lesions in 119 cases (89.5 %), suspicious for malignancy in 3 cases (2.2 %) and malignant in 11 cases (8.3%). From the subsequent histopathologic diagnoses, 3/133 cases of benign cytology turned out to be malignant lesions, the false negative rate being 2.2 % and 1/133 case of malignant cytology turned out to be a benign lesion, giving a false positive rate was 0.8%. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 97.0% (95% CI, 70.6%-99.4%), 81.3% (95% CI, 54.4%-96.0%), 99.1% (95% CI, 95.4%-100%), 92.9% (95% CI, 66.1%-99.8), 97.5% (95% CI, 92.8%-99.5%), respectively. This study indicated that FNA cytology of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.

  8. Positive Experiences and Life Aspirations among Adolescents with and without Hearing Impairments.

    ERIC Educational Resources Information Center

    Magen, Zipora

    1990-01-01

    Comparison of 79 normally hearing and 42 hearing-impaired adolescents found no differences regarding the intensity of their remembered positive experiences. Hearing-impaired subjects reported more positive interpersonal experiences, rarely experienced positive experiences "with self," and showed less desire for transpersonal commitment,…

  9. The STEM Pipeline: The Role of Summer Research Experience in Minority Students' Ph.D. Aspirations

    ERIC Educational Resources Information Center

    Pender, Matea; Marcotte, Dave E.; Sto. Domingo, Mariano R.; Maton, Kenneth I.

    2010-01-01

    Practical research experience has been seen as an important tool to enhance learning in STEM fields and shape commitment to science careers. Indeed, this was a prominent recommendation of the Boyer Commission. Further, there is evidence this is especially important for minority students. In this paper, we examine the role of practical research…

  10. African American Women Aspiring to the Superintendency: Lived Experiences and Barriers

    ERIC Educational Resources Information Center

    Angel, Roma B.; Killacky, Jim; Johnson, Patricia R.

    2013-01-01

    Focused on the absence of a viable population of African American women in the superintendency, this study addressed barriers described by 10 credentialed, district-level Southern women who hold advanced education degrees coupled with years of leadership experience. This phenomenological study used interview methodology to uncover the lived…

  11. The STEM Pipeline: The Role of Summer Research Experience in Minority Students' Ph.D. Aspirations.

    PubMed

    Pender, Matea; Marcotte, Dave E; Sto Domingo, Mariano R; Maton, Kenneth I

    2010-12-10

    Practical research experience has been seen as an important tool to enhance learning in STEM fields and shape commitment to science careers. Indeed, this was a prominent recommendation of the Boyer Commission. Further, there is evidence this is especially important for minority students. In this paper, we examine the role of practical research experience during the summer for talented minority undergraduates in STEM fields. We focus on the link between summer research and STEM Ph.D. program matriculation. We examine evidence on this question using detailed data on students participating in the Meyerhoff Scholarship Program over a 14 year period at the University of Maryland Baltimore County. Our results provide evidence of strong positive effects of summer research on participation in STEM Ph.D. programs. Further, we show that the effects of summer research vary with the frequency and timing of these experiences. The evidence that educational strategies such as summer research experiences improve academic outcomes of minorities is vital, given concern about the science pipeline in the U.S. and the continuing growth in the racial/ethnic diversity of the college-age population.

  12. The STEM Pipeline: The Role of Summer Research Experience in Minority Students' Ph.D. Aspirations

    PubMed Central

    Pender, Matea; Marcotte, Dave E.; Sto. Domingo, Mariano R.; Maton, Kenneth I.

    2011-01-01

    Practical research experience has been seen as an important tool to enhance learning in STEM fields and shape commitment to science careers. Indeed, this was a prominent recommendation of the Boyer Commission. Further, there is evidence this is especially important for minority students. In this paper, we examine the role of practical research experience during the summer for talented minority undergraduates in STEM fields. We focus on the link between summer research and STEM Ph.D. program matriculation. We examine evidence on this question using detailed data on students participating in the Meyerhoff Scholarship Program over a 14 year period at the University of Maryland Baltimore County. Our results provide evidence of strong positive effects of summer research on participation in STEM Ph.D. programs. Further, we show that the effects of summer research vary with the frequency and timing of these experiences. The evidence that educational strategies such as summer research experiences improve academic outcomes of minorities is vital, given concern about the science pipeline in the U.S. and the continuing growth in the racial/ethnic diversity of the college-age population. PMID:21841903

  13. Applications of endoscopic ultrasound in pancreatic cancer.

    PubMed

    Luz, Leticia Perondi; Al-Haddad, Mohammad Ali; Sey, Michael Sai Lai; DeWitt, John M

    2014-06-28

    Since the introduction of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA), EUS has assumed a growing role in the diagnosis and management of pancreatic ductal adenocarcinoma (PDAC). The objective of this review is to discuss the various applications of EUS and EUS-FNA in PDAC. Initially, its use for detection, diagnosis and staging will be described. EUS and EUS-FNA are highly accurate modalities for detection and diagnosis of PDAC, this high accuracy, however, is decreased in specific situations particularly in the presence of chronic pancreatitis. Novel techniques such as contrast-enhanced EUS, elastography and analysis of DNA markers such as k-ras mutation analysis in FNA samples are in progress and might improve the accuracy of EUS in the detection of PDAC in this setting and will be addressed. EUS and EUS-FNA have recently evolved from a diagnostic to a therapeutic technique in the management of PDAC. Significant developments in therapeutic EUS have occurred including advances in celiac plexus interventions with direct injection of ganglia and improved pain control, EUS-guided fiducial and brachytherapy seed placement, fine-needle injection of intra-tumoral agents and advances in EUS-guided biliary drainage. The future role of EUS and EUS in management of PDAC is still emerging.

  14. Development of a device for detecting target specimens from EUS-guided FNA samples

    PubMed Central

    Matsumoto, Kazuya; Ueki, Masaru; Takeda, Yohei; Harada, Kenichi; Onoyama, Takumi; Kawata, Soichiro; Ikebuchi, Yuichiro; Imamoto, Ryu; Horie, Yasushi; Murawaki, Yoshikazu

    2015-01-01

    Background and study aims: Specimens collected by fine needle are microscopic and contain blood; therefore, the presence of a target specimen within a sample is often difficult to confirm. Although rapid on-site evaluation (ROSE) during endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) is beneficial, many health care facilities are unable to apply this technique due to a lack of cytopathologists. The aim of this study was to develop and validate a device that detects the target specimen within pancreatic tumor EUS-FNA samples. Patients and methods: Fifty-eight consecutive patients with solid pancreatic masses were studied for a preliminary case series at a tertiary-care university hospital (Tottori University Hospital, Yonago, Japan). The material collected was checked with a target sample check illuminator (TSCI) and was evaluated by one cytopathologist. Results: The agreement rate between the TSCI and histopathology was 93.7 %. Further testing procedures were not needed in 91.4 % of patients, and the mean number of needle punctures was 1.2 after a single pass using TSCI. No adverse events were encountered with the procedure. Conclusions: With the introduction of the TSCI in EUS-FNA, it became possible to both collect the minimum necessary target samples by EUS-FNA and to end further procedures, even without performing ROSE. PMID:26716133

  15. Management of Patients With Pancreatic Cysts

    PubMed Central

    Siddiqui, Ali; Loren, David; Mertz, Howard R.; Mallat, Damien; Haddad, Nadim; Malhotra, Nidhi; Sadowski, Brett; Lybik, Mark J.; Patel, Sandeep N.; Okoh, Emuejevoke; Rosenkranz, Laura; Karasik, Michael; Golioto, Michael; Linder, Jeffrey; Catalano, Marc F.; Al-Haddad, Mohammad A.

    2016-01-01

    Goals: To examine the utility of integrated molecular pathology (IMP) in managing surveillance of pancreatic cysts based on outcomes and analysis of false negatives (FNs) from a previously published cohort (n=492). Background: In endoscopic ultrasound with fine-needle aspiration (EUS-FNA) of cyst fluid lacking malignant cytology, IMP demonstrated better risk stratification for malignancy at approximately 3 years’ follow-up than International Consensus Guideline (Fukuoka) 2012 management recommendations in such cases. Study: Patient outcomes and clinical features of Fukuoka and IMP FN cases were reviewed. Practical guidance for appropriate surveillance intervals and surgery decisions using IMP were derived from follow-up data, considering EUS-FNA sampling limitations and high-risk clinical circumstances observed. Surveillance intervals for patients based on IMP predictive value were compared with those of Fukuoka. Results: Outcomes at follow-up for IMP low-risk diagnoses supported surveillance every 2 to 3 years, independent of cyst size, when EUS-FNA sampling limitations or high-risk clinical circumstances were absent. In 10 of 11 patients with FN IMP diagnoses (2% of cohort), EUS-FNA sampling limitations existed; Fukuoka identified high risk in 9 of 11 cases. In 4 of 6 FN cases by Fukuoka (1% of cohort), IMP identified high risk. Overall, 55% of cases had possible sampling limitations and 37% had high-risk clinical circumstances. Outcomes support more cautious management in such cases when using IMP. Conclusions: Adjunct use of IMP can provide evidence for relaxed surveillance of patients with benign cysts that meet Fukuoka criteria for closer observation or surgery. Although infrequent, FN results with IMP can be associated with EUS-FNA sampling limitations or high-risk clinical circumstances. PMID:27332745

  16. When trainees reach competency in performing endoscopic ultrasound: a systematic review.

    PubMed

    Shahidi, Neal; Ou, George; Lam, Eric; Enns, Robert; Telford, Jennifer

    2017-04-01

    Background/Study aim The American Society for Gastrointestinal Endoscopy (ASGE) recommends that trainees complete 150 endoscopic ultrasound (EUS) procedures before assessing competency. However, this recommendation is largely based on limited evidence and expert opinion. With new evidence suggesting that this historical threshold is underestimating training requirements, we evaluated the learning curve for achieving competency in EUS. Patients/Materials and methods Two investigators independently searched MEDLINE for full-text citations assessing the learning curve for achieving competency in EUS in the period 1946 to 25 March 2016. A learning curve was defined as either a tabulated or graphic representation of competency as a function of increasing EUS experience. Results Eight studies assessing 28 trainees and 7051 EUS procedures were included. When stratifying studies based on procedural indication: three studies assessed competency in evaluating mucosal lesions, three studies assessed competency in EUS fine-needle aspiration (EUS-FNA), and two studies assessed comprehensive competency. Among studies assessing mucosal lesion T-staging accuracy, competency was achieved by 65 to 231 procedures. Among studies assessing EUS-FNA, competency was achieved by 30 to 40 procedures. Among the two studies assessing comprehensive competency in EUS, competency was not achieved in either study across all trainees. Only four of 17 trainees reached competency by 225 to 295 EUS procedures. Conclusion As EUS competency assessment has evolved to more closely reflect independent clinical practice, the number of procedures required to achieve competency has risen well above ASGE recommendations. Advanced endoscopy training programs and specialty societies need to re-assess the structure of EUS training.

  17. When trainees reach competency in performing endoscopic ultrasound: a systematic review

    PubMed Central

    Shahidi, Neal; Ou, George; Lam, Eric; Enns, Robert; Telford, Jennifer

    2017-01-01

    Background/Study aim The American Society for Gastrointestinal Endoscopy (ASGE) recommends that trainees complete 150 endoscopic ultrasound (EUS) procedures before assessing competency. However, this recommendation is largely based on limited evidence and expert opinion. With new evidence suggesting that this historical threshold is underestimating training requirements, we evaluated the learning curve for achieving competency in EUS. Patients/Materials and methods Two investigators independently searched MEDLINE for full-text citations assessing the learning curve for achieving competency in EUS in the period 1946 to 25 March 2016. A learning curve was defined as either a tabulated or graphic representation of competency as a function of increasing EUS experience. Results Eight studies assessing 28 trainees and 7051 EUS procedures were included. When stratifying studies based on procedural indication: three studies assessed competency in evaluating mucosal lesions, three studies assessed competency in EUS fine-needle aspiration (EUS-FNA), and two studies assessed comprehensive competency. Among studies assessing mucosal lesion T-staging accuracy, competency was achieved by 65 to 231 procedures. Among studies assessing EUS-FNA, competency was achieved by 30 to 40 procedures. Among the two studies assessing comprehensive competency in EUS, competency was not achieved in either study across all trainees. Only four of 17 trainees reached competency by 225 to 295 EUS procedures. Conclusion As EUS competency assessment has evolved to more closely reflect independent clinical practice, the number of procedures required to achieve competency has risen well above ASGE recommendations. Advanced endoscopy training programs and specialty societies need to re-assess the structure of EUS training. PMID:28367496

  18. ASPIRE - the first British student rocket programme

    NASA Astrophysics Data System (ADS)

    Baker, Adam M.; Murray, J.; Osborne, R.; Macfarlane, J.

    ASPIRE is the first British programme aiming to create and develop a small scale, hybrid engine powered launch vehicle. The project is also unique because it is a wholly amateur effort, volunteer team members having little or no professional experience in launch vehicle design, manufacture and operations; and being a mix of students and young professionals. Participants have the opportunity to develop their experience in the engineering/scientific, operational and management areas which ASPIRE encompasses. This experience will then be validated through the launching of a series of test vehicles, culminating in a demonstration of the orbital insertion of a payload by the year 2000. ASPIRE aims to eventually return an independent orbital launch capability to Britain, for the first time since 1971. This paper outlines the technical details of the ASPIRE rockets, including: airframe design and manufacture, hybrid motor design and testing, avionics development, guidance and recovery techniques, range safety practise and marketing and fund-raising. It will also cover the organisation and ethos of the programme in general. A timeline for the ASPIRE programme will be detailed, from the original ASPIRE 1 construction and launch in 1991/1992, evolving through the current series of ASPIRE Development Vehicles (ADVs), to ASPIRE 2 and 3, where the hybrid motor and other engineering subsystems are to be integrated on an increasing scale. The proposed union of an ASPIRE 3 vehicle with an Australian AUSROC launcher to achieve the 2000 orbital goal will also be covered.

  19. Academic Aspirations

    ERIC Educational Resources Information Center

    Durant, Linda

    2013-01-01

    As colleges and universities become even more complex organizations, advancement professionals need to have the skills, experience, and academic credentials to succeed in this ever-changing environment. Advancement leaders need competencies that extend beyond fundraising, alumni relations, and communications and marketing. The author encourages…

  20. Joint Aspiration (Arthrocentesis)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Joint Aspiration (Arthrocentesis) KidsHealth > For Parents > Joint Aspiration (Arthrocentesis) Print A A A What's in ... español Aspiración articular (artrocentesis) What It Is A joint aspiration (arthrocentesis) is a test that involves withdrawing ( ...

  1. Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Pancreas in a Patient with New Diagnosis of Follicular Non-Hodgkin's Lymphoma.

    PubMed

    Shah, Apeksha; Khurana, Tanvi; Freid, Lauren; Siddiqui, Ali A

    2014-01-01

    Pancreatic tumors with osteoclast-like giant cells are rare, with only 50 cases published to date. We report a case of a 67-year-old male with a new diagnosis of follicular non-Hodgkin's lymphoma with an incidental pancreatic body mass on abdominal imaging. Cytology from the pancreatic mass obtained via endoscopic ultrasound-directed fine-needle aspiration (EUS-FNA) revealed an undifferentiated carcinoma with osteoclast-like giant cells.

  2. Comparison of sample adequacy, pain-scale ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience.

    PubMed

    Lee, Yoo Jin; Kim, Dong Wook; Jung, Soo Jin

    2013-12-01

    This study aimed to assess and compare the sample adequacy, patient pain ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience. From March 2012 to May 2012, two radiologists performed ultrasound-guided fine-needle aspiration to diagnose thyroid nodules in consecutive patients using the same techniques. 157 patients were divided into two groups: group 1 consisted of 75 patients who underwent ultrasound-guided fine-needle aspiration by an experienced radiologist and group 2 consisted of 82 patients who underwent ultrasound-guided fine-needle aspiration by a less experienced radiologist. The sample adequacy, pain-scale ratings, and complications related to ultrasound-guided fine-needle aspiration were compared between the two groups. There was no statistical difference in sex, age, nodule size, or location between the two groups. There was no statistical difference (p = 0.710) in the prevalence of adequate cytology between group 1 (94.7 % [71/75]) and group 2 (96.3 % [79/82]). The mean ± standard deviation of pain-scale ratings was 1.99 ± 1.68 in group 1 and 2.30 ± 1.83 in group 2, but there was no statistical difference (p = 0.326). There were no significant complications related to the procedure and no sonographic changes on follow-up ultrasound for either group. The study results demonstrated good outcomes for ultrasound-guided fine-needle aspiration of thyroid nodules and no statistically significant differences in sample adequacy, pain-scale ratings, or complication rates between two radiologists with different levels of experience.

  3. Acute Intraoperative Pulmonary Aspiration.

    PubMed

    Nason, Katie S

    2015-08-01

    Acute intraoperative aspiration is a potentially fatal complication with significant associated morbidity. Patients undergoing thoracic surgery are at increased risk for anesthesia-related aspiration, largely due to the predisposing conditions associated with this complication. Awareness of the risk factors, predisposing conditions, maneuvers to decrease risk, and immediate management options by the thoracic surgeon and the anesthesia team is imperative to reducing risk and optimizing patient outcomes associated with acute intraoperative pulmonary aspiration. Based on the root-cause analyses that many of the aspiration events can be traced back to provider factors, having an experienced anesthesiologist present for high-risk cases is also critical.

  4. Liposuction: more curettage than aspiration.

    PubMed

    Mottura, A A

    1991-01-01

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

  5. Aspirations of Rural Youth.

    ERIC Educational Resources Information Center

    Bajema, Duane H.; Miller, W. Wade; Williams, David L.

    2002-01-01

    Of 883 Iowa high school seniors, 60% lived in towns, 40% on farms. Both groups had a high level of congruence between educational and occupational aspirations and perceived minimal barriers to goal achievement. Farm and town students had equally diverse aspirations. (Contains 23 references.) (SK)

  6. Aspiration in Jaffna Tamil

    ERIC Educational Resources Information Center

    Thananjayarajasingham, S.

    1975-01-01

    The article accounts for the phenomenon of aspiration in Jaffna Tamil, a dialect distinct form South Indian dialects of Tamil. Not being distinctive orphonologically determined, aspiration is dealt with as a prosodic feature affecting voiceless stops in various positions. Distribution and symbolic representation are handled; kymographic evidence…

  7. Endoscopic ultrasound-guided techniques for diagnosing pancreatic mass lesions: Can we do better?

    PubMed Central

    Storm, Andrew C; Lee, Linda S

    2016-01-01

    The diagnostic approach to a possible pancreatic mass lesion relies first upon various non-invasive imaging modalities, including computed tomography, ultrasound, and magnetic resonance imaging techniques. Once a suspect lesion has been identified, tissue acquisition for characterization of the lesion is often paramount in developing an individualized therapeutic approach. Given the high prevalence and mortality associated with pancreatic cancer, an ideal approach to diagnosing pancreatic mass lesions would be safe, highly sensitive, and reproducible across various practice settings. Tools, in addition to radiologic imaging, currently employed in the initial evaluation of a patient with a pancreatic mass lesion include serum tumor markers, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). EUS-FNA has grown to become the gold standard in tissue diagnosis of pancreatic lesions. PMID:27818584

  8. Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound.

    PubMed

    Liu, Roy; Adler, Douglas G

    2014-07-01

    Gastrointestinal tract duplication cysts are rare congenital gastrointestinal malformation in young patients and adults. They consist of foregut duplication cysts, small bowel duplication cysts, and large bowel duplication cysts. Endoscopic ultrasound (EUS) has been widely used as a modality for the evaluation and diagnosis of duplication cysts. EUS is the diagnostic tool of choice to investigate duplication cysts since it can distinguish between solid and cystic lesions. The question of whether or not to perform EUS-fine needle aspiration (EUS-FNA) on a lesion suspected of being a duplication cyst is controversial as these lesions can become infected with significant consequences, although EUS-FNA is often required to obtain a definitive diagnosis and to rule out more ominous lesions. This manuscript will review the literature on duplication cysts throughout the body and will also focus on the role of EUS and FNA with regards to these lesions.

  9. Do you believe in magic? improving the quality of pharmacy services through restricting entry and aspirational contracts, the Irish experience.

    PubMed

    Gorecki, Paul K

    2011-12-01

    A constant refrain of policy makers and public representatives is the necessity of improving the quality of public health services. In this paper, two inter-related policies designed to raise the quality of pharmacy services in Ireland are considered. The first was to restrict the opening of new pharmacies, the second to increase the quality of pharmacy services through contract specification. While the first policy restricted entry and raised returns to existing pharmacies, there is no evidence it raised service quality. Equally, the second policy appears to have had little effect on the quality of pharmacy services. The contractual provision itself is largely unenforceable, does not recognize the conflicting motivations of a pharmacist and results in no measurable output. Drawing on this experience, several lessons as presented as to how service quality can be improved, which are likely to have application beyond Ireland.

  10. Joint Aspiration (Arthrocentesis)

    MedlinePlus

    ... arthritis, or JRA), systemic lupus erythematosus (SLE), and Lyme disease. Joint aspiration is diagnostic but it also can ... Parents MORE ON THIS TOPIC Evaluate Your Child's Lyme Disease Risk Living With Lupus Bones, Muscles, and Joints ...

  11. Clinical Experience Using the Mann Assessment of Swallowing Ability for Identification of Patients at Risk for Aspiration in a Mixed-Disease Population

    ERIC Educational Resources Information Center

    Gonzalez-Fernandez, Marlis; Sein, Michael T.; Palmer, Jeffrey B.

    2011-01-01

    Purpose: To determine the clinical performance characteristics of the Mann Assessment of Swallowing Ability (MASA) for predicting aspiration (determined by videofluoroscopic swallowing study [VFSS]) in a mixed population. Method: We selected 133 cases clinically evaluated using MASA and VFSS from January through June 2007. Ordinal risk rating…

  12. Contrast-enhanced harmonic endoscopic ultrasonography for assessment of lymph node metastases in pancreatobiliary carcinoma

    PubMed Central

    Miyata, Takeshi; Kitano, Masayuki; Omoto, Shunsuke; Kadosaka, Kumpei; Kamata, Ken; Imai, Hajime; Sakamoto, Hiroki; Nisida, Naoshi; Harwani, Yogesh; Murakami, Takamichi; Takeyama, Yoshifumi; Chiba, Yasutaka; Kudo, Masatoshi

    2016-01-01

    AIM: To assess the usefulness of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for lymph node metastasis in pancreatobiliary carcinoma. METHODS: All patients suspected of pancreatobiliary carcinoma with visible lymph nodes after standard EUS between June, 2009 and January, 2012 were enrolled. In the primary analysis, patients with successful EUS-fine needle aspiration (FNA) were included. The lymph nodes were assessed by several standard EUS variables (short and long axis lengths, shape, edge characteristic and echogenicity), color Doppler EUS variable [central intranodal blood vessel (CIV) presence] and CH-EUS variable (heterogeneous/homogeneous enhancement patterns). The diagnostic accuracy relative to EUS-FNA was calculated. In the second analysis, N-stage diagnostic accuracy of CH-EUS was compared with EUS-FNA in patients who underwent surgical resection. RESULTS: One hundred and nine patients (143 lymph nodes) fulfilled the criteria. The short axis cut-off ≥ 13 mm predicted malignancy with a sensitivity and specificity of 72% and 85%, respectively. These values were 72% and 63% for the long axis cut-off ≥ 20 mm, 62% and 75% for the round shape variable, 81% and 30% for the sharp edge variable, 66% and 61% for the hypoechogenicity variable, 70% and 72% for the CIV-absent variable, and 83% and 91% for the heterogeneous CH-EUS-enhancement variable, respectively. CH-EUS was more accurate than standard and color Doppler EUS, except the short axis cut-off. Notably, three patients excluded because of EUS-FNA failure were correctly N-staged by CH-EUS. CONCLUSION: CH-EUS complements standard and color Doppler EUS and EUS-FNA for assessment of lymph node metastases. PMID:27022220

  13. Targeted next generation sequencing of endoscopic ultrasound acquired cytology from ampullary and pancreatic adenocarcinoma has the potential to aid patient stratification for optimal therapy selection

    PubMed Central

    Gleeson, Ferga C.; Kerr, Sarah E.; Kipp, Benjamin R.; Voss, Jesse S.; Minot, Douglas M.; Tu, Zheng Jin; Henry, Michael R.; Graham, Rondell P.; Vasmatzis, George; Cheville, John C.; Lazaridis, Konstantinos N.; Levy, Michael J.

    2016-01-01

    Background & Aims Less than 10% of registered drug intervention trials for pancreatic ductal adenocarcinoma (PDAC) include a biomarker stratification strategy. The ability to identify distinct mutation subsets via endoscopic ultrasound fine needle aspiration (EUS FNA) molecular cytology could greatly aid clinical trial patient stratification and offer predictive markers. We identified chemotherapy treatment naïve ampullary adenocarcinoma and PDAC patients who underwent EUS FNA to assess multigene mutational frequency and diversity with a surgical resection concordance assessment, where available. Methods Following strict cytology smear screening criteria, targeted next generation sequencing (NGS) using a 160 cancer gene panel was performed. Results Complete sequencing was achieved in 29 patients, whereby 83 pathogenic alterations were identified in 21 genes. Cytology genotyping revealed that the majority of mutations were identified in KRAS (93%), TP53 (72%), SMAD4 (31%), and GNAS (10%). There was 100% concordance for the following pathogenic alterations: KRAS, TP53, SMAD4, KMT2D, NOTCH2, MSH2, RB1, SMARCA4, PPP2R1A, PIK3R1, SCL7A8, ATM, and FANCD2. Absolute multigene mutational concordance was 83%. Incremental cytology smear mutations in GRIN2A, GATA3 and KDM6A were identified despite re-examination of raw sequence reads in the corresponding resection specimens. Conclusions EUS FNA cytology genotyping using a 160 cancer gene NGS panel revealed a broad spectrum of pathogenic alterations. The fidelity of cytology genotyping to that of paired surgical resection specimens suggests that EUS FNA represents a suitable surrogate and may complement the conventional stratification criteria in decision making for therapies and may guide future biomarker driven therapeutic development. PMID:27203738

  14. Impact of endoscopic ultrasonography and physician specialty on the management of patients with esophagus cancer.

    PubMed

    Gines, A; Cassivi, S D; Martenson, J A; Schleck, C; Deschamps, C; Sinicrope, F A; Alberts, S R; Murray, J A; Zinsmeister, Alan R; Vazquez-Sequeiros, Enrique; Nichols, F C; Miller, R C; Quevedo, J F; Allen, M S; Alexander, J A; Zais, T; Haddock, M G; Romero, Y

    2008-01-01

    While endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are the most accurate techniques for locoregional staging of esophageal cancer, little evidence exists that these innovations impact on clinical care. The objective on this study was to determine the frequency with which EUS and EUS-FNA alter the management of patients with localized esophageal cancer, and assess practice variation among specialists at a tertiary care center. Three gastroenterologists, three medical oncologists, three radiation oncologists and four thoracic surgeons were asked to independently report their management recommendations as the anonymized staging information of 50 prospectively enrolled patients from another study were sequentially disclosed on-line. Compared to initial management recommendations, that were based upon history, physical examination, upper endoscopy and CT scan results, EUS prompted a change in management 24% (95% CI: 12-36%) of the time; usually to a more resource-intensive approach (71%), for example from recommending palliation to recommending neoadjuvant chemoradiation therapy. EUS-FNA plus cytology results altered management an additional 8% (95% CI: 6-15%) of the time. Agreement between specialists ranged from fair (intraclass correlation [ICC=0.32) to substantial (ICC=0.65); improving with additional information. Among specialists, agreement was greatest for patients with stage I disease. EUS and EUS-FNA changed patient management the most for patients with stages IIA, IIB or III disease. EUS, with or without FNA, significantly impacts the management of patients with localized esophageal cancer. With respect to the optimal treatment for each patient, agreement among physicians incrementally increases with endoscopic ultrasound results. Specialty training appears to influence therapeutic decision-making behavior.

  15. Therapeutic aspects of endoscopic ultrasound

    NASA Astrophysics Data System (ADS)

    Woodward, Timothy A.

    1999-06-01

    Endoscopic ultrasound (EUS) is a technology that had been used primarily as a passive imaging modality. Recent advances have enabled us to move beyond the use of EUS solely as a staging tool to an interventional device. Current studies suggest that interventional applications of EUS will allow for minimally invasive assessment and therapies in a cost-effective manner. Endoscopic ultrasound with fine needle aspiration (EUS-FNA) has been demonstrated to be a technically feasible, relatively safe method of obtaining cytologic specimens. The clinical utility of EUS- FNA appears to be greatest in the diagnosis and staging of pancreatic cancer and in the nodal staging of gastrointestinal and pulmonary malignancies. In addition, EUS-FNA has demonstrated utility in the sampling pleural and ascitic fluid not generally appreciated or assessable to standard interventions. Interventional applications of EUS include EUS-guided pseudocyst drainage, EUS-guided injection of botulinum toxin in the treatment of achalasia, and EUS- guided celiac plexus neurolysis in the treatment of pancreatic cancer pain. Finally, EUS-guided fine-needle installation is being evaluated, in conjunction with recent bimolecular treatment modalities, as a delivery system in the treatment of certain gastrointestinal tumors.

  16. EUS-Guided Needle-Based Confocal Laser Endomicroscopy: A Novel Technique With Emerging Applications.

    PubMed

    Bhutani, Manoop S; Koduru, Pramoda; Joshi, Virendra; Karstensen, John G; Saftoiu, Adrian; Vilmann, Peter; Giovannini, Marc

    2015-04-01

    Endoscopic ultrasound (EUS) has emerged as an excellent tool for imaging the gastrointestinal tract, as well as surrounding structures. EUS-guided fine-needle aspiration (EUS-FNA) has become the standard of care for the tissue sampling of a variety of masses and lymph nodes within and around the gut, providing further diagnostic and staging information. Confocal laser endomicroscopy (CLE) is a novel endoscopic method that enables imaging at a subcellular level of resolution during endoscopy, allowing up to 1000-fold magnification of tissue and providing an optical biopsy. A new procedure that has been developed in the past few years is needle-based confocal laser endomicroscopy (nCLE), which involves a mini-CLE probe that can be passed through a 1 9-gauge needle during EUS-FNA. This enables the real-time visualization of tissue at a microscopic level, with the potential to further improve the diagnostic accuracy of EUS-FNA. The device has been studied in animals as well as in humans, and the results so far have been promising. Recently, this method has also been used for the visualization of regulatory proteins and receptors in the pancreas, setting a cornerstone for nCLE in molecular imaging. The aim of this article is to review the role of EUS-guided nCLE in modern endoscopy and its implications in molecular imaging.

  17. Role of the preoperative usefulness of the pathological diagnosis of pancreatic diseases

    PubMed Central

    Matsumoto, Kazuya; Takeda, Yohei; Onoyama, Takumi; Kawata, Soichiro; Kurumi, Hiroki; Ueki, Masaru; Miura, Norimasa; Isomoto, Hajime

    2016-01-01

    Pancreatic cancer is the fifth leading cause of cancer death and has the lowest survival rate of any solid cancer. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is currently capable of providing a cytopathological diagnosis of pancreatic malignancies with a higher diagnostic power, with a sensitivity and specificity of 85%-89% and 98%-99%, compared to pancreatic juice cytology (PJC), whose sensitivity and specificity are only 33.3%-93% and 83.3%-100%. However, EUS-FNA is not effective in the cases of carcinoma in situ and minimally invasive carcinoma because both are undetectable by endoscopic ultrasonography, although PJC is able to detect them. As for the frequency of complications such as post endoscopic retrograde cholangiopancreatography pancreatitis, EUS-FNA is safer than PJC. To diagnose pancreatic cancer appropriately, it is necessary for us to master both procedures so that we can select the best methods of sampling tissues while considering the patient’s safety and condition. PMID:27672423

  18. [Oropharyngeal dysphagia and aspiration].

    PubMed

    Barroso, Julia

    2009-11-01

    Oropharyngeal dysphagia, or inability to swallow liquids and/or solids, is one of the less well known geriatric syndromes, despite its enormous impact on functional ability, quality of life and health in affected individuals. The origin of oropharyngeal dysphagia can be structural or functional. Patients with neurodegenerative or cerebrovascular diseases and the frail elderly are the most vulnerable. The complications of oropharyngeal dysphagia are malnutrition, dehydration and aspiration, all of which are serious and provoke high morbidity and mortality. Oropharyngeal aspiration causes frequent respiratory infections and aspiration pneumonias. Antibiotic therapy must cover the usual microorganisms of the oropharyngeal flora. Oropharyngeal dysphagia should be identified early in risk groups through the use of screening methods involving clinical examination of swallowing and diagnostic confirmation methods. The simplest and most effective therapeutic intervention is adaptation of the texture of the solid and the viscosity of the liquid.

  19. Supersymmetry: aspirations and prospects

    NASA Astrophysics Data System (ADS)

    Tata, Xerxes

    2015-10-01

    The realization in the early 1980s that weak scale supersymmetry stabilizes the Higgs sector of the spectacularly successful Standard Model (SM) led several authors to explore whether low energy supersymmetry could play a role in particle physics. Among these were Richard Arnowitt, Ali Chamseddine and Pran Nath who constructed a viable locally supersymmetric grand unified theory (GUT), laying down the foundation for supergravity GUT models of particle physics. Supergravity models continue to be explored as one of the most promising extensions of the SM. After a quick overview of some of the issues and aspirations of early researchers working to bring supersymmetry into the mainstream of particle physics, we re-examine early arguments that seemed to imply that superpartners would be revealed in experiments at LEP2 or at the Tevatron. Our purpose is to assess whether the absence of any superpartners in searches at LHC8 presents a crisis for supersymmetry. Toward this end, we re-evaluate fine-tuning arguments that lead to upper bounds on (some) superpartner masses. We conclude that phenomenologically viable superpartner spectra that could arise within a high scale model tuned no worse than a few percent are perfectly possible. While no viable underlying model of particle physics that leads to such spectra has yet emerged, we show that the (supergravity-based) radiatively driven natural supersymmetry framework serves as a surrogate for a phenomenological analysis of an underlying theory with modest fine-tuning. We outline the phenomenological implications of this framework, with emphasis on those LHC and electron-positron collider signatures that might point to the underlying natural origin of gauge and Higgs boson masses. We conclude that the supergravity GUT paradigm laid down in 1982 by Arnowitt, Chamseddine and Nath, and others, remains a vibrant possibility.

  20. Small intestine aspirate and culture

    MedlinePlus

    ... ency/article/003731.htm Small intestine aspirate and culture To use the sharing features on this page, please enable JavaScript. Small intestine aspirate and culture is a lab test to check for infection ...

  1. Can nature make us more caring? Effects of immersion in nature on intrinsic aspirations and generosity.

    PubMed

    Weinstein, Netta; Przybylski, Andrew K; Ryan, Richard M

    2009-10-01

    Four studies examined the effects of nature on valuing intrinsic and extrinsic aspirations. Intrinsic aspirations reflected prosocial and other-focused value orientations, and extrinsic aspirations predicted self-focused value orientations. Participants immersed in natural environments reported higher valuing of intrinsic aspirations and lower valuing of extrinsic aspirations, whereas those immersed in non-natural environments reported increased valuing of extrinsic aspirations and no change of intrinsic aspirations. Three studies explored experiences of nature relatedness and autonomy as underlying mechanisms of these effects, showing that nature immersion elicited these processes whereas non-nature immersion thwarted them and that they in turn predicted higher intrinsic and lower extrinsic aspirations. Studies 3 and 4 also extended the paradigm by testing these effects on generous decision making indicative of valuing intrinsic versus extrinsic aspirations.

  2. Rising Aspirations Dampen Satisfaction

    ERIC Educational Resources Information Center

    Clark, Andrew E.; Kamesaka, Akiko; Tamura, Teruyuki

    2015-01-01

    It is commonly believed that education is a good thing for individuals. Yet, its correlation with subjective well-being is most often only weakly positive, or even negative, despite the many associated better individual-level outcomes. We here square the circle using novel Japanese data on happiness aspirations. If reported happiness comes from a…

  3. Assessing Children's Career Aspirations

    ERIC Educational Resources Information Center

    Plummer, Donna M.

    2008-01-01

    In the past several years, "Science and Children" has invited preservice and inservice teachers to participate in national studies of students' ideas about scientists (Barman 1997), animals (Barman et al. 2000), and plants (Barman et al. 2003). You are invited to participate in an additional study that will examine children's career aspirations.…

  4. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... Your 1- to 2-Year-Old Aspiration and Biopsy: Bone Marrow KidsHealth > For Parents > Aspiration and Biopsy: Bone Marrow A A A What's in this ... ósea What It Is Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy ...

  5. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Aspiration and Biopsy: Bone Marrow KidsHealth > For Teens > Aspiration and Biopsy: Bone Marrow A A A What's in this ... Questions What It Is Bone marrow aspirations and biopsies are performed to examine bone marrow, the spongy ...

  6. Factors Influencing High School Students' Career Aspirations

    ERIC Educational Resources Information Center

    Tang, Mei; Pan, Wei; Newmeyer, Mark D.

    2008-01-01

    This article explores the factors influencing high school students' career aspirations with a study analyzing 141 high school students. The Social Cognitive Career Development Model was utilized to examine the interactive relationships among learning experiences, career self-efficacy, outcome expectations, career interests, and career choices. The…

  7. Fine Needle Aspiration of Thyroid Nodules Using the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience in a Rural Setting

    PubMed Central

    Kaminoh, Yuuki; Forward, Terra; Schwartz, Frank L.; Jenkinson, Scott

    2017-01-01

    Background. Fine needle aspiration (FNA) remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC) to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015. Results. A total of 159 patients (18–88 years old) and 236 nodule aspirations were performed and submitted for evaluation. 79% were benign, 3% atypia/follicular lesion of unknown significance (AUS/FLUS), 5% follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 4% suspicious for malignancy (one case was indeed an atypical parathyroid neoplasm by surgical pathology), 2% malignant, and 7% nondiagnostic. Two cases also had advanced molecular analysis on FNA specimens before thyroidectomy. Conclusion. The diagnostic yield of FNA cytology from our practice in a rural setting suggests that accuracy and specificity are comparable to results from larger centers. PMID:28280507

  8. 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

  9. Ex vivo permeability experiments in excised rat intestinal tissue and in vitro solubility measurements in aspirated human intestinal fluids support age-dependent oral drug absorption.

    PubMed

    Annaert, Pieter; Brouwers, Joachim; Bijnens, Ann; Lammert, Frank; Tack, Jan; Augustijns, Patrick

    2010-01-31

    The possible influence of advanced age on intestinal drug absorption was investigated by determining the effects of aging on (i) solubility of model drugs in human intestinal fluids (HIF) obtained from two age groups (18-25 years; 62-72 years); and (ii) transepithelial permeation of model drugs across intestinal tissue excised from young, adult and old rats. Average equilibrium solubility values for 10 poorly soluble compounds in HIF aspirated from both age groups showed high interindividual variability, but did not reveal significant differences. Characterization of the HIF from both age groups demonstrated comparable pH profiles, while concentrations of individual bile salts showed pronounced variability between individuals, however without statistical differences between age groups. Transepithelial permeation of the transcellular probe metoprolol was significantly increased in old rats (38 weeks) compared to the younger age groups, while the modulatory role of P-glycoprotein in transepithelial talinolol transport was observed in adult and old rats but not in young rats. In conclusion, age-dependent permeability of intestinal tissue (rather than age-dependent luminal drug solubility) may contribute to altered intestinal drug absorption in older patients compared to young adults.

  10. Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy of pulmonary lesions with non-coaxial technique: a single center experience with 442 biopsies

    PubMed Central

    Uzun, Çağlar; Akkaya, Zehra; Atman, Ebru Düşünceli; Üstüner, Evren; Peker, Elif; Gülpınar, Başak; Elhan, Atilla Halil; Ceyhan, Koray; Atasoy, Kayhan Çetin

    2017-01-01

    PURPOSE We aimed to evaluate the diagnostic accuracy and safety of computed tomography (CT)-guided biopsy of pulmonary lesions with fine needle aspiration (FNA) using non-coaxial technique. METHODS We analyzed 442 patients who underwent CT-guided lung biopsy with FNA and non-coaxial technique to determine the diagnostic outcomes, complication rates, and independent risk factors for diagnostic failure and pneumothorax. RESULTS Diagnostic accuracy, sensitivity, and specificity were 97.6%, 97.3%, and 100%, respectively. Age and >35 mm lesion size were significant risk factors for diagnostic failure. The rates of pneumothorax and chest tube placement were 19% and 2.9%, respectively. Middle and lower lobe location, lesion to pleura distance >7.5 mm, and >45° needle trajectory angle were significant risk factors for pneumothorax. CONCLUSION CT-guided FNA of pulmonary lesions with non-coaxial technique is a safe and reliable method with a relatively low pneumothorax rate and an acceptably high diagnostic accuracy. PMID:28029638

  11. GEAR UP Aspirations Project Evaluation

    ERIC Educational Resources Information Center

    Trimble, Brad A.

    2013-01-01

    The purpose of this study was to conduct a formative evaluation of the first two years of the Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) Aspirations Project (Aspirations) using a Context, Input, Process, and Product (CIPP) model so as to gain an in-depth understanding of the project during the middle school…

  12. Death following crude oil aspiration.

    PubMed

    Rodriguez, M A; Martinez, M C; Martinez-Ruiz, D; Paz Giménez, M; Menéndez, M; Repetto, M

    1991-07-01

    This is a report on three deaths following oil aspiration by workers in petrol tankers. Lung aspiration was demonstrated by the presence of a yellowish-brown material in the alveolar spaces, which was difficult to identify by optic microscopy. Volatile hydrocarbons from petroleum were identified in lung samples by gas chromatography/mass spectrometry.

  13. Usefulness of conventional transbronchial needle aspiration in the diagnosis, staging and molecular characterization of pulmonary neoplasias by thin-prep based cytology: experience of a single oncological institute

    PubMed Central

    Ramieri, Maria Teresa; Marandino, Ferdinando; Visca, Paolo; Salvitti, Tommaso; Gallo, Enzo; Casini, Beatrice; Giordano, Francesca Romana; Frigieri, Claudia; Caterino, Mauro; Carlini, Sandro; Rinaldi, Massimo; Ceribelli, Anna; Pennetti, Annarita; Alò, Pier Luigi; Pescarmona, Edoardo; Filippetti, Massimo

    2016-01-01

    Background Conventional transbronchial needle aspiration (c-TBNA) contributed to improve the bronchoscopic examination, allowing to sample lesions located even outside the tracheo-bronchial tree and in the hilo-mediastinal district, both for diagnostic and staging purposes. Methods We have evaluated the sensitivity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the c-TBNA performed during the 2005–2015 period for suspicious lung neoplasia and/or hilar and mediastinal lymphadenopathy at the Thoracic endoscopy of the Thoracic Surgery Department of the Regina Elena National Cancer Institute, Rome. Data from 273 consecutive patients (205 males and 68 females) were analyzed. Results Among 158 (58%) adequate specimens, 112 (41%) were neoplastic or contained atypical cells, 46 (17%) were negative or not diagnostic. We considered in the analysis first the overall period; then we compared the findings of the first [2005–2011] and second period [2012–2015] and, finally, only those of adequate specimens. During the overall period, sensibility and accuracy values were respectively of 53% and 63%, in the first period they reached 41% and 53% respectively; in the second period sensibility and accuracy reached 60% and 68%. Considering only the adequate specimens, sensibility and accuracy during the overall period were respectively of 80% and 82%; the values obtained for the first period were 68% and 72%. Finally, in the second period, sensibility reached 86% and accuracy 89%. Carcinoma-subtyping was possible in 112 cases, adenocarcinomas being diagnosed in 50 cases; further, in 30 cases molecular predictive data could be obtained. Conclusions The c-TBNA proved to be an efficient method for the diagnosis/staging of lung neoplasms and for the diagnosis of mediastinal lymphadenopathy. Endoscopist’s skill and technical development, associated to thin-prep cytology and to a rapid on site examination (ROSE), were able to provide by c-TBNA a

  14. Aspiration of the retrocalcaneal bursa.

    PubMed Central

    Canoso, J J; Wohlgethan, J R; Newberg, A H; Goldsmith, M R

    1984-01-01

    We aspirated the retrocalcaneal bursa in cadavers to determine the characteristics of bursal fluid. A small amount of clear, viscous fluid was constantly present in the bursa. Leucocyte count was low, and the mucin clot test was good. With the same technique we aspirated the retrocalcaneal bursae of 4 patients. Three had Reiter's syndrome; the bursal fluid was inflammatory, and symptoms promptly resolved after local corticosteroid injection. The fourth patient presented with heel pain; intracellular, positively birefringent crystals were present in the aspirate, consistent with the diagnosis of pseudogout. Images PMID:6712303

  15. Creative Aspirations or Pipe Dreams? Toward Understanding Creative Mortification in Children and Adolescents

    ERIC Educational Resources Information Center

    Beghetto, Ronald A.; Dilley, Anna E.

    2016-01-01

    What experiences influence the development of creativity in children and adolescents? One experience is the mortification of creative aspirations. Creative mortification (CM) refers to the loss of one's willingness to pursue a particular creative aspiration following a negative performance outcome. The purpose of this article is to introduce an…

  16. Translating obstetrics and gynaecology undergraduate experience into career aspiration: an audit of Royal College of Obstetricians and Gynaecologists (RCOG) medical student placement standards.

    PubMed

    Bonnett, T J; Roberts, A L; Farrell, T A

    2012-11-01

    In 2006, the Royal College of Obstetricians and Gynaecologists (RCOG) published a list of undergraduate placement standards in an effort to improve the obstetrics and gynaecology (O&G) undergraduate experience and reverse declining interest in the specialty among UK graduates. We surveyed 3rd-year medical students undertaking O&G placements to investigate how appropriate they felt the RCOG placement standards were. We present the first evaluation of these standards and discuss their potential role in improving the undergraduate O&G experience. We also sought to examine the influence of undergraduate O&G exposure on interest in entering the specialty and the effect of gender on perceived learning experience. Students rated the RCOG standards as highly appropriate, and significant differences in clinical exposure and career intentions were seen between genders. Overall, students demonstrated greater interest in pursuing O&G than has previously been documented, which may represent a wider upturn in interest in the speciality.

  17. A Comparison of Compliance and Aspirational Accreditation Models: Recounting a University's Experience with Both a Taiwanese and an American Accreditation Body

    ERIC Educational Resources Information Center

    Cheng, Nellie S.

    2015-01-01

    Despite the widespread adoption of accreditation processes and the belief in their effectiveness for improving educational quality, the search for good accreditation practices remains a critical issue. This article recounts one university's experiences when simultaneously undergoing the accreditation processes of both the Middle States Commission…

  18. A Walk across the Bridge: A Reflection on My Experience as an Aspiring Educator at the Illinois Mathematics and Science Academy

    ERIC Educational Resources Information Center

    Feigel, Kristen A.

    2016-01-01

    Kristen Feigel is a sophomore at Wittenberg University in Springfield, OH, where she is preparing to teach secondary theater and English. When first asked if she wanted an opportunity to shadow a few teachers at the Illinois Mathematics and Science Academy (IMSA), she answered "Yes, absolutely!" Here she details experiences, surprises,…

  19. Pulmonary aspiration of gastric contents.

    PubMed

    Bynum, L J; Pierce, A K

    1976-12-01

    A retrospective analysis of 50 patients who had been observed to aspirate gastric contents was performed to define better the course of patients with this syndrome. The patients invariably had a disturbance of consciousness, most commonly due to sedative drug overdose or general anesthesia. The onset of clinical signs occurred prompty after aspiration and tended to be similar in all patients, irrespective of their subsequent course or outcome. These findings usually included fever, tachypnea, diffuse rales, and serious hypoxemia. Cough, cyanosis, wheezing, and apnea were each seen in approximately one third of the cases. Apena, shock, and early severe hypoxemia were particularly ominous events. Initial roentgenograms revealed diffuse or localized alveolar infiltrates, which progressed during the next 24 to 36 hours. Subsequent clinical courses followed 3 patterns: 12 per cent of the patients died shortly after aspiration; 62 per cent had rapid clinical and radiologic improvement, with clearing, on average, within 4.5 days; 26 per cent demonstrated rapid improvement, but then had clinical and radiographic progression associated with recovery of bacterial pathogens from the sputum and a fatal outcome in more than 60 per cent. Treatment from the outset by adrenocortical steroids or antimicrobial agents had no demonstrable effect on the outcome. The clinical features of aspiration of gastric contents are characteristic and distinguish it from other forms of aspiration-related lung disease.

  20. [Perioperative Pulmonary Aspiration: Preface and Comments].

    PubMed

    Asai, Takashi

    2016-01-01

    Since the risk of pulmonary aspiration was recognized in obstetric anesthesia in 1930's, numerous efforts have been made to reduce the incidence and severity of perioperative pulmonary aspiration: preoperative fasting, preoperative assessment of risk factors in perioperative pulmonary aspiration, emptying the stomach, rapid-sequence induction of anesthesia with cricoid pressure, and the use of a cuffed tracheal tube. With these efforts, the incidence of pulmonary aspiration has been reduced drastically, and aspiration is now rare. Nevertheless, recent large studies have shown that perioperative pulmonary aspiration is the main cause of anesthesia-related death or irreversible brain damage. In this special issue, experts summarize the current state of perioperative pulmonary aspiration, its diagnosis and treatment, risk factors of pulmonary aspiration, preoperative preventative methods, and appropriate anesthesia methods and airway management in patients at increased risk of pulmonary aspiration.

  1. [Prevention of Perioperative Aspiration Pneumonitis].

    PubMed

    Fukuda, Kazuhiko

    2016-01-01

    To prevent perioperative aspiration pneumonitis, it is necessary to reduce the volume and acidity of gastric content. The guideline for preoperative fasting published by Japanese Society of Anesthesiologists recommends fasting from intake of clear fluids, breast milk and nonhuman milk at least 2h, 4h and 6h, respectively, before elective procedures requiring general anesthesia, regional anesthesia or sedation/analgesia. Gastrointestinal stimulants, histamine-2 receptor antagonists, proton pump inhibitors, antacids, antiemetics, anticholinergics are effective for reduction of the volume or acidity of gastric content. However, the routine preoperative use of these drugs to reduce the risk of pulmonary aspiration in patients who have no apparent increased risk for pulmonary aspiration is not recommended.

  2. Dermabrasion using an ultrasonic surgical aspirator.

    PubMed

    Ito, Y; Kondo, S; Sumiya, N; Yoshii, M; Otani, K; Wako, M

    1996-04-01

    We used an ultrasonic surgical aspirator on the epidermal surface to perform dermabrasion instead of the conventional motor-driven grinder. It was determined on histologic examination that it is possible to fragment the epidermis with greater selectively using the ultrasonic surgical aspirator. Abrasion also can be performed safely on spotty lesions and intricate, problematic regions with the ultrasonic surgical aspirator. We feel that the ultrasonic surgical aspirator is a promising device for use in dermabrasion.

  3. Crowning achievement: a case of dental aspiration.

    PubMed

    Mark, Nicholas M; Lessing, Juan N; Çoruh, Başak

    2015-12-01

    Aspiration of foreign bodies during dental procedures is a rare but potentially serious complication. We present a case of a 75-year-old man who aspirated a dental crown requiring flexible bronchoscopic retrieval. We discuss the risk factors for aspiration, the radiographic features of diagnosis, and the techniques for management and retrieval.

  4. Crowning achievement: a case of dental aspiration

    PubMed Central

    Mark, Nicholas M.; Lessing, Juan N.; Çoruh, Başak

    2015-01-01

    Aspiration of foreign bodies during dental procedures is a rare but potentially serious complication. We present a case of a 75-year-old man who aspirated a dental crown requiring flexible bronchoscopic retrieval. We discuss the risk factors for aspiration, the radiographic features of diagnosis, and the techniques for management and retrieval. PMID:26649115

  5. Aspirations of Latina Adolescent Suicide Attempters

    ERIC Educational Resources Information Center

    Hausmann-Stabile, Carolina; Gulbas, Lauren; Zayas, Luis H.

    2013-01-01

    Parents' aspirations and expectations are communicated to their offspring. Children internalize their parents' aspirations and accept some of the expectations while rejecting others, all part of the developmental process and identity-consolidation. When the aspirations and expectations of youth and parents are incongruent, the outcomes…

  6. ACCURATE TEMPERATURE MEASUREMENTS IN A NATURALLY-ASPIRATED RADIATION SHIELD

    SciTech Connect

    Kurzeja, R.

    2009-09-09

    Experiments and calculations were conducted with a 0.13 mm fine wire thermocouple within a naturally-aspirated Gill radiation shield to assess and improve the accuracy of air temperature measurements without the use of mechanical aspiration, wind speed or radiation measurements. It was found that this thermocouple measured the air temperature with root-mean-square errors of 0.35 K within the Gill shield without correction. A linear temperature correction was evaluated based on the difference between the interior plate and thermocouple temperatures. This correction was found to be relatively insensitive to shield design and yielded an error of 0.16 K for combined day and night observations. The correction was reliable in the daytime when the wind speed usually exceeds 1 m s{sup -1} but occasionally performed poorly at night during very light winds. Inspection of the standard deviation in the thermocouple wire temperature identified these periods but did not unambiguously locate the most serious events. However, estimates of sensor accuracy during these periods is complicated by the much larger sampling volume of the mechanically-aspirated sensor compared with the naturally-aspirated sensor and the presence of significant near surface temperature gradients. The root-mean-square errors therefore are upper limits to the aspiration error since they include intrinsic sensor differences and intermittent volume sampling differences.

  7. Fine-Needle Aspiration in the Evaluation of Thyroid Neoplasms.

    PubMed

    Oertel, Yolanda C.

    1997-01-01

    Fine-needle aspiration (FNA) is a safe, rapid, and accurate diagnostic tool. Although it continues to gain acceptance, the pace is slow. Probably, if more pathologists master the basics (i.e., learn how to obtain a good sample), this simple technique could be utilized to its fullest advantage. If the sample is not adequate or representative of the lesion, the diagnosis will not be correct. Based on personal experience, we believe that suction should be minimal when obtaining thyroid aspirates. Cytologic diagnostic criteria for the most common neoplasms of the thyroid gland are provided.

  8. Subject Choice and Occupational Aspirations among Pupils at Girls' Schools

    ERIC Educational Resources Information Center

    Francis, Becky; Hutchings, Merryn; Archer, Louise; Amelling, Lindsay

    2003-01-01

    Various studies have found that British girls' curriculum subject preferences and future aspirations have changed and diversified in recent years. Other work has suggested that girls educated in single-sex schools might have a different (perhaps less gender-stereotypical) experience of education in comparison with their contemporaries at…

  9. College Aspirations and Preparation: How AVID Students Beat the Odds

    ERIC Educational Resources Information Center

    Cronin, Dana

    2013-01-01

    A study of "at risk" high school youth revealed how student participation in the Advancement Via Individual Determination (AVID) program positively affected student achievement and increased college aspirations and entrance rates. The experiences of the students, teachers, and administrators were examined using a case study approach…

  10. Silent aspiration: what do we know?

    PubMed

    Ramsey, Deborah; Smithard, David; Kalra, Lalit

    2005-01-01

    Although clinically evident aspiration is common in subjects with dysphagia, a significant proportion may aspirate silently, i.e., without any outward signs of swallowing difficulty. This article reviews the literature on the prevalence, etiology, and prognostic significance of silent aspiration. An electronic database search was performed using silent aspiration, aspiration, dysphagia, and stroke as search terms, together with hand-searching of articles. Silent aspiration has been described in many conditions and subgroups of patients (including normal individuals), using a number of detection methods, making comparisons a challenge. The best data are for acute stroke, in which 2%-25% of patients may aspirate silently. Mechanisms associated with silent aspiration may include central or local weakness/incoordination of the pharyngeal musculature, reduced laryngopharyngeal sensation, impaired ability to produce a reflexive cough, and low substance P or dopamine levels. In terms of prognosis, silent aspiration has been associated with increased morbidity and mortality in many but not all studies. However, some degree of silent aspiration at night may be normal in healthy individuals. The phenomenon of silent aspiration is poorly understood and further research is needed to improve methods of detection and thereby better define its prevalence and prognostic significance.

  11. [Pathophysiology and Therapeutic Approach of Pulmonary Aspiration].

    PubMed

    Uchida, Kanji

    2016-01-01

    Pulmonary aspiration is one of the serious adverse events in general anesthesia. Aspiration induced lung injury varies according to the nature of the contents of aspirates (acid or small particles in gastrointestinal tract, bile acid), amount of aspirates, and host-defense status. Early inflammatory responses to acid and small particles from gastrointestinal contents are categorized as aspiration pneumonitis causing rapid respiratory deterioration with early restoration of lung injury within a couple of days. Late phase lung injury is usually "aspiration pneumonia" caused by bacteria colonized in the aspirates. Treatment mainstream is to support respiratory function until the lung resolves from injury. Extracorporeal membrane oxygenation is another promising therapeutic option for cases with severe lung damage to keep the "lung rest" during fulminant lung injury, avoiding further lung damage by injurious ventilation. Empirical administration of antibiotics covering wide spectrum followed by meticulous bacteriological studies to either de-escalate or discontinue antibiotics is crucial.

  12. Aspirations of Latina adolescent suicide attempters

    PubMed Central

    Hausmann-Stabile, Carolina; Gulbas, Lauren; Zayas, Luis H.

    2013-01-01

    Parents’ aspirations and expectations are communicated to their offspring. Children internalize their parents’ aspirations and accept some of the expectations while rejecting others, all part of the developmental process and identity-consolidation. When the aspirations and expectations of youth and parents are incongruent, the outcomes in youths’ behavior can be deleterious, such as when adolescents manifest suicidal behaviors. We examined aspirations expressed by 12 Latina adolescent suicide attempters and their parents and compared them to 12 non-suicidal Latinas and parents. Qualitative analyses revealed that incongruence of aspirations between girls and their parents were greater among suicidal teens. Suicidal and non-suicidal Latinas presented contrasting aspirations: the former on gaining independence and the latter on completing their education and pursuing careers. Findings may inform developmental research and ways in which clinicians and policymakers can help Latinas achieve their own and their parents’ aspirations. PMID:24013464

  13. Aspiration of a speaking valve

    PubMed Central

    Schembri, John; Cortis, Kelvin; Mallia Azzopardi, Charles; Montefort, Stephen

    2013-01-01

    Foreign body aspiration (FBA) is a relatively common and serious condition that can result in a spectrum of presentations ranging from incidental to acutely life-threatening. Described here is a case of aspiration of a tracheo-oesophageal speaking valve through a permanent tracheostomy that went unnoticed for a number of years, and an overview of the technique used for its removal. A 70-year-old ex-heavy smoker with a permanent tracheo-oesophageal fistula presented with a relatively recent history of increasing shortness of breath, sputum purulence and haemoptysis. Further investigation with a CT scan and bronchoscopy revealed the presence of a foreign body within his right lower lobe bronchus which was later removed by advancing a flexible bronchoscope over a rigid one. PMID:23861275

  14. Contrast enhancement and elastography in endoscopic ultrasound: an update of clinical applications in pancreatic diseases.

    PubMed

    Serrani, Marta; Lisotti, Andrea; Caletti, Giancarlo; Fusaroli, Pietro

    2016-08-01

    It is well established that endoscopic ultrasound (EUS) is fundamental in the characterization of many diseases concerning different organs, i.e. pancreaticobiliary diseases, gastrointestinal pathologic conditions, and lymph nodes of unknown origin. It is also well known that many factors can hamper the accuracy of EUS, i.e. biliary stents, chronic pancreatitis, poor operator's expertise. These factors can also lead to suboptimal accuracy when cytological confirmation through EUS-fine needle aspiration (EUS-FNA) is indicated. In recent years, new technological tools have rapidly increased their clinical impact improving the diagnostic power of EUS and EUS-FNA. Among these new tools, the most investigated and useful ones are represented by contrast harmonic-EUS (CH-EUS) and EUS-elastography (EUS-E). The purpose of this paper is to provide, through a review of the literature, an update of the applications of CH-EUS and EUS-E in the routine clinical practice in pancreatic diseases. We discussed the first reports and applications of these techniques in our previous review published in Minerva Medica. The applications of CH-EUS and EUS-E to the study of pancreatic diseases appear feasible and safe. The use of both techniques is very simple and does not require any relevant additional workload for the endoscopic personnel. CH-EUS is now considered an important and accurate tool in the diagnosis of solid pancreatic masses and in the differential diagnosis of pancreatic cystic lesions. CH-EUS targeted FNA is an active field of research. However the available studies show that CH-EUS increases FNA accuracy by a little extent, without statistical significance; moreover, CH-EUS FNA showed a trend toward being more efficient vs. simple EUS FNA (less needle passes and more abundance in cytological material) but this trend did not reach statistical significance. On the other hand, the clinical impact of EUS-E in terms of differential diagnosis of pancreatic masses is still under

  15. "I Fall Asleep in Class … but Physics Is Fascinating": The Use of Large-Scale Longitudinal Data to Explore the Educational Experiences of Aspiring Girls in Mathematics and Physics

    ERIC Educational Resources Information Center

    Mujtaba, Tamjid; Reiss, Michael J.

    2016-01-01

    This article explores how students' aspirations to study mathematics or physics in post-16 education are associated with their perceptions of their education, their motivations, and the support they feel they received. The analysis is based on the responses of around 10,000 students in England in Year 8 (age 12-13) and then in Year 10 (age 14-15).…

  16. Strategies for prophylaxis and treatment for aspiration.

    PubMed

    Kalinowski, Christopher Peter Henry; Kirsch, Jeffery Robert

    2004-12-01

    The absolute incidence of aspiration is difficult to define because of its relatively low occurrence and difficulty in diagnosis. The gastric volume predisposing to aspiration is larger than 30 ml. Fasting times for fluids have reduced; however, a large meal may require 9 hours of preoperative fasting. Preoperative carbohydrate-enriched beverages may attenuate postoperative catabolism. Aspiration occurs most frequently during induction and laryngoscopy. Awake fibre-optic intubation may be a suitable alternative in high-risk cases for aspiration. The role of cricoid pressure in anaesthesia needs re-evaluation as radiological and clinical evidence suggest that it may be ineffective and may impede intubation and ventilation. Chemoprophylaxis does not reduce the severity of aspiration pneumonitis as gastric bile is unaffected by these agents and induces a worse pneumonitis than gastric acid. Patients may be discharged home 2 hours after aspirating provided they are clinically unaffected and have postoperative surveillance.

  17. Aspiration thrombectomy in concert with stent thrombectomy.

    PubMed

    Dumont, Travis M; Mokin, Maxim; Sorkin, Grant C; Levy, Elad I; Siddiqui, Adnan H

    2013-07-12

    In the SWIFT and TREVO 2 trials, aspiration thrombectomy was not able to be performed. Outside these studies, in post-market application, the interventionist can use aspiration thrombectomy in addition to stent device thrombectomy. This technique is described in detail in the present report. Combined aspiration/stentriever thrombectomy may improve recanalization efforts, simplify a second thrombectomy attempt if necessary and may limit distal embolization.

  18. Aspiration

    MedlinePlus

    ... diagnosis of benign lesions. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ... patient with liver disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ...

  19. Thrombus aspiration catheter is a Dottering balloon.

    PubMed

    Sheshagiri Rao, D; Barik, Ramachandra; Prasad, Akula Siva

    2016-01-01

    Coronary angiogram in a young man with history of STEMI with delayed presentation revealed subtotal occlusion of left anterior descending artery (LAD) with large thrombotic filling defect distal to the critical lesion. PCI was preferred without delay because of ongoing chest pain. Several runs of thrombus aspiration failed to detect any visible thrombus. However, the immediate angiogram after thrombus aspiration showed complete distal embolization of the thrombus which could have been achieved by Dottering or balloon dilatation. In contrary to the general perception, does thrombus aspiration push more thrombus than it can aspirate?

  20. High Aspirations but Low Progression: The Science Aspirations-Careers Paradox amongst Minority Ethnic Students

    ERIC Educational Resources Information Center

    DeWitt, Jennifer; Archer, Louise; Osborne, Jonathan; Dillon, Justin; Willis, Beatrice; Wong, Billy

    2011-01-01

    Students' interest in studying science and their aspirations to pursue science-related careers is a topic of global concern. In this paper, a set of data gathered for the initial phase of the 5-year study of Science Aspirations and Careers: Age 10-14 (the ASPIRES project) is presented. In the initial phase of this project, a questionnaire…

  1. Deep high-resolution fluorescence microscopy of full organs: the benefit of ultraminiature confocal miniprobes

    NASA Astrophysics Data System (ADS)

    Schwarz, France; Le Nevez, Arnaud; Genet, Magalie; Osdoit, Anne; Lacombe, François

    2009-02-01

    Background: Confocal Laser Endomicroscopy (CLE) based on ultraminiature miniprobes (Cellvizio®, Mauna Kea Technologies, Paris, France) is able to image the inner microstructure of retroperitoneal full organs punctured during EUS-FNA procedures, such as pancreas, liver or lymph nodes. Therefore, pCLE can provide an easy-to-use and precise adjunct tool to ultrasonographic interventions in order to target suspicious areas for biopsies in EUS-FNA. Material and Methods: Probe-based CLE (pCLE) was performed on ex-vivo surgically resected specimens after topical application of fluorophores in standard 19G and 22G needles. Two prototype miniprobes ("S-probe" 300 microns diameter, field of view 400*280 microns, and "S-probe" 650 microns diameter, field of view 500*600 microns) were then inserted into the needles and enabled visualization of the inner microstructures of uterus, lung, kidney, stomach and esophagus, in both healthy and cancerous conditions. Then, pCLE was performed in-vivo on four pigs during three NOTES and one EUS-FNA procedures after intravenous injection of 2-7mL fluorescein 1-10% using the prototype "S-probe" 350 microns diameter inserted in 19G FNA needles. Liver, pancreas and spleen were imaged. Results: During the ex-vivo experiments, pCLE made it possible to distinguish microstructures, such as alveoli and macrophages in the lungs. During the in-vivo experiments, Cellvizio® video sequences showed hepatic lobules and the portal vein in the liver, and red and white pulp in the spleen. Conclusion: pCLE provides in vivo cellular information about full organs. It has the potential to help target biopsies during EUSFNA, which suffers from a high rate of false negatives, thus increasing its sensitivity.

  2. Sialorrhea and aspiration pneumonia: a case study.

    PubMed

    Trigoboff, Eileen; Grace, Jeffery; Szymanski, Herman; Bhullar, Jaspinder; Lee, Claudia; Watson, Thomas

    2013-05-01

    This case study compares two different clinical outcomes for a patient with a long-standing psychotic disorder prescribed clozapine on two occasions. During the first trial, clozapine was used at a higher dose for this patient (350-450mg/day) and included clinically significant sialorrhea, pneumonia, and pneumonia-like illnesses requiring immediate medical intervention including hospitalization. There were also patient complaints of fatigue, cough, choking, and constipation leading to poor adherence. Clozapine was discontinued when the patient withdrew his consent due to side effects, despite his awareness of its benefits, including reduction of command hallucinations and irritability. The second clozapine trial was associated with lower daily doses and therapeutic serum blood levels. The patient was actively participating in and adhering to the medication plan. A very narrow window of clozapine dose was exceeded for two days and the patient complained of hypersalivation, cough, and lethargy. He was subsequently hospitalized for a two week period to treat aspiration pneumonia. This hospitalization helped establish the ideal daily dose of clozapine for this patient and also brought the relationship between aspiration pneumonia and clozapine to the attention of the psychiatrist and medical specialist. Once the appropriate dosage for this patient was established, his psychotic and affective symptoms were controlled, he was not hampered by adverse side effects, and he started to actively participate in social and recreational activities and plans that culminated in discharge from a state psychiatric facility to a supportive community residence. It is our hope that the lessons we have learned from our shared experience with this patient will be of benefit to other clinicians and patients.

  3. Sialorrhea and Aspiration Pneumonia: A Case Study

    PubMed Central

    Grace, Jeffery; Szymanski, Herman; Bhullar, Jaspinder; Lee, Claudia; Watson, Thomas

    2013-01-01

    This case study compares two different clinical outcomes for a patient with a long-standing psychotic disorder prescribed clozapine on two occasions. During the first trial, clozapine was used at a higher dose for this patient (350-450mg/day) and included clinically significant sialorrhea, pneumonia, and pneumonia-like illnesses requiring immediate medical intervention including hospitalization. There were also patient complaints of fatigue, cough, choking, and constipation leading to poor adherence. Clozapine was discontinued when the patient withdrew his consent due to side effects, despite his awareness of its benefits, including reduction of command hallucinations and irritability. The second clozapine trial was associated with lower daily doses and therapeutic serum blood levels. The patient was actively participating in and adhering to the medication plan. A very narrow window of clozapine dose was exceeded for two days and the patient complained of hypersalivation, cough, and lethargy. He was subsequently hospitalized for a two week period to treat aspiration pneumonia. This hospitalization helped establish the ideal daily dose of clozapine for this patient and also brought the relationship between aspiration pneumonia and clozapine to the attention of the psychiatrist and medical specialist. Once the appropriate dosage for this patient was established, his psychotic and affective symptoms were controlled, he was not hampered by adverse side effects, and he started to actively participate in social and recreational activities and plans that culminated in discharge from a state psychiatric facility to a supportive community residence. It is our hope that the lessons we have learned from our shared experience with this patient will be of benefit to other clinicians and patients. PMID:23882437

  4. Forward-viewing endoscopic ultrasound-guided NOTES interventions: A study on peritoneoscopic potential

    PubMed Central

    Jeong, Seung Uk; Aizan, Hassanuddin; Song, Tae Jun; Seo, Dong Wan; Kim, Su-Hui; Park, Do Hyun; Lee, Sang Soo; Lee, Sung Koo; Kim, Myung-Hwan

    2013-01-01

    AIM: To evaluate the feasibility of diagnostic and therapeutic transgastric (TG) peritoneoscopic interventions with a forward-viewing endoscopic ultrasound (FV-EUS). METHODS: This prospective endoscopic experimental study used an animal model. Combined TG peritoneoscopic interventions and EUS examination of the intra-abdominal organs were performed using an FV-EUS on 10 animal models (1 porcine and 9 canine). The procedures carried out include EUS evaluation and endoscopic biopsy of intraperitoneal organs, EUS-guided fine needle aspiration (EUS-FNA), EUS-guided radiofrequency ablation (EUS-RFA), and argon plasma coagulation (APC) for hemostatic control. The animals were kept alive for 7 d, and then necropsy was performed to evaluate results and complications. RESULTS: In all 10 animals, TG peritoneoscopy, followed by endoscopic biopsy for the liver, spleen, abdominal wall, and omentum, was performed successfully. APC helped control minor bleeding. Visualization of intra-abdominal solid organs with real-time EUS was accomplished with ease. Intraperitoneal EUS-FNA was successfully performed on the liver, spleen, and kidney. Similarly, a successful outcome was achieved with EUS-RFA of the hepatic parenchyma. No adverse events were recorded during the study. CONCLUSION: Peritoneoscopic natural orifice transluminal endoscopic surgery (NOTES) interventions through FV-EUS were feasible in providing evaluation and performing endoscopic procedures. It promises potential as a platform for future EUS-based NOTES. PMID:24222961

  5. Differentiation of Pancreatic Cyst Types by Analysis of Rheological Behavior of Pancreatic Cyst Fluid

    PubMed Central

    Khamaysi, Iyad; Abu Ammar, Aiman; Vasilyev, Gleb; Arinstein, Arkadii; Chowers, Yehuda; Zussman, Eyal

    2017-01-01

    Differentiation between mucinous and non-mucinous pancreatic cysts is exceedingly important and challenging, particularly as the former bears malignant transformation potential. Pancreatic cyst fluid (PCF)-based diagnostics, including analyses of biochemical markers, as well as cytology, has shown inadequate accuracy. Herein, a preliminary single-center study of 22 PCF samples, collected by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), assessed the rheological behavior of PCF and its correlation with lesion type. The dependence of PCF shear viscosity on shear rate was found to follow a power law and could be fitted using Ostwald–de Waele model. Three types of flow curves were identified, where two types correlated with non-mucinous cysts, differing by their power law exponent, and the third type corresponding to mucinous cysts. Viscosity measured at a high shear rate was shown to serve as an accurate and independent marker distinguishing between mucinous and non-mucinous cysts, with an optimal cutoff value of ηc = 1.3 cP The accuracy of this novel technique proved superior to string-sign, cytology, carcinoembryonic antigen, and amylase assessments. Moreover, the combined predictive value of ηc and patient age provided for sensitivity and specificity of 100% and 95.5%, respectively. This simple and rapid diagnostic tool can be immediately implemented after EUS-FNA sampling. PMID:28358122

  6. Endoscopic ultrasound-assisted direct peritoneal visualization with a small-caliber scope: A proof of concept study in a swine model

    PubMed Central

    Suzuki, Rei; Bhutani, Manoop S.; Shin, Dongsuk; Irisawa, Atsushi; Fleming, Jason B.; Richards-Kortum, Rebecca; Ohira, Hiromasa

    2014-01-01

    Background: Laparoscopic and natural orifice transluminal endoscopic surgery techniques can diagnose peritoneal findings that suggest tumor cell dissemination. However, they have not been incorporated into routine practice, mainly owing to their complexity. To develop a minimally invasive endoscopic technique for the diagnosis of peritoneal findings, we conducted feasibility study using an acute swine model. Materials and Methods: This study involved six domestic pigs. Trans-gastric access to the peritoneal cavity was performed utilizing an endoscopic ultrasound fine needle aspiration (EUS-FNA) technique. After dilation of the needle hole with a biliary dilatation catheter and balloon, a small-caliber scope was inserted into the peritoneal cavity. Peritoneal images were obtained with the scope and a high-resolution microendoscope (HRME). Main outcome measurements were technical feasibility and time needed to access the peritoneal cavity. Results: Direct visualization of the peritoneum was successful in all six pigs and gained access to the gross appearance of the peritoneal cavity. HRME imaging with topical contrast agent also obtained reasonable quality images representing nuclei of the peritoneal mesothelium. Average operation time from the initiation of EUS-FNA to acquiring peritoneal images was 26.5 min (range 15-40 min). Autopsy found no damage to the adjacent organs, and stomach wall defects were tightly closed with hemostasis clips. Conclusion: EUS-assisted direct peritoneal visualization with small-caliber scope is technically feasible. HRME may assist in the diagnosis of findings on the peritoneum. PMID:25485270

  7. The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts

    PubMed Central

    Oh, Se Hun; Lee, Jong Kyun; Lee, Kyu Taek; Lee, Kwang Hyuck; Woo, Young Sik; Noh, Dong Hyo

    2017-01-01

    Background/Aims The objective of this study was to investigate the value of cyst fluid carcinoembryonic antigen (CEA) in combination with cytology and viscosity for the differential diagnosis of pancreatic cysts. Methods We retrospectively reviewed our data for patients who underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and cyst fluid analysis. We investigated the sensitivity, specificity and accuracy of the combination of cyst fluid CEA, cytology and viscosity testing. Results A total of 177 patients underwent EUS-FNA and cyst fluid analysis. Of these, 48 subjects were histologically and clinically confirmed to have pancreatic cysts and were therefore included in the analysis. Receiver operator curve analysis demonstrated that the optimal cutoff value of cyst fluid CEA for differentiating mucinous versus nonmucinous cystic lesions was 48.6 ng/mL. The accuracy of cyst fluid CEA (39/48, 81.3%) was greater than the accuracy of cytology (23/45, 51.1%) or the string sign (33/47, 70.2%). Cyst fluid CEA in combination with cytology and string sign assessment exhibited the highest accuracy (45/48, 93.8%). Conclusions Cyst fluid CEA was the most useful single test for identifying mucinous pancreatic cysts. The addition of cytology and string sign assessment to cyst fluid CEA increased the overall accuracy for the diagnosis of mucinous pancreatic cysts. PMID:27609484

  8. Endoscopic ultrasonography for gastric submucosal lesions

    PubMed Central

    Papanikolaou, Ioannis S; Triantafyllou, Konstantinos; Kourikou, Anastasia; Rösch, Thomas

    2011-01-01

    Gastric submucosal tumors (SMTs) are a rather frequent finding, occurring in about 0.36% of routine upper GI-endoscopies. EUS has emerged as a reliable investigative procedure for evaluation of these lesions. Diagnostic Endoscopic ultrasonography (EUS) has the ability to differentiate intramural tumors from extraluminal compressions and can also show the layer of origin of gastric SMTs. Tumors can be further characterized by their layer of origin, echo pattern and margin. EUS-risk criteria of their malignant potential are presented, although the emergence of EUS-guided fne needle aspiration (EUS-FNA) has opened new indications for transmural tissue diagnosis and expanded the possibilities of EUS in SMTs of the stomach. Tissue diagnosis should address whether the SMT is a Gastrointestinal stromal tumour (GIST) or another tumor type and evaluate the malignant potential of a given GIST. However, there seems to be a lack of data on the optimal strategy in SMTs suspected to be GISTs with a negative EUS-FNA tissue diagnosis. The current management strategies, as well as open questions regarding their treatment are also presented. PMID:21772939

  9. Maximizing the endosonography: The role of contrast harmonics, elastography and confocal endomicroscopy

    PubMed Central

    Seicean, Andrada; Mosteanu, Ofelia; Seicean, Radu

    2017-01-01

    New technologies in endoscopic ultrasound (EUS) evaluation have been developed because of the need to improve the EUS and EUS-fine needle aspiration (EUS-FNA) diagnostic rate. This paper reviews the principle, indications, main literature results, limitations and future expectations for each of the methods presented. Contrast-enhanced harmonic EUS uses a low mechanical index and highlights slow-flow vascularization. This technique is useful for differentiating solid and cystic pancreatic lesions and assessing biliary neoplasms, submucosal neoplasms and lymph nodes. It is also useful for the discrimination of pancreatic masses based on their qualitative patterns; however, the quantitative assessment needs to be improved. The detection of small solid lesions is better, and the EUS-FNA guidance needs further research. The differentiation of cystic lesions of the pancreas and the identification of the associated malignancy features represent the main indications. Elastography is used to assess tissue hardness based on the measurement of elasticity. Despite its low negative predictive value, elastography might rule out the diagnosis of malignancy for pancreatic masses. Needle confocal laser endomicroscopy offers useful information about cystic lesions of the pancreas and is still under evaluation for use with solid pancreatic lesions of lymph nodes. PMID:28104978

  10. Undergraduate Women's Gender Awareness and Status Aspirations.

    ERIC Educational Resources Information Center

    Inoue, Yukiko

    A study was conducted to determine women's realization toward the quality of life, identifying their status aspirations. The study's primary purpose was to achieve a better understanding of how undergraduate women of Guam and Japan would aspire to their academic and social goals and how they would become aware of their gender equality. The…

  11. Aspirator increases relief valve poppet stroke

    NASA Technical Reports Server (NTRS)

    Biddle, M. E.

    1967-01-01

    Addition of an aspirator to a relief valve increases the valve poppet stroke under dynamic flow conditions. The aspirator allows poppet inlet dynamic forces to overcome relief valve spring force. It reduces the fluid pressure in the skirt cavity by providing a low pressure sense probe.

  12. Endometrial aspiration cytology in gynecological disorders

    PubMed Central

    Jadhav, Meenal V.; Phatke, Anjali S.; Kadgi, Nalini Vinayak; Rane, Sharda R.; Kulkarni, Kalpana K.

    2016-01-01

    Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP) stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality. PMID:27011435

  13. Gendered Trends in Student Teachers' Professional Aspirations

    ERIC Educational Resources Information Center

    Smith, Joan

    2015-01-01

    The paper reports on a small-scale, exploratory study investigating the professional aspirations of a cohort of student teachers at a UK university. Questionnaires and interviews sought insights into the students' perceptions of leadership, future aspirations and self-perceptions as potential leaders. Whilst there was commonality in male and…

  14. 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 ...

  15. Capital, Agency, Family and the Diaspora: An Exploration of Boys' Aspirations towards Higher Education in Urban Jamaica

    ERIC Educational Resources Information Center

    Stockfelt, Shawanda

    2015-01-01

    The paper discusses factors impacting on boys' educational aspirations at two case-study schools in urban Jamaica. It focuses on boys' experience of their educational environment in relation to social, cultural and economic factors, which shapes the nature of their aspirations towards higher education. The study utilised Bourdieu's notion of…

  16. Primary stentriever versus combined stentriever plus aspiration thrombectomy approaches: in vitro stroke model comparison

    PubMed Central

    Mokin, Maxim; Ionita, Ciprian N; Nagesh, Swetadri Vasan Setlur; Rudin, Stephen; Levy, Elad I; Siddiqui, Adnan H

    2014-01-01

    Background Artificial stroke models can be used for testing various thrombectomy devices. Objective To determine the value of combined stentriever–aspiration thrombectomy compared with the stentriever-alone approach. Methods We designed an in vitro model of the intracranial circulation with a focus on the middle cerebral artery (MCA) that closely resembles the human intracranial circulation. After introducing fresh clot in the MCA, we used conventional biplane angiography and microangiographic fluoroscopy to compare recanalization rates and occurrence of emboli in new, unaffected territory for thrombectomy approaches in which a stentriever (Solitaire flow restoration stentriever, Covidien) was used alone or in combination with continuous manual aspiration through a Navien catheter (Covidien). Results In a total of 22 experiments (11 for each approach), successful clot delivery to the MCA was achieved in all cases. Successful angiographic recanalization (thrombolysis in cerebral infarction score of 2b–3) was achieved more frequently with the combined stentriever–aspiration approach than with the stentriever-alone approach (in 10 vs 4 experiments, p=0.023). Emboli in new territory occurred in three experiments with the stentriever-alone approach, and none were seen with the combined approach (p=0.21). Conclusions The combined stentriever–aspiration approach to thrombectomy leads to better angiographic recanalization rates than use of the stentriever alone. Further experiments are needed to test the value of balloon-guide catheters and aspiration performed using other types of catheters and modes of aspiration. PMID:24789594

  17. Aspiration pneumonia in dogs: pathophysiology, prevention, and diagnosis.

    PubMed

    Schulze, Heidi M; Rahilly, Louisa J

    2012-12-01

    Aspiration pneumonia and aspiration pneumonitis are associated with significant morbidity in veterinary and human medicine. A variety of medical conditions and medications can predispose patients to aspiration, and every precaution should be taken to prevent aspiration from occurring. For dogs that aspirate oral or gastric contents and subsequently develop pneumonia, monitoring and supportive care are imperative. This article discusses the pathophysiology, prevention, and diagnosis of aspiration pneumonia.

  18. Surgical jejunostomy in aspiration risk patients.

    PubMed Central

    Weltz, C R; Morris, J B; Mullen, J L

    1992-01-01

    One hundred patients underwent laparotomy for independent jejunal feeding tube placement. Neurologic disease was present in 50%, and obtundation (28) and oropharyngeal dysmotility (25) were the most common indications for enteral feeding. The post-pyloric route was chosen because of aspiration risk in almost all (94%) patients. Postoperative (30-day) mortality rate was 21%, because of cardiopulmonary failure in most (18). One death resulted directly from aspiration of tube feeds. Two surgical complications required reoperation: one wound dehiscence and one small bowel obstruction. Four wound infections occurred. Two patients underwent reoperation after tube removal, and four tubes required fluoroscopically guided reinsertion for peritubular drainage (2), removal (1), and occlusion (1). Aspiration pneumonia was present in 18 patients preoperatively and in eight postoperatively. None of the patients with feeding-related preoperative aspiration pneumonia (13) had a recurrence while fed by jejunostomy. Three patients developed postoperative aspiration pneumonia before initiation of jejunostomy feedings. Jejunostomy may be performed with low morbidity rate and substantial reduction of feeding-related aspiration pneumonia, and is the feeding route of choice in aspiration risk patients. PMID:1546899

  19. Elemental Diets May Reduce the Risk of Aspiration Pneumonia in Bedridden Gastrostomy-Fed Patients

    PubMed Central

    Horiuchi, Akira; Nakayama, Yoshiko; Sakai, Ryosei; Suzuki, Manabu; Kajiyama, Masashi; Tanaka, Naoki

    2013-01-01

    OBJECTIVES: Our clinical experience suggested that elemental diets were associated with a reduction in aspiration pneumonia among bedridden patients with percutaneous endoscopic gastrostomy (PEG). We compared the effects of elemental and standard liquid diets on the risk of clinical aspiration pneumonia and gastric emptying in bedridden patients receiving PEG feedings. METHODS: Study 1: consecutive bedridden PEG patients received elemental diets or standard liquid diets in the same fashion. The frequency of defecation, diet aspirated from the trachea, and aspiration pneumonia during hospitalization were prospectively recorded. Study 2: a randomized, crossover trial using elemental or standard liquid diets containing 13C sodium acetate as a tracer given to bedridden PEG patients who had experienced aspiration pneumonia. 13C breath tests were performed to estimate gastric emptying. RESULTS: Study 1: 127 patients were enrolled, 60 with elemental and 67 with standard liquid diets. The diet was aspirated from the trachea in none (0%) with the elemental diet vs. 8 (11.9%) with standard liquid diets (P=0.0057); aspiration pneumonia developed none with the elemental diet vs. 5 (7.5%) with standard liquid diets (P=0.031) (number needed to treat 14, 95% confidence interval 7–85). Study 2: 19 patients were enrolled. The elemental diet was associated with a significant increase in the 10, 30 or 50% emptying (excretion) time (P<0.001) and increased the area under the curve (% dose/h) compared with the standard liquid diet (P<0.05). CONCLUSIONS: Elemental diets were associated with more rapid gastric empting and fewer episodes of aspiration than standard liquid diets in bedridden PEG patients. They may be preferred for bedridden PEG patients especially who have experienced aspiration pneumonia. Properly performed randomized-controlled trials are needed to prove this potential benefit. PMID:23399554

  20. Coronary air embolism treated with aspiration catheter

    PubMed Central

    Patterson, M S; Kiemeneij, F

    2005-01-01

    Coronary air embolism remains a recognised complication of coronary catheterisation despite a strong emphasis on prevention. Current treatment consists of supportive measures with 100% oxygen and analgesia. Recent case reports describe the use of mechanical treatments aimed at dispersing or removing the air embolus with variable success. A case of coronary air embolism causing an acute coronary syndrome is described that was definitively treated with an aspiration system. The effectiveness of the aspiration system in the distal section of an obtuse marginal artery indicates that such dedicated aspiration systems may prove useful in the standard treatment of air embolism. PMID:15831621

  1. Coronary air embolism treated with aspiration catheter.

    PubMed

    Patterson, M S; Kiemeneij, F

    2005-05-01

    Coronary air embolism remains a recognised complication of coronary catheterisation despite a strong emphasis on prevention. Current treatment consists of supportive measures with 100% oxygen and analgesia. Recent case reports describe the use of mechanical treatments aimed at dispersing or removing the air embolus with variable success. A case of coronary air embolism causing an acute coronary syndrome is described that was definitively treated with an aspiration system. The effectiveness of the aspiration system in the distal section of an obtuse marginal artery indicates that such dedicated aspiration systems may prove useful in the standard treatment of air embolism.

  2. Healthcare-associated Pneumonia and Aspiration Pneumonia

    PubMed Central

    Komiya, Kosaku; Ishii, Hiroshi; Kadota, Jun-ichi

    2015-01-01

    Healthcare-associated pneumonia (HCAP) is a new concept of pneumonia proposed by the American Thoracic Society/Infectious Diseases Society of America in 2005. This category is located between community-acquired pneumonia and hospital-acquired pneumonia with respect to the characteristics of the causative pathogens and mortality, and primarily targets elderly patients in healthcare facilities. Aspiration among such patients is recognized to be a primary mechanism for the development of pneumonia, particularly since the HCAP guidelines were published. However, it is difficult to manage patients with aspiration pneumonia because the definition of the condition is unclear, and the treatment is associated with ethical aspects. This review focused on the definition, prevalence and role of aspiration pneumonia as a prognostic factor in published studies of HCAP and attempted to identify problems associated with the concept of aspiration pneumonia. PMID:25657850

  3. Aspiration pneumonia in children: an iconographic essay.

    PubMed

    de Oliveira, Gabriel Antonio; Pessanha, Laís Bastos; Guerra, Luiz Felipe Alves; Martins, Diego Lima Nava; Rondina, Ronaldo Garcia; Silva, Jamine Ronacher Passos

    2015-01-01

    In most cases of aspiration pneumonia in children, the disease is specific to this age group. Clinical and radiological correlation is essential for the diagnosis. The present pictorial essay is aimed at showing typical images of the most common etiologies.

  4. To Aspire: A Systematic Reflection on Understanding Aspirations in Higher Education

    ERIC Educational Resources Information Center

    Gale, Trevor; Parker, Stephen

    2015-01-01

    Aspirations for higher education by people from low socioeconomic status backgrounds are now a focus of government policy in many OECD nations. This is part of a global trend emphasizing the perceived benefits of "raising" aspirations among under-represented groups as a social inclusion strategy to widen university participation, but…

  5. Aspirations and Actions: Early Childhood from Policy to Practice in Scotland

    ERIC Educational Resources Information Center

    Dunlop, Aline-Wendy

    2015-01-01

    This paper explores early childhood experience in Scotland in terms of how readily the aspirations of policy convert to day-to-day practices. Ambitions to improve the lives of children and families have been high on the political agenda. Policy may be understood as a tool that aims to influence childhood experience in positive ways. If this is to…

  6. A Challenge to Vocational Psychology: How Important are Aspirations in Determining Career Development?

    ERIC Educational Resources Information Center

    Gottfredson, Linda S.; Becker, Henry J.

    Data on a nationally representative sample of 3730 white men aged 15 to 24 in 1966 were obtained from the National Longitudinal Study of the Labor Market Experience of Young Men. The men were interviewed every year from 1966 to 1971, and the surveys provide data on aspirations and employment experiences for each year. Three variables--job…

  7. Stability analysis of micropipette aspiration of neutrophils.

    PubMed Central

    Derganc, J; Bozic, B; Svetina, S; Zeks, B

    2000-01-01

    During micropipette aspiration, neutrophil leukocytes exhibit a liquid-drop behavior, i.e., if a neutrophil is aspirated by a pressure larger than a certain threshold pressure, it flows continuously into the pipette. The point of the largest aspiration pressure at which the neutrophil can still be held in a stable equilibrium is called the critical point of aspiration. Here, we present a theoretical analysis of the equilibrium behavior and stability of a neutrophil during micropipette aspiration with the aim to rigorously characterize the critical point. We take the energy minimization approach, in which the critical point is well defined as the point of the stability breakdown. We use the basic liquid-drop model of neutrophil rheology extended by considering also the neutrophil elastic area expansivity. Our analysis predicts that the behavior at large pipette radii or small elastic area expansivity is close to the one predicted by the basic liquid-drop model, where the critical point is attained slightly before the projection length reaches the pipette radius. The effect of elastic area expansivity is qualitatively different at smaller pipette radii, where our analysis predicts that the critical point is attained at the projection lengths that may significantly exceed the pipette radius. PMID:10866944

  8. [What is the contribution of aspiration cytology?].

    PubMed

    Pluot, M

    1999-01-01

    Aspiration cytology of thyroid nodules is essentially designed to determine the benign nature of the nodule in order to avoid purely diagnosis surgery. It is reliable in the diagnosis of anaplastic papillary and medullary carcinomas and most lymphomas, but is more problematical for the diagnosis of the benign or malignant nature of Hürthle cell tumours and certain vesicular tumours, in which cytology reveals a suspicious, doubtful or undetermined appearance. However, whether they are unambiguous or doubtful, fine needle aspiration cytology results help the surgeon to define the therapeutic strategy under the best possible conditions. A therapeutic approach is proposed, based on the formulation of aspiration cytology results into benign, malignant, suspicious and inadequate.

  9. [Patient's Risk Factors for Perioperative Aspiration Pneumonia].

    PubMed

    Ishikawa, Teruhiko; Isono, Shiroh

    2016-01-01

    This article reviews patient's own risk factors for perioperative aspiration pneumonia. Maintaining the function of the lower esophageal sphincter (LES), the airway protective reflex, and the oral hygiene are the most important to prevent the pneumonia. The LES is adversely affected by excessive stomach distention, some medication given in perioperative periods, and habitual smoking, as well as pathological status such as esophageal hiatus hernia and achalasia. Postapoplectic patients may have insufficient airway protective reflex including swallowing and laryngeal reflex. It is emphasized that the perioperative oral care is increasing in its importance for the prevention of aspiration pneumonia.

  10. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide

    PubMed Central

    Korkmaz, Levent; Acar, Zeydin; Dursun, İhsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-01-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheters can be used in treating coronary artery fistulae with difficult anotomy. PMID:24748888

  11. Inadequate fine needle aspiration biopsy samples: Pathologists versus other specialists

    PubMed Central

    Gomez-Macías, GS; Garza-Guajardo, R; Segura-Luna, J

    2009-01-01

    Background: Fine needle aspiration biopsy (FNAB) is a simple, sensitive, quick and inexpensive method in which operator experience is essential for obtaining the best results. Methods: A descriptive study in which the aspiration biopsy cases of the Pathology and Cytopathology Service of the University Hospital of the UANL (2003–2005) were analyzed. These were divided into three study groups: Group 1, FNAB performed by a pathologist; Group 2, FNAB performed by specialists who are not pathologists, Group 3, FNAB guided by an imaging study with immediate evaluation by a pathologist. The samples were classified as adequate and inadequate for diagnosis, the organ, the size and characteristics of the lesions were taken into consideration. Results: A total of 1905 FNAB were included. In Group 1: 1347 were performed of which 1242 (92.2%) were adequate and 105 (7.7%) were inadequate. Of the 237 from Group 2, 178 were adequate (75.1%) and 59 inadequate (24.8%); in Group 3 there were 321 of which 283 (88.1%) were adequate and 38 (11.8%) inadequate. A statistically significant difference was found between FNAB performed by Group 1 (p< 0.001) and the other groups. A multivariate analysis was done where the organ punctured, the study groups, the size and characteristics of the lesion by study group were compared, finding that the most important variable was the person who performed the procedure. Conclusion: The experience and training of the person performing the aspiration biopsy, as well as immediate evaluation of the material when it is guided, substantially reduces the number of inadequate samples, improving the sensitivity of the method as well as reducing the need for open biopsies to reach a diagnosis. PMID:19621092

  12. Transthoracic needle aspiration in solitary pulmonary nodule

    PubMed Central

    Yang, Wen; Jiang, Hongli; Khan, Ali Nawaz; Allen, Carolyn; Bertolaccini, Luca

    2017-01-01

    With improved awareness of public health and the recent advances in various imaging technologies, the detection rate of solitary pulmonary nodules (SPN) is continuously increasing. Transthoracic needle aspiration (TTNA) has represented a major approach for the diagnosis and differential diagnosis of pulmonary masses, owing to its simplicity and minimal invasiveness. This paper demonstrates the role of TTNA in SPN. PMID:28331827

  13. Another Opinion No Inspiration, No Aspirations

    ERIC Educational Resources Information Center

    Brown, Donna W.

    2004-01-01

    School library media specialists are the first to witness the malaise that permeates American schools threatening the future of our society. Believing that personal lack of aspirations, our failure to encourage reading for pure enjoyment, and society's disrespect toward education has left a void in our children that is filled with apathy.

  14. Occupational Aspirations and Expectations of Australian Adolescents

    ERIC Educational Resources Information Center

    Patton, Wendy; Creed, Peter

    2007-01-01

    Adolescents across the five years of high school (169 females and 164 males) completed a survey that identified occupational status aspirations and expectations coded into six types-- realistic, investigative, artistic, social, enterprising, or conventional--according to the RIASEC model (Holland, 1997). As the focus of the study was to explore…

  15. Aspiring Girls: Great Expectations or Impossible Dreams?

    ERIC Educational Resources Information Center

    Richards, Gill; Posnett, Carol

    2012-01-01

    This study explores girls' aspirations for their future. The context was an ex-coalmining area where concerns had been raised by the local authority about the levels of girls' achievement. The focus of the research was the views of Year 6 girls as they prepared for their transition to secondary school and Year 11 girls as they prepared for their…

  16. Female Aspirants to the Roman Catholic Priesthood.

    ERIC Educational Resources Information Center

    Celmer, Virginia; Winer, Jane L.

    1990-01-01

    Investigated Holland vocational-personality types, job satisfaction, and psychological dysfunction among 85 parish priests, 55 nonparish priests, and 235 women who aspire to, but are barred from, ordination in the Roman Catholic Church. Found women's Holland-type code was most similar to code of clergy member as assigned by Dictionary of Holland…

  17. The Gap between Aspiration and Practice

    ERIC Educational Resources Information Center

    Tuckett, Alan

    2013-01-01

    At the time of the fifth UNESCO international conference on adult education (CONFINTEA V) in Hamburg in 1997, it seemed that a resilient alliance of governments and civil society organizations had been created. This alliance would have the commitment and cooperation needed to pursue the ambitious aspirations captured in the 10 themes of the…

  18. Aspiration pneumonia in children: an iconographic essay*

    PubMed Central

    de Oliveira, Gabriel Antonio; Pessanha, Laís Bastos; Guerra, Luiz Felipe Alves; Martins, Diego Lima Nava; Rondina, Ronaldo Garcia; Silva, Jamine Ronacher Passos

    2015-01-01

    In most cases of aspiration pneumonia in children, the disease is specific to this age group. Clinical and radiological correlation is essential for the diagnosis. The present pictorial essay is aimed at showing typical images of the most common etiologies. PMID:26811557

  19. Employment, Academic and Extracurricular Contributors to College Aspirations

    ERIC Educational Resources Information Center

    McGaha, Valerie; Fitzpatrick, Jacki

    2010-01-01

    Although there have been many studies on college entrance and aspirations, little attention has been paid to post-high school adults (who enter the workworld rather than college). it is possible that post-high school adults still have college aspirations, and it would be valuable to identify the factors that foster such aspirations. This study…

  20. Place-Based Stewardship Education: Nurturing Aspirations to Protect the Rural Commons

    ERIC Educational Resources Information Center

    Gallay, Erin; Marckini-Polk, Lisa; Schroeder, Brandon; Flanagan, Constance

    2016-01-01

    In this mixed-methods study, we examine the potential of place-based stewardship education (PBSE) for nurturing rural students' community attachment and aspirations to contribute to the preservation of the environmental "commons." Analyzing pre- and post-experience surveys (n = 240) and open-ended responses (n = 275) collected from…

  1. Career Advancement for African American School District Leaders: A Qualitative Study on Aspirations, Barriers, and Trust

    ERIC Educational Resources Information Center

    Robicheau, Jerry; Krull, Melissa

    2016-01-01

    In this article, the authors describe the use of phenomenology and thematic analysis to interpret raw data from interviews about the lived experiences of urban and suburban school African American administrators aspiring to the superintendency or another advanced school administrative position. The authors present overarching themes that capture…

  2. Positioning Oneself for Leadership: Feelings of Vulnerability among Aspirant School Principals

    ERIC Educational Resources Information Center

    Gronn, Peter; Lacey, Kathy

    2004-01-01

    The research context for this article is the difficulty being experienced by a number of school systems, especially in the UK, USA, Canada and Australia, in recruiting principals. In our discussion we draw on preliminary findings from ongoing research into the experiences of a cohort of aspiring primary and secondary school principals. Our data…

  3. Mini-aspirator: A new device for collection and transfer of small arthropods to plants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The process of collecting and/or infesting plants with a designated number of small arthropods in biological experiments is tedious and laborious. We developed a modified mini-aspirator, powered with a vacuum pump and fitted with a specially adapted (removeable) collecting vial to reduce the handli...

  4. How Religious, Social, and Cultural Capital Factors Influence Educational Aspirations of African American Adolescents

    ERIC Educational Resources Information Center

    Al-Fadhli, Hussain M.; Kersen, Thomas Michael

    2010-01-01

    Data from 2008 Monitoring the Future were used to test how well religious, family, and cultural social capital influenced 8th and 10th grade student aspirations, future plans, and prior academic experience. This study focused only on a sample of 4,273 African American students. Results indicated a strong association between family social capital…

  5. A Novel Approach for Performing Bone Marrow Aspiration at the Time of Radical Prostatectomy

    PubMed Central

    Tosoian, Jeffrey J.; Reyes, Diane K.; Gorin, Michael A.; Hortopan, Steven; Partin, Alan W.; Pienta, Kenneth J.; Ross, Ashley E.; Schaeffer, Edward M.

    2016-01-01

    The bone marrow microenvironment represents a “metastatic niche” in which prostate cancer cells may persist and evade cytotoxic therapy. In order to study the biology of prostate cancer dissemination, we have established a safe and efficient method for performing pubic bone marrow aspiration at the time of radical prostatectomy. We herein describe our experience with this technique. PMID:27175343

  6. A Novel Approach for Performing Bone Marrow Aspiration at the Time of Radical Prostatectomy.

    PubMed

    Tosoian, Jeffrey J; Reyes, Diane K; Gorin, Michael A; Hortopan, Steven; Partin, Alan W; Pienta, Kenneth J; Ross, Ashley E; Schaeffer, Edward M

    2016-05-01

    The bone marrow microenvironment represents a "metastatic niche" in which prostate cancer cells may persist and evade cytotoxic therapy. In order to study the biology of prostate cancer dissemination, we have established a safe and efficient method for performing pubic bone marrow aspiration at the time of radical prostatectomy. We herein describe our experience with this technique.

  7. There's No Place Like Home? The Effects of Childhood Themes on Women's Aspirations toward Leadership Roles

    ERIC Educational Resources Information Center

    Wojtalik, Janet R.; Breckenridge, Mary B.; Gibson Hancox, Melissa K.; Sobehart, Helen C.

    2007-01-01

    This qualitative study explores the impact of childhood themes on women's aspirations toward leadership as suggested by the Eccles Model of Achievement Related Choices. Using intensity sampling, the research solicits childhood gender-related experiences of women in leadership and non-leadership roles through interviews, focus groups, check lists,…

  8. Science Dual Enrollment: An Examination of High School Students' Post-Secondary Aspirations

    ERIC Educational Resources Information Center

    Berry, Chelsia

    2015-01-01

    The purpose of this study was to determine if participation in science dual enrollment courses influenced African American high school students' post-secondary aspirations that will lead to college attendance. The investigation examined the relationship between African American students' learning experiences and how their self-efficacy and outcome…

  9. Bright Futures in Malawi’s New Dawn: Educational Aspirations as Assertions of Identity1

    PubMed Central

    Frye, Margaret

    2013-01-01

    Imagined futures, once a vital topic of theoretical inquiry within the sociology of culture, have been sidelined in recent decades. Rational choice models cannot explain the seemingly irrational optimism of youth aspirations, pointing to the need to explore other alternatives. This article incorporates insights from pragmatist theory and cognitive sociology to examine the relationship between imagined futures and present actions and experiences in rural Malawi, where future optimism appears particularly unfounded. Drawing from in-depth interviews and archival sources documenting ideological campaigns promoting schooling, the author shows that four elements are understood to jointly produce educational success: ambitious career goals, sustained effort, unflagging optimism, and resistance to temptation. Aspirations should be interpreted not as rational calculations, but instead as assertions of a virtuous identity, claims to be “one who aspires.” PMID:23645932

  10. 78 FR 52929 - Scientific Information Request on Imaging Tests for the Diagnosis and Staging of Pancreatic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ..., PET-CT, MRI) for diagnosis of pancreatic adenocarcinoma in adults with suspicious symptoms? a. What is... effectiveness of imaging techniques (e.g., MDCT angiography 3D reconstruction, other MDCT, EUS-FNA, PET-CT, MRI..., EUS-FNA, PET- CT, MRI) when used to diagnose and/or stage pancreatic adenocarcinoma? a. How...

  11. Intrapancreatic Accessory Spleen: A Diagnosis Not to Forget!

    PubMed Central

    Marques, Susana; Bispo, Miguel; Noia, Lariño

    2016-01-01

    A 69-year-old male patient was incidentally diagnosed with a 5-mm lesion in the pancreatic tail by endoscopic ultrasound (EUS). After contrast-enhanced EUS and EUS-elastography, all imaging features were highly suggestive of a benign pancreatic solid lesion such as an intrapancreatic accessory spleen (IPAS) or a benign neuroendocrine tumor. Interposition of the splenic artery precluded EUS-guided fine-needle aspiration (FNA). When an asymptomatic pancreatic mass is detected, IPAS diagnosis should be considered, and, if EUS-FNA is infeasible, contrast-enhanced EUS and EUS-elastography are useful tools to differentiate a pancreatic benign lesion as IPAS from a malignancy, with avoidance of unnecessary surgery. PMID:28100996

  12. Role of contrast-enhanced endoscopic ultrasound in lymph nodes

    PubMed Central

    Hocke, Michael; Ignee, Andre; Dietrich, Christoph

    2017-01-01

    Diagnosing unclear lymph node (LN) enlargements in the mediastinum and abdomen is the most important indication of endoscopic ultrasound (EUS)-fine needle aspiration (FNA) after the diagnosis and treatment of pancreatic diseases. Investigating LNs in these areas can happen in different clinical settings. Mostly, it is the first modality in general LN diseases without any peripheral LN enlargements. On the other hand, it can be the question of LN involvement in a known or suspected primary tumor. Due to EUS-FNA cytology, those questions can be answered highly, accurately. However, a primary discrimination of LNs might be helpful to increase the diagnostic value of the FNA cytology, especially in cases with multiple LN enlargements and hard to reach enlarged LNs for example by vessel interposition. Because of the unreliability of B-mode criteria, further diagnostic improvements such as elastography and contrast-enhanced EUS are investigated to increase the accuracy of the initial diagnosis. PMID:28218194

  13. Integration of single-fiber reflectance spectroscopy into ultrasound-guided endoscopic lung cancer staging of mediastinal lymph nodes.

    PubMed

    Kanick, Stephen Chad; van der Leest, Cor; Aerts, Joachim G J V; Hoogsteden, Henk C; Kascáková, Slávka; Sterenborg, Henricus J C M; Amelink, Arjen

    2010-01-01

    We describe the incorporation of a single-fiber reflectance spectroscopy probe into the endoscopic ultrasound fine-needle aspiration (EUS-FNA) procedure utilized for lung cancer staging. A mathematical model is developed to extract information about the physiological and morphological properties of lymph tissue from single-fiber reflectance spectra, e.g., microvascular saturation, blood volume fraction, bilirubin concentration, average vessel diameter, and Mie slope. Model analysis of data from a clinical pilot study shows that the single-fiber reflectance measurement is capable of detecting differences in the physiology between normal and metastatic lymph nodes. Moreover, the clinical data show that probe manipulation within the lymph node can perturb the in vivo environment, a concern that must be carefully considered when developing a sampling strategy. The data show the feasibility of this novel technique; however, the potential clinical utility has yet to be determined.

  14. Complications of endoscopic ultrasonography.

    PubMed

    Fabbri, C; Luigiano, C; Cennamo, V; Ferrara, F; Pellicano, R; Polifemo, A M; Tarantino, I; Barresi, L; Morace, C; Consolo, P; D'Imperio, N

    2011-06-01

    Since its development in the 1980s, endoscopic ultrasonography (EUS) has undergone a great deal of technological modifications. EUS has become an important tool in the evaluation of patients with various clinical disorders and is increasingly being utilized in many centers. EUS has been evolving over the years; EUS-guided fine needle aspiration (FNA) for cytological and/or histological diagnosis has become standard practice and a wide array of interventional and therapeutic procedures are performed under EUS guidance for diseases which otherwise would have needed surgery, with its associated morbidities. EUS shares the risks and complications of other endoscopic procedures. This article addresses the specific adverse effects and risks associated with EUS, EUS-FNA and interventional EUS, namely perforation, bleeding, pancreatitis and infection. Measures to help minimizing these risks will also be discussed.

  15. In vivo cytological observation of liver and spleen by using high-resolution microendoscopy system under endoscopic ultrasound guidance: A preliminary study using a swine model

    PubMed Central

    Suzuki, Rei; Shin, Dongsuk; Richards-Kortum, Rebecca; Coghlan, Lezlee; Bhutani, Manoop S.

    2016-01-01

    Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is useful to obtain specimens from lesions underlying deep parts of the liver and spleen. However, the development of novel ancillary techniques must be explored to reduce the number of needle passes and potential adverse effects during this procedure. We conducted an animal study using a swine to demonstrate technical feasibility of in vivo cytological observation of liver and spleen using the high-resolution microendoscopy (HRME) system under EUS guidance. We successfully performed the study. No significant acute adverse events occurred during the procedure. The HRME system could obtain clear images representing cytology-level morphology of spleen and liver. Hence, it is found out that in vivo cytological observation of liver and spleen using the HRME system under EUS guidance is technically feasible. PMID:27503155

  16. Integration of single-fiber reflectance spectroscopy into ultrasound-guided endoscopic lung cancer staging of mediastinal lymph nodes

    NASA Astrophysics Data System (ADS)

    Kanick, Stephen Chad; van der Leest, Cor; Aerts, Joachim G. J. V.; Hoogsteden, Henk C.; Kaščáková, Slávka; Sterenborg, Henricus J. C. M.; Amelink, Arjen

    2010-01-01

    We describe the incorporation of a single-fiber reflectance spectroscopy probe into the endoscopic ultrasound fine-needle aspiration (EUS-FNA) procedure utilized for lung cancer staging. A mathematical model is developed to extract information about the physiological and morphological properties of lymph tissue from single-fiber reflectance spectra, e.g., microvascular saturation, blood volume fraction, bilirubin concentration, average vessel diameter, and Mie slope. Model analysis of data from a clinical pilot study shows that the single-fiber reflectance measurement is capable of detecting differences in the physiology between normal and metastatic lymph nodes. Moreover, the clinical data show that probe manipulation within the lymph node can perturb the in vivo environment, a concern that must be carefully considered when developing a sampling strategy. The data show the feasibility of this novel technique; however, the potential clinical utility has yet to be determined.

  17. Risk and outcome of aspiration pneumonia in a city hospital.

    PubMed Central

    Jones, J.

    1993-01-01

    Because aspiration pneumonia contributes significantly to morbidity and mortality in hospitalized patients, this study was undertaken to identify risk factors for morbidity and mortality associated with aspiration pneumonia. Patients with a discharge diagnosis of aspiration pneumonia in 1985 and 1990 were studied. Factors associated with death from aspiration pneumonia were: altered mental status, cerebrovascular accident, endotracheal intubation, tachycardia, and hypoxemia. Fever, cough, and unilateral infiltrates on chest radiograph were associated with survival. Attention to proper positioning of comatose patients, aggressive treatment of gastroesophageal reflux, and strict attention to endotracheal tubes and tracheostomies should decrease the morbidity and mortality associated with aspiration pneumonia. PMID:8350375

  18. Ultrasonic gas alloy atomization under near-zero aspiration pressure

    NASA Astrophysics Data System (ADS)

    Yan, Pengfei; Wang, Deping; Yan, Biao

    2015-04-01

    In this paper, ultrasonic gas atomization (USGA) of Zn-Al under near-zero aspiration pressure was discussed. The protrusion length of delivery tube was modified to adjust the aspiration pressure. Under near-zero aspiration pressure, melt filming was observed by camera and more fine powders were produced. While under larger subambient aspiration pressure, melt filming was unavailable, corresponding to less fine powders. The results suggest that the position of the wake near the delivery tube can be optimized under near-zero aspiration. Less protrusion of delivery tube reduces the energy loss in gas flow deflection. Both facilitate to produce finer powders.

  19. Dysphagia, dystussia, and aspiration pneumonia in elderly people.

    PubMed

    Ebihara, Satoru; Sekiya, Hideki; Miyagi, Midori; Ebihara, Takae; Okazaki, Tatsuma

    2016-03-01

    Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly people and mouse lung. These observations suggest the need for a paradigm shift of the treatment for pneumonia in the elderly. Since aspiration pneumonia is fundamentally based on dysphagia, we should shift the therapy for aspiration pneumonia from pathogen-oriented therapy to function-oriented therapy. Function-oriented therapy in aspiration pneumonia means therapy focusing on slowing or reversing the functional decline that occurs as part of the aging process, such as "dementia → dysphagia → dystussia → atussia → silent aspiration". Atussia is ultimate dysfunction of cough physiology, and aspiration with atussia is called silent aspiration, which leads to the development of life-threatening aspiration pneumonia. Research pursuing effective strategies to restore function in the elderly is warranted in order to decrease pneumonia deaths in elderly people.

  20. Clinical utility of head and neck aspiration cytology.

    PubMed

    Karayianis, S L; Francisco, G J; Schumann, G B

    1988-01-01

    Over the past 3.5 yr, we have examined 195 head and neck fine-needle aspiration (FNA) specimens from three diverse medical settings. Specimens were collected in saline solution or Saccomanno fixative and processed using cytocentrifugation or membrane filtration. This allowed us simultaneously to perform cytologic evaluations, special stains, and immunologic marker studies from a single specimen. Good correlation between clinical experience with FNA and obtaining satisfactory specimens was demonstrated. Our sensitivity (89%) and specificity (94%) reflect problems associated with specimen collection in a training environment where clinician experience with the procedure is low. A definitive diagnosis was possible in most cases, and the treatment plan was often based on the FNA results. In patients without a history of a primary malignancy, a FNA done early in the clinical course helped direct the initial workup of the patient, saving time and expense.

  1. Meconium aspiration syndrome: possible pathophysiological mechanisms and future potential therapies.

    PubMed

    Lindenskov, Paal Helge Haakonsen; Castellheim, Albert; Saugstad, Ola Didrik; Mollnes, Tom Eirik

    2015-01-01

    Does meconium cause meconium aspiration syndrome (MAS) or is meconium discharge only a marker of fetal hypoxia? This dispute has lasted for centuries, but since the 1960s, detrimental effects of meconium itself on the lungs have been demonstrated in animal experiments. In clinical MAS, persistent pulmonary hypertension of the newborn is the leading cause of death in MAS. Regarding the complex chemical composition of meconium, it is difficult to identify a single agent responsible for the pathophysiology. However, considering that meconium is stored in the intestines, partly unexposed to the immune system, aspirated meconium could be recognized as ‘danger', representing damaged self. The common denominator in the pathophysiology could therefore be activation of innate immunity. Thus, a bulk of evidence implies that meconium is a potent activator of inflammatory mediators, including cytokines, complement, prostaglandins and reactive oxygen species. We hypothesize that the two main recognition systems of innate immunity, the Toll-like receptors and the complement system, recognize meconium as ‘danger', which leads not only to lung dysfunction but also to a systemic inflammatory response. This might have therapeutic implications in the future.

  2. Facial Blast Injury Resulting in Sand Aspiration

    DTIC Science & Technology

    2009-01-01

    recent case of a blast-injury survivor in Iraq with findings consistent with sand aspiration on computed tomography (CT) and review presentation...which may contain material such as calcium carbonate or aluminum silicate, produces characteristic findings on both computed tomography (CT) and...extubated. On hospital day 2, copious thick fluid described as “muddy” was suctioned from the respiratory tract, at which time a well tolerated

  3. Role of biochemistry and cytological analysis of cyst fluid for the differential diagnosis of pancreatic cysts

    PubMed Central

    Soyer, Ozlem Mutluay; Baran, Bulent; Ormeci, Asli Ciftcibasi; Sahin, Davut; Gokturk, Suut; Evirgen, Sami; Basar, Rafet; Firat, Pinar; Akyuz, Filiz; Demir, Kadir; Besisik, Fatih; Kaymakoglu, Sabahattin; Karaca, Cetin

    2017-01-01

    Abstract Background: Management of pancreatic cysts is based on neoplastic–nonneoplastic discrimination. Endoscopic ultrasound (EUS) enables to differentiate neoplastic–nonneoplastic lesions and also allows fine-needle aspiration (FNA). In this study, we aim to assess feasibility and clinical relevance of cytological and biochemical analysis in differential diagnosis of cystic pancreatic lesions in patients who had undergone endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) due to pancreatic cysts. Methods: Participants were 96 patients who had undergone EUS-FNA for differential diagnosis of pancreatic cysts. Pancreatic cysts were classified as benign-mucinous, nonmucinous, and malignant according to patient history, physical examination, EUS appearance, and cystic fluid assessment. Tumor markers (CEA, CA(cancer antigens) 72.4, CA 19-9) , amylase, lipase and cytological assesment were compared between 3 different groups. Receiver-operating characteristics (ROC) curves were constructed to identify appropriate cut-off values. Results: Fluid CEA and CA 72.4 levels for benign-mucinous and malignant cysts were significantly higher than for nonmucinous cysts (P ≤ 0.04). A cut-off CEA level of 207 ng/mL differentiated mucinous etiology with a sensitivity of 72.7%, specificity of 97.7%, and accuracy of 89.5%. The sensitivity, specificity, and accuracy of the CA 72.4 cut-off level of 3.32 ng/mL were 80%, 69.5%, and 73.6%, respectively. Conclusion: Cyst fluid CEA and CA 72.4 levels have a high accuracy in discriminating mucinous from nonmucinous cysts. When combined with cytology their accuracy rate increases. PMID:28072692

  4. Percutaneous gallbladder aspiration for acute cholecystitis

    PubMed Central

    Rassameehiran, Supannee; Nugent, Kenneth

    2016-01-01

    Early cholecystectomy for patients with acute cholecystitis may not be possible in some clinical settings. Percutaneous gallbladder aspiration (PGBA) offers an alternative approach, but the benefits and risks of this procedure are unclear. We synthesized data on the outcomes of PGBA in acute cholecystitis patients using data sources from online databases, including MEDLINE and EMBASE, and bibliographies of included studies from January 2000 through December 2015. Two reviewers independently reviewed and critiqued the quality of each study. Seven eligible studies met our criteria. The success rates in single PGBA and repetitive PGBA (2–4 times) were 50% to 93% and 76% to 96%, respectively. Complication rates were 0% to 8% and were unrelated to the size of needle gauge used for aspiration and the number of aspirations. Salvage percutaneous cholecystostomy (PC) and urgent surgery were required in 0% to 43% of patients and 0% to 4% of patients, respectively. Two studies with antibiotic instillation had clinical success rates of 95% and 96%. In conclusion, repetitive PGBA combined with antibiotic instillation and salvage PC are useful alternatives to early cholecystectomy in patients with acute cholecystitis. PMID:27695167

  5. "I Was Told It Was Going to Be Hard Work but I Wasn't Told It Was Going to Be This Much Work": The Experiences and Aspirations of Undergraduate Science Students

    ERIC Educational Resources Information Center

    Smith, Emma; Cooke, Sandra

    2011-01-01

    The recruitment and training of scientists is an area of international concern. Much of the research and policy focus around this issue in the UK has been on how science is taught in schools and in particular on the structure of the school science curriculum. Much less attention has been devoted to the undergraduate student experience and the…

  6. Therapeutic Endoscopy Can Be Performed Safely in an Ambulatory Surgical Center: A Multicenter, Prospective Study

    PubMed Central

    Ho, Henry C.; Gaughan, John P.; Elfant, Adam B.

    2016-01-01

    Background. Even amongst experienced endoscopists, endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound with fine needle aspiration (EUS-FNA) carry a potential risk for complications. These procedures are typically performed in a hospital-based endoscopy unit with general anesthesia. Aims. The goal of our study was to evaluate the feasibility of ERCP and EUS-FNA in an ambulatory surgical center (ASC). Methods. From June to November of 2014, we prospectively enrolled consecutive subjects undergoing ERCP and/or EUS-FNA in an ASC. An anesthesiologist, who was not involved in our study group, screened all subjects prior to their scheduled procedure. In order to monitor for adverse events (AE), all subjects received a telephone call at day 1 and 30 days after procedure. Results. 375 subjects (98 inpatients and 277 from an ASC) were enrolled. In the total population, a high proportion of subjects underwent procedures for neoplasms (21 (23.3%) inpatients versus 44 (17.1%) from an ASC) and for sphincter of Oddi dysfunction (SOD) (27 (27.5%) versus 48 (17.3%)) and had the American Society for Anesthesiologists (ASA) class ≥III (75 (76.5%) versus 140 (50.5%)) and high-risk features (17 (17.3%) versus 75 (27.1%)). Overall ERCP-related AE (10 (13.2%) versus 12 (7.5%), p = 0.2), pancreatitis (7 (9.2%) versus 11 (6.9%), p = 0.6), and hemorrhage (3.9% versus 0.6%, p = 0.25) were not different between inpatients and ASC subjects. There was also no difference between inpatients and ASC subjects' EUS-related AE (1 (4.5%) versus 4 (3.4%), p = 0.6), pancreatitis (1 (4.5%) versus 3 (2.6%), p = 0.2), and hemorrhage (0% versus 1 (0.9%), p = 0.9). Conclusions. ERCP and EUS can be performed in a higher risk population under the supervision of anesthesia in ASCs. Overall, the AE are equivalent between inpatients and ASC subjects. PMID:27840569

  7. Therapeutic Endoscopy Can Be Performed Safely in an Ambulatory Surgical Center: A Multicenter, Prospective Study.

    PubMed

    Mok, Shaffer R S; Ho, Henry C; Gaughan, John P; Elfant, Adam B

    2016-01-01

    Background. Even amongst experienced endoscopists, endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound with fine needle aspiration (EUS-FNA) carry a potential risk for complications. These procedures are typically performed in a hospital-based endoscopy unit with general anesthesia. Aims. The goal of our study was to evaluate the feasibility of ERCP and EUS-FNA in an ambulatory surgical center (ASC). Methods. From June to November of 2014, we prospectively enrolled consecutive subjects undergoing ERCP and/or EUS-FNA in an ASC. An anesthesiologist, who was not involved in our study group, screened all subjects prior to their scheduled procedure. In order to monitor for adverse events (AE), all subjects received a telephone call at day 1 and 30 days after procedure. Results. 375 subjects (98 inpatients and 277 from an ASC) were enrolled. In the total population, a high proportion of subjects underwent procedures for neoplasms (21 (23.3%) inpatients versus 44 (17.1%) from an ASC) and for sphincter of Oddi dysfunction (SOD) (27 (27.5%) versus 48 (17.3%)) and had the American Society for Anesthesiologists (ASA) class ≥III (75 (76.5%) versus 140 (50.5%)) and high-risk features (17 (17.3%) versus 75 (27.1%)). Overall ERCP-related AE (10 (13.2%) versus 12 (7.5%), p = 0.2), pancreatitis (7 (9.2%) versus 11 (6.9%), p = 0.6), and hemorrhage (3.9% versus 0.6%, p = 0.25) were not different between inpatients and ASC subjects. There was also no difference between inpatients and ASC subjects' EUS-related AE (1 (4.5%) versus 4 (3.4%), p = 0.6), pancreatitis (1 (4.5%) versus 3 (2.6%), p = 0.2), and hemorrhage (0% versus 1 (0.9%), p = 0.9). Conclusions. ERCP and EUS can be performed in a higher risk population under the supervision of anesthesia in ASCs. Overall, the AE are equivalent between inpatients and ASC subjects.

  8. Dysphagia, dystussia, and aspiration pneumonia in elderly people

    PubMed Central

    Sekiya, Hideki; Miyagi, Midori; Ebihara, Takae; Okazaki, Tatsuma

    2016-01-01

    Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly people and mouse lung. These observations suggest the need for a paradigm shift of the treatment for pneumonia in the elderly. Since aspiration pneumonia is fundamentally based on dysphagia, we should shift the therapy for aspiration pneumonia from pathogen-oriented therapy to function-oriented therapy. Function-oriented therapy in aspiration pneumonia means therapy focusing on slowing or reversing the functional decline that occurs as part of the aging process, such as “dementia → dysphagia → dystussia → atussia → silent aspiration”. Atussia is ultimate dysfunction of cough physiology, and aspiration with atussia is called silent aspiration, which leads to the development of life-threatening aspiration pneumonia. Research pursuing effective strategies to restore function in the elderly is warranted in order to decrease pneumonia deaths in elderly people. PMID:27076964

  9. Importance of diffuse aspiration bronchiolitis caused by chronic occult aspiration in the elderly.

    PubMed

    Matsuse, T; Oka, T; Kida, K; Fukuchi, Y

    1996-11-01

    Diffuse aspiration bronchiolitis (DAB) is a new term that we proposed to define a clinical entity that is characterized by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles. In the present study, a total of 4,880 consecutive autopsies were reviewed and we found 31 patients with DAB (0.64%). To investigate the clinicopathologic features of DAB, the 23 patients with DAB (age, 81.2 +/- 6.2 years [mean +/- SD]), from whom clinical information was available, had their features compared to those of 40 randomly selected patients with aspiration pneumonia (age, 81.9 +/- 8.3 years [mean +/- SD]). Oropharyngeal dysphagia was observed in half of the patients with DAB, and two thirds of patients with DAB were bedridden. The onset of DAB was more insidious than aspiration pneumonia, and in half of the patients with DAB episodes of aspiration were unrecognized. Neurologic disorders (52.2%) and dementia (47.8%) were common associated diseases. Most patients with DAB showed signs of bronchorrhea, bronchospasm, and dyspnea. The macroscopic appearance of the cut surface of DAB lung showed diffusely scattered miliary yellowish nodules that resembled those of diffuse panbronchiolitis (DPB). Histologic findings of DAB were characterized by localization of chronic mural inflammation with foreign body reaction in bronchioles. Recurrence of small amounts of aspiration might play a role in the pathogenesis of DAB. In view of possible therapeutic intervention, we emphasized the importance of recognizing this entity and differentiating DAB from pulmonary diseases associated with bronchospasm in the elderly, in particular, late-onset asthma and DPB.

  10. The Difference between Ideal and Actual Fasting Duration in the Treatment of Patients with Aspiration Pneumonia: A Nationwide Survey of Clinicians in Japan.

    PubMed

    Kenzaka, Tsuneaki; Kosami, Koki; Matsuoka, Yasufumi; Noda, Ayako; Kumabe, Ayako

    2016-01-01

    In Japan, aspiration pneumonia is common among the elderly and patients are often treated by temporary discontinuation of meals. However, there are few published studies on the fasting duration for aspiration pneumonia treatment. Therefore, we conducted the present study to assess the opinions of clinicians regarding the fasting duration for the treatment of patients with aspiration pneumonia and the actual medical practice with regard to oral ingestion in hospitalized patients with aspiration pneumonia. We targeted hospitals with internal medicine and respiratory medicine departments across Japan. A questionnaire regarding the fasting duration for aspiration pneumonia treatment and oral ingestion in hospitalized patients with aspiration pneumonia was mailed to physicians treating patients with pneumonia at 2,490 hospitals. We received appropriate responses from 350 facilities (response rate, 14.1%). Most clinicians (78.3%) responded that it best to keep the fasting duration for treatment as short as possible and considered that fasting is absolutely unnecessary. Regarding oral ingestion in hospitalized patients, more than 25% of clinicians restricted oral intake for a certain number of days. The majority of these clinicians (53.3%) preferred prolonged fasting for 3 to 7 days. Although most physicians preferred the fasting duration to be as short as possible, there was a difference between the ideal and actual scenarios in reintroducing oral intake early in patients with aspiration pneumonia. Improving physicians' knowledge and experience will bridge the gap between the ideal situation and what currently occurs. Further studies should investigate the acceptable fasting duration for the treatment of aspiration pneumonia.

  11. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students

    PubMed Central

    Cruwys, Tegan

    2015-01-01

    A paradox exists in modern schooling: students are simultaneously more positive about the future and more depressed than ever. We suggest that these two phenomena may be linked. Two studies demonstrated that students are more likely to be depressed when educational aspirations exceed expectations. In Study 1 (N = 85) aspiring to a thesis grade higher than one expected predicted greater depression at the beginning and end of the academic year. In Study 2 (N = 2820) aspiring to a level of education (e.g., attending college) higher than one expected to achieve predicted greater depression cross-sectionally and five years later. In both cases the negative effects of aspiring high while expecting low persisted even after controlling for whether or not students achieved their educational aspirations. These findings highlight the danger of teaching students to aspire higher without also investing time and money to ensure that students can reasonably expect to achieve their educational goals. PMID:26352151

  12. The use of oxytocin in nipple fluid aspiration.

    PubMed

    Zhang, Liping; Shao, Zhi-Ming; Beatty, Perrin; Sartippour, Maryam; Wang, He-Jing; Elashoff, Robert; Chang, Helena; Brooks, Mai N

    2003-01-01

    It has been shown that early detection of breast cancer saves lives. Recently there has been increasing interest in nipple aspirate fluid as a potential avenue for breast cancer diagnosis. One major challenge regarding studies of nipple aspirate fluid is the ability to obtain adequate samples. Here we describe the use of nasal oxytocin in a group of volunteer women in order to increase the yield of nipple aspirate fluid.

  13. [An Overview of Incidence and Outcome of Perioperative Pulmonary Aspiration].

    PubMed

    Nakazawa, Koichi; Shinoda, Ken

    2016-01-01

    Examination of the literature suggests that the incidence of aspiration pneumonia in the perioperative period is relatively infrequent. Since Mendelson's report of aspiration pneumonitis in 1946, the factors that contribute to the likelihood of aspiration have been identified, and numerous attempts for preventions for regurgitation or pulmonary aspiration have been made. The low incidence of major morbidity of anesthesia-related pulmonary aspiration may be due to adopting quality measures, applying practice guidelines for preoperative fasting, and the use of pharmacologic agents to reduce the risk of pulmonary aspiration. More systematic preoperative checking and more careful selection of patients are necessary when a supraglottic airway is used in preference to a tracheal tube. Second generation supraglottic airways may not reduce the risk of regurgitation, but may reduce the chance of aspiration if the mask position is correct and drain tube works well. Because the mortality and morbidity of aspiration pneumonia remain relatively high, the preoperative risk evaluation is very important to avoid regurgitation or aspiration.

  14. Effects of aspiration on fundamental frequency in Taiwanese syllables

    NASA Astrophysics Data System (ADS)

    Lai, Yuwen; Jongman, Allard

    2005-04-01

    The perturbation effect on vowel fundamental frequency (F0) by voiceless aspirated and unaspirated prevocalic obstruents is investigated in Taiwanese. It is well known that F0 is significantly higher after voiceless than voiced stops. However, the perturbation effect caused by aspiration has received much less attention. Twenty-eight minimal pairs contrasting in prevocalic aspiration across three different places of articulation from seven tonal categories in Taiwanese were recorded from two male and two female speakers. An acoustic study was conducted on a total of 1120 syllables. Onset, offset, and mean F0 as well as contours of the tones after the aspirated and unaspirated obstruents were compared. Results indicate that the onset and mean F0 are significantly higher when following aspirated obstruents but no difference was found in offset F0. Tonal contour comparison shows that the F0 raising effect triggered by aspirated obstruents disappears at 50-60% of the tone. Higher larynx and faster airflow rate are posited as the major factors for the higher F0 after voiceless aspirated obstruents. The present results warrant a reconsideration of the traditional theory of aspiration-induced tonal split according to which a tonal split resulted from the lowering of F0 due to aspiration.

  15. Silent aspiration detection by breath and swallowing sound analysis.

    PubMed

    Sarraf Shirazi, Samaneh; Moussavi, Zahra

    2012-01-01

    Detecting aspiration after swallows (the entry of bolus into trachea) is often a difficult task particularly when the patient does not cough; those are called silent aspiration. In this study, the application of acoustical analysis in detecting silent aspiration is investigated. We recorded the swallowing and the breath sounds of 10 individuals with swallowing disorders, who demonstrated silent aspiration during the fiberoptic endoscopic evaluation of swallowing (FEES) assessment. We analyzed the power spectral density (PSD) of the breath sound signals following each swallow; the PSD showed higher magnitude at low frequencies for the breath sounds following an aspiration. Therefore, we divided the frequency range below 300 Hz into 3 sub-bands, over which we calculated the average power as the characteristic features for the classification purpose. Then, the fuzzy k-means unsupervised classification method was deployed to find the two clusters in the data set: the aspirated and non-aspirated groups. The results were evaluated using the FEES assessments provided by the speech language pathologists. The results show 82.3% accuracy in detecting swallows with silent aspiration. Although the proposed method should be verified on a larger dataset, the results are promising for the use of acoustical analysis as a clinical tool to detect silent aspiration.

  16. Aspirations langagieres: Negociation et apprentissage du francais (Language Aspirations: Negotiation and Learning French).

    ERIC Educational Resources Information Center

    Lepetit, Daniel; Cichocki, Wladyslaw

    1990-01-01

    A survey of 130 beginning French students at the University of Windsor (Canada) focused on their second language aspirations, expectations, and anticipated needs. Interpersonal relations appear to be the primary motivator, with travel and instrumental motivation secondary. (20 references) (Author/MSE)

  17. Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty.

    PubMed

    Porter, Ryan M; Liu, Fangjun; Pilapil, Carmencita; Betz, Oliver B; Vrahas, Mark S; Harris, Mitchel B; Evans, Christopher H

    2009-01-01

    Intramedullary nailing preceded by canal reaming is the current standard of treatment for long-bone fractures requiring stabilization. However, conventional reaming methods can elevate intramedullary temperature and pressure, potentially resulting in necrotic bone, systemic embolism, and pulmonary complications. To address this problem, a reamer irrigator aspirator (RIA) has been developed that combines irrigation and suction for reduced-pressure reaming with temperature modulation. Osseous particles aspirated by the RIA can be recovered by filtration for use as an autograft, but the flow-through is typically discarded. The purpose of this study was to assess whether this discarded filtrate has osteogenic properties that could be used to enhance the total repair potential of aspirate. RIA aspirate was collected from five patients (ages 71-78) undergoing hip hemiarthroplasty. Osseous particles were removed using an open-pore filter, and the resulting filtrate (230 +/- 200 mL) was processed by Ficoll-gradient centrifugation to isolate mononuclear cells (6.2 +/- 5.2 x 10(6) cells/mL). The aqueous supernatant contained FGF-2, IGF-I, and latent TGF-beta1, but BMP-2 was below the limit of detection. The cell fraction included culture plastic-adherent, fibroblastic cells that displayed a surface marker profile indicative of mesenchymal stem cells and that could be induced along the osteogenic, adipogenic, and chondrogenic lineages in vitro. When compared to outgrowth cells from the culture of osseous particles, filtrate cells were more sensitive to seeding density during osteogenic culture but had similar capacity for chondrogenesis. These results suggest using RIA aspirate to develop improved, clinically expeditious, cost-effective technologies for accelerating the healing of bone and other musculoskeletal tissues.

  18. Osteogenic Potential of Reamer Irrigator Aspirator (RIA) Aspirate Collected from Patients Undergoing Hip Arthroplasty

    PubMed Central

    Porter, Ryan M.; Liu, Fangjun; Pilapil, Carmencita; Betz, Oliver B.; Vrahas, Mark S.; Harris, Mitchel B.; Evans, Christopher H.

    2009-01-01

    Intramedullary nailing preceded by canal reaming is the current standard of treatment for long-bone fractures requiring stabilization. However, conventional reaming methods can elevate intramedullary temperature and pressure, potentially resulting in necrotic bone, systemic embolism, and pulmonary complications. To address this problem, a reamer irrigator aspirator (RIA) has been developed that combines irrigation and suction for reduced-pressure reaming with temperature modulation. Osseous particles aspirated by the RIA can be recovered by filtration for use as an autograft, but the flow-through is typically discarded. The purpose of this study was to assess whether this discarded filtrate has osteogenic properties that could be used to enhance the total repair potential of aspirate. RIA aspirate was collected from five patients (ages 71–78) undergoing hip hemiarthroplasty. Osseous particles were removed using an open-pore filter, and the resulting filtrate (230 ± 200 mL) was processed by Ficoll-gradient centrifugation to isolate mononuclear cells (6.2 ± 5.2 × 106 cells/mL). The aqueous supernatant contained FGF-2, IGF-I, and latent TGF-β1, but BMP-2 was below the limit of detection. The cell fraction included culture plastic-adherent, fibroblastic cells that displayed a surface marker profile indicative of mesenchymal stem cells and that could be induced along the osteogenic, adipogenic, and chondrogenic lineages in vitro. When compared to outgrowth cells from the culture of osseous particles, filtrate cells were more sensitive to seeding density during osteogenic culture but had similar capacity for chondrogenesis. These results suggest using RIA aspirate to develop improved, clinically expeditious, cost-effective technologies for accelerating the healing of bone and other musculoskeletal tissues. PMID:18655129

  19. A novel pneumatic micropipette aspiration method using a balance pressure model

    NASA Astrophysics Data System (ADS)

    Zhao, Qili; Wu, Ming; Cui, Maosheng; Qin, Yanding; Yu, Jin; Sun, Mingzhu; Zhao, Xin; Feng, Xizeng

    2013-12-01

    This paper presents a novel micropipette aspiration (MA) method based on a common pneumatic micro-injection system. This method is the first to quantify the influence of capillary effect on aspiration pressure using a balance pressure model, and in return, uses the capillary effect to quantify the aspiration pressure. Subsequently, the seal between the cell and the micropipette is detected to judge and exclude the ineffective MA attempts. The rationality of the balance pressure model is validated by the designed micropipette-filling experiments. Through applied to elasticity-determination of the cells with different sizes, the feasibility and versatility of this MA method are proved. With abilities to quantify aspiration pressures and detect the seam between the cell and the micropipette, our method is expected to advance the application of the commercial pneumatic injector in the MA of cells. Moreover, with the quantified volume of the liquid entering into the micropipette during MA process, our method also has a potential applicability to the study of the permeability of the cell membrane in the future.

  20. A novel pneumatic micropipette aspiration method using a balance pressure model.

    PubMed

    Zhao, Qili; Wu, Ming; Cui, Maosheng; Qin, Yanding; Yu, Jin; Sun, Mingzhu; Zhao, Xin; Feng, Xizeng

    2013-12-01

    This paper presents a novel micropipette aspiration (MA) method based on a common pneumatic micro-injection system. This method is the first to quantify the influence of capillary effect on aspiration pressure using a balance pressure model, and in return, uses the capillary effect to quantify the aspiration pressure. Subsequently, the seal between the cell and the micropipette is detected to judge and exclude the ineffective MA attempts. The rationality of the balance pressure model is validated by the designed micropipette-filling experiments. Through applied to elasticity-determination of the cells with different sizes, the feasibility and versatility of this MA method are proved. With abilities to quantify aspiration pressures and detect the seam between the cell and the micropipette, our method is expected to advance the application of the commercial pneumatic injector in the MA of cells. Moreover, with the quantified volume of the liquid entering into the micropipette during MA process, our method also has a potential applicability to the study of the permeability of the cell membrane in the future.

  1. Influences to post-graduation career aspirations and attainment in STEM doctoral candidates and recipients

    NASA Astrophysics Data System (ADS)

    Barry, Deborah S.

    As the realities of the academic job market have forced some PhD recipients to accept less-preferable position types, there has been increasing concerns that these students are not prepared for their careers, especially in STEM fields. However, aside from the labor market, few studies have explored the influences on career aspiration and attainment among doctoral degree holders. This study utilized the socialization theory framework to identify aspects of the doctoral education process that are predictive of the likelihood of certain career aspirations among science and engineering doctoral candidates and career attainment among STEM doctoral recipients by utilizing nationally representative datasets: The National Research Council's Assessment of Research Doctorate Programs student questionnaire and the National Science Foundation's Survey of Earned Doctorates. This study identified field of study, research productivity rank of doctoral programs, primary type of finding doctoral students received, level of satisfaction with research experiences, and their sense of belonging within their doctoral program as factors that predict the likelihood of certain career aspirations compared with a career in education. Doctoral candidates' background characteristics that were significant predictors of career aspirations were gender, marital status, dependent status, race, age, and citizenship status. Further, this study identified participant's field of study, the Carnegie Rank of institutions attended, primary type of funding received, length of time to PhD, gender, marital status, dependent status, race, citizenship stats, and age as factors that predict the likelihood of the career outcomes investigated in this study, including doctoral recipients' employment field and primary work activity.

  2. Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study

    PubMed Central

    2014-01-01

    Background Maternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers. Methods Data from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents’ grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures. Results Among Black adolescents, those who ever skipped a grade had higher offspring’s birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring’s birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations. Conclusions Some indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers. PMID:24422664

  3. Emergent intrathecal baclofen withdrawal after pseudomeningocele aspiration.

    PubMed

    Smith, Timothy R; Mithal, Divakar S; Park, Anne; Bohnen, Angela; Adel, Joseph; Rosenow, Joshua M

    2013-01-01

    Intrathecal baclofen (ITB) infusion has become a common treatment for severe spasticity. Many complications of these drug delivery systems have been reported such as those related to improper dosing, mechanical failure of the implanted pump or catheter, or post-operative wound issues. We report a case of ITB withdrawal after pseudomeningocele aspiration. A 21 year-old male with spastic quadriparesis due to traumatic brian injury (TBI) presented with a pseudomeningocele surrounding an ITB pump (215 mcg/day, continuous) implanted in the abdomen. The pseudomeningocele was percutaneously aspirated and approximately 15 hours later the patient developed signs and symptoms of acute baclofen withdrawal. As a result, the patient underwent an exploration of the ITB infusion system with an intraoperative epidural blood patch. The symptoms of ITB withdrawal improved over the next 18 hours. The subcutaneous cerebrospinal fluid (CSF) collection partially recurred 48 hours later, but this resolved after a second epidural blood patch. The case illustrates a unique presentation of a serious complication of ITB infusion. This underscores that timely diagnosis and treatment of acute baclofen withdrawal is key to optimal outcomes.

  4. Occupational Aspirations of State FFA Contest and Award Winners.

    ERIC Educational Resources Information Center

    Bowen, Blannie E.; Doerfert, David L.

    1989-01-01

    A study explored the occupational aspirations of 300 (of 503) students with high levels of participation in Future Farmers of America's (FFA) Computers in Agriculture (CIA), Proficiency Award (PA), and Prepared and Extemporaneous Speaking (PES) contests. CIA and PES winners aspired to professional occupations more than PA winners. PES winners…

  5. Factors Related to Postgraduate Educational Aspirations of Women College Graduates.

    ERIC Educational Resources Information Center

    de Wolf, Virginia A.

    This study compared 105 women university baccalaureates intending graduate study the year following graduation with women graduates matched by age and major who did not intend such study. Aspirers had significantly higher GPAs than non-aspirers, were more satisfied with their undergraduate major, had more often selected their major as preparation…

  6. Sociological Theory and Youth Aspiration Research: A Critical Overview.

    ERIC Educational Resources Information Center

    Picou, J. Steven; Wells, Richard H.

    Reviewing sociological theories relative to youth aspiration research, the following thesis was presented: "pre-path analysis aspiration research was characterized by a person-centered, middle-range functionalist approach which eventually shifted to a person-centered, functionalist-system approach with the introduction of the path model…

  7. 21 CFR 886.4150 - Vitreous aspiration and cutting instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Vitreous aspiration and cutting instrument. 886.4150 Section 886.4150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... cutting instrument. (a) Identification. A vitreous aspiration and cutting instrument is an...

  8. 21 CFR 886.4150 - Vitreous aspiration and cutting instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vitreous aspiration and cutting instrument. 886.4150 Section 886.4150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... cutting instrument. (a) Identification. A vitreous aspiration and cutting instrument is an...

  9. A new portable aspirator for culicidae and other winged insects.

    PubMed

    Governatori, M; Bulgarini, C; Rivasi, F; Pampiglione, S

    1993-12-01

    A new type of portable aspirator is described. The aspirator uses as a suction device a fan that normally cools computers, in conjunction with other structural elements especially designed to cope with the greater suction power available. The device proved to be efficient, strong, light, easy to use, and silent.

  10. Career Aspirations of Women in the 20th Century

    ERIC Educational Resources Information Center

    Domenico, Desirae M.; Jones, Karen H.

    2006-01-01

    Women have increasingly become more involved in the workforce following World War II. Paid employment of women has shifted from primarily traditional female-oriented jobs to more non-traditional, and previously male-oriented careers. Women's participation in the workforce has lead to the study of career aspirations of women. Career aspirations are…

  11. A tale of three aspirations: foreign bodies in the airway.

    PubMed

    Pritt, B; Harmon, M; Schwartz, M; Cooper, K

    2003-10-01

    Tracheobronchial foreign body aspiration is a serious medical problem, with clinical manifestations ranging from acute asphyxiation to insidious lung damage, as demonstrated by the three presented cases. Patient 1 aspirated during dinner, emergency bronchoscopy retrieved pieces of food, and she fully recovered the following day. Patient 2 presented with recurrent pneumonia and a right lower lobe lung abscess. After right lower lobectomy, pathology revealed a foreign object in the right main stem bronchus, a peanut aspirated one year earlier. Patient 3 became unresponsive several days after spinal surgery. The differential diagnosis included myocardial infarction, stroke, and foreign body aspiration. The patient died and necropsy revealed a foreign body in the right main stem bronchus (cooked meat). Thus, foreign body aspiration is not always suspected clinically, and the pathologist may play an important role in making the diagnosis. Histological identification of the aspirated material may be necessary for definitive diagnosis. Therefore, sections of commonly aspirated foods are presented, together with a 10 year history of aspirated objects received by this institution's surgical pathology department.

  12. Rural Aspirations, Rural Futures: From "Problem" to Possibility

    ERIC Educational Resources Information Center

    Tieken, Mara Casey; San Antonio, Donna M.

    2016-01-01

    Young people aspire, make choices, and develop within a particular place and historical context. Recently, federal and state governments, policy and research institutes, and advocacy organizations have shown a growing interest in the aspirations and transitions of rural youth--and, in particular, the role that schools play in shaping and…

  13. An Analysis of Taiwanese Aboriginal Students' Educational Aspirations

    ERIC Educational Resources Information Center

    Hou, Hsiao-I; Huang, Chia-Kai

    2012-01-01

    By analysing the national data from the Junior Survey of the Taiwan Higher Education Dataset, this study identified significant variables influencing the educational aspirations of aboriginal students at technical and vocational institutions. The study shows that several variables are predictive of the educational aspirations of aboriginal…

  14. Study of Educational Aspirations of Preparatory School Students in Yemen.

    ERIC Educational Resources Information Center

    Edington, Everett D.

    To identify causes for low enrollment in secondary agricultural schools in Yemen, the United States Agency for International Development and the Yemen Ministry of Education surveyed 990 preparatory (junior high) students, examining their educational aspirations, differences between rural and urban youth, major influences on student aspirations,…

  15. The Aspiration-Attainment Gap: Black Students and Education

    ERIC Educational Resources Information Center

    Buttaro, Anthony, Jr.; Battle, Juan; Pastrana, Antonio, Jr.

    2010-01-01

    Using a nationally representative sample from two waves of the National Educational Longitudinal Study (NELS), this research examines the aspiration-attainment gap that exists for Black students (N = 823). This gap is a measure of the difference between the educational level students said they aspired to reach reported in 1988 when attending 8th…

  16. Stability of Career Aspirations: A Longitudinal Test of Gottfredson's Theory

    ERIC Educational Resources Information Center

    Junk, Kate E.; Armstrong, Patrick Ian

    2010-01-01

    Gottfredson's theory of the career compromise process was evaluated using a longitudinal data set of 2,353 female and 321 male students recruited for Zuckerman's "Seven College Study," who reported their career aspirations twice over a 1-year period. Expressed career aspirations were coded on the dimensions of sex type, prestige, and the…

  17. Aspiration pneumonia. Pathophysiological aspects, prevention and management. A review.

    PubMed

    Petroianni, A; Ceccarelli, D; Conti, V; Terzano, C

    2006-12-01

    Aspiration pneumonias occur more frequently than reported and, in many cases, the disease is not recognised. In hospitalised and institutionalised patients with predisposing diseases prompt diagnosis of this complication and correct preventive measures can drastically reduce the worsening of clinical conditions and the deaths due to aspiration pneumonia. Normal airway structure, effective defence mechanisms, and preventive measures are decisive in reducing aspiration episodes. An increased aspiration risk for food, fluids, medications, or secretions may lead to the development of pneumonia. Pneumonia is the most common respiratory complication in all stroke deaths and in mechanical ventilation patients. In addition, the increased incidence of aspiration pneumonia with aging may be a consequence of impairment of swallowing and the cough reflex. Dysphagia, compromised consciousness, invasive procedures, anaesthesia, insufficient oral care, sleep disorders, and vomiting are all risk factors. Aspiration pneumonia includes different characteristic syndromes based on the amount (massive, acute, chronic) and physical character of the aspirated material (acid, infected, lipoid), needing a different therapeutic approach. Chronic patients education and correct health care practices are the keys for preventing the events of aspiration. In patients at risk a clinical and instrumental assessment of dysphagia should be evaluated. Management includes the removal of etiologic factors (drugs, tubes, mobilisation, oral hygiene), supportive care, and in bacterial pneumonias a specific antibiotic therapy for community-acquired or nosocomial events.

  18. Students' Aspirations, Expectations and School Achievement: What Really Matters?

    ERIC Educational Resources Information Center

    Khattab, Nabil

    2015-01-01

    Using the Longitudinal Study of Young People in England (LSYPE), this study examines how different combinations of aspirations, expectations and school achievement can influence students' future educational behaviour (applying to university at the age of 17-18). The study shows that students with either high aspirations or high expectations have…

  19. The Relationship between Gender and Aspirations to Senior Management

    ERIC Educational Resources Information Center

    Litzky, Barrie; Greenhaus, Jeffrey

    2007-01-01

    Purpose: The purpose of this paper is to examine the relationship of gender, work factors, and non-work factors with aspirations to positions in senior management. A process model of senior management aspirations was developed and tested. Design/methodology/approach: Data were collected via an online survey that resulted in a sample of 368 working…

  20. Mortality, morbidity, and disease severity of patients with aspiration pneumonia

    PubMed Central

    Lanspa, Michael J.; Jones, Barbara E.; Brown, Samuel M.; Dean, Nathan C.

    2013-01-01

    Background Aspiration pneumonia is a common syndrome, although less well characterized than other pneumonia syndromes. We describe a large population of patients with aspiration pneumonia. Methods In this retrospective population study, we queried the electronic medical record at a tertiary-care, university-affiliated hospital from 1996–2006. Patients were initially identified by ICD-9 code 507.x; subsequent physician chart review excluded patients with aspiration pneumonitis and those without a confirmatory radiograph. Patients with community-acquired aspiration pneumonia were compared to a contemporaneous population of community-acquired pneumonia (CAP) patients. We compared CURB-65 predicted mortality with actual 30-day mortality. Results We identified 628 patients with aspiration pneumonia, of which 510 were community-acquired. Median age was 77, with 30-day mortality of 21%. Compared to CAP patients, patients with community-acquired aspiration pneumonia had more frequent inpatient admission (99% vs. 58%) and ICU admission (38% vs. 14%), higher Charlson comorbidity index (3 vs. 1), and higher prevalence of “do not resuscitate/intubate” orders (24% vs. 11%). CURB-65 predicted mortality poorly in aspiration pneumonia patients (AUC 0.66). Conclusions Patients with community-acquired aspiration pneumonia are older, have more comorbidities, and demonstrate higher mortality than CAP patients, even after adjustment for age and comorbidities. CURB-65 poorly predicts mortality in this population. PMID:23184866

  1. Calculating Student Aspiration: Bourdieu, Spatiality and the Politics of Recognition

    ERIC Educational Resources Information Center

    Gale, Trevor; Parker, Stephen

    2015-01-01

    This paper reports on a recent study of aspirations for higher education by secondary school students from disadvantaged backgrounds in regional Australia. At the same time, it goes in search of explanations that transcend a Bourdieuian account of aspirations as produced by and reproductive of cultural histories and dominance, given the apparent…

  2. Students' School Motivation and Aspiration over High School Years

    ERIC Educational Resources Information Center

    Yeung, Alexander Seeshing; McInerney, Dennis M.

    2005-01-01

    Students from a school in Hong Kong (n = 199) responded to 22 items asking about their school motivation and aspirations in a survey. Structural equation models found four school motivation factors consistent with the task, effort, competition, and praise scales of the Inventory of School Motivation, one education aspiration factor, one career…

  3. Fine needle aspiration biopsy of suspected metastatic cancers to the posterior uvea.

    PubMed Central

    Augsburger, J J

    1988-01-01

    This thesis presents the author's experience with diagnostic intraocular fine needle aspiration biopsy in 18 patients with a suspected metastatic choroidal or ciliary body tumor. The author has reviewed the literature on biopsy of intraocular tumors and has specified what he believes to be valid indications for diagnostic biopsy of posterior uveal tumors. He has evaluated the accuracy, limitations, and complications of diagnostic fine needle aspiration biopsy in this series and others, and he has suggested methods for improving the recovery of sufficient cells for cytologic diagnosis and lessening the risks of tumor cell seeding during the biopsy. The author has concluded that fine needle aspiration biopsy appears to be a relatively safe, generally reliable means of establishing the pathologic diagnosis of a choroidal or ciliary body tumor in highly selected patients suspected of having metastatic cancer. In spite of its apparent safety and reliability, however, the author has cautioned against the routine use of fine needle aspiration biopsy in patients with posterior uveal tumors since its long-term safety has not been established. The author has suggested that diagnostic fine needle aspiration biopsy of posterior uveal tumors be performed only in medical centers where there can be input from and cooperation among ophthalmologists, ophthalmic pathologists, and cytopathologists who are experienced in the diagnosis of intraocular malignancies. Images FIGURE 3 A FIGURE 3 B FIGURE 4 A FIGURE 4 B FIGURE 4 C FIGURE 4 D FIGURE 5 A FIGURE 5 B FIGURE 5 C FIGURE 5 D FIGURE 6 A FIGURE 6 B FIGURE 7 A FIGURE 7 B FIGURE 7 C FIGURE 7 D FIGURE 8 A FIGURE 8 B FIGURE 8 C FIGURE 8 D FIGURE 9 A FIGURE 9 B FIGURE 9 C FIGURE 9 D FIGURE 10 A FIGURE 10 B FIGURE 10 C FIGURE 11 PMID:2979028

  4. Aspiration lung disorders in bovines: a case report and review.

    PubMed

    Shakespeare, Anthony S

    2012-11-01

    Lung aspiration disorders in bovines are invariably diagnosed as infectious aspiration pneumonias. There is a distinct differentiation between aspiration pneumonia and aspiration pneumonitis in humans that can be applied to bovines. The nature and quantity of the aspirate can result in differing pathogeneses which can require differing therapeutic approaches. Whilst blood gases were important in detecting and prognosticating lung problems, changes in barometric pressure with altitude have to be considered when interpreting partial pressures of oxygen. Anatomical differences in the lungs of bovines can explain why this species is more prone to certain pneumonic problems. Pulmonary physiotherapy is important in treating lung disorders in humans and should be considered as an adjunct therapy in bovine respiratory conditions. A case work-up was used to highlight some of the points discussed in this article.

  5. Transrectal fine needle aspiration cytology of granulomatous prostatitis.

    PubMed

    Mondal, A; Mukherjee, B; Ghosh, E

    1994-07-01

    Transrectal fine needle aspiration cytology by Franzen technique was carried out from January, 1985 till January, 1992 on 567 patients having prostatomegaly which were suspicious of malignancy by clinical per rectal examination. Granulomatous prostatitis was diagnosed in 56 cases. Analysis showed 34 cases were tuberculous prostatitis and 22 cases were nonspecific granulomatous prostatitis. Comparison of aspiration cytology with bacteriological study of the aspirated material and histopathology showed correct diagnosis of granulomatous prostatitis by fine needle aspiration. The findings indicate that transrectal fine needle aspiration cytology is a reliable procedure for diagnosis of granulomatous prostatitis which can clinically mimic prostatic malignancy when it presents as a diffuse or nodular enlargement with firm to hard consistency.

  6. Knowledge Transformation and Impact: Aspirations and Experiences from TLRP

    ERIC Educational Resources Information Center

    Pollard, Andrew

    2008-01-01

    This paper reviews the intentions and strategies adopted by the UK's Teaching and Learning Research Programme (TLRP) in its attempts to maximise the impact of its research portfolio. The Programme's early commitment to user engagement and to an 'interactive, iterative, constructive, distributed and transformative' impact strategy is described. The…

  7. Deaf People as British Sign Language Teachers: Experiences and Aspirations

    ERIC Educational Resources Information Center

    Atherton, Martin; Barnes, Lynne

    2012-01-01

    Little research has been undertaken into the profession of British Sign Language (BSL) teaching, despite a huge increase in the number of BSL classes offered over the past twenty years. Following the introduction of Qualified Teacher Learning and Skills standards in 2007, BSL teachers working in "further education" (FE) colleges were…

  8. Experimental determination of the filling coefficient for an aspirated spark-ignition engine

    NASA Astrophysics Data System (ADS)

    Raţiu, S.; Alexa, V.; Kiss, I.; Cioată, V.

    2017-01-01

    This study aims at determining, by experiment, the filling coefficient of a spark-ignition, normal aspirated engine, with carburettor. For this purpose, a pilot plant was designed for measuring the pressure at various points on the route, simulating a stationary air flow regime by means of a vacuum pump. Measurements were made for various lifting heights of the intake valve and various opening positions of the throttle body, thus highlighting how their influence on the pressure loss and on the filling coefficient.

  9. Acid aspiration-induced airways hyperresponsiveness in mice

    PubMed Central

    Leclair, Timothy R.; von Reyn, Jessica; Larrabee, Yuna C.; Cloutier, Mary E.; Irvin, Charles G.; Bates, Jason H. T.

    2009-01-01

    The role of gastroesophageal reflux and micro-aspiration as a trigger of airways hyperresponsiveness (AHR) in patients with asthma is controversial. The role of acid reflux and aspiration as a direct cause of AHR in normal subjects is also unclear. We speculated that aspiration of a weak acid with a pH (1.8) equivalent to the upper range of typical gastric contents would lead to AHR in naive mice. We further speculated that modest reductions in aspirate acidity to a level expected during gastric acid suppression therapy (pH 4.0) would impede aspiration-induced AHR. BALB/c female mice were briefly anesthetized with isoflurane and allowed to aspirate 75 μl of saline with HCl (pH 1.8, 4.0, or 7.4) or underwent sham aspiration. Mice were re-anesthetized 2 or 24 h later, underwent tracheostomy, and were coupled to a mechanical ventilator. Forced oscillations were used to periodically measure respiratory impedance (Zrs) following aerosol delivery of saline and increasing doses of methacholine to measure for AHR. Values for elastance (H), airways resistance (RN), and tissue damping (G) were derived from Zrs. Aspirate pH of 1.8 led to a significant overall increase in peak RN, G, and H compared with pH 4.0 and 7.4 at 2 and 24 h. Differences between pH 7.4 and 4.0 were not significant. In mice aspirating pH 1.8 compared with controls, airway lavage fluid contained more neutrophils, higher protein, and demonstrated higher permeability. We conclude that acid aspiration triggers an acute AHR, driven principally by breakdown of epithelial barrier integrity within the airways. PMID:19797689

  10. Fine needle aspiration cytology in fibromatosis

    PubMed Central

    Tanwar, Pranay; Gupta, Nalini; Vasishta, Rakesh Kumar; Singh, Gurpreet

    2012-01-01

    Fibromatosis form a spectrum of clinicopathologic entities characterized by the infiltrative proliferation of fibroblasts that lack malignant cytologic features. The fibromatosis can be localized or infiltrative and multicentric and can involve internal tissues and organs as the mesentery, retroperitoneum, breast, and almost every organ and region of the body, including the bones, the meninges and the central nervous system. We report a case of 37-year-old male who presented with a right supraclavicular mass with superficial infiltrative type of fibromatosis and fine needle aspiration cytology (FNAC) was performed. We report this case because of limited literature of FNAC in fibromatosis and quick role of FNAC in the diagnosis of fibromatosis. PMID:22438623

  11. Religiosity and Migration Aspirations among Mexican Youth.

    PubMed

    Hoffman, Steven; Marsiglia, Flavio Francisco; Ayers, Stephanie L

    2015-02-01

    International migration has become an important topic of discussion from a policy and humanitarian perspective. Part of the debate includes a renewed interest in understanding the factors that influence decisions about migration to the US among Mexican youth still residing in their country of origin. The purpose of this study was to advance knowledge specifically about internal and external religiosity and their influence on youths' migration aspirations. The data for this study were collected in 2007 from students enrolled in an alternative high school program located in the state of Guanajuato, Mexico. The findings indicated that as external religiosity increases, the desire to work or live in the USA decreases. Furthermore, as internal religiosity increases, the desire to work or live in the USA and plans to migrate increase. The results are interpreted and discussed in light of previous research on religious and cultural norm adherence.

  12. Complications of oropharyngeal dysphagia: aspiration pneumonia.

    PubMed

    Almirall, Jordi; Cabré, Mateu; Clavé, Pere

    2012-01-01

    The incidence and prevalence of aspiration pneumonia (AP) are poorly defined. They increase in direct relation with age and underlying diseases. The pathogenesis of AP presumes the contribution of risk factors that alter swallowing function and predispose to the oropharyngeal bacterial colonization. The microbial etiology of AP involves Staphylococcus aureus, Haemophilus influenzae and Streptococcus pneumoniae for community-acquired AP and Gram-negative aerobic bacilli in nosocomial pneumonia. It is worth bearing in mind the relative unimportance of anaerobic bacteria in AP. When we choose the empirical antibiotic treatment, we have to consider some pathogens identified in oropharyngeal flora. Empirical treatment with antianaerobics should only be used in certain patients. According to some known risks factors, the prevention of AP should include measures in order to avoid it.

  13. Religiosity and Migration Aspirations among Mexican Youth

    PubMed Central

    Marsiglia, Flavio Francisco; Ayers, Stephanie L.

    2014-01-01

    International migration has become an important topic of discussion from a policy and humanitarian perspective. Part of the debate includes a renewed interest in understanding the factors that influence decisions about migration to the US among Mexican youth still residing in their country of origin. The purpose of this study was to advance knowledge specifically about internal and external religiosity and their influence on youths' migration aspirations. The data for this study were collected in 2007 from students enrolled in an alternative high school program located in the state of Guanajuato, Mexico. The findings indicated that as external religiosity increases, the desire to work or live in the USA decreases. Furthermore, as internal religiosity increases, the desire to work or live in the USA and plans to migrate increase. The results are interpreted and discussed in light of previous research on religious and cultural norm adherence. PMID:25663825

  14. Preventing aspiration in the nursing home: the role of biofilm and data from the ICU.

    PubMed

    Drinka, Paul

    2010-01-01

    Two aspiration syndromes have been identified: Aspiration pneumonia is infectious caused by micro-aspiration of oral bacteria secondary to neurogenic dysphagia or sedation. Infectious bacteria may also be aspirated from the stomach. Aspiration pneumonitis classically follows large bolus aspiration of food, acid, or digestive enzymes and is initially noninfectious. Large bolus gastric aspiration events may have an acute/dramatic onset. This article discusses (1) prevention of recurrent aspiration events caused by 2 common motility disorders: neurogenic dysphagia and gastro esophageal reflux; (2) mechanical source control (debridement/drainage) of sites that may harbor large collections of bacteria protected from antibiotics in biofilm including dental plaque, coated tongue, and chronic sinusitis.

  15. Promoting positive youth development by examining the career and educational aspirations of African American males: implications for designing educational programs.

    PubMed

    Lee, Felecia A; Lewis, Rhonda K; Sly, Jamilia R; Carmack, Chakema; Roberts, Shani R; Basore, Polly

    2011-01-01

    African American males experience poor academic performance, high absenteeism at school, and are at increased risk of being involved in violence than other racial groups. Given that the educational outlook for African American males appears bleak, it is important to assess the aspirations of these adolescent males in order to find the gap between aspirations and educational attainment. In order to promote positive development within this population, it is essential that factors that affect African American males be identified. A survey was administered to male students attending elementary, middle, and high schools in a local school district. A cross-sectional study was conducted to examine the career and educational aspirations of African American males. A total of 473 males were surveyed: 45% African American, 22% Caucasian, 13% biracial, and 19% Other (including Asian American, Hispanic, Native American). The results revealed that African American males aspired to attend college at the same rate as other ethnic groups. Also, African American males were more likely to aspire to be professional athletes than males from other ethnic groups. Important factors to consider when designing a program are discussed as well as future research and limitations.

  16. Young People with Intellectual Disabilities Attending Mainstream and Segregated Schooling: Perceived Stigma, Social Comparison and Future Aspirations

    ERIC Educational Resources Information Center

    Cooney, G.; Jahoda, A.; Gumley, A.; Knott, F.

    2006-01-01

    `Mainstream schooling is a key policy in the promotion of social inclusion of young people with learning disabilities. Yet there is limited evidence about the school experience of young people about to leave mainstream as compared with segregated education, and how it impacts on their relative view of self and future aspirations. Methods: Sixty…

  17. Design and Implementation of a Web-Based Portfolio for Aspiring Educational Leaders: A Comprehensive, Evidence-Based Model

    ERIC Educational Resources Information Center

    Redish, Traci; Webb, Linda; Jiang, Binbin

    2006-01-01

    Following a programmatic model for change, one new educational leadership department describes the process involved to design, develop, and implement a Web-portfolio to integrate, document, and evaluate leadership experiences of aspiring school leaders in a graduate education program. To ensure the successful implementation of the Web-portfolios,…

  18. [Recommendations for the prevention of foreign body aspiration].

    PubMed

    Lluna, Javier; Olabarri, Mikel; Domènech, Anna; Rubio, Bárbara; Yagüe, Francisca; Benítez, María T; Esparza, María J; Mintegi, Santiago

    2017-01-01

    The aspiration of a foreign body remains a common paediatric problem, with serious consequences that can produce both acute and chronic disease. Aspiration usually causes a medical emergency that requires a prompt diagnosis and an urgent therapeutic approach as it may result in the death of the child or severe brain injury. It typically involves organic foreign bodies (mainly food or nuts) aspirated by children under 5 years old, and usually at home. In this statement, the Committee on Safety and Prevention of Non-Intentional Injury in Childhood of the Spanish Paediatrics Association provides a series of recommendations, both educational (while eating and playing), as well as legal, to prevent such episodes.

  19. Aspiring to physical health: The role of aspirations for physical health in facilitating long-term tobacco abstinence

    PubMed Central

    Niemiec, Christopher P.; Ryan, Richard M.; Deci, Edward L.; Williams, Geoffrey C.

    2009-01-01

    Objective To assess aspirations for physical health over 18 months. To examine whether maintained importance of aspirations for physical health mediated and/or moderated the effect of an intensive intervention on long-term tobacco abstinence. Methods Participants were randomly assigned to an intervention based on self-determination theory or to community care, and provided data at baseline and at 18 and 30 months post-randomization. Results Aspirations for physical health were better maintained over 18 months among participants in the intervention (mean change = .05), relative to community care (mean change = -.13), t = 2.66, p < .01. Maintained importance of aspirations for physical health partially mediated the treatment condition effects on seven-day point prevalence tobacco abstinence (z′ = 1.68, p < .01) and the longest number of days not smoking (z′ = 2.16, p < .01), and interacted with treatment condition to facilitate the longest number of days not smoking (β = .08, p < .05). Conclusion Maintained importance of aspirations for physical health facilitated tobacco abstinence. Practice implications Smokers may benefit from discussing aspirations for physical health within autonomy-supportive interventions. Patients may benefit from discussing aspirations during counseling about therapeutic lifestyle change and medication use. PMID:18838243

  20. Prevention of suicide: aspirations and evidence.

    PubMed Central

    Gunnell, D.; Frankel, S.

    1994-01-01

    The Health of the Nation white paper set a target for 15% reduction in overall suicide rates by the year 2000. If the targets are to be achieved interventions must be identified which are of proved effectiveness. This paper examines the evidence on the available interventions and points of access to the population at risk. No single intervention has been shown in a well conducted randomised controlled trial to reduce suicide. The greatest potential seems to arise from limiting the availability of methods. In particular it is likely that the introduction of the catalytic convertor will lead to reduced lethality of care exhausts and reductions in suicide using this method. General practitioner education programmes, the effectiveness of lithium and maintenance antidepressants, and limits on the quantity of medicines available over the counter or on prescription should all be evaluated. Particular high risk groups include people recently discharged from psychiatric hospitals and those with a history of parasuicide. Many social processes affect suicide rates and these rather than specific interventions may help or hinder the ability to realise the Health of the Nation targets. Well conducted trials are essential to distinguish complex social processes from the effects of specific interventions for suicide prevention. This review of the available evidence offers little support for the aspiration that the posited targets can be achieved on the basis of current knowledge and current policy. Images p1229-a p1233-a PMID:8080520

  1. 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.

  2. Dermal mass aspirate from a Persian cat.

    PubMed

    Zimmerman, Kurt; Feldman, Bernard; Robertson, John; Herring, Erin S; Manning, Thomas

    2003-01-01

    A 1-year-old spayed female Persian cat with alopecia and weight loss had numerous variably ulcerated dermal nodules. Cytologic examination of an aspirate of one of the nodules revealed pyogranulomatous inflammation along with septate hyphae and basophilic round bodies, 0.5-1.0 microm in diameter, surrounded by a thin clear halo (arthrospores). The cytologic diagnosis was dermatophytic pseudomycetoma. Histologically, there were dermal granulomas containing poorly staining, septate hyphae with bulbous spores embedded within abundant amorphous eosinophilic material (Splendore-Hoeppli reaction), and the histologic diagnosis was pseudomycetoma-associated chronic multifocal severe granulomatous dermatitis with lymphocytic perifolliculitis and furunculosis. Microsporum canis was cultured from the lesion. Pseudomycetomas are distinguished from fungal mycetomas, or eumycotic mycetomas, by the findings of multiple lesions, lack of a history of skin trauma, an association with dermatophytes, most commonly Microsporum canis, and, histologically, lack of true cement material and a more abundant Splendore-Hoeppli reaction in pseudomycetomas. Additionally, pseudomycetomas differ from dermatophytosis, in which lesions are restricted to epidermal structures. Persian cats have a high incidence of pseudomycetoma formation, suggesting a heritable predisposition. The prognosis is fair with systemic antifungal therapy. When examining cytologic specimens from Persian cats with single or multiple dermal nodules, especially if pyogranulomatous inflammation is present, a diagnosis of pseudomycetoma should be suspected and is warranted if arthrospores and refractile septate hyphae are present.

  3. Amniotic fluid aspiration in cases of SIDS.

    PubMed

    Fracasso, Tony; Karger, Bernd; Vennemann, Mechtild; Bajanowski, Thomas; Golla-Schindler, Ute Maria; Pfeiffer, Heidi

    2010-03-01

    The scope of this study was to evaluate the incidence and the eventual consequences of amniotic fluid aspiration (AFA) in cases of sudden infant death. Cases of sudden infant death syndrome (SIDS; n = 113: 39 females, 74 males; mean age 4.6 months) were compared to a control group of 39 cases of explained death (14 females, 25 males; mean age 5.6 months). In each case, sections of the lung stained with hematoxylin and eosin and with the immunohistochemical reaction 34BE12 specific for cytokeratins were available. The microscope slides were observed at x200 magnification and semi-quantitatively classified into four categories(-, +, ++, and +++). In both groups, rests of amniotic fluid could be observed up to the fourth month of life. The comparison between the two groups did not show any significant difference. In the SIDS group, immunohistochemical reactions with the antibodies CD68, MRP8, MRP14, 27E10, 25F9, CD3, CD20Cy, and CD45R0 were available for the lungs. Twelve cases with AFA were compared to a group of SIDS cases without AFA with similar age and pathological distribution to evaluate whether the presence of amniotic remnants induced inflammatory changes in the lungs. No differences emerged. This study shows that AFA is not a rare event. Even moderate to severe AFA does not necessary cause death. A correlation between AFA and SIDS could not be shown.

  4. Lung ultrasound findings in meconium aspiration syndrome.

    PubMed

    Piastra, Marco; Yousef, Nadya; Brat, Roselyne; Manzoni, Paolo; Mokhtari, Mostafa; De Luca, Daniele

    2014-09-01

    Meconium aspiration syndrome (MAS) is a rare and life-threatening neonatal lung injury induced by meconium in the lung and airways. Lung ultrasound (LUS) is a quick, easy and cheap imaging technique that is increasingly being used in critical care settings, also for newborns. In this paper we describe ultrasound findings in MAS. Six patients with MAS of variable severity were examined by LUS during the first hours of life. Chest X-rays were used as reference. The following dynamic LUS signs were seen in all patients: (1) B-pattern (interstitial) coalescent or sparse; (2) consolidations; (3) atelectasis; (4) bronchograms. No pattern was observed for the distribution of signs in lung areas, although the signs varied with time, probably due to the changing localisation of meconium in the lungs. LUS images corresponded well with X-ray findings. In conclusion, we provide the first formal description of LUS findings in neonates with MAS. LUS is a useful and promising tool in the diagnosis and management of MAS, providing real-time bedside imaging, with the additional potential benefit of limiting radiation exposure in sick neonates.

  5. Current Concepts in the Management of Meconium Aspiration Syndrome.

    PubMed

    Chettri, Subhash; Bhat, B Vishnu; Adhisivam, B

    2016-10-01

    In developing countries, meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among neonates. The concepts of pathophysiology and management of meconium stained amniotic fluid (MSAF) and meconium aspiration syndrome have undergone tremendous change in recent years. Routine intranatal and postnatal endotracheal suctioning of meconium in vigorous infants is no longer recommended. Recent studies have challenged its role even in non-vigorous infants. Supportive therapy like oxygen supplementation, mechanical ventilation and intravenous fluids are the cornerstone in the management of meconium aspiration syndrome. Availability of surfactant, inhaled nitric oxide, high frequency ventilators and extracorporeal membrane oxygenation has made it possible to salvage more infants with meconium aspiration syndrome. In this review the authors have discussed the current concepts in the pathophysiology and management of MAS. Drugs in trials and future therapeutic targets are also discussed briefly.

  6. Cognitive correlates of adolescents' aspirations to leadership: a developmental study.

    PubMed

    Singer, M

    1990-06-01

    The study examined age and gender differences in leadership aspirations among teenage adolescents. It was hypothesized that adolescents' valence, self-efficacy and attribution perceptions about leadership would be predictive of their aspirations to leadership. Altogether 52 fourth form and 78 seventh form high school students completed a questionnaire measuring (a) overall leadership aspirations, (b) 13 valence-instrumentality expectancies for 13 leadership outcomes, (c) self-efficacy perceptions, and (d) attributions of effective leadership. The results revealed significant gender differences in valence scores and significant age differences in self-efficacy and attribution measures. Regression analyses indicated that fourth formers' leadership aspirations were significantly predicted from their "ease-of-success" self-efficacy expectation; whereas seventh formers from either valence perceptions (males) or self-efficacy and attribution scores (females). These results were discussed in the context of the valence and self-efficacy models of career decision-making processes and attribution theory.

  7. 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

  8. Pulmonary aspiration following Dettol poisoning: the scope for prevention.

    PubMed

    Chan, T Y; Critchley, J A

    1996-10-01

    1. After ingestion, Dettol liquid (4.8% chloroxylenol, pine oil, isopropyl, alcohol), a common household disinfectant, can cause central nervous system depression and corrosion of the oral mucosa, larynx and the gastrointestinal tract. The main risk from Dettol poisoning is pulmonary aspiration, leading to pneumonia, adult respiratory distress syndrome (ARDS) and/or sudden cardiorespiratory arrest. 2. To determine to what extent pulmonary aspiration in Dettol poisoning could be prevented, 13 patients treated in a general teaching hospital in Hong Kong were studied. Their clinical details were compared with those of control Dettol poisoning cases without pulmonary aspiration in order to identify possible risk factors for this complication. 3. At presentation, evidence of pulmonary aspiration was present in eight of the 13 patients prior to gastric emptying, but the use of gastric lavage without adequate protection of the airways could have aggravated the problem in three. In two other patients, evidence of aspiration was only present after gastric lavage was performed. The consequences of pulmonary aspiration were pneumonia (n = 10), ARDS (n = 2), acute exacerbation of asthma or chronic obstructive airway disease (n = 2) and sudden cardiorespiratory arrest (n = 1). Three patients with aspiration pneumonia (n = 2), ARDS (n = 1) and/or sudden cardiorespiratory arrest (n = 1) died. 4. Compared with the controls, the median amount of Dettol ingested was considerably larger (400 vs 150 ml), vomiting (100% vs 72.6%) and drowsiness/ confusion (60.2% vs 19.4%) occurred more often. 5. Amongst the 13 patients with Dettol poisoning and pulmonary aspiration, gastric lavage using the nasogastric tube technique without adequate production of the airways had been responsible for the occurrence or worsening of aspiration in two and three patients, respectively. Thus, gastric lavage particularly when using a nasogastric tube appeared to carry more harm than benefits in patients with

  9. From Educational Aspirations to College Enrollment: A Road with Many Paths

    ERIC Educational Resources Information Center

    Liu, Lu

    2009-01-01

    Educational aspiration is one of the most important factors influencing an individual's educational attainment. Although students' aspirations are changeable and the stability of their aspirations is important for their goal reaching, previous studies are rather limited in their ability to capture aspiration changes due to their incomplete…

  10. Cross-Lagged Relationships between Career Aspirations and Goal Orientation in Early Adolescents

    ERIC Educational Resources Information Center

    Creed, Peter; Tilbury, Clare; Buys, Nick; Crawford, Meegan

    2011-01-01

    We surveyed 217 students (145 girls; average age = 14.6 years) on two occasions, twelve months apart, on measures of career aspirations (job aspirations, job expectations, educational aspirations) and goal orientation (learning, performance-prove, performance-avoid), and tested the causal relationship between goal orientation and aspirations. We…

  11. Survey of Foreign Body Aspiration in Airways and Lungs

    PubMed Central

    Samarei, R.

    2014-01-01

    Introduction: Foreign body aspiration is a very serious problem and the diversity of clinical protests in each geographic region has its own characteristics and common problems of childhood that is an important cause of mortality and morbidity. No area is separate from this problem and conducting this research is due to achieve basic information regarding foreign body aspiration. Materials and Methods: This was performed as descriptive - cross sectional study on 200 cases that has been hospitalized in Imam Khomeini Hospital, Urmia due to foreign body aspiration problem from 2009 to 2011. And all cases of foreign body aspiration records extracted and analyzed using SPSS 16 software. Results: Foreign body aspiration under 4 years was 57% and was more common in males than females; approximately 74% of patients were hospitalized in the first 10 days and 13% of patients did not remember the initial incident that led to the aspiration. Cough and shortness of breath and reduced lung sounds and wheezing were common symptoms. Chest radiographic findings are not specific and can be normal of a high percentage. The most common aspirated foreign body was food especially sunflower seeds. Right bronchus with 55% of cases was more common than the left bronchus and all patients were treated with rigid bronchoscopy, 24% of patients had complications, 15% had hospitalized with pneumonia. Totally, 75% of patients were urban residents. Discussion: We need to understand all the aspects related to foreign body aspiration and education to the community, to recognize symptoms and type of foreign body in terms of geographical area and to create a strong clinical suspicion in physicians and awareness of its prevalence that by reducing the incidence and early detecting and treatment can reduce the mortality and morbidity and prevent additional expenses. PMID:25363168

  12. A Case of Bipolar Affective Disorder and Aspiration Pneumonia

    PubMed Central

    Dell'Erba, Gaetano

    2013-01-01

    Adults with mental illness are at a higher risk of aspiration pneumonia than the general population. We describe the case of a patient with bipolar affective disorder and two separate episodes of aspiration pneumonia associated with acute mania. We propose that he had multiple predisposing factors, including hyperverbosity, sedative medications, polydipsia (psychogenic and secondary to a comorbidity of diabetes insipidus), and neuroleptic side effects. PMID:23956911

  13. Aspiration dynamics of multi-player games in finite populations

    PubMed Central

    Du, Jinming; Wu, Bin; Altrock, Philipp M.; Wang, Long

    2014-01-01

    On studying strategy update rules in the framework of evolutionary game theory, one can differentiate between imitation processes and aspiration-driven dynamics. In the former case, individuals imitate the strategy of a more successful peer. In the latter case, individuals adjust their strategies based on a comparison of their pay-offs from the evolutionary game to a value they aspire, called the level of aspiration. Unlike imitation processes of pairwise comparison, aspiration-driven updates do not require additional information about the strategic environment and can thus be interpreted as being more spontaneous. Recent work has mainly focused on understanding how aspiration dynamics alter the evolutionary outcome in structured populations. However, the baseline case for understanding strategy selection is the well-mixed population case, which is still lacking sufficient understanding. We explore how aspiration-driven strategy-update dynamics under imperfect rationality influence the average abundance of a strategy in multi-player evolutionary games with two strategies. We analytically derive a condition under which a strategy is more abundant than the other in the weak selection limiting case. This approach has a long-standing history in evolutionary games and is mostly applied for its mathematical approachability. Hence, we also explore strong selection numerically, which shows that our weak selection condition is a robust predictor of the average abundance of a strategy. The condition turns out to differ from that of a wide class of imitation dynamics, as long as the game is not dyadic. Therefore, a strategy favoured under imitation dynamics can be disfavoured under aspiration dynamics. This does not require any population structure, and thus highlights the intrinsic difference between imitation and aspiration dynamics. PMID:24598208

  14. Risk of aspiration in care home residents and associated factors.

    PubMed

    van der Maarel-Wierink, Claar D; van der Putten, Gert-Jan; De Visschere, Luc M J; Bronkhorst, Ewald M; de Baat, Cees; Schols, Jos M G A

    2015-02-01

    Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five experienced speech-language therapists assessed 203 care home residents (115 primarily physically disabled, 88 primarily cognitively impaired) 60 and older in the first week after admission to a care home. In 43 (21.2%) residents, speech-language therapists assessed risk of aspiration and found no significant difference between physically disabled (26.1%) and cognitively impaired (14.8%) residents. After multivariate logistic regression analysis, the final prediction model for risk of aspiration showed Parkinson's disease as a significant factor (odds ratio = 5.11; 95% confidence interval [1.49, 17.52]) . The authors therefore conclude that risk of aspiration is a relevant care problem among Dutch care home residents and requires further assessment.

  15. Coevolution of aspirations and cooperation in spatial prisoner's dilemma game

    NASA Astrophysics Data System (ADS)

    Chen, Wei; Wu, Te; Li, Zhiwu; Wang, Long

    2015-01-01

    Suboptimal outcomes are often more acceptable than the best ones when the latter are hard or even impossible to find. In order to describe the emergence of cooperation when suboptimal alternatives prevail, an evolutionary game model is established by considering the effects of aspirations. A win-stay-lose-shift like rule for strategy updating is proposed. The rule prescribes that if the payoff of the current strategy is greater than the aspiration, the strategy remains, otherwise the strategy changes. Aspiration updating allows for individuals to adjust their expected payoff levels. It is shown that suboptimal alternatives can promote the emergence and persistence of cooperation over a wide range of the temptation to defect. Furthermore, a nontrivial phenomenon is found that cooperators prevail as the temptation increases when it is small. The aspirations are stabilized at an intermediate level which can most facilitate cooperation. The obtained results also show that the average level of aspirations decreases as the temptation increases. Furthermore, the variance of aspiration levels is minimized for an intermediate level of temptation.

  16. Improved Measurement of Elastic Properties of Cells by Micropipette Aspiration and Its Application to Lymphocytes.

    PubMed

    Esteban-Manzanares, Gustavo; González-Bermúdez, Blanca; Cruces, Julia; De la Fuente, Mónica; Li, Qingxuan; Guinea, Gustavo V; Pérez-Rigueiro, José; Elices, Manuel; Plaza, Gustavo R

    2017-01-17

    Mechanical deformability of cells is an important property for their function and development, as well as a useful marker of cell state. The classical technique of micropipette aspiration allows single-cell studies and we provide here a method to measure the two basic mechanical parameters, elastic modulus and Poisson's ratio. The proposed method, developed from finite-element analysis of micropipette aspiration experiments, may be implemented in future technologies for the automated measurement of mechanical properties of cells, based on the micropipette aspiration technique or on the cell transit through flow constrictions. We applied this method to measure the elastic parameters of lymphocytes, in which the mechanical properties depend on their activation state. Additionally, we discuss in this work the accuracy of previous models to estimate the elastic modulus of cells, in particular the analytical model by Theret et al., widely used in the field. We show the necessity of using an improved model, taking into account the finite size of the cells, to obtain new insights that may remain hidden otherwise.

  17. Cytological diagnosis of metastatic malignant melanoma by fine-needle aspiration biopsy.

    PubMed

    Lindsey, Kathryn G; Ingram, Courtney; Bergeron, Joseph; Yang, Jack

    2016-07-01

    Despite increased surveillance and public awareness, the incidence of melanoma is increasing. Frequently, fine-needle aspiration is employed for the diagnosis of metastatic disease, and aspirated material is used for cytogenetic and molecular studies to guide treatment options. The pairing of a significant diagnosis with the numerous morphologic variants of melanoma can make the cytologic evaluation disquieting. We present selected examples of our experiences and a brief review of the literature to provide cytodiagnostic clues for this malignancy. The clinical history is foremost, although the fine-needle aspiration (FNA) of metastatic melanoma can provide a diagnosis before identification of the primary lesion in up to 20% of cases. If a history of melanoma is assured, negative results in sampling of pulmonary and subcutaneous nodules should be suspected as false negatives. The smearing pattern usually features poorly cohesive cells. Frankly malignant, spindled, and epithelioid cell shapes are most common, and cytoplasmic vacuoles, if sought on Romanowsky-stained specimens, can usually be found. The telltale feature of melanin production, although diagnostic, is only present in 50% of cases. Finally, eccentric placement of nuclei, nucleoli, and nuclear pseudoinclusions are accessory features for the cytologic interpretation of melanoma. Numerous morphologic patterns of melanoma are potentially seen, but a stepwise approach to diagnosis usually produces a successful result.

  18. Science-related Aspirations Across the Primary-Secondary Divide: Evidence from two surveys in England

    NASA Astrophysics Data System (ADS)

    DeWitt, Jennifer; Archer, Louise; Osborne, Jonathan

    2014-07-01

    Students' engagement with science and the numbers pursuing further study of science continue to be a concern among policy-makers, particularly in Western countries. Previous research reflects that most children have positive attitudes to science at age 10 but that, by age 14, attitudes towards and interest in further pursuit of science have declined. The Science Aspirations and Career Choice (ASPIRES) project, a 5-year longitudinal study, seeks to trace and track changes in students' interest in science and in scientific careers over the key period of ages 10-14. Building on an initial survey (consisting primarily of Likert-type items) of over 9,000 children in their last year of primary school, we explore shifts in attitudes and aspirations in science as reflected in a second survey of students from this cohort (over 5,600 students), completed when children were in their second year of secondary school (ages 12-13). Survey findings are supplemented by longitudinal interview data from 85 children. Contrary to previous research, descriptive, multivariate and multi-level modelling (MLM) analyses of the data indicate that the majority of our sample enjoy school science in secondary school and hold positive views of scientists. However, as with the primary school data, these positive attitudes also continue not to translate into an interest in 'being' a scientist. Attention is drawn to the importance of families and student experiences of school science in helping to explain this gap.

  19. Where are the women? Campus climate and the degree aspirations of women in science, technology, engineering and mathematics programs

    NASA Astrophysics Data System (ADS)

    Schulz, Phyllis

    Women remain underrepresented in science, technology, engineering, and mathematics (STEM) at all levels of higher education, which has become a concern in the competitive global marketplace. Using both quantitative and qualitative analysis, this dissertation sought to learn more about how the campus climate and self-concept influence the degree aspirations of female undergraduate students majoring in STEM programs. Using the Beginning Post-Secondary dataset, regression analyses showed that a student's initial degree aspirations, SAT scores, and interactions with faculty were all positively related to their degree aspirations three years later. Interviews with seven current STEM undergraduates confirmed the importance of interaction with faculty and suggested undergraduate research and classroom experiences also play a role in the degree aspirations of STEM students. Three of the seven students interviewed began their undergraduate educations as non-STEM majors, suggesting that the traditional STEM pipeline may no longer be the norm. These findings suggest that both future research and current practitioners should focus on undergraduate STEM classroom and research experiences. Additionally, the characteristics of students who switch into STEM majors should be explored so that we may continue to expand the number of students pursuing STEM degrees.

  20. Risk Factors for Aspiration Pneumonia in Older Adults

    PubMed Central

    Manabe, Toshie; Teramoto, Shinji; Tamiya, Nanako; Okochi, Jiro; Hizawa, Nobuyuki

    2015-01-01

    Backgrounds Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly. Methodology and Principal Findings We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76%) who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL), and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample) were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16–22.62, p < 0.001), daily oxygen therapy (OR = 8.29, 95% CI: 4.39–15.65), feeding support dependency (OR = 8.10, 95% CI: 6.27–10.48, p < 0.001), and urinary catheterization (OR = 4.08, 95% CI: 2.81–5.91, p < 0.001). In the multiple logistic regression analysis, the risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each) were sputum suctioning (OR = 3.276, 95% CI: 1.910–5.619), deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948–6.952), dehydration (OR = 8.019, 95% CI: 2.720–23.643), and dementia (OR = 1.618, 95% CI: 1.031–2.539). Conclusion The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia

  1. Aspiration in injections: should we continue or abandon the practice?

    PubMed Central

    Sepah, Yasir; Samad, Lubna; Altaf, Arshad; Halim, Muhammad Sohail; Rajagopalan, Nithya; Javed Khan, Aamir

    2017-01-01

    Aspiration during any kind of injection is meant to ensure that the needle tip is at the desired location during this blind procedure. While aspiration appears to be a simple procedure, it has generated a lot of controversy concerning the perceived benefits and indications. Advocates and opponents of aspiration both make logically sound claims. However, due to scarcity of available data, there is no evidence that this procedure is truly beneficial or unwarranted. Keeping in view the huge number of injections given worldwide, it is important that we draw attention to key questions regarding aspiration that, up till now, remain unanswered. In this review, we have attempted to gather and present literature on aspiration both from published and non-published sources in order to provide not only an exhaustive review of the subject, but also a starting point for further studies on more specific areas requiring clarification. A literature review was conducted using the US National Institute of Health’s PubMed service (including Medline), Google Scholar and Scopus. Guidelines provided by the World Health Organization, Safe Injection Global Network, International Council of Nursing, Center for Disease Control, US Federal Drug Agency, UK National Health Services, British Medical Association, Europe Nursing and Midwifery Council, Public Health Agency Canada, Pakistan Medical Association and International Organization of Standardization recommendations 7886 parts 1-4 for sterile hypodermics were reviewed for relevant information. In addition, curricula of several medical/nursing schools from India, Nigeria and Pakistan, the US pharmacopeia Data from the WHO Program for International Drug Monitoring network in regard to adverse events as a result of not aspirating prior to injection delivery were reviewed. Curricula of selected major medical/nursing schools in India, Nigeria and Pakistan, national therapeutic formularies, product inserts of most commonly used drugs and other

  2. Laryngeal Elevation Velocity and Aspiration in Acute Ischemic Stroke Patients

    PubMed Central

    Zhang, Jing; Zhou, Yun; Wei, Na; Yang, Bo; Wang, Anxin; Zhou, Hai; Zhao, Xingquan; Wang, Yongjun; Liu, Liping; Ouyoung, Melody; Villegas, Brenda; Groher, Michael

    2016-01-01

    Objectives Aspiration after stroke has been associated with aspiration pneumonia, which contributes to increased mortality of stroke. Laryngeal elevation is a core mechanism for protection from aspiration. Few studies have explored the predictive value of laryngeal elevation velocity for aspiration after stroke. This study aimed to explore the ability of laryngeal elevation velocity to predict aspiration in patients with acute ischemic stroke. Methods This was a prospective cohort study that included consecutive acute ischemic stroke patients treated at a teaching hospital during a 10-month period. Patients underwent magnetic resonance imaging (MRI) to confirm the diagnosis of acute ischemic stroke. Patients who were at risk of aspiration and could swallow 5 ml of diluted barium (40%, w/v) for a videofluoroscopic swallowing (VFS) study were included. The association between abnormal indices in the oral and pharyngeal phase of the VFS study and aspiration was examined using univariate analyses. These indices included the lip closure, tongue movement and control, laryngeal elevation velocity and range, the latency of pharyngeal swallowing, pharyngeal transit time (PTT), abnormal epiglottis tilt, residual barium in the pharynx, and the duration of upper esophageal sphincter (UES) opening. The laryngeal elevation velocity (%/s) was calculated as the range of laryngeal elevation (%) from the resting position to the maximum superior position or to the position where the laryngeal vestibule is fully closed divided by the corresponding duration of laryngeal elevation. The range of laryngeal elevation (%) was the percentage calculated as the distance between the resting laryngeal position and the maximum superior excursion position or position where the laryngeal vestibule is fully closed divided by the distance between the resting laryngeal position and the lowest edge of the mandible. A logistic regression analysis was used to determine the predictive value for aspiration

  3. Thermal blooming on laser propagation in an aspirating pipe

    NASA Astrophysics Data System (ADS)

    Zhu, Fuyin; Wang, Jihong; Ren, Ge; Tan, Yufeng; Zhu, Nengbing; Ai, Zhiwei

    2016-10-01

    Thermal blooming effect of gas on laser propagation can seriously degrade performance of far-field beam quality and energy distribution. Numerical simulation is carried out to study the influences of thermal blooming on laser propagation in line pipes. A physical model of thermal blooming effect of gas on laser propagation in an aspirating pipe is established. Axial flow and suction in the outlet are used to attenuate the thermal blooming effect. Based on the computational fluid dynamics (CFD) software, stable calculation of flow field is carried out first, then the optical field and the fluent field is coupling calculated by means of user defined function (UDF). The results show that radial flow is enhanced in the aspirating pipe and the index of refraction gradient caused by thermal blooming effect is decreased. It is indicated that the beam quality of the outlet is improved compared with the pipe model without aspirating. The optical path difference (OPD) distribution of the outlet is analyzed and decomposed by Zernike polynomials. It is shown that the defocus item of 4m aspirating pipe is decreased more than an order of magnitude compared with the 4m pipe without aspirating.

  4. Dental prosthesis aspiration: An uncommon cause of respiratory distress.

    PubMed

    De Wilde, Belphine A L; Malfait, Thomas L; Bonte, Katrien; Malfait, Thomas L A

    2016-12-01

    We present a case of a 66-year-old Caucasian man with acute respiratory distress. The patient had a history of multiple cerebrovascular accidents which resulted in left hemiplegia, swallowing problems, and aphasia. He was tentatively diagnosed with aspiration pneumonia. However, because of clinical deterioration further investigations concluded to the aspiration of a dental prosthesis. After intubation and stabilization, the prosthesis could be manually extracted. However, the patient developed a Staphylococcus epidermidis sepsis and despite adequate antibiotic therapy, he eventually died. Dental prosthesis aspiration is a medical situation associated with a higher morbidity and mortality rate compared to ingested foreign bodies. It requires a high level of suspicion to ensure a timely diagnosis and life-saving treatment. Thorough history taking is of great importance in case of tracheobronchial aspiration, which is in the adult population mostly secondary to an underlying disorder. In impaired adults with missing dental prostheses there should be extra awareness for this problem. This case report illustrates the importance of a detailed history in case of tracheobronchial aspiration and shows the limitations in the diagnostic usefulness of bedside chest radiography.

  5. Pulmonary aspiration of gastric contents during routine endoscopy

    SciTech Connect

    La France, N.D.; Cole, P.; Wolfe, E.; Giardello, F.; Wagner, H.N.

    1985-05-01

    Radioactive tracer studies are a sensitive means to detect occult pulmonary aspiration of gastric contents. A complication of diagnostic endoscopy is aspiration of contents even in fasted patients. The authors have studied 21 hospitalized patients who underwent elective endoscopy (END) for suspected UGI pathology. Fifteen minutes before END, and prior to pharygeal anesthesia, 1 mCi Tc-99m-sulfur colloid, added to the usual 30cc of simethicone routinely administered before END, was given orally. END was performed as usual and 2 hours later anterior 100,000 count images of the chest were obtained. All the studies were interpreted without history or clinical information. Fever developed within 24 hours (and septic shock in 1) in both patients with positive studies while no fever occurred in the remaining patients with negative studies (rho<.001). The authors conclude that oral radionuclide pulmonary aspiration studies may; detect aspiration not recognized by the endoscopist, reveal evidence of aspiration that preceeds adverse clinical signs and symptoms, and be influenced by systemic pre-END drugs known to affect GI secretions and motility.

  6. Prevention and treatment of aspiration pneumonia in intensive care units.

    PubMed

    d'Escrivan, Thibaud; Guery, Benoit

    2005-01-01

    Aspiration is a leading cause of nosocomial infection in the intensive care unit. Techniques to avoid or reduce aspiration are important in preventing pneumonia and pneumonitis. The most important preventive measures include the semi-recumbent position, the surveillance of enteral feeding, the use of promotility agents, and avoiding excessive sedation. The analysis of the pathogens involved in these syndromes usually shows a minor role for the anerobes. With regard to treatment, aspiration pneumonitis does not require any antimicrobials; on the contrary, aspiration pneumonia has to be treated. Empiric antimicrobials treatment should be started on clinical suspicion. The choice of the drug has to be guided by local pathogen epidemiology and clinical features; in fact, community type pneumonia requires a first-line antimicrobial such as amoxicillin/clavulanic acid. On the contrary, a nosocomial type of infection needs to be treated as a ventilator-associated pneumonia in agreement with published guidelines. Nevertheless, quantitative culture should be obtained in order to de-escalate antimicrobials. In conclusion, aspiration pneumonia is a frequently encountered disease that can be prevented by relatively simple measures.

  7. If Stigmatized, Self-Esteem Is not Enough: Effects of Sexism, Self-Esteem and Social Identity on Leadership Aspiration.

    PubMed

    Fedi, Angela; Rollero, Chiara

    2016-11-01

    Ambivalent sexism has many pernicious consequences. Since gender stereotypes also affect leadership roles, the present research investigated the effects of ambivalent sexism on envisioning oneself as a leader. Our studies tested the influence of sexist attitudes (toward women - Study 1 - and men - Study 2) on leadership aspiration, taking into account the interaction among ambivalent attitudes, personal characteristics (e.g. self-esteem), and group processes (e.g. level of identification with gender). Specifically, the current study used a 3 (sexism: hostile, benevolent, control) x 2 (social identification: high, low) x 2 (self-esteem: high, low) factorial design. 178 women participated in Study 1. Results showed that, although sexism was not recognised as a form of prejudice and did not trigger negative emotions, in sexist conditions high-identified women increase their leadership aspiration. In Study 2 men (N = 184) showed to recognise hostility as a form of prejudice, to experience more negative emotions, but to be not influenced in leadership aspiration. For both men and women self-esteem had a significant main effect on leadership aspiration.

  8. Determination of the Poisson's ratio of the cell: recovery properties of chondrocytes after release from complete micropipette aspiration.

    PubMed

    Trickey, Wendy R; Baaijens, Frank P T; Laursen, Tod A; Alexopoulos, Leonidas G; Guilak, Farshid

    2006-01-01

    Chondrocytes in articular cartilage are regularly subjected to compression and recovery due to dynamic loading of the joint. Previous studies have investigated the elastic and viscoelastic properties of chondrocytes using micropipette aspiration techniques, but in order to calculate cell properties, these studies have generally assumed that cells are incompressible with a Poisson's ratio of 0.5. The goal of this study was to measure the Poisson's ratio and recovery properties of the chondrocyte by combining theoretical modeling with experimental measures of complete cellular aspiration and release from a micropipette. Chondrocytes isolated from non-osteoarthritic and osteoarthritic cartilage were fully aspirated into a micropipette and allowed to reach mechanical equilibrium. Cells were then extruded from the micropipette and cell volume and morphology were measured throughout the experiment. This experimental procedure was simulated with finite element analysis, modeling the chondrocyte as either a compressible two-mode viscoelastic solid, or as a biphasic viscoelastic material. By fitting the experimental data to the theoretically predicted cell response, the Poisson's ratio and the viscoelastic recovery properties of the cell were determined. The Poisson's ratio of chondrocytes was found to be 0.38 for non-osteoarthritic cartilage and 0.36 for osteoarthritic chondrocytes (no significant difference). Osteoarthritic chondrocytes showed an increased recovery time following full aspiration. In contrast to previous assumptions, these findings suggest that chondrocytes are compressible, consistent with previous studies showing cell volume changes with compression of the extracellular matrix.

  9. If Stigmatized, Self-Esteem Is not Enough: Effects of Sexism, Self-Esteem and Social Identity on Leadership Aspiration

    PubMed Central

    Fedi, Angela; Rollero, Chiara

    2016-01-01

    Ambivalent sexism has many pernicious consequences. Since gender stereotypes also affect leadership roles, the present research investigated the effects of ambivalent sexism on envisioning oneself as a leader. Our studies tested the influence of sexist attitudes (toward women – Study 1 – and men – Study 2) on leadership aspiration, taking into account the interaction among ambivalent attitudes, personal characteristics (e.g. self-esteem), and group processes (e.g. level of identification with gender). Specifically, the current study used a 3 (sexism: hostile, benevolent, control) x 2 (social identification: high, low) x 2 (self-esteem: high, low) factorial design. 178 women participated in Study 1. Results showed that, although sexism was not recognised as a form of prejudice and did not trigger negative emotions, in sexist conditions high-identified women increase their leadership aspiration. In Study 2 men (N = 184) showed to recognise hostility as a form of prejudice, to experience more negative emotions, but to be not influenced in leadership aspiration. For both men and women self-esteem had a significant main effect on leadership aspiration. PMID:27872665

  10. Aspiration biopsy of testis: another method for histologic examination

    SciTech Connect

    Nseyo, U.O.; Englander, L.S.; Huben, R.P.; Pontes, J.E.

    1984-08-01

    The most important method for evaluating the pathogenesis of male infertility is open testicular biopsy. Herein the authors describe a method of aspiration biopsy of testis for histologic examination. Sexually mature dogs and rats treated with chemotherapeutic agents and ionizing radiation were followed with periodic testicular aspiration biopsy during and after treatment. The histologic findings from the aspiration biopsy compare with the results of routine histologic examination in assessing spermatogenetic activity and delineating pathologic changes. The puncture in the experimental animals was performed under general anesthesia. In human patients testicular biopsy could be done under local anesthesia in an outpatient clinic. The procedure would be less painful, minimally invasive, and more cost-effective.

  11. UNCERTAINTY IN EARLY OCCUPATIONAL ASPIRATIONS: ROLE EXPLORATION OR AIMLESSNESS?

    PubMed Central

    Staff, Jeremy; Harris, Angel; Sabates, Ricardo; Briddell, Laine

    2014-01-01

    Many youth in the United States lack clear occupational aspirations. This uncertainty in achievement ambitions may benefit socioeconomic attainment if it signifies “role exploration,” characterized by career development, continued education, and enduring partnerships. By contrast, uncertainty may diminish attainment if it instead leads to “aimlessness,” involving prolonged education without the acquisition of a degree, residential dependence, and frequent job changes. We use nationally representative data from the National Education Longitudinal Study (NELS) to examine how uncertainty in occupational aspirations in adolescence (age 16) affects wage attainments in young adulthood (age 26). Results suggest that youth with uncertain career ambitions earn significantly lower hourly wages in young adulthood than youth with professional and non-professional aspirations, supporting the view that uncertainty heightens the risk of labor-market problems. PMID:25540465

  12. The Reamer-Irrigator-Aspirator System: A Review.

    PubMed

    Billow, Damien; Khlopas, Anton; Chughtai, Morad; Saleh, Anas; Siqueira, Marcelo B; Marinello, Patrick; Mont, Michael A

    2016-10-26

    The reamer-irrigator-aspirator (RIA) system has been recently developed to decrease the incidence of osseous thermal necrosis and fat embolism associated with intramedullary reaming of long bones in trauma cases. This is achieved by continuous irrigation and suction. Recently, the use of RIA has been expanded to harvest bone graft and debride the medullary canal of long bones in cases of osteomyelitis and intramedullary tumors. Additionally, the collection system of this device has been utilized for its ability to capture bone graft and marrow aspirate. The purpose of this study is to report a comprehensive literature review on the: 1) use of RIA for canal reaming prior to intramedullary nailing; 2) use of RIA for the treatment of intramedullary osteomyelitis of long bones; 3) use of RIA for bone graft harvesting; 4) osteogenic potential of the RIA aspirate; and 5) future applications of the RIA system.

  13. Aspiration prevention protocol: decreasing postoperative pneumonia in heart surgery patients.

    PubMed

    Starks, Bobbie; Harbert, Christy

    2011-10-01

    BACKGROUND Postoperative pneumonia contributes to morbidity and mortality in patients who have open heart surgery. OBJECTIVES To determine if measures to reduce aspiration in patients after cardiothoracic surgery would decrease the occurrence of postoperative pneumonia. METHODS All patients undergoing cardiothoracic surgery from April 2008 through October 2008 were prospectively enrolled in the study. An aspiration prevention protocol was developed and implemented in a 24-bed intensive care unit. The protocol incorporated a bedside swallowing evaluation by a speech therapist and progressive oral intake. RESULTS In the 6 months before development and implementation of the protocol, postoperative pneumonia developed in 11% of patients. After implementation of the protocol, no patients had postoperative pneumonia (P < .01). CONCLUSIONS Implementing an aspiration prevention protocol was effective in reducing the occurrence of postoperative pneumonia in patients who had cardiothoracic surgery.

  14. Aspiration pneumonia in an infant with neurological sequelae - case report.

    PubMed

    Dop, Dalia; Gheonea, Cristian; Stănescu, Georgeta Ligia; Moroşanu, Aritina Elvira; Diaconu, Radu; Niculescu, Elena Carmen; Ognean, Maria Livia; Niculescu, Dragoş

    2015-01-01

    Aspiration pneumonia is a frequent cause of morbidity and mortality in children with neurological deficits. We present the case of a 4-month-old infant from the Foster Care Center, with severe psychomotor retardation, blindness, and associated cardiac malformation, who was admitted to the Pediatrics Clinic of the Emergency County Hospital of Craiova, Romania, presenting aspiration pneumonia and moderate respiratory insufficiency. Under sustained, early instituted treatment, the evolution was towards death. The chest radiography and histopathological examination of the pulmonary tissue confirmed the diagnosis. The neurological impairment was not only a favoring factor for aspiration, through the deglutition disorders, but it was also an aggravating one, through the bacterial colonization of the lungs.

  15. Bladder outlet obstruction treated with transurethral ultrasonic aspiration

    NASA Astrophysics Data System (ADS)

    Malloy, Terrence R.

    1991-07-01

    Fifty-nine males with bladder outlet obstruction were treated with transurethral ultrasonic aspiration of the prostate. Utilizing a 26.5 French urethral sheath, surgery was accomplished with a 10 French, 0-700 micron vibration level ultrasonic tip with an excursion rate of 39 kHz. Complete removal of the adenoma was accomplished, followed by transurethral electrocautery biopsies of both lateral lobes to compare pathologic specimens. One-year follow-up revealed satisfactory voiding patterns in 57 of 59 men (96%). Two men developed bladder neck contractures. Pathologic comparisons showed 100% correlation between aspirated and TUR specimens (56 BPH, 3 adeno-carcinoma). Forty-sevel men were active sexually preoperatively (6 with inflatable penile prostheses). Post ultrasonic aspiration, 46 men had erectile function similar to preoperative levels with one patient suffering erectile dysfunction. Forty men (85%) had antegrade ejaculation while 7 (15%) experienced retrograde or retarded ejaculation. No patients were incontinent.

  16. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

    PubMed Central

    Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.

    2016-01-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents’ attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

  17. Evaluation of the lipid-rich layer of reamer aspirate.

    PubMed

    Kay Sinclair, Sarina S; Jeray, Kyle J; Tanner, Stephanie L; Burg, Karen J L

    2010-08-01

    The fatty layer of aspirate obtained by reaming the femoral shaft using a reamer/irrigator/aspirator (RIA) device was characterized for fatty acid content and the presence of adult stem cells. Gas chromatography analysis was performed on samples taken from multiple patients to determine and compare the fatty acid contents of aspirate lipid samples. All four patients had the same four fatty acids present in the highest percentages: oleic, palmitic, linoleic and stearic. After successful isolation from bulk material, cells isolated from this lipid-rich layer were studied to determine their osteogenic and growth potential on a clinically available ceramic bone graft substitute. The results of metabolic activity and intracellular protein assays indicated that the ceramics supported growth of the cells isolated from the aspirate fat layer, although levels of alkaline phosphatase (ALP) expression were low for cells grown on the ceramics. Cells will not transition along the osteogenic pathway when they are actively dividing, and active growth may have contributed to the lack of ALP expression in this study. Isolated cells grown on tissue culture plastic expressed significant levels of the bone marker ALP. The results of this study suggest that cells isolated from the fat layer of RIA aspirate proliferate on ceramic bone void filler and have the potential to differentiate along an osteogenic pathway. Previously considered waste, the lipid-rich fat layer of aspirate may be a source of mesenchymal stem cells that, either alone or in conjunction with currently available synthetic bone graft material, could be used to stimulate new bone growth.

  18. AstroBiology Explorer Mission Concepts (ABE/ASPIRE)

    NASA Technical Reports Server (NTRS)

    Sandford, Scott; Ennico, Kimberly A.

    2006-01-01

    The AstroBiology Explorer (ABE) and the Astrobiology Space InfraRed Explorer (ASPIRE) Mission Concepts are two missions designed to address the questions (1) Where do we come from? and (2) Are we alone? as outlined in NASA s Origins Program using infrared spectroscopy to explore the identity, abundance, and distribution of molecules of astrobiological importance throughout the Universe. The ABE mission s observational program is focused on six tasks to: (1) Investigate the evolution of ice and organics in dense clouds and star formation regions, and the young stellar/planetary systems that form in them; (2) Measure the evolution of complex organic molecules in stellar outflows; (3) Study the organic composition of a wide variety of solar system objects including asteroids, comets, and the planets and their satellites; (4) Identify organic compounds in the diffuse interstellar medium and determine their distribution , abundance, and change with environment; (5) Detect and identify organic compounds in other galaxies and determine their dependence on galactic type; and (6) Measure deuterium enrichments in interstellar organics and use them as tracers of chemical processes. The ASPIRE mission s observational program expands upon ABE's core mission and adds tasks that (7) Address the role of silicates in interstellar organic chemistry; and (8) Use different resolution spectra to assess the relative roles and abundances of gas- and solid-state materials. ABE (ASPIRE) achieves these goals using a highly sensitive, cryogenically-cooled telescope in an Earth drift-away heliocentric orbit, armed with a suite of infrared spectrometers that cover the 2.5-20(40) micron spectral region at moderate spectral resolution (R>2000). ASPIRE's spectrometer complement also includes a high-resolution (R>25,000) module over the 4-8 micron spectral region. Both missions target lists are chosen to observe a statistically significant sample of a large number of objects of varied types in

  19. Cytologic findings of tracheobronchial aspirates from 66 thoroughbred racehorses.

    PubMed

    Sweeney, C R; Humber, K A; Roby, K A

    1992-07-01

    Tracheobronchial aspirates obtained from 66 healthy Thoroughbred racehorses in training at the same track were examined. Twenty-seven percent of the horses had greater than 20% neutrophils in the aspirate. Eosinophils, mast cells, giant cells, and Curschmann's spirals of mucus were observed in 94, 83, 65, and 42% of the horses, respectively. Hemosiderophages were observed in 86% of the horses, half of which had previous confirmation of exercise-induced pulmonary hemorrhage. Although fungal elements were seen in 70% of the horses, bacteria were detected in only 3% of the horses. The authors conclude that inflammatory airway disease is widespread in the racing Thoroughbred population.

  20. Cooperation in aspiration-based N -person prisoner's dilemmas

    NASA Astrophysics Data System (ADS)

    Płatkowski, Tadeusz; Bujnowski, Paweł

    2009-03-01

    We propose a mathematical model of the N -person prisoner’s dilemma game played by a continuous population of agents with a time-dependent aspiration level. The model—a system of differential equations—takes into account the evolution of the aspiration level and of the mean frequency of the cooperators in the population. The dependence of the asymptotic level of cooperation on the individual payoffs and on the transition rates determining the agent’s reaction to the received payoffs is studied. In general the existence and the magnitude of the asymptotic level of cooperation depends on N , the payoffs and the transition rates, and decreases with increasing N .

  1. Pulmonary Aspiration of Gastric Acid—Mendelson's Syndrome

    PubMed Central

    Berris, Barnet; Kasler, David

    1965-01-01

    Three cases of pulmonary aspiration of gastric acid as a complication of obstetrical anesthesia are described. The clinical picture consists of dyspnea, cyanosis, tachycardia and shock appearing several hours after the aspiration has occurred. On examination, the chest may be quite clear, but the chest radiograph shows a picture indistinguishable from that of pulmonary edema. The most important therapeutic measure is the intravenous administration of corticosteroids in large doses for several days. Bronchoscopy is contraindicated. With routine use of epidural anesthesia, this obstetrical complication can be avoided. PMID:14289137

  2. Relationship of school context to rural youth's educational achievement and aspirations.

    PubMed

    Irvin, Matthew J; Meece, Judith L; Byun, Soo-Yong; Farmer, Thomas W; Hutchins, Bryan C

    2011-09-01

    Though the poverty encountered by many rural youth encompasses numerous developmental challenges and substantially increases the chances for educational problems, the school context is central to promoting and constraining their development. Therefore, the purpose of this study was to investigate the relationship of school characteristics and schooling experiences to the educational achievement and aspirations of youth from high-poverty rural communities. Differences in the relationship of school characteristics and schooling experiences to the educational outcomes of students from high- versus low-poverty rural communities were also examined. Participants included 6,247 high school students from 43 low-poverty and 21 high-poverty rural communities. Approximately 51.7% of participants were female and the sample was racially/ethnically diverse (66.4% White, 9.2% African American, 8.1% Hispanic/Latino(a), 4.4% Native American, and 11.8% Multiracial). After controlling for student and family background, school characteristics (e.g., lower student-teacher ratio) were predictive of achievement for rural youth from high-poverty communities. Schooling experiences (e.g., positive perceptions of their ability, a sense of school valuing and belonging, and preparation for postsecondary education) were predictive of educational achievement and aspirations for rural youth from high- and low-poverty communities. Overall, the study highlights unique ways schools can positively shape the educational outcomes for rural youth despite community poverty.

  3. Structure of a micropipette-aspirated vesicle determined from the bending-energy model.

    PubMed

    Chen, Jeff Z Y

    2012-10-01

    The structure of the system consisting of an aspirating pipette and an aspirated vesicle is investigated with fixed total vesicle volume, total vesicle surface area, and aspirated volume fraction, based on the bending-energy model. Through an energetic consideration, the usage of an aspirated volume fraction can be converted to the aspirating pressure for the determination of a phase diagram; the procedure identifies a first-order transition, between a weakly aspirated state and the strongly aspirated state, as the pressure increases. The physical properties of the system are obtained from minimization of the bending energy by an implementation of the simulated annealing Monte Carlo procedure, which searches for a minimum in a multivariable space. An analysis of the hysteresis effects indicates that the experimentally observed aspirating and releasing critical pressures are related to the location of the spinodal points.

  4. Sex Differences in the Determination of Adolescent Aspirations: A Review of Research.

    ERIC Educational Resources Information Center

    Marini, Margaret Mooney

    1978-01-01

    Factors influencing levels of adolescent aspiration are reviewed, including socioeconomic background, academic ability, number of siblings, parental encouragement, mother's employment, academic performance, peer aspirations, dating, and participation in school activities. Although sex differences affect the formation of both educational and…

  5. The Path Taken: Consequences of Attaining Intrinsic and Extrinsic Aspirations in Post-College Life.

    PubMed

    Niemiec, Christopher P; Ryan, Richard M; Deci, Edward L

    2009-06-01

    Life goals, or aspirations, organize and direct behavior over extended periods of time. The present study, guided by self-determination theory, examined the consequences of pursuing and attaining aspirations over a one-year period in a post-college sample. Results indicated that placing importance on either intrinsic or extrinsic aspirations related positively to attainment of those goals. Yet, whereas attainment of intrinsic aspirations related positively to psychological health, attainment of extrinsic aspirations did not; indeed, attainment of extrinsic aspirations related positively to indicators of ill-being. Also as predicted, the association between change in attainment of intrinsic aspirations and change in psychological health was mediated by change in the satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Discussion focuses on the idea that not all goal attainment is beneficial; rather, attainment of aspirations with different contents relates differentially to psychological health.

  6. The Path Taken: Consequences of Attaining Intrinsic and Extrinsic Aspirations in Post-College Life

    PubMed Central

    Niemiec, Christopher P.; Ryan, Richard M.; Deci, Edward L.

    2009-01-01

    Life goals, or aspirations, organize and direct behavior over extended periods of time. The present study, guided by self-determination theory, examined the consequences of pursuing and attaining aspirations over a one-year period in a post-college sample. Results indicated that placing importance on either intrinsic or extrinsic aspirations related positively to attainment of those goals. Yet, whereas attainment of intrinsic aspirations related positively to psychological health, attainment of extrinsic aspirations did not; indeed, attainment of extrinsic aspirations related positively to indicators of ill-being. Also as predicted, the association between change in attainment of intrinsic aspirations and change in psychological health was mediated by change in the satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Discussion focuses on the idea that not all goal attainment is beneficial; rather, attainment of aspirations with different contents relates differentially to psychological health. PMID:20161160

  7. Does aspiration of bones and joints affect results of later bone scanning

    SciTech Connect

    Canale, S.T.; Harkness, R.M.; Thomas, P.A.; Massie, J.D.

    1985-01-01

    To determine the effect, if any, of needle aspiration on /sup 99m/Tc bone scanning, three different areas of 15 dogs were first aspirated and then imaged with technetium bone scintigraphy. The hip joint was aspirated, the distal femoral metaphysis was drilled and aspirated, and the tibial periosteum was scraped with an 18- or 20-gauge needle. Varying amounts of trauma were inflicted to simulate varying difficulties at aspiration. /sup 99m/Tc bone scans were obtained from 5 h to 10 days later. There was no evidence of focal technetium uptake after any hip joint aspiration. This was consistent regardless of the amount of trauma inflicted or the time from aspiration to bone scanning. Metaphyseal cortical drilling and tibial periosteal scraping occasionally caused some focal uptake when scanning was delayed greater than 2 days. When osteomyelitis or pyarthrosis is clinically suspected, joint aspiration can be performed without fear of producing a false- positive bone scan.

  8. Endoscopic ultrasound in the diagnosis of mediastinal diseases

    PubMed Central

    Wang, Zhiguo; Jiang, Chunmeng

    2015-01-01

    EUS is a useful tool for diagnosis of mediastinal diseases. EUS-FNA plays an important role in staging of lung cancer and in tissue acquisition in patients with mediastinal masses. In this review, the following issues will be addressed: EUS-FNA and EBUS-TBNA, metastatic mediastinal lymph nodes diagnosed by EUS, EUS in assessment of mediastinal lymph node status for staging of lung cancer, mediastinal lymphoma diagnosed by EUS, sarcoidosis and tuberculosis diagnosed by EUS. PMID:28352755

  9. Comparison of the CDC Backpack aspirator and the Prokopack aspirator for sampling indoor- and outdoor-resting mosquitoes in southern Tanzania

    PubMed Central

    2011-01-01

    Background Resting mosquitoes can easily be collected using an aspirating device. The most commonly used mechanical aspirator is the CDC Backpack aspirator. Recently, a simple, and low-cost aspirator called the Prokopack has been devised and proved to have comparable performance. The following study evaluates the Prokopack aspirator compared to the CDC backpack aspirator when sampling resting mosquitoes in rural Tanzania. Methods Mosquitoes were sampled in- and outdoors of 48 typical rural African households using both aspirators. The aspirators were rotated between collectors and households in a randomized, Latin Square design. Outdoor collections were performed using artificial resting places (large barrel and car tyre), underneath the outdoor kitchen (kibanda) roof and from a drop-net. Data were analysed with generalized linear models. Results The number of mosquitoes collected using the CDC Backpack and the Prokopack aspirator were not significantly different both in- and outdoors (indoors p = 0.735; large barrel p = 0.867; car tyre p = 0.418; kibanda p = 0.519). The Prokopack was superior for sampling of drop-nets due to its smaller size. The number mosquitoes collected per technician was more consistent when using the Prokopack aspirator. The Prokopack was more user-friendly: technicians preferred using the it over the CDC backpack aspirator as it weighs considerably less, retains its charge for longer and is easier to manoeuvre. Conclusions The Prokopack proved in the field to be more advantageous than the CDC Backpack aspirator. It can be self assembled using simple, low-cost and easily attainable materials. This device is a useful tool for researchers or vector-control surveillance programs operating in rural Africa, as it is far simpler and quicker than traditional means of sampling resting mosquitoes. Further longitudinal evaluations of the Prokopack aspirator versus the gold standard pyrethrum spray catch for indoor resting catches are recommended. PMID

  10. Effects of coda voicing and aspiration on Hindi vowels

    NASA Astrophysics Data System (ADS)

    Lampp, Claire; Reklis, Heidi

    2001-05-01

    This study reexamines the well-attested coda voicing effect on vowel duration [Chen, Phonetica 22, 125-159 (1970)], in conjunction with the relationship between vowel duration and aspiration of codas. The first step was to replicate the results of Maddieson and Gandour [UCLA Working Papers Phonetics 31, 46-52 (1976)] with a larger, language-specific data set. Four nonsense syllables ending in [open-o] followed by [k, kh, g, gh] were read aloud in ten different carrier sentences by four native speakers of Hindi. Results confirm that longer vowels precede voiced word-final consonants and aspirated word-final consonants. Thus, among the syllables, vowel duration would be longest when preceding the voiced aspirate [gh]. Coda voicing, and thus, vowel duration, have been shown to correlate negatively to vowel F1 in English and Arabic [Wolf, J. Phonetics 6, 299-309 (1978); de Jong and Zawaydeh ibid, 30, 53-75 (2002)]. It is not known whether vowel F1 depends directly on coda voicing, or is determined indirectly via duration. Since voicing and aspiration both increase duration, F1 measurements of this data set (which will be presented) may answer that question.

  11. Parental Involvement, Children's Aspirations, and Achievement in New Immigrant Families

    ERIC Educational Resources Information Center

    Jung, Eunjoo; Zhang, Yue

    2016-01-01

    The authors investigated the relationships among multiple aspects of parental involvement (English proficiency, school involvement, control and monitoring of children), children's aspirations, and achievement in new immigrant families in the United States. They used data on immigrant parents and school-age children (N = 1,255) from the New…

  12. Uncertainty in Early Occupational Aspirations: Role Exploration or Aimlessness?

    ERIC Educational Resources Information Center

    Staff, Jeremy; Harris, Angel; Sabates, Ricardo; Briddell, Laine

    2010-01-01

    Many youth in the United States lack clear occupational aspirations. This uncertainty in achievement ambitions may benefit socio-economic attainment if it signifies "role exploration," characterized by career development, continued education and enduring partnerships. By contrast, uncertainty may diminish attainment if it instead leads…

  13. Failing Young People? Education and Aspirations in a Deprived Community

    ERIC Educational Resources Information Center

    Sinclair, S.; McKendrick, J. H.; Scott, G.

    2010-01-01

    Recent UK government statements and education policies have emphasized the need to instil a "culture of aspiration" among young people in deprived communities to address social exclusion. Specific proposals include raising the school leaving age to 18 and extending compulsory employment training. These statements and measures express the…

  14. Personal Commitment: A Prerequisite for Women Aspiring to Educational Administration.

    ERIC Educational Resources Information Center

    Moore, Colleen A.

    The decline in the number and status of women in educational administration and the magnitude of their lack of representation in administrative positions is evidenced by numerous studies. To achieve the goal of identifying the components of the problem, solutions suggested by the research, and implications for women who aspire to administrative…

  15. Bacteriology of aspiration pneumonia in patients with acute coma.

    PubMed

    Lauterbach, Enise; Voss, Frederik; Gerigk, Roland; Lauterbach, Michael

    2014-12-01

    Loss of protective airway reflexes in patients with acute coma puts these patients at risk of aspiration pneumonia complicating the course of the primary disease. Available data vary considerably with regard to bacteriology, role of anaerobic bacteria, and antibiotic treatment. Our objective was to research the bacteriology of aspiration pneumonia in acute coma patients who were not pre-treated with antibiotics or hospitalized within 30 days prior to the event. We prospectively analyzed 127 patient records from adult patients admitted, intubated and ventilated to a tertiary medical intensive care unit with acute coma. Bacteriology and antibiotic resistance testing from tracheal aspirate sampled within 24 h after admission, blood cultures, ICU scores (APACHE II, SOFA), hematology, and clinical chemistry were assessed. Patients were followed up until death or hospital discharge. The majority of patients with acute coma suffered from acute cardiovascular disorders, predominantly myocardial infarction, followed by poisonings, and coma of unknown cause. In a majority of our patients, microaspiration resulted in overt infection. Most frequently S. aureus, H. influenzae, and S. pneumoniae were isolated. Anaerobic bacteria (Bacteroides spec., Fusobacteria, Prevotella spec.) were isolated from tracheal aspirate in a minority of patients, and predominantly as part of a mixed infection. Antibiotic monotherapy with a 2nd generation cephalosporin, or a 3rd generation gyrase inhibitor, was most effective in our patients regardless of the presence of anaerobic bacteria.

  16. Aspiration Levels and Educational Choices: An Experimental Study

    ERIC Educational Resources Information Center

    Page, Lionel; Garboua, Louis Levy; Montmarquette, Claude

    2007-01-01

    The explanation of social inequalities in education is still a debated issue in economics. Recent empirical studies tend to downplay the potential role of credit constraint. This article tests a different potential explanation of social inequalities in education, specifically that social differences in aspiration level result in different…

  17. Auditing Inequity: Teaching Aspiring Administrators to Be Social Justice Leaders

    ERIC Educational Resources Information Center

    Hernandez, Frank; Marshall, Joanne

    2017-01-01

    While much has been written about preparing educational leaders to lead for social justice, much less has been written about how to do so. This study is one of the first to analyze the reflections and written assignments of aspiring administrators to determine what they are currently thinking about poverty, race/ethnicity, and social justice…

  18. Women Teachers' Aspirations to School Leadership in Uganda

    ERIC Educational Resources Information Center

    Sperandio, Jill; Kagoda, Alice Merab

    2010-01-01

    Purpose: The under-representation of women in the leadership of secondary schooling is a problem common to many developing countries, raising issues of social justice and sustainable development. It has its roots in societal understandings about leadership, the schooling and career aspirations of girls, the organizational characteristics of the…

  19. Needed: A Valid Measure of Women's Career Aspirations.

    ERIC Educational Resources Information Center

    Lentz, Linda P.

    As part of a longitudinal study of women's and coeducational college graduates, women's career salience ratings and aspirations were compared. Participants were 1979 female graduates of 15 small, private, liberal arts colleges in the northeastern United States that had three selectivity levels: selective, very selective, and highly selective. A…

  20. Latino Males Degree Aspirations in Community College: A Qualitative Study

    ERIC Educational Resources Information Center

    Dorame, Francisco

    2012-01-01

    Latino males are the least likely to attend, persist, and attain a baccalaureate degree compared to other male groups in higher education. Moreover, they tend to have the lowest degree aspirations of any major race or ethnic group (Saenz & Ponjuan, 2009; Driscoll, 2007; Swail, Cabrera, & Lee, 2004; Laanan, 2000; Kao & Tienda, 1998). To…

  1. The Career Aspirations of Rural Appalachian High School Students

    ERIC Educational Resources Information Center

    Ali, Saba Rasheed; Saunders, Jodi L.

    2009-01-01

    The purpose of the present study was to investigate the contributions of several social cognitive career theory (SCCT) factors in predicting the career aspirations of a group of high school students living in the central part of rural Appalachia. Sixty-three high school students completed measures assessing their vocational/educational…

  2. Career Aspirations of Undergraduate Mathematics Majors: An Exploratory Study

    ERIC Educational Resources Information Center

    Piotrowski, Chris; Hemasinha, Rohan

    2012-01-01

    There has been much research attention on ability level, motivation, and self-efficacy of students at schools of science, technology, engineering and mathematics (STEM). However, there is scant research on vocational choice, career development and aspirations of these students. The current study addresses this gap in the literature by asking…

  3. The Evolution of Roles and Aspirations: Burgeoning Choices for Females.

    ERIC Educational Resources Information Center

    Scott, Robert A.

    Traditional female status, roles, and aspirations and changes that have occurred in American society are traced. While women were barred from colleges and universities in the 1800's, they now account for more than 50 percent of college students. It is projected that by the year 2000, women will represent an even larger percentage of the college…

  4. Desired Mobility or Satisfied Immobility? Migratory Aspirations among Knowledge Workers

    ERIC Educational Resources Information Center

    Ferro, Anna

    2006-01-01

    Among the aspects discussed within the globalisation process, the international mobility of professional workers assumes considerable relevance. This paper focuses on migratory aspirations among knowledge workers within the context of economic globalisation and market restructuring in Romania. Due to a lack of literature dealing with these issues,…

  5. Aspirations, Expectations, and Attitudes of South Carolina High School Students.

    ERIC Educational Resources Information Center

    Boyd, Virlyn A.

    Forty-two representative South Carolina high schools were surveyed via similar, group administered questionnaires in 1966-67 (5,400 sophomore students) and again in 1969-69 (4,376 senior students) to determine: (1) the aspirations and expectations of South Carolina youth with regard to occupation, education, marriage and family size, future…

  6. Searching for Autonomy: Young Black Men, Schooling and Aspirations

    ERIC Educational Resources Information Center

    Law, Ian; Finney, Sarah; Swann, Sarah Jane

    2014-01-01

    This article examines the relationships between being young and black, and educational and career aspirations, drawing on new research evidence from two recent studies carried out in two urban locations in Northern England. The first of these studies forms part of a wider research project concerned with analysing the connections between aspects of…

  7. First-Year Student Aspirations: A Multinodal Analysis

    ERIC Educational Resources Information Center

    Grellier, Jane

    2014-01-01

    This article explores the aspirations of first-year university students in a particular socio-geographic context, by juxtaposing this context with those of Western universities in the 1970s. The rhizomatic analysis enables student voices and personal narratives to complement, extend and undercut the words of published researchers and of the…

  8. The Hierarchical Personality Structure of Aspiring Creative Writers

    ERIC Educational Resources Information Center

    Maslej, Marta M.; Rain, Marina; Fong, Katrina; Oatley, Keith; Mar, Raymond A.

    2014-01-01

    Empirical studies of personality traits in creative writers have demonstrated mixed findings, perhaps due to issues of sampling, measurement, and the reporting of statistical information. The goal of this study is to quantify the personality structure of aspiring creative writers according to a modern hierarchal model of trait personality. A…

  9. Effects of coda voicing and aspiration on Hindi vowels

    NASA Astrophysics Data System (ADS)

    Lampp, Claire; Reklis, Heidi

    2004-05-01

    This study reexamines the well-attested coda voicing effect on vowel duration [Chen, Phonetica 22, 125-159 (1970)], in conjunction with the relationship between vowel duration and aspiration of codas. The first step was to replicate the results of Maddieson and Gandour [UCLA Working Papers Phonetics 31, 46-52 (1976)] with a larger, language-specific data set. Four nonsense syllables ending in [open-o] followed by [k, kh, g, gh] were read aloud in ten different carrier sentences by four native speakers of Hindi. Results confirm that longer vowels precede voiced word-final consonants and aspirated word-final consonants. Thus, among the syllables, vowel duration would be longest when preceding the voiced aspirate [gh]. Coda voicing, and thus, vowel duration, have been shown to correlate negatively to vowel F1 in English and Arabic [Wolf, J. Phonetics 6, 299-309 (1978); de Jong and Zawaydeh ibid, 30, 53-75 (2002)]. It is not known whether vowel F1 depends directly on coda voicing, or is determined indirectly via duration. Since voicing and aspiration both increase duration, F1 measurements of this data set (which will be presented) may answer that question.

  10. The Intangibles: Advice for New and Aspiring Heads

    ERIC Educational Resources Information Center

    Walsh, Matthew J.

    2010-01-01

    For those who have just been appointed to their first headship or who are aspiring to be a head of school, they undoubtedly know the importance of the mechanics of finance, curriculum, development, and trustee work. These are critical to their success. After four years of headship, however, the author has come to learn that the intangibles can be…

  11. Adolescent Boys' Science Aspirations: Masculinity, Capital, and Power

    ERIC Educational Resources Information Center

    Archer, Louise; DeWitt, Jennifer; Willis, Beatrice

    2014-01-01

    There is widespread international concern about post-16 participation rates in science, with women's under-representation constituting a particular issue. This paper contributes to these debates through a novel, critical examination of the role of masculinity within boys' negotiations of science aspirations. Drawing on a UK longitudinal study of…

  12. Infrared Thermal Imaging During Ultrasonic Aspiration of Bone

    NASA Astrophysics Data System (ADS)

    Cotter, D. J.; Woodworth, G.; Gupta, S. V.; Manandhar, P.; Schwartz, T. H.

    Ultrasonic surgical aspirator tips target removal of bone in approaches to tumors or aneurysms. Low profile angled tips provide increased visualization and safety in many high risk surgical situations that commonly were approached using a high speed rotary drill. Utilization of the ultrasonic aspirator for bone removal raised questions about relative amount of local and transmitted heat energy. In the sphenoid wing of a cadaver section, ultrasonic bone aspiration yielded lower thermal rise in precision bone removal than rotary mechanical drills, with maximum temperature of 31 °C versus 69 °C for fluted and 79 °C for diamond drill bits. Mean ultrasonic fragmentation power was about 8 Watts. Statistical studies using tenacious porcine cranium yielded mean power levels of about 4.5 Watts to 11 Watts and mean temperature of less than 41.1 °C. Excessively loading the tip yielded momentary higher power; however, mean thermal rise was less than 8 °C with bone removal starting at near body temperature of about 37 °C. Precision bone removal and thermal management were possible with conditions tested for ultrasonic bone aspiration.

  13. Pulmonary Paragonimiasis Diagnosed by Fine-Needle Aspiration Biopsy▿

    PubMed Central

    Zarrin-Khameh, Neda; Citron, Deborah R.; Stager, Charles E.; Laucirica, Rodolfo

    2008-01-01

    We report a case of paragonimiasis involving a 12-year-old Latin American boy. The diagnosis was made by fine-needle aspiration biopsy of a pulmonary nodule. Identification of the species by morphometric analysis of the eggs indicated that the infection was caused by Paragonimus mexicanus. PMID:18385444

  14. Tracheoesophageal Fistula Secondary to Esophageal Carcinoma Presenting With Aspiration Pneumonia

    PubMed Central

    Adler, Leon; Kabnick, Earl M.; Patel, Mahendra; Azueta, Victor; Helfgott, Andrew; Alexander, Leslie L.; Tafreshi, Mahmood

    1985-01-01

    Tracheoesophageal fistulas should be suspected in patients with recurring chronic aspiration pneumonitis. They are most often secondary to intrathoracic malignancies. A case report of a patient with this disorder is presented, along with a review of pertinent literature. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:3999155

  15. Acute pneumonia in Zimbabwe: bacterial isolates by lung aspiration.

    PubMed Central

    Ikeogu, M O

    1988-01-01

    Forty children, aged 2 months to 11 years, with severe acute pneumonia were investigated by needle aspiration of the lung. Fourteen organisms were isolated in only 13 patients. Streptococcus pneumoniae was isolated in six patients, Staphylococcus aureus in three, and Haemophilus influenzae in two. Two patients had mixed organisms. PMID:3196056

  16. Foreign body aspiration pneumonia in an intravenous drug user

    PubMed Central

    Bhaskar, Balu; Andelkovic, Vladimir

    2012-01-01

    Heroin use is associated with several well described respiratory complications, including noncardiogenic pulmonary edema, aspiration pneumonitis, acute respiratory distress syndrome,pneumonia, lung abscess, septic pulmonary emboli, and atelectasis. We describe an interesting case of a young female patient, an intravenous heroin user who presented with progressive dyspnea, hypoxia, and left lung consolidation. PMID:22412782

  17. An Unusual Case of Foreign Body Aspiration in an Infant

    PubMed Central

    Dias, E

    2012-01-01

    Inhalation of foreign body is a serious condition in childhood and may result in acute respiratory distress, lung injury or death. A nine month old baby with history of severe respiratory distress, cyanosis and gasping breathing diagnosed as foreign body aspiration due to a balloon which was recovered post mortem during the removal of the endotracheal tube. PMID:23439996

  18. Aspire Public Schools: Building the Organizational Capacity for Healthy Growth

    ERIC Educational Resources Information Center

    Saxton, Amy; Perigo, Mike

    2008-01-01

    Two years into an aggressive expansion plan, Aspire Public Schools was on track in terms of school openings, but behind on its goals to add a layer of management. The schools were performing well, but the nonprofit's leaders were stretched paper thin and concerned about the organization's ability to perform in the face of more growth. Determined…

  19. The anaesthetic consideration of tracheobronchial foreign body aspiration in children

    PubMed Central

    2016-01-01

    Cases of tracheobronchial foreign body aspiration are frequently encountered emergency cases of childhood; and, delays in its recognition and treatment do result in serious morbidity and mortality. Diagnosis mainly relies on taking history which should indicate what the foreign body is, when it has been aspirated and where it is located. Belated consultation can cause misdiagnosis with the mixing of the symptoms and data with those of other pathologies common to childhood and further delays in the correct diagnosis. Bronchoscopy is required for the differential diagnosis of suspected tracheobronchial foreign body aspiration in order to eliminate other common pediatric respiratory concerns. Given the shared use of the airways by the surgeon and the anaesthesiologist, bronchoscopy is a challenging procedure requiring experienced teams with an efficient method of intercommunication, and also well planning of the anaesthesia and bronchoscopy ahead of the procedures. Despite the recent popularisation of the fiberoptic brochoscopes, the rigid bronchoscopy remains to be used commonly and is regarded to provide the gold standard technique. There have been reports in the literature on the uses of inhalation and/or intravenous (IV) anaesthesia and spontaneous or controlled ventilation methods without any demonstration of the superiority of one technique over the other. The most suitable methods of anaesthesia and ventilation would be those that reduce the risks of complications, morbidity and mortality; and, preventive measures should be taken with priority against childhood cases of tracheobronchial foreign body aspiration. PMID:28149580

  20. Aspirations for a Master's-Level Teaching Profession in England

    ERIC Educational Resources Information Center

    Thomas, Lorraine

    2016-01-01

    This research investigates aspirations for a master's-level teaching profession in England, providing key stakeholder perceptions in one densely populated region within a multiple case study. Although this intended move to a master's-level profession represented a major shift in teachers' professional development in England, only limited…

  1. Aspiring Principal Development Programme Evaluation in New Zealand

    ERIC Educational Resources Information Center

    Piggot-Irvine, Eileen; Youngs, Howard

    2011-01-01

    Purpose: The New Zealand Ministry of Education has constructed a wide-ranging "Professional Development Plan" providing a four-stage national pathway for progression to principalship; the first stage has been the conduction of the National Aspiring Principals Pilot (NAPP) programme in five regional locations. The purpose of this paper is…

  2. Factors Affecting the Career Aspirations of Asian Americans.

    ERIC Educational Resources Information Center

    Leung, S. Alvin

    This study examined the career aspirations of Asian American college students, using a retrospective method of data collection that asked subjects to report various occupational alternatives that they have considered in their lifetime so far. Male (N=52) and female (N=97) Asian Americans were compared with a Euro-American group of 95 males and 151…

  3. Primary health care: from aspiration to achievement.

    PubMed

    Diallo, I; Molouba, R; Sarr, L C

    1993-01-01

    A review is presented of Senegal's response to the Bamako Initiative, aimed at strengthening primary health care. The experience gained is of broad interest since the basic principles involved are the same everywhere. Of particular importance are users' financial contributions and improved organization and management.

  4. Simulations of the erythrocyte cytoskeleton at large deformation. II. Micropipette aspiration.

    PubMed Central

    Discher, D E; Boal, D H; Boey, S K

    1998-01-01

    Coarse-grained molecular models of the erythrocyte membrane's spectrin cytoskeleton are presented in Monte Carlo simulations of whole cells in micropipette aspiration. The nonlinear chain elasticity and sterics revealed in more microscopic cytoskeleton models (developed in a companion paper; Boey et al., 1998. Biophys. J. 75:1573-1583) are faithfully represented here by two- and three-body effective potentials. The number of degrees of freedom of the system are thereby reduced to a range that is computationally tractable. Three effective models for the triangulated cytoskeleton are developed: two models in which the cytoskeleton is stress-free and does or does not have internal attractive interactions, and a third model in which the cytoskeleton is prestressed in situ. These are employed in direct, finite-temperature simulations of erythrocyte deformation in a micropipette. All three models show reasonable agreement with aspiration measurements made on flaccid human erythrocytes, but the prestressed model alone yields optimal agreement with fluorescence imaging experiments. Ensemble-averaging of nonaxisymmetrical, deformed structures exhibiting anisotropic strain are thus shown to provide an answer to the basic question of how a triangulated mesh such as that of the red cell cytoskeleton deforms in experiment. PMID:9726959

  5. Percutaneous aspiration of fluid for management of peritonitis in space

    NASA Technical Reports Server (NTRS)

    Kirkpatrick, A. W.; Nicolaou, S.; Campbell, M. R.; Sargsyan, A. E.; Dulchavsky, S. A.; Melton, S.; Beck, G.; Dawson, D. L.; Billica, R. D.; Johnston, S. L.; Hamilton, D. R.

    2002-01-01

    BACKGROUND: As a medical emergency that can affect even well-screened, healthy individuals, peritonitis developing during a long-duration space exploration mission may dictate deviation from traditional clinical practice due to the absence of otherwise indicated surgical capabilities. Medical management can treat many intra-abdominal processes, but treatment failures are inevitable. In these circumstances, percutaneous aspiration under sonographic guidance could provide a "rescue" strategy. Hypothesis: Sonographically guided percutaneous aspiration of intra-peritoneal fluid can be performed in microgravity. METHODS: Investigations were conducted in the microgravity environment of NASA's KC-135 research aircraft (0 G). The subjects were anesthetized female Yorkshire pigs weighing 50 kg. The procedures were rehearsed in a terrestrial animal lab (1 G). Colored saline (500 mL) was introduced through an intra-peritoneal catheter during flight. A high-definition ultrasound system (HDI-5000, ATL, Bothell, WA) was used to guide a 16-gauge needle into the peritoneal cavity to aspirate fluid. RESULTS: Intra-peritoneal fluid collections were easily identified, distinct from surrounding viscera, and on occasion became more obvious during weightless conditions. Subjectively, with adequate restraint of the subject and operators, the procedure was no more demanding than during the 1-G rehearsals. CONCLUSIONS: Sonographically guided percutaneous aspiration of intra-peritoneal fluid collections is feasible in weightlessness. Treatment of intra-abdominal inflammatory conditions in spaceflight might rely on pharmacological options, backed by sonographically guided percutaneous aspiration for the "rescue" of treatment failures. While this risk mitigation strategy cannot guarantee success, it may be the most practical option given severe resource limitations.

  6. Parental Influence on Mainland Chinese Children's Career Aspirations: Child and Parental Perspectives

    ERIC Educational Resources Information Center

    Liu, Jianwei; McMahon, Mary; Watson, Mark

    2015-01-01

    Career aspirations developed in childhood may impact on future career development in adolescence and adulthood. Family is an important context in which children develop their career aspirations. This study examined how parents influence children's career aspirations in mainland China from both the parents' and children's perspectives. Eight…

  7. Structural and Socio-Psychological Influences on Adolescents' Educational Aspirations and Subsequent Academic Achievement

    ERIC Educational Resources Information Center

    Rothon, Catherine; Arephin, Muna; Klineberg, Emily; Cattell, Vicky; Stansfeld, Stephen

    2011-01-01

    Previous literature indicates that educational aspirations are an important predictor of achievement at school and beyond. This paper examines the factors that are associated with high educational aspirations. It also looks at the relationship between aspirations and achievement at the General Certificate of Secondary Education in a deprived area…

  8. Career Decision-Making, Career Barriers and Occupational Aspirations in Chinese Adolescents

    ERIC Educational Resources Information Center

    Creed, Peter A.; Wong, Oi Yin; Hood, Michelle

    2009-01-01

    The study tested the relationship between occupational aspirations/expectations (type and status) and decision-making difficulties, efficacy and career barriers in 498 Chinese high school students. Males aspired to investigative and enterprising types, but expected realistic and enterprising ones; females aspired to enterprising and conventional…

  9. Exploring the Factors that Influence Men and Women to Form Medical Career Aspirations.

    ERIC Educational Resources Information Center

    Antony, James Soto

    1998-01-01

    Medical-career aspirations prior to college are examined in longitudinal data (N=27,065; 59.1% female). Men and women aspire to medical careers at roughly the same rate and for mostly the same reasons, but the strength of influence varies significantly for certain factors. Fewer women maintain medical-career aspirations during college. (Author/EMK)

  10. Swiss Adolescents' Career Aspirations: Influence of Context, Age, and Career Adaptability

    ERIC Educational Resources Information Center

    Hirschi, Andreas

    2010-01-01

    This study investigated the content, realism, stability, and coherence of the career aspirations of 262 students in seventh grade in Switzerland (ages 13-15 years). The content analysis revealed that 82% of the participants named at least one realistic career aspiration, and aspirations showed clear resemblance to existing opportunities in the…

  11. Validity of Vocational Aspirations and Interest Inventories: Extended, Replicated, and Reinterpreted.

    ERIC Educational Resources Information Center

    Holland, John L.; And Others

    1990-01-01

    Found classified vocational aspirations of 467 male and 250 female Navy recruits superior to Vocational Preference Inventory (VPI). Predictions for subjects with coherent vocational aspirations were very predictive over short time interval. Hypothesized links between coherence of vocational aspirations and Identity Scale, NEO Personality Inventory…

  12. The Role of Aspirations in Young Children's Emotional and Behavioural Problems

    ERIC Educational Resources Information Center

    Moulton, Vanessa; Flouri, Eirini; Joshi, Heather; Sullivan, Alice

    2015-01-01

    Using data from a large UK cohort (n = 11,656), we investigated the determinants of 7-year-old children's aspirations, and the role of these aspirations in emotional and behavioural problems, as reported by both parents and teachers. Aspirations were classified to reflect their occupational status, masculinity/femininity and intrinsic/extrinsic…

  13. Intrinsic Aspirations and Personal Meaning across Adulthood: Conceptual Interrelations and Age/Sex Differences

    ERIC Educational Resources Information Center

    Morgan, Jessica; Robinson, Oliver

    2013-01-01

    The present study examined adult age and sex differences in self-reported aspirations and personal meaning. Young, midlife, and older adults (N = 2,557) from the United Kingdom or United States completed an online survey of their aspiration striving, aspiration importance, and personal meaning (subscales of Purposeful Life, Exciting Life,…

  14. Female peers in small work groups enhance women's motivation, verbal participation, and career aspirations in engineering

    PubMed Central

    Dasgupta, Nilanjana; Scircle, Melissa McManus; Hunsinger, Matthew

    2015-01-01

    For years, public discourse in science education, technology, and policy-making has focused on the “leaky pipeline” problem: the observation that fewer women than men enter science, technology, engineering, and mathematics fields and more women than men leave. Less attention has focused on experimentally testing solutions to this problem. We report an experiment investigating one solution: we created “microenvironments” (small groups) in engineering with varying proportions of women to identify which environment increases motivation and participation, and whether outcomes depend on students’ academic stage. Female engineering students were randomly assigned to one of three engineering groups of varying sex composition: 75% women, 50% women, or 25% women. For first-years, group composition had a large effect: women in female-majority and sex-parity groups felt less anxious than women in female-minority groups. However, among advanced students, sex composition had no effect on anxiety. Importantly, group composition significantly affected verbal participation, regardless of women’s academic seniority: women participated more in female-majority groups than sex-parity or female-minority groups. Additionally, when assigned to female-minority groups, women who harbored implicit masculine stereotypes about engineering reported less confidence and engineering career aspirations. However, in sex-parity and female-majority groups, confidence and career aspirations remained high regardless of implicit stereotypes. These data suggest that creating small groups with high proportions of women in otherwise male-dominated fields is one way to keep women engaged and aspiring toward engineering careers. Although sex parity works sometimes, it is insufficient to boost women’s verbal participation in group work, which often affects learning and mastery. PMID:25848061

  15. Female peers in small work groups enhance women's motivation, verbal participation, and career aspirations in engineering.

    PubMed

    Dasgupta, Nilanjana; Scircle, Melissa McManus; Hunsinger, Matthew

    2015-04-21

    For years, public discourse in science education, technology, and policy-making has focused on the "leaky pipeline" problem: the observation that fewer women than men enter science, technology, engineering, and mathematics fields and more women than men leave. Less attention has focused on experimentally testing solutions to this problem. We report an experiment investigating one solution: we created "microenvironments" (small groups) in engineering with varying proportions of women to identify which environment increases motivation and participation, and whether outcomes depend on students' academic stage. Female engineering students were randomly assigned to one of three engineering groups of varying sex composition: 75% women, 50% women, or 25% women. For first-years, group composition had a large effect: women in female-majority and sex-parity groups felt less anxious than women in female-minority groups. However, among advanced students, sex composition had no effect on anxiety. Importantly, group composition significantly affected verbal participation, regardless of women's academic seniority: women participated more in female-majority groups than sex-parity or female-minority groups. Additionally, when assigned to female-minority groups, women who harbored implicit masculine stereotypes about engineering reported less confidence and engineering career aspirations. However, in sex-parity and female-majority groups, confidence and career aspirations remained high regardless of implicit stereotypes. These data suggest that creating small groups with high proportions of women in otherwise male-dominated fields is one way to keep women engaged and aspiring toward engineering careers. Although sex parity works sometimes, it is insufficient to boost women's verbal participation in group work, which often affects learning and mastery.

  16. Spectrum of pediatric tumors diagnosed by fine-needle aspiration cytology

    PubMed Central

    Shirian, Sadegh; Daneshbod, Yahya; Haghpanah, Sezaneh; Khademi, Bijan; Noorbakhsh, Farshid; Ghaemi, Amir; Mosayebi, Ziba

    2017-01-01

    Abstract Pediatric tumors differ markedly from adult tumors in their nature, distribution, and prognosis. In this 10-year retrospective study, we present our experience with fine-needle aspiration (FNA) in pediatric patients 18 years of age and younger and correlate relationship between gender with organ, diagnosis, malignancy, and age. In our study, FNA material of pediatric tumors or masses with 18 years aged and younger were analyzed retrospectively. All FNAs in pediatric patients during this time period were identified and analyzed for age, gender, cytologic diagnosis, and site of aspiration. A total 1000 FNAs were performed from January 2007 to October 2015 in 499 children. Regardless the gender, the most frequently aspirated organ was lymph node, comprising 129 of the 499 cases followed by thyroid (112), neck cyst (79), and parotid (35) cases. The majority of the cases were diagnosed as benign lesions (436 of 499 cases). Other 63 cases comprising 40 female and 23 male cases had malignant lesions. There was significant age difference between people with or without malignancy. In malignant cases, there was a significant difference between the age on males and females. In regard to gender and diagnosis, cytologic diagnosis was stratified into 9 broad diagnostic categories: lymphadenitis, benign and malignant thyroid, cyst contents, benign breast, benign and malignant salivary, and negative for malignancy. In conclusion, our study supports the use of FNA cytology (FNAC) in lesions of various anatomic sites in the children less than 18 years old. As a simple, minimally invasive, and rapid procedure, cytopathologists can reliably utilize FNAC in children. The mean age of children receiving a malignant diagnosis was significantly higher than that of benign lesions. The mean age of malignancy in boys is significantly lower than that of girls with malignancy. PMID:28178123

  17. Using Forceps Biopsy after Small Submucosal Dissection in the Diagnosis of Gastric Subepithelial Tumors.

    PubMed

    Jung, Yoon Suk; Lee, Hyuk; Kim, Kyungeun; Sohn, Jin Hee; Kim, Hong Joo; Park, Jung Ho

    2016-11-01

    The current tissue sampling techniques for subepithelial tumors (SETs) of the gastrointestinal (GI) tract have limited diagnostic efficacy. We evaluated the diagnostic yield and safety of forceps biopsies after small endoscopic submucosal dissection (SESD biopsies) in the diagnosis of gastric SETs. A total of 42 patients with gastric SETs > 10 mm were prospectively enrolled between May 2013 and October 2014. A dual knife was used to incise the mucosa and submucosa and forceps biopsies were then introduced deep into the lesion. To compare SESD biopsies with EUS-FNA, we used the retrospective data of 30 EUS-FNA cases. The diagnostic yield of SESD biopsies was comparable to that of EUS-FNA (35/42, 83.3% vs. 24/30, 80.0%, P = 0.717). The mean procedure time of SESD biopsies was shorter than that of EUS-FNA (10 vs. 37 minutes, P < 0.001). There were no procedure-related adverse events in the both group. The pathological diagnoses in SESD biopsies group included 15 leiomyomas, 7 GISTs, 10 heterotopic pancreases, 2 lipomas, and one other lesion. SESD biopsies are an easy, effective and safe technique for the diagnosis of gastric SETs and its diagnostic yield is comparable to that of EUS-FNA. This technique may be a reliable alternative to conventional EUS-FNA (Clinical trial registration No. KCT0000730).

  18. Using Forceps Biopsy after Small Submucosal Dissection in the Diagnosis of Gastric Subepithelial Tumors

    PubMed Central

    2016-01-01

    The current tissue sampling techniques for subepithelial tumors (SETs) of the gastrointestinal (GI) tract have limited diagnostic efficacy. We evaluated the diagnostic yield and safety of forceps biopsies after small endoscopic submucosal dissection (SESD biopsies) in the diagnosis of gastric SETs. A total of 42 patients with gastric SETs > 10 mm were prospectively enrolled between May 2013 and October 2014. A dual knife was used to incise the mucosa and submucosa and forceps biopsies were then introduced deep into the lesion. To compare SESD biopsies with EUS-FNA, we used the retrospective data of 30 EUS-FNA cases. The diagnostic yield of SESD biopsies was comparable to that of EUS-FNA (35/42, 83.3% vs. 24/30, 80.0%, P = 0.717). The mean procedure time of SESD biopsies was shorter than that of EUS-FNA (10 vs. 37 minutes, P < 0.001). There were no procedure-related adverse events in the both group. The pathological diagnoses in SESD biopsies group included 15 leiomyomas, 7 GISTs, 10 heterotopic pancreases, 2 lipomas, and one other lesion. SESD biopsies are an easy, effective and safe technique for the diagnosis of gastric SETs and its diagnostic yield is comparable to that of EUS-FNA. This technique may be a reliable alternative to conventional EUS-FNA (Clinical trial registration No. KCT0000730). PMID:27709855

  19. "My Parents Have Stressed that since I Was a Kid": Young Minority Ethnic British Citizens and the Phenomenon of Aspirational Capital

    ERIC Educational Resources Information Center

    Basit, Tehmina N.

    2012-01-01

    This article investigates retrospectively and prospectively the educational and career aspirations and experiences of young minority ethnic British citizens. It focuses on one aspect of a larger mixed methods study, that is, qualitative research involving in-depth interviews with a stratified sample of 20 young men and women of minority ethnic…

  20. Familial and Economic Influences on the Gender-Related Educational and Occupational Aspirations of Rural Adolescents

    PubMed Central

    Meece, Judith L.; Askew, Karyl J. S.; Agger, Charlotte A.; Hutchins, Bryan C.; Byun, Soo-yong

    2015-01-01

    Economic, occupational, and social shifts in rural economies have influenced nuanced changes in the educational and occupational aspirations of rural adolescent women and men. However, there is limited contemporary research that examines the aspirations of rural adolescents at the beginning of the 21st century. Drawing on a sample of 8,756 rural adolescents in the United States, we examine how familial, geographic, and economic variables influence gender-related differences in educational and occupational aspirations. Findings revealed significant gender differences, favoring girls, in youth's educational aspirations, occupational aspirations, and aspirations for nontraditional careers. Results highlight the importance of contextual variables such as parental expectations, family income, and motivation variables in predicting gender-related aspirations of rural youth. PMID:26681990

  1. Bronchoscopy for foreign body aspiration and effects of nebulized albuterol and budesonide combination

    PubMed Central

    Akcora, Bulent; Celikkaya, Mehmet Emin; Ozer, Cahit

    2017-01-01

    Objective: A foreign body aspiration in the tracheobronchial tree is a dangerous medical condition in the childhood period. Although rigid bronchoscopy is a safe procedure, it may cause complications. The aim of this study was to present our bronchoscopy experience and to evaluate the efficacy of pre-operative administration of nebulized albuterol and budesonide combination for reducing intra-operative complications in foreign body aspirated cases. Methods: In this retrospective study our pediatric cases in which a foreign body was removed from tracheobronchial tree in last 8 years were analyzed. After excluding the patients who needed emergent and negative bronchoscopies, the remaining clinically stable 84 patients were compared for the effects of preoperative administration of nebulized albuterol and budesonide combination on bronchoscopy complications. Results: There were 51 boys (60.3%) and 33 girls (39.7%). There were 38 children in the non-nebulized group and 46 children in the nebulized group. We found that the combined albuterol and budesonide nebulization decrease complications such as arterial oxygen desaturation (p<0.05), and bronchospasm (p<0.05) during the bronchoscopic intervention. Conclusion: Preoperative nebulization of albuterol and budesonide combination may decrease perioperative complications of bronchoscopy. PMID:28367177

  2. Career aspirations and perceived level of preparedness among marriage and family therapy doctoral students.

    PubMed

    Miller, John K; Lambert-Shute, Jennifer

    2009-10-01

    The authors conducted a survey of marriage and family therapy (MFT) doctoral students in programs accredited by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE). MFT doctoral students (N = 82) from across the United States responded to a web-based survey that focused on career aspirations, training opportunities, and the level of preparedness they experienced during their doctoral education. Results of this survey indicated that students felt they were well prepared for many aspects of their chosen career path. Some respondents desired more training to prepare them for careers in academia. More men than women indicated a career in academia as their primary career aspiration. While most of the respondents perceived that their internship experiences were beneficial, some expressed the desire for more opportunities to supervise master's-level students, to write grants, and to teach graduate-level MFT courses. The authors conclude with a discussion of how these findings may influence the development of core competencies specific to doctoral education in MFT.

  3. Review of tracheobronchial foreign body aspiration in the South African paediatric age group

    PubMed Central

    Sultan, Tamer Ali

    2016-01-01

    Children, and in particular young children under the age of three, are the most vulnerable for aspiration and ingestion of foreign bodies (FBs). The Red Cross War Memorial Children’s Hospital in Cape Town is the only children’s hospital in South Africa and is unique in having a dedicated trauma unit for children under the age of 13 as part of its institution. Core activities of Childsafe South Africa (CSA), located at the hospital, are data accumulation and interpretation, development of educational programmes, health inculcation and advising in legislation involving child health. To achieve this task, CSA works in close co-operation with government, industry, non-governmental and community predicated organisations, community groups and individuals. A database of all children treated for trauma at CSA has been maintained since 1991; it currently contains detailed information of over 170,000 injuries in children under the age of 13. This review consists of a literature review combined with data from our database and aims to provide information on our experiences with tracheobronchial aspiration of FBs in children. PMID:28149578

  4. A study of underlying variables affecting aspirations of rural adolescents.

    PubMed

    Quaglia, R J; Perry, C M

    1995-01-01

    Aspirations are comprised of two major components--inspiration and ambition. Ambitions represents the ability to look ahead and invest in the future. Inspiration can be described as the ability to invest the time, energy, and effort to reach those ambitions. Variables such as how and why students spend their time illustrate the dynamics of these two components. The data in this report are based on the responses to the Aspirations Survey of 2,677 eighth- to twelfth-grade students from seven rural schools in Maine. The data suggest that many students have no understanding of why they engage in certain activities. If students are to be responsible for their education and more importantly for themselves, they must see purpose in their pursuits.

  5. Suicidal Ideation and Migration Aspirations among Youth in Central Mexico

    PubMed Central

    Hoffman, Steven

    2014-01-01

    Over the past 100 years the state of Guanajuato has consistently been one of the highest migrant sending states in Mexico. Youth living in high migratory states such as Guanajuato are heavily influenced by the expectation that they will travel to the US, and research has shown that those who do not migrate may be looked down upon by members of their community. This secondary analysis looks at the connection between suicidal ideation and migration aspirations among a group of adolescents living in Guanajuato, Mexico. Data were originally collected in 2007 as part of a comprehensive health survey of youth attending an alternative high schooling program. Regression analyses show that suicidal ideation predicts intentions to migrate among both males and females, while other factors differentially influence the adolescents by gender. The results indicate that suicidal ideation may be associated with migration aspirations among Mexican youth living in high migratory communities. Study limitations and implications are discussed. PMID:24373268

  6. How to overcome surfactant dysfunction in meconium aspiration syndrome?

    PubMed

    Mokra, Daniela; Calkovska, Andrea

    2013-06-01

    Surfactant dysfunction in meconium aspiration syndrome (MAS) is caused by meconium components, by plasma proteins leaking through the injured alveolocapillary membrane and by substances originated in meconium-induced inflammation. Surfactant inactivation in MAS may be diminished by several ways. Firstly, aspirated meconium should be removed from the lungs to decrease concentrations of meconium inhibitors coming into the contact with surfactant in the alveolar compartment. Once the endogenous surfactant becomes inactivated, components of surfactant should be substituted by exogenous surfactant at a sufficient dose, and surfactant administration should be repeated, if oxygenation remains compromised. To delay the inactivation by inhibitors, exogenous surfactants may be enriched with surfactant proteins, phospholipids, or other substances such as polymers. Finally, to diminish an adverse action of products of meconium-induced inflammation on both endogenous and exogenously delivered surfactant, anti-inflammatory drugs may be administered. A combined therapeutic approach may result in better outcome in patients with MAS and in lower costs of treatment.

  7. Massive reflux and aspiration after radiographically inserted gastrostomy tube placement.

    PubMed

    Chesoni, Sandra A; Bach, John R; Okamura, Erica Mia

    2015-01-01

    To the authors' knowledge, fatal postgastrostomy aspiration within 2 days of enteral nutrition has not been reported. The authors report consecutive cases of severe postgastrotomy aspiration with one being fatal for a 26-yr-old with Duchenne muscular dystrophy 2 days after initiation of gastrostomy feedings. Previous to these consecutive radiographically inserted gastrostomies, all gastrotomies at the institution were percutaneous endoscopic gastrostomies or open gastrostomies. Radiographically inserted gastrostomy tubes have an increased likelihood of being oriented toward the esophagus as opposed to the duodenum, which may increase the risk for reflux. Elimination of invasive airway tubes should be delayed until after gastrostomy feedings are documented to be well tolerated. Oximetry and repeated measurements of vital capacity can suggest changes in the status of airway clearance.

  8. [Aspiration syndrome due to laryngeal cleft in an infant].

    PubMed

    Cuestas, Giselle; Demarchi, Victoria; Zanetta, Adrián; Urquizo, Mauricio; Lobos, Pablo; Razetti, Juan

    2014-02-01

    Aspiration is the passage of food content and endogenous secretions into the airway. Anatomical, neuromuscular or functional anomalies are among the major causes. The laryngeal cleft is a rare congenital anomaly that should be considered in the differential diagnosis of aspiration syndrome in neonates and infants. The main symptoms are stridor, recurrent respiratory infections and cyanotic crisis, cough and choking during feeding. The diagnosis is confirmed by endoscopic examination. The therapeutic behaviour will depend on the extent of the cleft, among other factors. We describe the clinical manifestations, diagnostic methods and treatment of an infant with this disease, and we emphasize the need for recognition of swallowing disorders in children in order to establish an accurate diagnosis and appropriate treatment to prevent and avoid malnutrition as well as a severe and potentially irreversible lung compromise.

  9. Suicidal ideation and migration aspirations among youth in central Mexico.

    PubMed

    Hoffman, Steven

    2013-10-16

    Over the past 100 years the state of Guanajuato has consistently been one of the highest migrant sending states in Mexico. Youth living in high migratory states such as Guanajuato are heavily influenced by the expectation that they will travel to the US, and research has shown that those who do not migrate may be looked down upon by members of their community. This secondary analysis looks at the connection between suicidal ideation and migration aspirations among a group of adolescents living in Guanajuato, Mexico. Data were originally collected in 2007 as part of a comprehensive health survey of youth attending an alternative high schooling program. Regression analyses show that suicidal ideation predicts intentions to migrate among both males and females, while other factors differentially influence the adolescents by gender. The results indicate that suicidal ideation may be associated with migration aspirations among Mexican youth living in high migratory communities. Study limitations and implications are discussed.

  10. Behavior of liquid metal droplets in an aspirating nozzle. Revision

    SciTech Connect

    Swank, W.D.; Fincke, J.R.; Mason, T.A.

    1990-12-31

    Measurements of particle size, velocity, and relative mass flux were made on spray field produced by aspirating liquid tin into 350{degrees}C argon flowing through a venturi nozzle via a small orifice in the throat of the nozzle. Details of the aspiration and droplet formation process were observed through windows in the nozzle. The spatial distribution of droplet size, velocity, and relative number density were measured at a location 10 mm from the nozzle exit. Due to the presence of separated flow in the nozzle, changes in nozzle inlet pressure did not significantly effect resulting droplet size and velocity. This suggests that good aerodynamic nozzle design is required if spray characteristics are to be controlled by nozzle flow. 5 refs.

  11. Behavior of liquid metal droplets in an aspirating nozzle

    SciTech Connect

    Swank, W.D.; Fincke, J.R.; Mason, T.A.

    1990-01-01

    Measurements of particle size, velocity, and relative mass flux were made on spray field produced by aspirating liquid tin into 350{degrees}C argon flowing through a venturi nozzle via a small orifice in the throat of the nozzle. Details of the aspiration and droplet formation process were observed through windows in the nozzle. The spatial distribution of droplet size, velocity, and relative number density were measured at a location 10 mm from the nozzle exit. Due to the presence of separated flow in the nozzle, changes in nozzle inlet pressure did not significantly effect resulting droplet size and velocity. This suggests that good aerodynamic nozzle design is required if spray characteristics are to be controlled by nozzle flow. 5 refs.

  12. Stainless steel crown aspiration during sedation in pediatric dentistry.

    PubMed

    Adewumi, A; Kays, David W

    2008-01-01

    Foreign body aspiration (FBA) causes death in more than 300 children every year in the United States. Morbidity and mortality are increased in children due to narrow airways and immature protective mechanisms. Factors to consider in pediatric dentistry are: (1) the patient's age and behavior; (2) presence and extent of disability; (3) local anesthesia; (4) body positioning; and (5) loose teeth. FBA requires prompt recognition and early treatment to minimize potentially serious and sometimes fatal consequences. The purpose of this case report was to describe the aspiration of a stainless steel crown in a 5-year-old boy during conscious sedation. It also discusses how a prompt and accurate diagnosis, early referral, and immediate treatment helped prevent serious complications.

  13. Art in Science Promoting Interest in Research and Exploration (ASPIRE)

    NASA Astrophysics Data System (ADS)

    Fillingim, M.; Zevin, D.; Thrall, L.; Croft, S.; Raftery, C.; Shackelford, R.

    2015-11-01

    Led by U.C. Berkeley's Center for Science Education at the Space Sciences Laboratory in partnership with U.C. Berkeley Astronomy, the Lawrence Hall of Science, and the YMCA of the Central Bay Area, Art in Science Promoting Interest in Research and Exploration (ASPIRE) is a NASA EPOESS-funded program mainly for high school students that explores NASA science through art and highlights the need for and uses of art and visualizations in science. ASPIRE's aim is to motivate more diverse young people (especially African Americans) to learn about Science, Technology, Engineering, and Mathematics (STEM) topics and careers, via 1) Intensive summer workshops; 2) Drop-in after school workshops; 3) Astronomy visualization-focused outreach programming at public venues including a series of free star parties where the students help run the events; and 5) A website and a number of social networking strategies that highlight our youth's artwork.

  14. Aspiring and Residing IT Leaders: A Legacy for the Future

    ERIC Educational Resources Information Center

    McIntosh, Keith W.

    2012-01-01

    Many people think there is a quick road to leadership success. Those who want to become IT leaders--that is, "aspiring leaders"--often think: "If I just do my job well, I will rise to a leadership position." Those who are already IT leaders--that is, "residing leaders"--often think: "If I just do my job well, I will leave a lasting legacy." Doing…

  15. Primary pulmonary botryomycosis: a late complication of foreign body aspiration

    PubMed Central

    Tuggey, J; Hosker, H; DaCosta, P

    2000-01-01

    Primary pulmonary botryomycosis is a rare cause of haemoptysis and can enter the differential diagnosis of a mass on the plain chest radiograph. The case history is presented of a 63 year old man with botryomycosis which was initially thought to be a bronchial carcinoma. When the diagnosis was made several years later it was found to be secondary to persisting vegetable material in the bronchial tree following previous aspiration.

 PMID:11083895

  16. Aspiration tests in aqueous foam using a breathing simulator

    SciTech Connect

    Archuleta, M.M.

    1995-12-01

    Non-toxic aqueous foams are being developed by Sandia National Laboratories (SNL) for the National Institute of Justice (NIJ) for use in crowd control, cell extractions, and group disturbances in the criminal justice prison systems. The potential for aspiration of aqueous foam during its use and the resulting adverse effects associated with complete immersion in aqueous foam is of major concern to the NIJ when examining the effectiveness and safety of using this technology as a Less-Than-Lethal weapon. This preliminary study was designed to evaluate the maximum quantity of foam that might be aspirated by an individual following total immersion in an SNL-developed aqueous foam. A.T.W. Reed Breathing simulator equipped with a 622 Silverman cam was used to simulate the aspiration of an ammonium laureth sulfate aqueous foam developed by SNL and generated at expansion ratios in the range of 500:1 to 1000:1. Although the natural instinct of an individual immersed in foam is to cover their nose and mouth with a hand or cloth, thus breaking the bubbles and decreasing the potential for aspiration, this study was performed to examine a worst case scenario where mouth breathing only was examined, and no attempt was made to block foam entry into the breathing port. Two breathing rates were examined: one that simulated a sedentary individual with a mean breathing rate of 6.27 breaths/minute, and one that simulated an agitated or heavily breathing individual with a mean breathing rate of 23.7 breaths/minute. The results of this study indicate that, if breathing in aqueous foam without movement, an air pocket forms around the nose and mouth within one minute of immersion.

  17. Perfectionism and life aspirations in intrinsically and extrinsically religious individuals.

    PubMed

    Steffen, Patrick R

    2014-08-01

    Religiosity is related to positive health and life satisfaction but the pathways through which this occurs have not been clearly delineated. The purpose of this study was to examine potential mediators of the relationships between intrinsic and extrinsic religiosity and negative affect and life satisfaction. Perfectionism and life aspirations are two possible pathways through which religious orientation is related to outcome. It was hypothesized that adaptive perfectionism and intrinsic life aspirations would act as mediators between intrinsic religiosity and negative affect and life satisfaction, and that maladaptive perfectionism and extrinsic life aspirations would act as mediators between the extrinsic religiosity and negative affect and life satisfaction. Two consecutive samples of religious college students (N = 540 and N = 485) completed measures of the Age Universal Religious Orientation Index, the Frost Multi-Dimensional Perfectionism Scale, the Aspiration Index, the Beck Depression Inventory-II, the Spielberger State-Trait Anxiety Inventory, and the Satisfaction with Life Scale. Intrinsic religiosity had a direct negative relationship with negative affect and positive relationship with life satisfaction. Contrary to the hypotheses, intrinsic religiosity had its strongest indirect effect via maladaptive perfectionism such that increased intrinsic religiosity was related to decreased maladaptive perfectionism which in turn lead to better negative affect and life satisfaction. Extrinsic religiosity was related to increased maladaptive perfectionism and thereby indirectly contributed to worse negative affect and life satisfaction. Interestingly, when the effects of maladaptive perfectionism were controlled, the direct effects of extrinsic religiosity were related to reduced negative affect and increased life satisfaction. Overall, the strongest mediator in this study of both intrinsic and extrinsic religiosity was maladaptive perfectionism, with intrinsic

  18. Use of Videofluoroscopic Swallowing Study in Patients with Aspiration Pneumonia

    PubMed Central

    Park, Seunglee; Lee, Jin-Youn; Jung, Heeyoune; Koh, Seong-Eun; Lee, In-Sik; Yoo, Kwang Ha; Lee, Seung Ah

    2012-01-01

    Objective To investigate the clinical characteristics of dysphagic elderly Korean patients diagnosed with aspiration pneumonia as well as to examine the necessity of performing a videofluoroscopic swallowing study (VFSS) in order to confirm the presence of dysphagia in such patients. Method The medical records of dysphagic elderly Korean subjects diagnosed with aspiration pneumonia were retrospectively reviewed for demographic and clinical characteristics as well as for VFSS findings. Results In total, medical records of 105 elderly patients (81 men and 24 women) were reviewed in this study. Of the 105 patients, 82.9% (n=87) were admitted via the emergency department, and 41.0% (n=43) were confined to a bed. Eighty percent (n=84) of the 105 patients were diagnosed with brain disorders, and 68.6% (n=72) involved more than one systemic disease, such as diabetes mellitus, cancers, chronic cardiopulmonary disorders, chronic renal disorders, and chronic liver disorders. Only 66.7% (n=70) of the 105 patients underwent VFSS, all of which showed abnormal findings during the oral or pharyngeal phase, or both. Conclusion In this study, among 105 dysphagic elderly patients with aspiration pneumonia, only 66.7% (n=70) underwent VFSS in order to confirm the presence of dysphagia. As observed in this study, the evaluation of dysphagia is essential in order to consider elderly patients with aspiration pneumonia, particularly in patients with poor functional status, brain disorders, or more than one systemic disease. A greater awareness of dysphagia in the elderly, as well as the diagnostic procedures thereof, particularly VFSS, is needed among medical professionals in Korea. PMID:23342310

  19. Riedel thyroiditis: Fine needle aspiration findings of a rare entity.

    PubMed

    Weidner, Anna-Sophie; Molina, David; DeSimone, Robert A; Cohen, Marc A; Giorgadze, Tamar; Scognamiglio, Theresa; Hoda, Rana S

    2015-09-01

    Riedel thyroiditis is a rare fibrosing disorder characterized by extension of the fibroinflammatory process beyond the thyroid capsule. Due to the nature of this lesion, fine-needle aspiration often yields scant material and may be interpreted as non-diagnostic. In this report, we describe cytologic features that allow the cytopathologist to favor a diagnosis of Riedel thyroiditis, thereby guiding appropriate further work-up and management.

  20. Aspiration-based partner switching boosts cooperation in social dilemmas.

    PubMed

    Li, Zhi; Yang, Zhihu; Wu, Te; Wang, Long

    2014-01-01

    Most previous studies concerning linking dynamics often assumed that links pairing individuals should be identified and treated differently during topology adjusting procedure, in order to promote cooperation. A common assumption was that cooperators were expected to avoid being exploited by quickly breaking up relationships with defectors. Then the so-called prosocial links linking two cooperators (abbreviated as CC links hereafter) would be much favored by evolution, whereby cooperation was promoted. However, we suggest that this is not always necessary. Here, we developed a minimal model in which an aspiration-based partner switching mechanism was embedded to regulate the evolution of cooperation in social dilemmas. Individuals adjusted social ties in a self-questioning manner in line with the learning theory. Less game information was involved during dynamic linking and all links were tackled anonymously irrespective of their types (i.e., CD links, DD links, or CC links). The main results indicate that cooperation flourishes for a broad range of parameters. The denser the underlying network, the more difficult the evolution of cooperation. More importantly, moderate aspirations do much better in promoting the evolution of altruistic behavior and for most cases there exists the optimal aspiration level that most benefits cooperation. Too strong or too weak selection intensity turns out to be pretty conducive to the evolution of cooperation in such a dynamical system.

  1. Numerical determination of personal aerosol sampler aspiration efficiency.

    PubMed

    Lo Savio, Simone; Paradisi, Paolo; Tampieri, Francesco; Belosi, Franco; Morigi, Maria Pia; Agostini, Sergio

    2003-04-01

    In this work the determination of the aspiration efficiency of personal aerosol samplers, commonly used in occupational exposure assessment, is investigated by means of CFD techniques. Specifically, it will be described a code to calculate the particle trajectories in a given flow field. At the present state the code considers only the effects of the mean flow field on the particle motion, whereas the turbulent diffusion effects are neglected. Comparisons with experimental measurements are also given in the framework of a research contract, supported by the European Community, with several experimental contributions from the participants. The main objective of the European research is to develop a new approach to experimentation with airborne particle flows, working on a reduced scale. This methodology has the advantage of allowing real-time aerosol determination and use of small wind tunnels, with a better experimental control. In this article we describe how the methodology has been verified using computational fluid dynamics. Experimental and numerical aspiration efficiencies have been compared and the influence of gravity and turbulence intensity in full and reduced scale has been investigated. The numerical techniques described here are in agreement with previous similar research and allow at least qualitative predictions of aspiration efficiency for real samplers, taking care of orientation from the incoming air flow. The major discrepancies among predicted and experimental results may be a consequence of bounce effects, which are very difficult to eliminate also by greasing the sampler surface.

  2. Aspiration pneumonia: experimental evaluation of albumin and steroid therapy.

    PubMed Central

    Toung, T J; Bordos, D; Benson, D W; Carter, D; Zuidema, G D; Permutt, S; Cameron, J L

    1976-01-01

    An experimental model using an ex vivo perfused ventilated canine pulmonary lobe was used to study aspiration pneumonia. After intrabronchial acid instillation, the lobe weight tripled, air way pressure and pulmonary artery pressure doubled, and intrapulmonary shunting increased from 5.5% to 53.4%. If large quantities of albumin were added to the lobe perfusate 5 minutes after intrabronchial acid instillation, weight gain, air way and pulmonary artery pressure, and intrapulmonary shunting were unchanged from control levels. If large quantities of steroid were added to the lobe perfusate 5 minutes after intrabronchial acid instillation, the lobe weight doubled but air way pressure and pulmonary artery pressure, and intrapulmonary shunting were not significantly different from control values. It is surmised that intrapulmonary acid aspiration causes an immediate and marked changed in pulmonary capillary permeability. Albumin administration by counteracting this permeability change, and steroid administration by modifying the permeability change, are both beneficial following acid aspiration. Images Fig. 7a. Fig. 7a., Fig. 7c. PMID:1247316

  3. Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma.

    PubMed

    Tashtoush, Basheer; Schroeder, Jonathan; Memarpour, Roya; Oliveira, Eduardo; Medina, Michael; Hadeh, Anas; Ramirez, Jose; Smolley, Laurence

    2015-01-01

    The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of steak from the airway, the patient remained hypotensive and required continued hemodynamic support. Repeated laboratory tests within 24 hrs of aspiration showed a significant decline in the hemoglobin level. A computed tomography (CT) scan of the abdomen and pelvis showed a lacerated liver with a large subcapsular hematoma draining into the pelvis. Conclusion. Hepatic rupture is a rare complication of Heimlich maneuver; this paper represents the second case report in the literature. It emphasizes the necessity of early identification and surveillance of fatal Heimlich maneuver complications in a high risk population.

  4. Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma

    PubMed Central

    Schroeder, Jonathan; Memarpour, Roya; Oliveira, Eduardo; Medina, Michael; Smolley, Laurence

    2015-01-01

    The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of steak from the airway, the patient remained hypotensive and required continued hemodynamic support. Repeated laboratory tests within 24 hrs of aspiration showed a significant decline in the hemoglobin level. A computed tomography (CT) scan of the abdomen and pelvis showed a lacerated liver with a large subcapsular hematoma draining into the pelvis. Conclusion. Hepatic rupture is a rare complication of Heimlich maneuver; this paper represents the second case report in the literature. It emphasizes the necessity of early identification and surveillance of fatal Heimlich maneuver complications in a high risk population. PMID:26090241

  5. The Perceived Value of Education and Educational Aspirations in the Czech Republic: Changes in the Determination of Educational Aspirations between 1989 and 2003

    ERIC Educational Resources Information Center

    Mateju, Petr; Smith, Michael L.

    2009-01-01

    This article compares the changes in the determination of educational aspirations from the end of the communist period in 1989 to 2003, focusing on a single postcommunist country, the Czech Republic. The Czech case is particularly relevant for comparative research on educational inequality and aspirations, as previous studies have shown…

  6. Endoscopic ultrasound characteristics of pancreatic lymphoepithelial cysts: A case series from a large referral center

    PubMed Central

    Dalal, Kunal S.; DeWitt, John M.; Sherman, Stuart; Cramer, Harvey M.; Tirkes, Temel; Al-Haddad, Mohammad A.

    2016-01-01

    Background and Objectives: Lymphoepithelial cysts (LECs) of the pancreas are benign lesions that can mimic cystic neoplasms on imaging. Endoscopic ultrasound (EUS) features have not been well described. We aimed to describe the clinical and EUS characteristics of LECs and the present outcomes of management at a high-volume referral center. Materials and Methods: We identified patients who underwent EUS and were found to have LECs based on fine-needle aspiration (FNA) cytology or surgical pathology from existing databases. EUS features, imaging characteristics, and pathology results were described. Results: Sixteen patients were found to have 17 LECs. The mean size was 33 mm ± 15 mm. Locations within the pancreas included 10 lesions in the tail, 3 in the body, 1 in the uncinate process; the remaining 3 were exophytic. Six lesions were anechoic, 6 were hypoechoic, and 5 had mixed echogenicity. Nine lesions had mixed solid/cystic components, 7 were purely cystic, and 1 was solid. Cyst fluid was thick or viscous in six cases and thin in three. Eleven patients had diagnostic cytopathology. Six patients ultimately underwent surgery due to symptoms, nondiagnostic FNA, or other clinical concerns for malignancy. Conclusions: Pancreatic LECs have variable morphology and echogenicity on EUS, but the appearance of a cyst with variable solid and cystic components combined with the appearance of thick, turbid, and viscous aspirate should raise suspicion for an LEC. The majority of patients with LECs at our center avoided surgery for LECs on the basis of diagnostic EUS-FNA. PMID:27503157

  7. Time costs, aspirations and the effect of economic growth on German fertility.

    PubMed

    Ermisch, J F

    1980-01-01

    Recent research has shown strong support for the model of reproductive behavior derived from the new home economics, and it is shown in this discussion that the evidence from the Federal Republic of Germany is consistent with the new home economics model. There is little support for Easterlin's relative economic hypothesis, but there is limited endorsement for model which adds the influence of experience based material aspirations to the new home economics model. Easterlin's relative income model is reviewed before directing attention to the new home economics model and an explanation of fertility movements in West Germany. The new home economics model focuses on the family division of labor between home activities and work outside the home. The marked decline in German fertility during the 1970s is mostly attributable to factors such as expanding women's earning capacities which increased the importance of 2 earner families, who have a different family division of labor and possibly preferences biased towards "quality" of children rather than numbers. Also, real wage growth lagged behind the growth in experience based aspirations, and this drop in relative income is more dramatic if it is presumed that material aspirations are based upon the family's income experienced by a young adult during his/her adolescence, rather than just the father's earnings. The mother's contribution to family income will contribute to her family's actual standard of living and the desired standard of living of her children. The labor force participation rates of married, middle-aged German women increased markedly during the 1st half of the 1950s, thus tending to enhance the increase in the standard of living desired by the young adults reaching marrying and childbearing ages in the mid-1960s. The analysis indicates that if there is not a substantial reduction in the proportion of young married women in the labor force, fertility will move countercyclically. In that there must be some

  8. Model for Probing Membrane-Cortex Adhesion by Micropipette Aspiration and Fluctuation Spectroscopy

    PubMed Central

    Alert, Ricard; Casademunt, Jaume; Brugués, Jan; Sens, Pierre

    2015-01-01

    We propose a model for membrane-cortex adhesion that couples membrane deformations, hydrodynamics, and kinetics of membrane-cortex ligands. In its simplest form, the model gives explicit predictions for the critical pressure for membrane detachment and for the value of adhesion energy. We show that these quantities exhibit a significant dependence on the active acto-myosin stresses. The model provides a simple framework to access quantitative information on cortical activity by means of micropipette experiments. We also extend the model to incorporate fluctuations and show that detailed information on the stability of membrane-cortex coupling can be obtained by a combination of micropipette aspiration and fluctuation spectroscopy measurements. PMID:25902428

  9. [Health education in radiology service: orientations for breast and thyroid aspiration puncture].

    PubMed

    Rosini, Ivone; Salum, Nádia Chiodelli

    2013-09-01

    This is a convergent care research developed in a school hospital's radiology service whose purpose is to learn about the concerns and expectations of clients submitted to breast and thyroid Fine Needle Aspiration Puncture. Data collection was conducted from September 2010 to April 2011, through 10 educational meetings in the waiting room interviewing 88 clients. The results show: clients' perception of the test, cancer as a stigma and healthcare education as a confrontation strategy. In addition, they revealed fear of both the procedure and the diagnosis of cancer. Educational practice in the waiting room is a space to decrease anxiety and allows the exchange of experiences and knowledge between professional and client, it also fosters a support network among clients. It is characterized as important space of action to the nurse within radiology service.

  10. Self-concept, aspirations, and well-being in South Korea and the United States.

    PubMed

    Kim, Youngmee; Kasser, Tim; Lee, Hoonkoo

    2003-06-01

    The authors examined the similarities and differences between 3 dimensions that represent people's focus on self vs. other: individualistic vs. collectivistic nations, independent vs. interdependent self-concepts, and intrinsic vs. extrinsic aspirations. In samples of South Korean and U.S. college students, the authors found that each of these dimensions was interrelated in expected ways and that each also was independently associated with different aspects of participants' self-report of their own well-being (i.e., self-actualization, vitality, happiness, anxiety, and physical manifestations). The authors concluded that environmental circumstances and personality characteristics that focus on personal needs are more likely to provide experiences supportive of psychological well-being.

  11. The Role of Social Capital in Educational Aspirations of Rural Youth*

    PubMed Central

    Byun, Soo-yong; Meece, Judith L.; Irvin, Matthew J.; Hutchins, Bryan C.

    2013-01-01

    Drawing on a recent national survey of rural high school students, this study investigated the relationship between social capital and educational aspirations of rural youth. Results showed that various process features of family and school social capital were important to predict rural youth's educational aspirations beyond sociodemographic background. In particular, parents' and teachers' educational expectations for their child and student respectively were positively related to educational aspirations of rural youth. In addition, discussion with parents about college was positively related to educational aspirations of rural youth. On the other hand, there was little evidence to suggest that number of siblings and school proportions of students on free lunch and minority students are related to educational aspirations of rural youth, after controlling for the other variables. The authors highlight unique features of rural families, schools, and communities that may combine to explain the complexity of the role of social capital in shaping educational aspirations of rural youth. PMID:24039302

  12. Total laryngectomy for management of chronic aspiration pneumonia in a myopathic dog.

    PubMed

    Vernau, Karen M; Marks, Stanley L; Kuhn, Maggie A; Culp, William T N; Owens, Tammy J; Shelton, G Diane; Siddiqui, Tausif; Pollard, Rachel; Belafsky, Peter C

    2016-07-01

    A 5-month-old female pit bull terrier dog evaluated for ataxia, progressive regurgitation, and recurrent aspiration pneumonia had markedly elevated creatine kinase activity, non-inflammatory generalized myopathy, and severe esophageal dysmotility. A narrow-field total laryngectomy was performed. The dog is doing well 30 months after surgery, and no longer has episodes of aspiration pneumonia, despite intermittent regurgitation. This case represents the first application of total laryngectomy for the prevention of chronic recurrent aspiration pneumonia in the dog.

  13. Fine-needle aspiration biopsy: a historical overview.

    PubMed

    Rosa, Marilin

    2008-11-01

    Fine needle aspiration biopsy is a safe, inexpensive and accurate technique for the diagnosis of benign and malignant conditions. Its increase in popularity in the present days has made it a technique used on daily basis in the majority of medical centers in United States and around the world. However, the situation was not always like this. In its beginnings the procedure suffered from all kinds of criticism and attacks. The purpose of this manuscript is to provide an overview about the development of this technique from its birth to our days.

  14. Granulomatous lung disease in children by aspiration of medications.

    PubMed

    Hański, W; Figurski, R; Fermus, R

    1987-01-01

    Post mortem examinations of 8 infants, 11 d to 5 months old and one 12 year old girl, demonstrated foreign bodies in the lungs which could be identified as orally administered drugs: cholestyramine (Questran) and phenobarbital (Luminal, Gardenal) or phenydantin-components. The microscopic changes caused by such deposits and the histologic methods of identifying medicines are presented. The authors point to the role of aspiration in deposit formation and to the pseudomiliary granulomatous nature of subsequent changes. It is proposed to define the alterations as a separate form of aspiratory lesion in children.

  15. Aspiration of tracheoesophageal prosthesis in a laryngectomized patient

    PubMed Central

    2012-01-01

    Background The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation We describe a case of tracheoesophageal prosthesis’ (TEP) aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature. PMID:22958961

  16. Fine needle aspiration cytology of thymic carcinoid tumor.

    PubMed

    Wang, D Y; Kuo, S H; Chang, D B; Yang, P C; Lee, Y C; Hsu, H C; Luh, K T

    1995-01-01

    Carcinoid tumors of the thymus are very rare, and their cytologic findings have not been reported previously in English. Retrospective study of fine needle aspiration (FNA) cytologic features in four histopathologically verified thymic carcinoid tumors are described here in detail. The FNA cytology of thymic carcinoids is characterized by predominantly single and some loose clusters of small, round to oval cells with scanty cytoplasm, interspersed with some larger cells with moderate to abundant, granular cytoplasm. The differential diagnosis of the cytologic features between carcinoid tumor and other mediastinal tumors is also discussed.

  17. Meconium aspiration syndrome treatment - new approaches using old drugs.

    PubMed

    Ivanov, Vadim A

    2006-01-01

    Presently, modern medicine does not offer any disease-modifying treatment for meconium aspiration syndrome (MAS). Several medications with already established safety profiles when employed for similar or other conditions could be useful for MAS treatment. N-Acetylcysteine and DNAse have the capability to reduce viscosity and thickness of meconium by breaking disulfide bonds and slicing DNA, respectively. N-Acetylcysteine, antiprotease drugs, or low pH buffer solutions may have the capability to neutralize meconium's digestive enzymes responsible for lung damage in patients with MAS. All these compounds have great potential to reduce meconium's pathogenic properties which in turn could alleviate MAS severity.

  18. Metastatic Chordoma: A Diagnostic Challenge on Fine Needle Aspiration

    PubMed Central

    Tranesh, Ghassan; Nassar, Aziza

    2016-01-01

    Chordomas are primary low grade malignant tumors of bone that usually arise within both ends of axial skeleton. The Notochord is a midline, ectoderm-derived structure that defines the phylum of chordates. Chordomas may pose difficult diagnostic challenges when encountered in secondary locations, such as lungs or other parenchymatous organs. We report the cytologic findings of a metastatic chordoma sampled through CT-scan guided fine needle aspiration (FNA) of lower lobe lung nodule in a 54-year-old man diagnosed with recurrent chordoma involving the lumber spine and paraspinal region. PMID:26881166

  19. Laryngospasm With Apparent Aspiration During Sedation With Nitrous Oxide.

    PubMed

    Babl, Franz E; Grindlay, Joanne; Barrett, Michael Joseph

    2015-11-01

    Nitrous oxide and oxygen mixture has become increasingly popular for the procedural sedation and analgesia of children in the emergency department. In general, nitrous oxide is regarded as a very safe agent according to large case series. We report a case of single-agent nitrous oxide sedation of a child, complicated by laryngospasm and radiographically confirmed bilateral upper lobe pulmonary opacities. Although rarely reported with parenteral sedative agents, laryngospasm and apparent aspiration has not been previously reported in isolated nitrous oxide sedation. This case highlights that, similar to other sedative agents, nitrous oxide administration also needs to be conducted by staff and in settings in which airway emergencies can be appropriately managed.

  20. Sclerosing hemangioma: A diagnostic dilemma in fine needle aspiration cytology

    PubMed Central

    Zeng, Jennifer; Zhou, Fang; Wei, Xiao-Jun; Kovacs, Sandor; Simsir, Aylin; Shi, Yan

    2016-01-01

    Sclerosing hemangioma of the lung is a benign neoplasm with a widely debated histogenesis. It has a polymorphic histomorphology characterized by a biphasic cell population of “surface cells” and “round cells” arranged in four general patterns: Papillary, solid, angiomatous, and sclerotic. This variability in histomorphology makes it difficult to diagnose sclerosing hemangioma by fine needle aspiration (FNA). We present a case of sclerosing hemangioma diagnosed on FNA with immunohistochemistry performed on an accompanied cell block. The clinical presentation, cytomorphology, immunohistochemistry, and differential diagnoses are discussed. PMID:27168758

  1. Perineal nodule due to enterobiasis: an aspiration cytologic diagnosis.

    PubMed

    Kumar, Neeta; Sharma, Prashant; Sachdeva, Ritesh; Jain, Shyama

    2003-01-01

    Subcutaneous swelling due to Enterobious vermicularis infection is rare. Their presence in perineal subcutaneous tissue is unusual and a clinical curiosity. A case of subcutaneous nodule in the perineum due to E. vermicularis infection diagnosed on fine-needle aspiration is described. Tissue reaction was granulomatous with neutrophils and eosinophils. Lack of familiarity with the morphology of parasites or its eggs, degeneration, and inadequate sampling may make the diagnosis difficult. This case report provides the morphologic clues to cytopathologists toward rendering a diagnosis and alerts them to the possibility of parasitic infection in unusual locations.

  2. Optical evaluation of red blood cell geometry using micropipette aspiration.

    PubMed

    Engström, K G; Möller, B; Meiselman, H J

    1992-01-01

    Although red blood cell (RBC) geometry has been extensively studied by micropipette aspiration, the small size of RBC and pipettes vs. the optical resolution of light microscopy suggests the need to consider potential errors. The present study addressed such difficulties and investigated four specific problems: (1) use of exact equations to calculate RBC membrane area and volume; (2) calibration of the pipette internal diameter (PID); (3) correction for a noncylindrical pipette barrel; (4) diffraction distortion of the RBC image. The observed PID represents a cylinder lens enlargement that can be theoretically derived from the glass/buffer refractive index ratio (1.49/1.33 = 1.12). This enlargement was experimentally confirmed by: (1) studying pipettes bent to allow measurement through the barrel (horizontal) and at the orifice (vertical), with a resulting diameter ratio of 1.12 +/- 0.01; (2) and by replacing the surrounding buffer with immersion oil and hence abolishing the lens phenomenon (ratio = 1.12 +/- 0.02). In addition, use of aspirated oil droplets demonstrated a 3.2 +/- 0.2% error when the PID is focused at a sharp, maximum diameter. The average pipette cone angle was 1.49 +/- 0.09 degrees and varied considerably with pipette pulling procedures; calculated tongue geometry inside the pipette was affected by the noncylindrical pipette barrel. The RBC diffraction error, demonstrated by touching two aspirated cells held by opposing pipettes, was 0.091 +/- 0.002 microns. The PID, cone angle, and diffraction artifacts significantly (p < 0.001) affected calculated RBC geometry (average errors up to 5.4% for area and 9.6% for volume). Two new methods to calculate, rather than directly measure, the PID from images of a single RBC, during either osmotic or pressure manipulation, were evaluated; the osmotic method closely predicted the PID, whereas the pressure method markedly underestimated the PID. Our results thus confirm the need to consider the above

  3. Mechanical stability of particle-stabilized droplets under micropipette aspiration

    NASA Astrophysics Data System (ADS)

    Samudrala, Niveditha; Nam, Jin; Sarfati, Raphaël; Style, Robert W.; Dufresne, Eric R.

    2017-01-01

    We investigate the mechanical behavior of particle-stabilized droplets using micropipette aspiration. We observe that droplets stabilized with amphiphilic dumbbell-shaped particles exhibit a two-stage response to increasing suction pressure. Droplets first drip, then wrinkle and buckle like an elastic shell. While particles have a dramatic impact on the mechanism of failure, the mechanical strength of the droplets is only modestly increased. On the other hand, droplets coated with the molecular surfactant sodium dodecyl sulfate are even weaker than bare droplets. In all cases, the magnitude of the critical pressure for the onset of instabilities is set by the fluid surface tension.

  4. Aspiration pneumonia and death in Huntington’s disease

    PubMed Central

    Heemskerk, Anne-Wil; Roos, Raymund A.C.

    2012-01-01

    Huntington’s disease (HD) is a progressive neurodegenerative autosomal dominant disease characterized by choreatic and hypokinetic movements, disturbed behaviour, and cognitive decline. Pneumonia is the most common cause of death, followed by cardiovasculair diseases. It has been suggested that choking is the causative underlying factor for pneumonia in HD. As a detailed specification of the type of pneumonia has never been performed, we analyzed the records of our Brain Bank containing 224 cases to determine the exact cause of death and type of pneumonia. The conclusion is that the majority (86.8%) of our HD patients where the cause of death could be identified died from aspiration pneumonia. PMID:22307361

  5. Ductal lavage, nipple aspiration, and ductoscopy for breast cancer diagnosis.

    PubMed

    Dooley, William C

    2003-01-01

    The intraductal approach to breast cancer has been invigorated this year by a series of papers exploring ductal-based screening through nipple aspiration and lavage and ductal exploration through endoscopy. The merging of these efforts to define the earliest biologic changes in the progression toward breast cancer is opening new fields for both bench-translational and clinical research. These techniques have already begun to show value in defining the presence and extent of proliferative disease in high-risk patients, allowing for more informed therapeutic decision making.

  6. Aspirated safety pin requiring thoracotomy: report of a case and review.

    PubMed

    Causey, A L; Talton, D S; Miller, R C; Warren, E T

    1997-12-01

    Foreign body aspirations in children are relatively uncommon occurrences, but they can be a serious events, causing respiratory distress, atelectasis, chronic pulmonary infections, or death. Safety pins are not commonly aspirated objects and account for less than 3% of all foreign bodies found in the tracheobronchial tree. Fewer than 2% of patients require thoracotomy, and most aspirated materials can be removed by bronchoscopy, with low morbidity and mortality. A discussion of airway foreign bodies follows the presentation of a case of an older child who aspirated a safety pin, which required open thoracostomy for removal.

  7. North American Summit on Aspiration in the Critically Ill Patient: consensus statement.

    PubMed

    McClave, Stephen A; DeMeo, Mark T; DeLegge, Mark H; DiSario, James A; Heyland, Daren K; Maloney, James P; Metheny, Norma A; Moore, Frederick A; Scolapio, James S; Spain, David A; Zaloga, Gary P

    2002-01-01

    Aspiration is the leading cause of pneumonia in the intensive care unit and the most serious complication of enteral tube feeding (ETF). Although aspiration is common, the clinical consequences are variable because of differences in nature of the aspirated material and individual host responses. A number of defense mechanisms normally present in the upper aerodigestive system that protect against aspiration become compromised by clinical events that occur frequently in the critical care setting, subjecting the patient to increased risk. The true incidence of aspiration has been difficult to determine in the past because of vague definitions, poor assessment monitors, and varying levels of clinical recognition. Standardization of terminology is an important step in helping to define the problem, design appropriate research studies, and develop strategies to reduce risk. Traditional clinical monitors of glucose oxidase strips and blue food coloring (BFC) should no longer be used. A modified approach to use of gastric residual volumes and identification of clinical factors that predispose to aspiration allow for risk stratification and an algorhythm approach to the management of the critically ill patient on ETF. Although the patient with confirmed aspiration should be monitored for clinical consequences and receive supportive pulmonary care, ETF may be continued when accompanied by appropriate steps to reduce risk of further aspiration. Management strategies for treating aspiration pneumonia are based on degree of diagnostic certainty, time of onset, and host factors.

  8. Immunocytochemical detection of milk proteins in tracheal aspirates of ventilated infants: a pilot study.

    PubMed

    Miller, Jamey; Colasurdo, Giuseppe N; Khan, Amir M; Jajoo, Charu; Patel, Tarak J; Fan, Leland L; Elidemir, Okan

    2002-11-01

    In this study, we evaluated immunocytochemical staining for milk proteins (alpha-lactalbumin and beta-lactoglobulin) in tracheal aspirates of mechanically ventilated infants, and assessed whether this staining technique supported a clinical diagnosis of aspiration in infants receiving orogastric feedings. All newborns requiring mechanical ventilation in the neonatal intensive care unit of a major tertiary care hospital were potential subjects for this study. Tracheal aspirates were obtained prior to the introduction of enteral feeding and at various time points thereafter in newborns requiring mechanical ventilation. Cells were obtained and processed for immunocytochemical staining of alpha-lactalbumin and beta-lactoglobulin. In total, 88 specimens recovered from 34 infants were adequate for staining. Alveolar macrophages recovered from most of the infants who were never fed (true negative controls) did not display immunoreactivity for milk proteins: 4/34 or 12% of infants' aspirates demonstrated presence of milk proteins before enteral feeding was commenced. Tracheal aspirates obtained from 12 infants after introduction of enteral feedings appeared to support clinical and radiological findings suggestive of aspiration events, with positive immunostaining on several occasions. These observations support our work in a murine model and demonstrate that immunocytochemical staining of tracheal aspirates for milk proteins may enhance the ability to diagnose pulmonary aspiration. Further studies are needed to define the clinical significance of our findings and the effects of single and repeated aspiration events on respiratory status.

  9. The natural history and clinical consequences of aspiration in acute stroke.

    PubMed

    Kidd, D; Lawson, J; Nesbitt, R; MacMahon, J

    1995-06-01

    Sixty consecutive patients admitted to a teaching hospital with acute stroke were studied prospectively for 3 months to define the natural history and consequences of lung aspiration. Using videofluoroscopy, aspiration was identified in 25 patients (42%) within 72 h of stroke onset, and had resolved in all but three patients (8%) after 3 months. It was closely related to the presence of dysphagia, which itself resolved within 2 weeks in all but the persistent aspirators. Lower respiratory tract infection (LRTI) was more common in aspirating patients (68%) than non-aspirators (6%). The use of intravenous fluids without oral intake did not appear to prevent LRTI in aspirating patients who were also dysphagic. Pneumonia occurred after 2 weeks in the three patients subsequently found to aspirate persistently. Aspiration is a transient phenomenon in most cases of acute stroke; it is associated with a high incidence of LRTI, but mortality in this series was not significantly associated either with respiratory tract infection or aspiration itself.

  10. Effectiveness of milrinone for cardiogenic shock due to massive pulmonary aspiration: a case report

    PubMed Central

    Park, Jeong Heon; Kim, Dong Hee; Kim, Seok-Kon; Jeon, Dae Geun; Song, Jaegyok; Ji, Seung Heon; Lee, Gwan Woo; Kang, Bong Jin

    2014-01-01

    Pulmonary aspiration of gastric contents is one of the most frightening complications during anesthesia. Although pulmonary aspiration of gastric contents in general surgical patients is not common and resulting long-term morbidity and mortality are rare, severe hypoxemia and other sequelae of pulmonary aspiration continue to be reported. We report a case of massive aspiration of gastric contents during induction of general anesthesia, resulting in cardiac arrest due to severe pulmonary hypertension and myocardial infarction. Sustained cardiac arrest and shock that did not respond the conventional resuscitation was successfully treated using milrinone. The patient was discharged without complications in 20 days. PMID:25006374

  11. Spheres of Influence: What Shapes Young People's Aspirations at Age 12/13 and What Are the Implications for Education Policy?

    ERIC Educational Resources Information Center

    Archer, Louise; DeWitt, Jennifer; Wong, Billy

    2014-01-01

    Young people's aspirations remain an enduring focus of education policy interest and concern. Drawing on data from an ongoing five-year study of young people's science and career aspirations (age 10-14), this paper asks what do young people aspire to at age 12/13, and what influences these aspirations? It outlines the main aspirations and sources…

  12. Simple and specific test for the diagnosis of aspiration into the airways using a corn flour-milk mixture in a hamster model.

    PubMed

    Springer, Chaim; Avital, Avraham

    2003-05-01

    Aspiration into the airways is one of the major causes of lung disease in infants and young children. Unfortunately, the diagnosis of aspiration is often delayed due to unawareness and low sensitivity and specificity of existing diagnostic tests. We tested the efficacy of a new method, using a mixture of corn flour in milk instilled into the trachea, to diagnose aspiration in a hamster model. Forty-five female hamsters were used for the experiments. Twenty hamsters underwent tracheal instillation of 0.1 ml of a mixture of 7.5% corn flour (containing starch granules with a diameter of 2-30 microm) in milk. Twenty control animals underwent tracheal instillation of saline. Five hamsters served as naive controls. Five animals from the corn flour and saline groups underwent bronchoalveolar lavage on days 1, 3, 7, and 14 after tracheal instillation. Starch granules were identified under light microscopy, using both iodine and Diff-Quik staining in all the corn flour-instilled animals and during all days after tracheal instillation. No starch granules were detected in naive or saline-treated animals. Starch granules were detected over 14 days following tracheal instillation, with a half-life rate of disappearance of about 6 days. Corn flour aspiration in hamsters can be easily identified by light microscopy, using simple laboratory techniques.

  13. Aspiring to leadership--identifying teacher-leaders.

    PubMed

    Rogers, John

    2005-11-01

    Educational institutions need effective leaders at many levels. This paper explores the applicability of the Porter/Mazlow need-priority and Herzberg maintenance-motivation models to the challenge of identifying individuals who aspire to leadership. The review includes literature from teaching, engineering, medicine, astronomy, business, and the military. Autonomy need and achievement motivation consistently distinguished leaders from non-leaders in several studies. Affiliation and esteem needs also characterized leaders in two studies. These empirical data support the use of these theoretical models, which are intuitively appealing and have potential for practical applications. One such application could be the identification and recruitment of education "champions" who would be teacher-leaders at dispersed sites. Through self-reflection faculty members could become aware of their needs and motivations and may realize their leadership aspirations and accept the teacher-leader role. For an education "champions" program to be successful, the department leadership would need to attend to the organizational culture and provide release time for the teacher-leaders. A blueprint for the development of teacher-leaders is outlined.

  14. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    PubMed Central

    Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis. PMID:24392235

  15. Kinematics of red cell aspiration by fluorescence-imaged microdeformation.

    PubMed Central

    Discher, D E; Mohandas, N

    1996-01-01

    Maps of fluorescing red cell membrane components on a pipette-aspirated projection are quantitated in an effort to elucidate and unify the heterogeneous kinematics of deformation. Transient gradients of diffusing fluorescent lipid first demonstrate the fluidity of an otherwise uniform-density bilayer and corroborate a "universal" calibration scale for relative surface density. A steep but smooth and stable gradient in the densities of the skeleton components spectrin, actin, and protein 4.1 is used to estimate large elastic strains along the aspirated skeleton. The deformation fields are argued to be an unhindered response to loading in the surface normal direction. Density maps intermediate to those of the compressible skeleton and fluid bilayer are exhibited by particular transmembrane proteins (e.g., Band 3) and yield estimates for the skeleton-connected fractions. Such connected proteins appear to occupy a significant proportion of the undeformed membrane surface and can lead to steric exclusion of unconnected integral membrane proteins from regions of network condensation. Consistent with membrane repatterning kinematics in reversible deformation, final vesiculation of the projection tip produces a cell fragment concentrated in freely diffusing proteins but depleted of skeleton. Images FIGURE 1 FIGURE 2 FIGURE 4 FIGURE 5 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 PMID:8889146

  16. Mechanosensitive shivering of model tissues under controlled aspiration

    PubMed Central

    Guevorkian, Karine; Gonzalez-Rodriguez, David; Carlier, Camille; Dufour, Sylvie; Brochard-Wyart, Françoise

    2011-01-01

    During embryonic development and wound healing, the mechanical signals transmitted from cells to their neighbors induce tissue rearrangement and directional movements. It has been observed that forces exerted between cells in a developing tissue under stress are not always monotonically varying, but they can be pulsatile. Here we investigate the response of model tissues to controlled external stresses. Spherical cellular aggregates are subjected to one-dimensional stretching forces using micropipette aspiration. At large enough pressures, the aggregate flows smoothly inside the pipette. However, in a narrow range of moderate aspiration pressures, the aggregate responds by pulsed contractions or “shivering.” We explain the emergence of this shivering behavior by means of a simple analytical model where the uniaxially stretched cells are represented by a string of Kelvin–Voigt elements. Beyond a deformation threshold, cells contract and pull on neighboring cells after a time delay for cell response. Such an active behavior has previously been found to cause tissue pulsation during dorsal closure of Drosophila embryo. PMID:21771735

  17. A Patient With Aspiration Pneumonia After Mandibular Osteotomy With Genioplasty.

    PubMed

    Ohba, Seigo; Kawasaki, Takako; Hashimoto, Megumi; Yoshida, Noriaki; Ashina, Izumi

    2016-06-01

    Orthognathic surgery including maxillary osteotomy, mandibular osteotomy, and genioplasty is a reliable treatment strategy for jaw deformity. However, there are some complications associated with these surgeries, including neurovascular damage and abnormal bleeding. The authors present here a patient of aspiration pneumonia after mandibular osteotomy.An 18-year-old female patient underwent sagittal split ramus osteotomy and genioplasty for mandibular prognathism. She began choking and coughing immediately after surgery. She was diagnosed with aspiration pneumonia based on chest radiography and computed tomography findings. Her hyoid bone was shifted 23 mm inferiorly after surgery, and this movement may have caused swallowing dysfunction. She was treated with intravenous antibiotics and discharged on the 18th postoperative day.Although the hyoid bone is transiently shifted inferiorly by mandibular setback with or without genioplasty, this shift does not usually affect swallowing function. Damage to the suprahyoid muscles during genioplasty may cause both an inferior shift and dysmobility of the hyoid bone. Therefore, surgeons must be careful not to damage the suprahyoid muscles at the lingual site osteotomy in genioplasty to avoid this complication.

  18. The orientation-averaged aspiration efficiency of IOM-like personal aerosol samplers mounted on bluff bodies.

    PubMed

    Paik, Samuel Y; Vincent, James H

    2004-01-01

    This paper describes two sets of experiments that were intended to characterize the orientation-averaged aspiration efficiencies of IOM samplers mounted on rotating bluff bodies. IOM samplers were mounted on simplified, three-dimensional rectangular bluff bodies that were rotated horizontally at a constant rate. Orientation-averaged aspiration efficiencies (A360) were measured as a function of Stokes' number (St), velocity ratio (R) and dimension ratio (r). Aspiration efficiency (A) is the efficiency with which particles are transported from the ambient air into the body of a sampler, and A360 is A averaged over all orientations to the wind. St is a dimensionless variable that represents particle inertia, R is the ratio of the air velocity in the freestream and that at the plane of the sampler's entry orifice, and r is the ratio of the sampler's orifice diameter and the bluff body's width. The first set of experiments were instrumental in establishing a hierarchy of effects on orientation-averaged A. It was clear that compared to r, St had a much larger influence on A. It was also clear, however, that the effects of St were overpowered by the effects of R in many cases. As concluded in previous studies, R and St were considered the most important factors in determining A, even for A360. The second set of experiments investigated A360 of IOM samplers for a much wider range of r than examined in previous research. Two important observations were made from the experimental results. One was that the A360 of IOM samplers, as a function of St, did not change for an r-range of 0.066-0.4. This meant that an IOM sampler mounted on a near life-size mannequin would measure the same aerosol concentration as one not mounted on anything. The second observation was that the aspiration efficiency curve of the IOM sampler was close to the inhalability curve. This gave further evidence that the bluff body did not play a major role in influencing A360, as the IOM samplers, in these

  19. Aspiration pneumonia after concurrent chemoradiotherapy for head-and-neck cancer

    PubMed Central

    Xu, Beibei; Boero, Isabel J.; Hwang, Lindsay; Le, Quynh-Thu; Moiseenko, Vitali; Sanghvi, Parag R.; Cohen, Ezra E. W.; Mell, Loren K.; Murphy, James D.

    2016-01-01

    Background Aspiration pneumonia represents an under-reported complication of chemoradiotherapy in head-and-neck cancer. This study evaluated the incidence, risk factors, and mortality of aspiration pneumonia in a large cohort of head-and-neck cancer patients treated with concurrent chemoradiotherapy. Methods Patients with head-and-neck cancer diagnosed between 2000 and 2009 were identified from the SEER-Medicare database. Aspiration pneumonia was identified from Medicare billing claims. The cumulative incidence, risk factors, and survival after aspiration pneumonia were estimated and compared to a non-cancer population. Results Of 3,513 head-and-neck cancer patients, 801 patients developed aspiration pneumonia at a median time of 5 months after initiating treatment. The 1- and 5-year cumulative incidence of aspiration pneumonia was 15.8% and 23.8% for head-and-neck cancer patients and 3.6% and 8.7% for non-cancer controls, respectively. Among cancer patients multivariate analysis identified independent risk factors (p<0.05) for aspiration pneumonia including hypopharyngeal and nasopharyngeal tumors, male gender, older age, increased comorbidity, no surgery prior to radiation, and care received at a teaching hospital. Among cancer patients who experienced aspiration pneumonia, 674 (84%) were hospitalized of which 301 (45%) were admitted to an intensive care unit. Thirty-day mortality after hospitalization for aspiration pneumonia was 32.5%. Aspiration pneumonia was associated with a 42% increased risk of death (HR=1.42, p<0.001) after controlling for confounders. Conclusions This study found that nearly one-quarter of elderly patients will develop aspiration pneumonia within 5 years of chemoradiotherapy for head-and-neck cancer. A better understanding of mitigating factors will help identify patients at risk for this potentially lethal complication. PMID:25537836

  20. Science dual enrollment: An examination of high school students' post-secondary aspirations

    NASA Astrophysics Data System (ADS)

    Berry, Chelsia

    The purpose of this study was to determine if participation in science dual enrollment courses influenced African American high school students' post-secondary aspirations that will lead to college attendance. The investigation examined the relationship between African American students' learning experiences and how their self-efficacy and outcome expectations impact their goal setting. The goal was to determine the impact of the following variables on African American students' plan to pursue a bachelor's or advanced degree: (a) STEM exposure, (b) Algebra 1 achievement, (c) level of science class, and (d) receiving science college credit for dual enrollment course. The social cognitive career theory framed this body of research to explore how career and academic interests mature, are developed, and are translated into action. Science dual enrollment participation is a strategy for addressing the lack of African American presence in the STEM fields. The causal comparative ex post facto research design was used in this quantitative study. The researcher performed the Kruskal-Wallis non-parametric analysis of variance and Pearson's chi-square tests to analyze secondary data from the High School Longitudinal Study first follow-up student questionnaire. The results indicate that STEM exposure and early success in Algebra 1 have a statistically significant impact on African American students' ambition to pursue a bachelor's or advanced degree. According to the Pearson's chi-square and independent sample Kruskal-Wallis analyses, level of students' science class and receiving college credit for dual enrollment do not significantly influence African American students' postsecondary aspirations.

  1. Rural Scholars or Bright Rednecks? Aspirations for a Sense of Place among Rural Youth in Appalachia.

    ERIC Educational Resources Information Center

    Howley, Craig; And Others

    This study compares the attitudes of academically gifted rural students with those of their classmates with regard to their communities and their aspirations for a sense of place. Although West Virginia, a largely rural state in Appalachia, is considered by outsiders as a place of deprivation, despair, and backwardness, an aspiration for a sense…

  2. Career Aspirations of Youth: Untangling Race/Ethnicity, SES, and Gender

    ERIC Educational Resources Information Center

    Howard, Kimberly A. S.; Carlstrom, Aaron H.; Katz, Andrew D.; Chew, Aaronson Y.; Ray, G. Christopher; Laine, Lia; Caulum, David

    2011-01-01

    This study examined the influence of gender, socioeconomic status, and race/ethnicity on the career aspirations of over 22,000 8th and 10th grade youth. The top five occupations identified by youth as aspirations included artist, lawyer, musician, FBI agent, and actor/actress. Top occupations were also reported for each gender x socioeconomic…

  3. Aspiration, Identity and Self Belief: Snapshots of Social Structure at Work

    ERIC Educational Resources Information Center

    Riddell, Richard, Ed.

    2010-01-01

    This book presents the evidence gathered from original interviews to show how the aspirations of young people develop in light of their social circumstances. Those who attend independent schools will find that the relationship between what goes on at home and at school makes it socially almost impossible not to have achievable aspirations for a…

  4. Independent School Department Heads: The Influence of Role Ambiguity, Relationships, and Professional Development on Career Aspirations

    ERIC Educational Resources Information Center

    Kinsella, Shane

    2012-01-01

    Little research exists on the career aspirations of department heads in independent schools. What does exist focuses on public school teachers in the United States and the United Kingdom. This study sought to determine the career aspirations, job satisfaction, and job efficacy of department heads. Using data from an original survey instrument…

  5. Parents Influencing Secondary Students' University Aspirations: A Multilevel Approach Using School-SES

    ERIC Educational Resources Information Center

    Watson, Stuart; Vernon, Lynette; Seddon, Sarah; Andrews, Yolanda; Wang, Angela

    2016-01-01

    Students' university aspirational capacity and expectancies are key factors in predicting future university participation. Aspirations and expectations to attend university are strongly influenced by parent educational socialisation and school culture. This study investigates associations between students' university discussions with parents and…

  6. Bounded Aspirations: Rural, African American High School Students and College Access

    ERIC Educational Resources Information Center

    Means, Darris R.; Clayton, Ashley B.; Conzelmann, Johnathan G.; Baynes, Patti; Umbach, Paul D.

    2016-01-01

    This qualitative case study explores the career and educational aspirations, college choice process, and college barriers and opportunities of 26 rural, African American high school students. Data included interviews with 26 students and 11 school staff members. Findings suggest that the students' rural context shapes aspirations. In addition,…

  7. Educational and Career Aspirations of Secondary School Students in Grenada Following the American Intervention.

    ERIC Educational Resources Information Center

    Chadwick, Bruce A.; Albrecht, Stan L.

    1989-01-01

    Examined educational and occupational aspirations of secondary school students in Grenada following 1983 American intervention. Questionnaire data from 729 students revealed that Grenadian students had exceptionally and unrealistically high aspirations. Opportunity structure in Grenada was found to be very limited compared to that in United…

  8. Parents' Aspirations for Their Children's Educational and Occupational Prospects in Greece: The Role of Social Class

    ERIC Educational Resources Information Center

    Vryonides, Marios; Gouvias, Dionysios

    2012-01-01

    This paper focuses on parents and the way they perceive and formulate expectations and aspirations about their children's educational and occupational outcomes. Drawing on evidence from a survey among more than 700 parents of primary school pupils this paper demonstrates that interesting patterns in parental aspirations can be observed. These…

  9. Motivation and Career Aspirations of Female Students Studying Science at Achimota School in Accra, Ghana

    ERIC Educational Resources Information Center

    Andoh, Paul K.; Bosiakoh, Thomas Antwi; Afranie, Stephen

    2012-01-01

    This paper examines science education for girls in Achimota School, a second cycle institution in Accra, in terms of their motivations for pursuing science and future aspirations. It explores parental backgrounds and how they impacted on the motivations and aspirations of the girls. The survey method was adopted in this study, which involved a…

  10. The Relationship between Career Variables and Occupational Aspirations and Expectations for Australian High School Adolescents

    ERIC Educational Resources Information Center

    Patton, Wendy; Creed, Peter

    2007-01-01

    This study surveyed 925 Australian high school students enrolled in grades 8 through 12 on measures of occupational aspirations, occupational expectations, career status aspirations, and career status expectations; it tested the association between these variables and career maturity, career indecision, career decision-making self-efficacy, and…

  11. The Effects on Motor Performance of Setting an Overt Level of Aspiration by Mentally Retarded Students.

    ERIC Educational Resources Information Center

    Kozar, Bill

    This study investigates the effects of setting an overt level of aspiration on the standing long jump performance of mildly and moderately retarded institutionalized children. Thirty-three mildly retarded and seven moderately retarded students were randomly assigned to either an overt level of aspiration (OLA) group or a control group. Each…

  12. Developing Conceptual Understandings of the Capacity to Aspire for Higher Education

    ERIC Educational Resources Information Center

    Prodonovich, Samuel; Perry, Laura B.; Taggart, Andrew

    2014-01-01

    This paper reviews research and theory relating to aspirations for higher education as a cultural capacity. Understanding the social and cultural dimensions of aspirations for higher education is important as they are increasingly becoming part of social commentary and more recently educational policy, research and practice. This paper synthesises…

  13. Project ASPIRE: Assisting Special Populations in Readiness for Employment. A California Work Ability Project.

    ERIC Educational Resources Information Center

    Butler, Marsha L.

    ASPIRE--"Assisting Special Populations in Readiness for Employment"--is a secondary special education transition program featuring coordinated services between the public and private sectors to integrate secondary level disabled students into subsidized private sector employment. ASPIRE was introduced into the Lake Tahoe Unified School…

  14. Aspiring Principals' Perception of the Challenges of Beginning Principals and the Support That They Need

    ERIC Educational Resources Information Center

    Ng, Pak Tee

    2015-01-01

    This paper presents the results of an exploratory research project about the perception of aspiring principals regarding the challenges of beginning principals and the support that they need. These aspiring principals are participants on the Leaders in Education Programme (LEP) in Singapore. According to the research findings, the LEP participants…

  15. [Broncho-pulmonary complications due to aspiration of foreign bodies by children].

    PubMed

    Pogorzelski, A; Zebrak, J; Pawlik, J; Cherian, Z; Buchwald, J

    1995-04-01

    The paper describes 239 children with bronchopulmonary disease due to foreign body (f.b.) aspiration treated in our center during between 1980-1992. Twenty-eight percent of the cases had been referred to hospital without any suspicion of f.b. aspiration. Almost half of the children (49.7%) were below the age of 2 years. Boys were affected more often (61.5%) than girls. In 61.1% the cases the f.b. had been aspirated into the right bronchial tree. Pieces of nuts were the most common f.b. - 35.1%. The most common chest X-ray symptoms were disturbances of bronchial patency (74.1%). Non-metalic, but potential shadowing f.b. like bones and teeth gave the clear signs only in 17.6% of the cases. After f.b. aspiration chronic irreversible lesions such as bronchiectasis and lung fibrosis were observed in 18.8% of the children. The prevalence of bronchiectasis was proportional to the duration of deposition. If the f.b. had been removed within the first month after aspiration we observed no complications. After aspiration of ears of grain, bronchiectasis was present in 80% of cases. Aspiration of f.b. into the left bronchial tree very often caused ventilation disturbations. Such cases were diagnosed and treated earlier than cases of right side f.b. aspirations. As a consequence bronchiectasis in the left lung was observed 2.7 less frequently.

  16. Career Aspirations and Expectations of College Students: Demographic and Labor Market Comparisons

    ERIC Educational Resources Information Center

    Metz, A. J.; Fouad, Nadya; Ihle-Helledy, Kris

    2009-01-01

    Replicating previous research, this study examined differences in 677 diverse college students' career aspirations and expectations based on gender and ethnicity, and compared their career expectations to the U.S. workforce. This study extended the literature base by exploring discrepancies between occupational aspirations and expectations…

  17. African American Career Aspirations: Examining the Relative Influence of Internalized Racism

    ERIC Educational Resources Information Center

    Brown, Danice L.; Segrist, Daniel

    2016-01-01

    The present study examined the relative influence of aspects of internalized racism on the career aspirations of a sample of African American adults. Participants (N = 315), ranging in age from 18 to 62 years, completed measures of internalized racism and career aspirations online. A hierarchical multiple regression analysis was conducted to…

  18. Educational Aspirations in an Urban Community College: Differences between Immigrant and Native Student Groups

    ERIC Educational Resources Information Center

    Conway, Katherine M.

    2010-01-01

    This study explored the educational aspirations of immigrant and native students in an urban community college. Using Burton Clark's cooling-out theory as a framework, the study looked at choices students make when applying to college and the extent to which students later change their aspirations. Immigrant students who were educated in United…

  19. ''Fake It 'Til You Make It'': Why Community College Students' Aspirations ''Hold Steady''

    ERIC Educational Resources Information Center

    Nielsen, Kelly

    2015-01-01

    Sociologists of education have explored the relationship between students' postsecondary aspirations and their propensity to get "cooled out" in community colleges. However, researchers have directed little attention to students whose aspirations remain stable over long periods of time or to the different roles that college degree goals…

  20. Scintigraphy for the detection and quantification of subglottic aspiration: preliminary observations.

    PubMed

    Silver, K H; Van Nostrand, D; Kuhlemeier, K V; Siebens, A A

    1991-10-01

    Eleven patients with previously documented aspiration underwent a radioisotopic swallowing study to detect and quantify airway penetration. In those subjects able to complete a rapid-acquisition phase during swallowing, no laryngotracheal penetration was seen despite previous evidence of aspiration. However, sequential static pulmonary imaging showed significant aspiration in three individuals. Attempts were made to measure the percentage of ingested material aspirated and the clearance rate from the airways. Eight patients (73%) failed to show definite evidence of aspiration on scintigrams. It is hypothesized that the lack of scintigraphic detection in previously proven aspirators was due either to interval improvement of the dysphagia or to difficult-to-detect laryngotracheal aspiration. Isotopic imaging during swallowing appears to have little utility; however, after ingestion, the technique can demonstrate more distal penetration not detected on videofluoroscopy. More studies are suggested to better define the sensitivity and specificity of scintigraphy in aspiration detection and to determine whether these techniques have prognostic value that could alter patient management.

  1. Growing Up at the "Margins": Concerns, Aspirations, and Expectations of Young People Living in Nairobi's Slums

    ERIC Educational Resources Information Center

    Kabiru, Caroline W.; Mojola, Sanyu A.; Beguy, Donatien; Okigbo, Chinelo

    2013-01-01

    We explore the concerns, challenges, aspirations, and expectations of sub-Saharan African youth, and investigate how these youth cope with neighborhood constraints to aspiration achievement. We draw on cross-sectional survey data from 4,033 12-22-year-olds (50.3% males) from two Kenyan urban slums and subsequent in-depth interviews conducted with…

  2. Image Theory and Career Aspirations: Indirect and Interactive Effects of Status-Related Variables

    ERIC Educational Resources Information Center

    Thompson, Mindi N.; Dahling, Jason J.

    2010-01-01

    The present study applied Image Theory (Beach, 1990) to test how different components of a person's value image (i.e., perceived social status identity and conformity to masculine and feminine gender role norms) interact to influence trajectories toward high career aspirations (i.e., high value for status in one's work and aspirations for…

  3. The Impact of the Kalamazoo Promise on Student Attitudes, Goals, and Aspirations

    ERIC Educational Resources Information Center

    Miron, Gary; Jones, Jeffrey N.; Kelaher-Young, Allison J.

    2012-01-01

    Student goals and aspirations are an important determinant of success in secondary schools and promote access to post-secondary education. This paper reports on changes in student attitudes, goals, and aspirations that result from the implementation of a universal scholarship program. The Kalamazoo Promise is an innovative reform effort that…

  4. Development of Predicted Paths for ACT Aspire Score Reports. WP-2014-06

    ERIC Educational Resources Information Center

    Allen, Jeff

    2014-01-01

    This report focuses on the initial development of the predicted score paths for ACT Aspire reporting. The paths provide predicted score ranges for the next two years--as well as predicted ACT score ranges for tests administered at grades 9 and 10. Longitudinal ACT Aspire data for students tested in spring 2013 and spring 2014, as well as…

  5. Middle School Children's Career Aspirations: Relationship to Adult Occupations and Gender

    ERIC Educational Resources Information Center

    Schuette, Christine T.; Ponton, Michael K.; Charlton, Margaret L.

    2012-01-01

    The authors explored the relationship between the career aspirations of 89 preadolescents from low socioeconomic backgrounds and the actual occupations of the working adults in their homes with regard to status, job gender identification, and interest (Holland, 1997). There was a significant relationship between boys' career aspirations and the…

  6. Using Propensity Score Matching to Determine the Efficacy of Secondary Career Academies in Raising Educational Aspirations

    ERIC Educational Resources Information Center

    Rojewski, Jay W.; Lee, In Heok; Gemici, Sinan

    2010-01-01

    Data from the Education Longitudinal Study of 2002 database was used to determine the effects of career academy participation in grades 9 or 10 on educational aspirations. Propensity score matching was used to obtain initially equivalent groups for analysis. No statistically significant differences in postsecondary educational aspirations were…

  7. Development Patterns of Occupational Aspirations in Adolescents with High-Incidence Disabilities

    ERIC Educational Resources Information Center

    Rojewski, Jay W.; Lee, In Heok; Gregg, Noel; Gemici, Sinan

    2012-01-01

    This study analyzed the longitudinal development of occupational aspiration prestige scores over a 12-year period (Grade 8 to 8 years postsecondary) to better understand this aspect of career choice from adolescence into adulthood for people with high-incidence disabilities. A curvilinear trajectory was detected where aspirations increased during…

  8. The Effect of Neighborhood Context on the College Aspirations of African American Adolescents

    ERIC Educational Resources Information Center

    Stewart, Endya B.; Stewart, Eric A.; Simons, Ronald L.

    2007-01-01

    Previous research on educational aspirations has focused almost exclusively on micro-level predictors of educational aspirations. Notably absent from these studies are measures reflecting the neighborhood context in which adolescents live. Drawing on Wilson's theory of neighborhood effects, the present study examines the extent to which…

  9. Constructing New Identities? The Role of Gender and Education in Rural Girls' Life Aspirations in Peru

    ERIC Educational Resources Information Center

    Ames, Patricia

    2013-01-01

    This paper focuses on rural and indigenous girls and their mothers in Peru, examining how they position schooling and education in their current life and future aspirations, in order to better understand girls' increasing participation in education. It is argued here that the high educational aspirations girls and their families have are not only…

  10. The Role of Educational Aspirations and Expectations in the Discontinuity of Intergenerational Low-Income Status

    ERIC Educational Resources Information Center

    Lee, Jungeun Olivia; Hill, Karl G.; Hawkins, J. David

    2012-01-01

    This study investigated one potential mechanism mediating continuity and discontinuity in low-income status across generations: children's educational aspirations and expectations. Data were drawn from a community sample of 808 participants who were followed from age 10 to 30. Four trajectory groups of children's educational aspirations and…

  11. White Working-Class Male Narratives of "Loyalty to Self" in Discourses of Aspiration

    ERIC Educational Resources Information Center

    Stahl, Garth

    2016-01-01

    This paper intends to show the processes and identity negotiations of white working-class boys surrounding their own learner-identity within a "raising aspirations" rhetoric. The current dominant neoliberal discourse, which prioritizes a view of aspiration that is competitive, economic, and status-based, shapes the subjectivities of…

  12. Aspiration pneumonia in the child with DiGeorge syndrome -A case report-.

    PubMed

    Lee, Ji-Young; Han, Yun-Joung

    2011-06-01

    DiGeorge syndrome is associated with a chromosome 22q11.2 deletion and manifests with variable clinical findings. Aspiration pneumonia can be a perioperative complication of great concern in this syndrome. In this report, we present a case of a 16-month old child with DiGeorge syndrome undergoing cranioplasty. He developed perioperative aspiration pneumonia but was managed successfully.

  13. A Structural Model of Student Career Aspiration and Science Education: The 10th Grade Investigation.

    ERIC Educational Resources Information Center

    Wang, Jianjun; Turner, Dianne

    Career aspiration is an important factor articulating student academic preparation and career orientation. On the basis of H. Walberg's educational productivity theory, 10th grade national data from the Longitudinal Study of American Youth have been analyzed to examine structural relations between educational productivity and career aspiration in…

  14. "Influence of Institutional Climate Perception on the Professional Aspirations of Teacher Educators"

    ERIC Educational Resources Information Center

    Kumar, Amruth G.; Nair, Devika R.

    2006-01-01

    The major objectives of the study "Influence of Institutional Climate Perception on the Professional Aspirations of Teacher Educators" are: (1) To estimate the relationship between professional aspirations and institutional climate perception for the total sample and relevant sub samples; and (2) To test whether the comparable…

  15. A Comparison Study of 12th Grade Hispanic Students' College Anticipations, Aspirations, and College Preparatory Measures

    ERIC Educational Resources Information Center

    Lozano, Aliber; Watt, Karen M.; Huerta, Jeffery

    2009-01-01

    This study assessed the differences in educational aspirations and educational anticipations between four groups (AVID, GEAR UP, AVID/GEAR UP, and Control) of high school seniors who participated in a previous study as 10th graders (Watt, Huerta, & Lozano, 2007). It also measured whether any change in aspirations and anticipations occurred…

  16. Adolescent Occupational Aspirations: Test of Gottfredson's Theory of Circumscription and Compromise

    ERIC Educational Resources Information Center

    Cochran, Daria B.; Wang, Eugene W.; Stevenson, Sarah J.; Johnson, Leah E.; Crews, Charles

    2011-01-01

    The authors investigated the relationship between adolescent occupational aspirations and midlife career success. The model for adolescent occupational aspirations was derived from Gottfredson's (1981) theory of circumscription and compromise. The authors hypothesized that parental socioeconomic status (SES), ability, and gender predict adolescent…

  17. Development of Occupational Aspirations in Early Korean Adolescents: A Multiple-Group Latent Curve Model Analysis

    ERIC Educational Resources Information Center

    Lee, In Heok; Rojewski, Jay W.

    2012-01-01

    The complex phenomenon of intraindividual and interindividual differences in the development of occupational aspirations and factors influencing this development were examined in a longitudinal sample of 5,727 Korean adolescents over a 4-year period. A downward trajectory of occupational aspirations from junior high school to the first year of…

  18. Cloning Their Own: Aspirant Principals and the School-Based Selection Game

    ERIC Educational Resources Information Center

    Gronn, Peter; Lacey, Kathy

    2006-01-01

    In this article, we report data from two projects concerned with the aspirant principals' perspectives about school principal recruitment in three Australian states. In particular, we consider what our informants perceive as factors that inhibit the realisation of their aspirations. These factors include aspects of the operation of school-based…

  19. The Effect of Social Programs and Exposure to Professionals on the Educational Aspirations of the Poor

    ERIC Educational Resources Information Center

    Chiapa, Carlos; Garrido, Jose Luis; Prina, Silvia

    2012-01-01

    Investment in human capital is an important tool for reducing poverty. However, the poor may lack the capacity to aspire, which often results in underinvestment in their children's education. This paper studies the effect of a social program on the educational aspirations poor parents have for their children, and explores the role of exposure to…

  20. College Talk and the Rural Economy: Shaping the Educational Aspirations of Rural, First-Generation Students

    ERIC Educational Resources Information Center

    Tieken, Mara Casey

    2016-01-01

    The college-going rates of rural students lag behind those of more urban students, a gap likely due, in part, to rural students' lower educational aspirations. These lower aspirations appear to be tied to the dilemma that higher education presents for many rural students: whether to remain in their rural home, working in traditional trades and…

  1. Pneumonia due to aspiration of povidine iodine after induction of general anesthesia -A case report-

    PubMed Central

    Ahn, Byung Ryang

    2011-01-01

    Aspiration pneumonia is usually caused by aspiration of gastric contents during anesthesia. It causes severe pulmonary complications. Povidone iodine was used widely as an oral antiseptic. Although povidone iodine is thought to be a safe and effective antiseptic, severe complications from its aspiration may occur. We present a case of pneumonia secondary to aspiration of povidone iodine in a 16 year old female patient who underwent orofacial surgery. Aspiration pneumonia must be treated immediately. Mechanical ventilation with PEEP and periodical bronchial toilet with fiberoptic bronchoscopy were carried in the operating room and ICU. Bronchodilators, antibiotics, steroids and diuretics were also used to treat pneumonia. The patient was treated successfully without any complication. PMID:22025949

  2. Impaired urge-to-cough in elderly patients with aspiration pneumonia

    PubMed Central

    Yamanda, Shinsuke; Ebihara, Satoru; Ebihara, Takae; Yamasaki, Miyako; Asamura, Takaaki; Asada, Masanori; Une, Kaori; Arai, Hiroyuki

    2008-01-01

    Background The down-regulation of the cough reflex in patients with aspiration pneumonia can involve both cortical facilitatory pathways for cough and medullary reflex pathways. In order to study the possible involvement of the supramedullary system in the down-regulation of cough reflex, we evaluated the urge-to-cough in patients with aspiration pneumonia. Methods Cough reflex sensitivity and the urge-to-cough to inhaled citric acid were evaluated in patients with at least a history of aspiration pneumonia and age-matched healthy elderly people. The cough reflex sensitivities were defined as the lowest concentration of citric acid that elicited two or more coughs (C2) and five or more coughs (C5). The urge-to-cough scores at the concentration of C2 and C5, and at the concentration of two times dilution of C2 (C2/2) and C5 (C5/2) were estimated for each subject. Results Both C2 and C5 in the control subjects were significantly greater than those for patients with aspiration pneumonia. There were no significant differences in the urge-to-cough at C2 and C5 between control subjects and patients with aspiration pneumonia. However, the urge-to-cough scores at both C2/2 and C5/2 in patients with aspiration pneumonia were significantly lower than those in control subjects. The number of coughs at C5/2 was significantly greater in the control subjects than those in the patients with aspiration pneumonia whereas the number of coughs at C2/2 did not show a significant difference between the control subjects and the patients with aspiration pneumonia. Conclusion The study suggests the involvement of supramedullary dysfunction in the etiology of aspiration pneumonia in the elderly. Therefore, restoration of the cough motivation system could be a new strategy to prevent aspiration pneumonia in the elderly. PMID:19019213

  3. Karman's cannula and vacuum aspirator in gynecological practice.

    PubMed Central

    Adinma, J. I.; Adinma, E.

    1996-01-01

    The charts of 340 patients who underwent an endometrial suction procedure using Karman's cannula and syringe were reviewed. The therapeutic uses of this instrument were for the treatment of chronic endometritis (18.6%), the evacuation of incomplete or missed abortion (14.6%) and hydatidiform mole (0.8%), and the retrieval of the missing tail of an intrauterine contraceptive device (1.2%). Its diagnostic indications include: the investigation of infertility (55.3%), dysfunctional uterine bleeding (8.7%), and postcoital bleeding (0.8%). The diagnostic yield of the instrument was 96.6%. Transient postoperative abdominal pain occurred in 65.9% of the cases while cervical dilatation preceded aspiration in 12.9% of the cases with cervical stenosis. The advantages of the instrument are discussed and its usefulness in everyday gynecological practice highlighted. PMID:8583487

  4. Fine Needle Aspiration Cytology in Diagnosis of Pure Neuritic Leprosy

    PubMed Central

    Kumar, Bipin; Pradhan, Anju

    2011-01-01

    Leprosy is a chronic infection affecting mainly the skin and peripheral nerve. Pure neuritic form of this disease manifests by involvement of the nerve in the absence of skin lesions. Therefore, it can sometimes create a diagnostic problem. It often requires a nerve biopsy for diagnosis, which is an invasive procedure and may lead to neural deficit. Fine needle aspiration cytology (FNAC) of an affected nerve can be a valuable and less invasive procedure for the diagnosis of such cases. We report five suspected cases of pure neuritic Hansen's disease involving the common and superficial peroneal, ulnar, and median nerve, who underwent FNAC. Smears revealed nerve fibers infiltrated by chronic inflammatory cells in all cases, presence of epithelioid cells granulomas, and Langhans giant cells in three cases, and acid fast bacilli in two cases. In conclusion, FNAC is a safe, less invasive, and time saving procedure for the diagnosis of pure neuritic leprosy. PMID:21660285

  5. Rotor and stator assembly configured as an aspirating face seal

    NASA Technical Reports Server (NTRS)

    Turnquist, Norman Arnold (Inventor); Bagepalli, Bharat Sampathkumaran (Inventor); Reluzco, George (Inventor); Tseng, Wu-Yang (Inventor)

    1999-01-01

    A rotor and stator assembly having a rotor and a stator with opposing surfaces defining an air bearing and an air dam of an aspirating face seal. In a first embodiment, the air bearing and the air dam are axially offset. In a second embodiment, the rotor has an axially extending protuberance located radially between the air bearing and the air dam. The axial offset and the protuberance each act to divert the air flow (e.g., compressed gas or combustion gases in a gas turbine or steam in a steam turbine) in a direction transverse to the air flow direction through the air bearing and the air dam, thus isolating the air flows from the air bearing and the air dam which improves seal performance.

  6. Incisional endometriosis: diagnosed by fine needle aspiration cytology.

    PubMed

    Veda, P; Srinivasaiah, M

    2010-07-01

    Incisional endometriosis (IE) is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC). Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  7. Endotracheal tuberculous granuloma formation following endobronchial ultrasound transbronchial needle aspiration.

    PubMed

    Lee, Jeong-Won; Kim, Woo-Jin; Park, Chan-Woo; Kang, Hyun-Wook; Ban, Hee-Jung; Oh, In-Jae; Kwon, Yong-Soo; Kim, Kyu-Sik; Kim, Yu-Il; Lim, Sung-Chul; Kim, Young-Chul; Choi, Yoo-Duk

    2013-01-01

    Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) is a useful and safe diagnostic test. We herein report a case of endotracheal granuloma formation that occurred after EBUS-TBNA in a 73-year-old woman. The patient was admitted due to coughing and dyspnea after 70 days of antituberculous therapy for mediastinal lymphadenitis. Computed tomography revealed decreases in the size of the lymph nodes with a new mass protruding into the tracheal lumen. The mass originated from the right paratracheal area, which was a previous puncture site. This case suggests that clinicians should pay attention to complications because tuberculosis can produce new granulomas via the sinus tract after EBUS-TBNA.

  8. Primary tibial adamantinoma diagnosed by fine needle aspiration.

    PubMed

    Bishop, Justin A; Ali, Syed Z

    2010-03-01

    Adamantinoma is one of the rarest primary bone tumors and is almost exclusively found in the tibia. Because of its scarcity, there are only a handful of reported cases of adamantinoma diagnosed by fine needle aspiration (FNA). We report a case of a 30-year-old woman seen at The Johns Hopkins Hospital for a 2.5-cm lytic lesion in the distal diaphysis of the tibia. A computed tomography-guided FNA of the lesion revealed a moderately cellular lesion consisting of a biphasic admixture of epithelioid cells seen singly and in fragments. These cells had round to oval nuclei with pale chromatin and well-formed nuclear grooves. The other population had more elongated nuclei and spindled appearance. An immunostain for cytokeratin was positive, supporting the diagnosis of adamantinoma. Due primarily to its rarity, the diagnosis of adamantinoma on FNA can be challenging and must be made in the context of its characteristic clinical and radiographic setting.

  9. Hints for the aspiring public health nurse. 1923.

    PubMed

    Abrams, Sarah E

    2010-01-01

    The original article from which these excerpts were taken, "Some Hints to the Nurse Who Seeks to Become a Successful Partner in the Community Health Program," by Mary Margaret Muckley, was published the 1923 volume of the original Public Health Nursing journal. The paper listed practical pointers to nurses wanting to work in the area of public or community health nursing. The author's advice involved personal attributes, professional engagement, skills, effective organization, and community relations. Much of the original article contained sound advice for aspirants to nursing work in community settings, but some advice may be considered too idealistic even for this optimistic time period. While the particular references to organizations and agencies existing in Helena, Montana have been omitted, the nurse reading the paper in 1923 had a general guide to her key stakeholders. The excerpts from this paper may give contemporary readers an appreciation of the endurance of what Muckley terms the public health nurse's "Valuable Assets."

  10. Microfluidic micropipette aspiration for measuring the deformability of single cells.

    PubMed

    Guo, Quan; Park, Sunyoung; Ma, Hongshen

    2012-08-07

    We present a microfluidic technique for measuring the deformability of single cells using the pressure required to deform such cells through micrometre-scale tapered constrictions. Our technique is equivalent to whole-cell micropipette aspiration, but involves considerably simpler operation, less specialized equipment, and less technical skill. Single cells are infused into a microfluidic channel, and then deformed through a series of funnel-shaped constrictions. The constriction openings are sized to create a temporary seal with each cell as it passes through the constriction, replicating the interaction with the orifice of a micropipette. Precisely controlled deformation pressures are generated using an external source and then attenuated 100 : 1 using an on-chip microfluidic circuit. Our apparatus is capable of generating precisely controlled pressures as small as 0.3 Pa in a closed microchannel network, which is impervious to evaporative losses that normally limit the precision of such equipment. Intrinsic cell deformability, expressed as cortical tension, is determined from the threshold deformation pressure using the liquid-drop model. We measured the deformability of several types of nucleated cells and determined the optimal range of constriction openings. The cortical tension of passive human neutrophils was measured to be 37.0 ± 4.8 pN μm(-1), which is consistent with previous micropipette aspiration studies. The cortical tensions of human lymphocytes, RT4 human bladder cancer cells, and L1210 mouse lymphoma cells were measured to be 74.7 ± 9.8, 185.4 ± 25.3, and 235.4 ± 31.0 pN μm(-1) respectively. The precision and usability of our technique demonstrates its potential as a biomechanical assay for wide-spread use in biological and clinical laboratories.

  11. Career Barriers and Reading Ability as Correlates of Career Aspirations and Expectations of Parents and Their Children

    ERIC Educational Resources Information Center

    Creed, Peter A.; Conlon, Elizabeth G.; Zimmer-Gembeck, Melanie J.

    2007-01-01

    Data were obtained from 176 Year 7 children (mean age=12.2 years) on career status aspirations and expectations, career barriers, academic engagement, academic control beliefs, general ability and literacy; and from parents, mainly mothers, on aspirations, expectations and career barriers. Discrepancy scores between aspirations and expectations…

  12. Endoscopic approach to the diagnosis of pancreatic cystic tumor

    PubMed Central

    Kawaguchi, Yoshiaki; Mine, Tetsuya

    2016-01-01

    Because of the aging of the population, prevalence of medical checkups, and advances in imaging studies, the number of pancreatic cystic lesions detected has increased. Once these lesions are detected, neoplastic cysts should be differentiated from non-neoplastic cysts. Furthermore, because of the malignant potential of some neoplastic pancreatic cysts, further differentiation between benign and malignant cysts should be made regardless of their size. Although endoscopic ultrasound (EUS) has a very high diagnostic performance for pancreatic cystic lesions among the various imaging modalities, EUS findings alone are insufficient for the differentiation of pancreatic cysts and diagnosis of malignancy. In addition, cytology by EUS-guided fine-needle aspiration (FNA) has a high specificity but a low sensitivity for diagnosing malignancy in pancreatic cystic tumors. The levels of amylase, lipase, and tumor markers in pancreatic cystic fluid are considered auxiliary parameters for diagnosis of benign and malignant cysts, and a definitive diagnosis of malignancy using these parameters is difficult. Thus, in addition to EUS, cytology by EUS-FNA, and cystic fluid analysis, new techniques based on EUS-guided through-the-needle imaging, such as confocal laser endomicroscopy and cystoscopy, have been explored in recent years. PMID:26909130

  13. Endoscopic ultrasonography-guided transmural drainage of an infected hepatic cyst due to Edwardsiella tarda: a case report.

    PubMed

    Taguchi, Hiroki; Tamai, Tsutomu; Numata, Masatsugu; Maeda, Hitomi; Ohshige, Akihiko; Iwaya, Hiromichi; Hashimoto, Shinichi; Kanmura, Shuji; Funakawa, Keita; Fujita, Hiroshi; Ido, Akio; Tsubouchi, Hirohito

    2014-10-01

    Infected hepatic cysts are very rare compared to simple liver cysts and abscesses. We treated a 77-year-old man with an infected hepatic cyst in the lateral segment caused by Edwardsiella tarda, which has not been previously reported as a pathogenic organism associated with infected hepatic cysts. Percutaneous drainage was temporarily effective, but infection recurred after the drainage tube was removed. We then inserted two drainage tubes into the cyst using an endoscopic ultrasonography (EUS)-guided technique, which was developed from EUS-guided fine needle aspiration (EUS-FNA). The internal drainage tube was a 7 Fr double pigtail stent, and the external tube was a 6 Fr nasobiliary drainage tube. Lavage through the external drainage tube was carried out for one week. The external drainage tube was discontinued when the patient's condition improved significantly. Sixteen days after tube insertion, he was discharged with the internal tube draining the hepatic cyst into the stomach. Fifteen months after EUS-guided drainage, CT examination showed no recurrence of the hepatic cyst. EUS-guided drainage is an effective treatment for infected hepatic cysts.

  14. Utility of intranasal Ketamine and Midazolam to perform gastric aspirates in children: a double-blind, placebo controlled, randomized study

    PubMed Central

    2014-01-01

    Background We performed a prospective, randomized, placebo-controlled study aimed to evaluate the efficacy and safety of a sedation protocol based on intranasal Ketamine and Midazolam (INKM) administered by a mucosal atomizer device in uncooperative children undergoing gastric aspirates for suspected tuberculosis. Primary outcome: evaluation of Modified Objective Pain Score (MOPS) reduction in children undergoing INKM compared to the placebo group. Secondary outcomes: evaluation of safety of INKM protocol, start time sedation effect, duration of sedation and evaluation of parents and doctors’ satisfaction about the procedure. Methods In the sedation group, 19 children, mean age 41.5 months, received intranasal Midazolam (0.5 mg/kg) and Ketamine (2 mg/kg). In the placebo group, 17 children received normal saline solution twice in each nostril. The child’s degree of sedation was scored using the MOPS. A questionnaire was designed to evaluate the parents’ and doctors’ opinions on the procedures of both groups. Results Fifty-seven gastric washings were performed in the sedation-group, while in the placebo-group we performed 51 gastric aspirates. The degree of sedation achieved by INMK enabled all procedures to be completed without additional drugs. The mean duration of sedation was 71.5 min. Mean MOPS was 3.5 (range 1-8) in the sedation-group, 7.2 (range 4-9) in the placebo-group (p <0.0001). The questionnaire revealed high levels of satisfaction by both doctors and parents in the sedation-group compared to the placebo-group. The only side effect registered was post-sedation agitation in 6 procedures in the sedation group (10.5%). Conclusions Our experience suggests that atomized INKM makes gastric aspirates more acceptable and easy to perform in children. Trial registration Unique trial Number: UMIN000010623; Receipt Number: R000012422. PMID:24598046

  15. Postmortem endogenous ethanol production and diffusion from the lung due to aspiration of wood chip dust in the work place.

    PubMed

    Furumiya, Junichi; Nishimura, Hiroyuki; Nakanishi, Akinori; Hashimoto, Yoshiaki

    2011-07-01

    We report an autopsy case of postmortem ethanol diffusion into the cardiac blood after aspiration of wood chips, although antemortem ethanol consumption was not evident. A man in his twenties, who was loading a truck with small wood chips in a hot, humid storehouse, was accidentally buried in a heap of chips. At the time the body was discovered, 20 h after the accident, rectal temperature was 36°C. Autopsy showed the cause of death to be asphyxia due to obstruction of the airway by aspiration of wood chips. The ethanol and n-propanol levels were significantly higher in the lungs (left, 0.603 and 0.009 mg/g; right, 0.571 and 0.006 mg/g) than in other tissues. A significant difference in ethanol concentration was observed between the left cardiac blood (0.243 mg/g) and the right femoral blood (0.042 mg/g). Low levels of ethanol and n-propanol were detected in the stomach contents (0.105 and 0.001 mg/g, respectively). In order to determine whether aspiration of wood chips affects postmortem ethanol production in the lung, we measured the ethanol and n-propanol levels of homogenized rabbit lung tissue incubated with autoclaved or non-autoclaved wood chips. Levels of ethanol and n-propanol were significantly higher in the homogenates incubated with non-autoclaved chips for 24h. The results of this animal experiment suggested that the ethanol detected in the lung was produced by putrefactive bacteria within the wood chips. After death, the ethanol produced endogenously in the lung appears to have diffused and affected the ethanol concentration of the left cardiac blood.

  16. Kinematic and temporal factors associated with penetration-aspiration in swallowing liquids.

    PubMed

    Molfenter, Sonja M; Steele, Catriona M

    2014-04-01

    In this study we undertook careful analysis of 13 quantitative physiological variables related to oropharyngeal swallowing from a sample of 42 subacute patients referred for dysphagia assessment. Each patient underwent a videofluoroscopic swallowing examination in which they swallowed up to five boluses of 22 % w/v ultrathin liquid barium suspension administered by teaspoon. Our goal was to determine whether scores on 13 kinematic or temporal parameters of interest were independently associated with the presence of penetration-aspiration in the final compiled dataset of 178 swallows. Participants were classified as aspirators based on the presence of at least one swallow that demonstrated a Penetration-Aspiration Scale score of ≥3. The parameters of interest included six kinematic parameters for capturing hyoid position, three swallow durations [laryngeal closure duration, hyoid movement duration, and upper esophageal sphincter (UES) opening duration], and four swallow intervals (laryngeal closure to UES opening, bolus dwell time in the pharynx prior to laryngeal closure, stage transition duration, and pharyngeal transit time). Mixed-model repeated-measures ANOVAs were conducted to determine the association between each parameter and aspiration status. Only 1 of the 13 parameters tested distinguished aspirators from nonaspirators: aspirators demonstrated significantly shorter UES opening duration. In addition, a trend toward reduced maximum superior position of the hyoid was seen in aspirators. Limitations and future considerations are discussed.

  17. "If We Can't Do It, Our Children Will Do It One Day": A Qualitative Study of West African Immigrant Parents' Losses and Educational Aspirations for Their Children

    ERIC Educational Resources Information Center

    Roubeni, Sonia; De Haene, Lucia; Keatley, Eva; Shah, Nira; Rasmussen, Andrew

    2015-01-01

    This study examined migration narratives of West African immigrants for the connections between experiences of loss and educational aspirations for their children. The qualitative design consisted of three interviews per family in which parents (N = 20, 12 families) were asked to narrate their families' migration histories. Transcripts were…

  18. Transvaginal Aspiration of Ovarian Cysts: Long-Term Follow-up

    SciTech Connect

    Duke, D.; Colville, J.; Keeling, A.; Broe, D.; Fotheringham, T.; Lee, M.J.

    2006-06-15

    Background and purpose. Transvaginal aspiration of ovarian cysts has been advocated as a viable alternative to surgery in patients who are high-risk surgical candidates. We describe a retrospective study evaluating the results of transvaginal aspirations of benign ovarian cysts in patients at increased surgical risk, focusing on long-term follow-up for recurrence of the cyst and/or development of malignancy. Methods. Twenty-four women with ovarian cysts underwent 34 transvaginal drainages between October 1998 and December 2004. All patients were referred following diagnosis of a persistent ovarian cyst with a benign appearance on ultrasound. All patients were unsuitable candidates for surgery (history of previous pelvic surgery, n = 21; high risk for anesthesia, n = 1; and unsuitable for laparoscopy due to obesity, n = 2). Patients with a history of pregnancy, acute abdominal symptoms, or previous gynecologic malignancy were excluded. A 20G x 20 cm Chiba needle was used for transvaginal aspiration using an endocavity probe (Acuson XP, Mountain View, CA, USA; Siemens Sololine, Erlangen, Germany) and intravenous sedoanalgesia. Cysts were aspirated to dryness. Results. Long-term follow-up of patients was performed and revealed a recurrence rate of 75%. Eighty-three percent of cysts on the left and 42% of those on the right recurred. Nine of 15 (60%) patients with recurrence required further intervention. Two of 9 underwent surgical intervention only, 4 of 9 had repeat transvaginal aspiration(s) performed, and 3 of 9 had a combination of both transvaginal aspiration and surgery. No patient developed ovarian malignancy. Conclusion. Transvaginal cyst aspiration has many advantages including short hospital stay, rapid recovery, excellent patient tolerance, and a low rate of procedure-related complications. Our study demonstrates that ovarian cyst recurrence following transvaginal drainage is a more significant problem than previously documented, especially if the cyst is

  19. Murray secretion scale and fiberoptic endoscopic evaluation of swallowing in predicting aspiration in dysphagic patients.

    PubMed

    Kuo, Chia-Wei; Allen, Clint Tanner; Huang, Chu-Chun; Lee, Chia-Jung

    2017-03-12

    The objective of this retrospective review is to evaluate the ability of the Murray secretion scale to predict aspiration as determined by fiberoptic endoscopic evaluation of swallowing. Patients with dysphagia undergoing a fiberoptic endoscopic evaluation of swallowing study between January 2013 and November 2015 from a single, tertiary care institution were retrospectively reviewed. The Murray secretion scale and penetration aspiration scale on fiberoptic endoscopic evaluation of swallowing examination were determined. Spearman's correlation analysis, sensitivity, specificity, predictive values, and relative risk evaluating the relationship between the Murray secretion scale and aspiration on fiberoptic endoscopic evaluation of swallowing were calculated. Subgroups of head and neck cancer patients, penetration group, and aspiration group were also analyzed. The mean age of the cases (N = 212) was 62.4 years. Eighty percent were male. There was a strong correlation between Murray secretion scale grade and penetration aspiration scale score (r = 0.785, p < 0.001). The sensitivity and specificity of a Murray secretion scale grade 2 or higher in predicting aspiration were 74 and 90%, respectively. Individuals with a Murray secretion scale grade of 2 or higher were 13.6 times more likely to aspirate than patients with a lower Murray secretion scale grade. All subgroups showed similar trend. Determination of a Murray secretion scale grade, determined by flexible nasopharyngoscopy, may predict patients at high risk for aspiration. In clinical scenarios where more complete assessments of aspiration risk are immediately impossible or impractical, the Murray secretion scale grade may add valuable information to assist in clinical decision-making in patients with dysphagia.

  20. Cough in the elderly: a novel strategy for preventing aspiration pneumonia.

    PubMed

    Ebihara, Satoru; Ebihara, Takae

    2011-06-01

    Management of cough in the elderly with a deteriorated physical and mental status has received little focus. Since an aged population is rapidly increasing in developed countries, the research in this population are warranted. Cough reflex sensitivity in the elderly was shown to be hypersensitive, normosensitive and hyposensitive. The hypersensitive cough reflex is mostly due to gastro-esophageal reflux in nursing home patients. Impaired cough reflex sensitivity is assumed to play a crucial role in the development of pneumonia in the elderly. A marked depression of cough reflex sensitivity is reported in elderly patients with aspiration pneumonia. The impairment of the cough reflex in patients with aspiration pneumonia can involve both cortical facilitatory pathways for cough and medullary reflex pathways. We found the urge-to-cough in patients with aspiration pneumonia was also down-regulated, suggesting the involvement of supramedullary dysfunction in the etiology of aspiration pneumonia in the elderly. In order to prevent aspiration pneumonia in the elderly, restoration of cough reflex sensitivity is essential. We found several methods to restore cough reflex sensitivity in the elderly. They also improved the swallowing reflex, another important airway protective reflex, in the elderly. In the treatment of aspiration pneumonia, one of the most challenging steps is the start of eating for patients who usually fast at the time of hospitalization. By combining the methods to restore the cough reflex sensitivity and swallowing reflex, we developed a protocol to start eating in the elderly patients with aspiration pneumonia. Using the protocol, we reduced the incidence of re-aspiration due to start of eating in patients with aspiration pneumonia to one third of the patients without the protocol.

  1. A Comprehensive Evaluation for Aspiration After Esophagectomy Reduces the Incidence of Post-Operative Pneumonia

    PubMed Central

    Berry, Mark F.; Atkins, B. Zane; Tong, Betty C.; Harpole, David H.; D’Amico, Thomas A.; Onaitis, Mark W.

    2011-01-01

    OBJECTIVE This study assesses the impact of using a comprehensive swallowing evaluation before starting oral feedings on aspiration detection and pneumonia occurrence after esophagectomy. METHODS The records of all esophagectomy patients between January 1996 and June 2009 were reviewed. Multivariable logistic regression analysis assessed the effect of preoperative and operative variables on the incidence of aspiration and pneumonia. Separate analyses were performed on patients before (early era, 1996–2002) and after (later era, 2003–2009) a rigorous swallowing evaluation was used routinely before starting oral feedings. RESULTS During the study period, 799 patients (379 early era, 420 later era) underwent esophagectomy; 30-day mortality was 3.5% (28 patients). Cervical anastomoses were performed in 76% of patients in the later era compared with 40% of patients in the early era. Overall, 96 patients (12%) had evidence of aspiration postoperatively, and the pneumonia incidence was 14% (113 patients). Age (odds ratio 1.05 per year, p<0.0001) and later era (odds ratio 1.90, p=0.0001) predicted aspiration in all patients in a multivariable model. In the early era, cervical anastomosis and aspiration independently predicted pneumonia. With a comprehensive swallowing evaluation in the later era, the detected incidence of aspiration increased (16% vs 7%, p<0.0001) while the incidence of pneumonia declined (11% vs 18%, p=0.004) compared to the early era, such that neither anastomotic location nor aspiration predicted pneumonia in the later era. CONCLUSIONS Esophagectomy is often associated with occult aspiration. A comprehensive swallowing evaluation for aspiration prior to initiating oral feedings significantly decreases the occurrence of pneumonia. PMID:20884018

  2. Anti-inflammatory treatment of meconium aspiration syndrome: benefits and risks.

    PubMed

    Mokra, Daniela; Mokry, Juraj; Tonhajzerova, Ingrid

    2013-06-01

    Meconium aspiration syndrome (MAS) is a major cause of respiratory insufficiency in the term and post-term newborns. There are several pathomechanisms participating in this disorder, particularly the airway obstruction, surfactant dysfunction, inflammation, lung edema, pulmonary vasoconstriction and bronchoconstriction. Inflammatory changes resulting from meconium aspiration cause severe impairment of lung parenchyma and surfactant, and influence the reactivity of both vascular and airway smooth muscle. Therefore, anti-inflammatory drugs may be of benefit in the management of MAS. This article reviews the pharmacological actions and side effects of various anti-inflammatory drugs used up to now in the experimental models of MAS and in the treatment of newborns with meconium aspiration.

  3. The Application of Micropipette Aspiration in Molecular Mechanics of Single Cells.

    PubMed

    Lee, Lap Man; Liu, Allen P

    2014-11-01

    Micropipette aspiration is arguably the most classical technique in mechanical measurements and manipulations of single cells. Despite its simplicity, micropipette aspiration has been applied to a variety of experimental systems that span different length scales to study cell mechanics, nanoscale molecular mechanisms in single cells, bleb growth, and nucleus dynamics, to name a few. Enabled by micro/nanotechnology, several novel microfluidic devices have been developed recently with better accuracy, sensitivity, and throughput. Further technical advancements of microfluidics-based micropipette aspiration would have broad applications in both fundamental cell mechanics studies and for disease diagnostics.

  4. Total laryngectomy for management of chronic aspiration pneumonia in a myopathic dog

    PubMed Central

    Vernau, Karen M.; Marks, Stanley L.; Kuhn, Maggie A.; Culp, William T.N.; Owens, Tammy J.; Shelton, G. Diane; Siddiqui, Tausif; Pollard, Rachel; Belafsky, Peter C.

    2016-01-01

    A 5-month-old female pit bull terrier dog evaluated for ataxia, progressive regurgitation, and recurrent aspiration pneumonia had markedly elevated creatine kinase activity, non-inflammatory generalized myopathy, and severe esophageal dysmotility. A narrow-field total laryngectomy was performed. The dog is doing well 30 months after surgery, and no longer has episodes of aspiration pneumonia, despite intermittent regurgitation. This case represents the first application of total laryngectomy for the prevention of chronic recurrent aspiration pneumonia in the dog. PMID:27429466

  5. Aspiration-induced dormancy promotes cooperation in the spatial Prisoner's Dilemma games

    NASA Astrophysics Data System (ADS)

    Chen, Ya-Shan; Yang, Han-Xin; Guo, Wen-Zhong

    2017-03-01

    An interesting phenomenon is often observed in realistic systems. In the process of games, if the expected payoff from game interactions is not achieved, players would refuse to participate in the games. Inspired by this fact, we propose an aspiration-induced dormant mechanism, in which players quit the games and become dormant if their payoffs are less than the aspiration level. After a dormant period, they continue to play the game with others. Our results indicate an intermediate aspiration value, leading to the highest cooperation level in the spatial prisoner's dilemma games. The effects of the dormant period are also studied.

  6. Strain, Psychological Conflicts, Aspirations-Attainment Gap, and Depressive Tendencies among Youth of Mexican Immigrants.

    PubMed

    Paat, Yok-Fong

    2016-01-01

    Using Children of Immigrants Longitudinal Study (CILS), this study examined the links between strain, psychological conflicts, aspiration-attainment gap, and depressive tendencies of 755 youth of Mexican origin. Two research questions were raised: (a) What types of strain and psychological conflict induced depressive tendencies? (b) What types of aspirations were relevant to these depressive symptoms? Overall, this study showed that factors implicated by collision of values, perceived discrepancies between aspiration and attainment, and negative appraisal of self could induce depressive mood, feelings, and behaviors, an important finding revealing that this underserved population can benefit from better public health services.

  7. Aspiration pneumonia as a complication of a rare type of hernia

    PubMed Central

    Fazekas, Balazs; Frecker, Peter; Francis, Lucy; Patel, Kunal

    2014-01-01

    INTRODUCTION Inguinal hernias are a common pathology and can contain unusual abdominal contents; the stomach is only infrequently involved due to its position in the abdominal cavity. PRESENTATION OF CASE An 85-year old male patient presented with symptoms of bowel obstruction and was subsequently found to have an incarcerated stomach within his chronic left-sided inguinal hernia. The patient had also developed aspiration pneumonia. DISCUSSION Aspiration pneumonia is a yet unreported complication of this unusual type of hernia. Our aim is to describe the presentation and management of this complication. CONCLUSION Development of aspiration pneumonia in a patient with an incarcerated stomach within an inguinal hernia. PMID:25460474

  8. Acute myocardial infarction caused by left atrial myxoma: Role of intracoronary catheter aspiration.

    PubMed

    Al-Fakhouri, Ahmad; Janjua, Muhammad; DeGregori, Michele

    2017-01-01

    Acute ST-segment elevation myocardial infarction (STEMI) caused by left atrial myxoma is very rare. Catheter-based approaches or thrombolytic therapy are mostly the first step in the management of STEMI with less time delay. We report a case of acute anterior/lateral STEMI caused by a left atrial myxoma. The patient was successfully treated by intracoronary aspiration with an Export aspiration catheter, with excellent distal coronary flow. Intracoronary catheter aspiration in acute myocardial infarction caused by a left atrial myxoma may help to salvage the infarcting myocardium with less time delay.

  9. A case of accidental aspiration of an endodontic instrument by a child treated under conscious sedation

    PubMed Central

    Mahesh, R; Prasad, Vishnu; Menon, Padma A.

    2013-01-01

    Dental management of children with attention-deficit hyperactivity disorder (ADHD) often requires the need for pharmacological behavior management techniques such as the use of sedation. The purpose of this article is to describe a clinical case involving accidental aspiration of an Endodontic instrument during root canal therapy under sedation. To our knowledge, this is the first case report of aspiration of an Endodontic instrument and should serve to heighten the awareness with regard to aspiration during dental procedures under sedation. It also emphasizes the need for proper isolation techniques in patients treated under sedation, thereby preventing such complications. PMID:24883031

  10. Reducing the risk of aspiration pneumonia among elderly patients in long-term care facilities through oral health interventions.

    PubMed

    Sarin, Jaya; Balasubramaniam, Ramesh; Corcoran, Amy M; Laudenbach, Joel M; Stoopler, Eric T

    2008-02-01

    Aspiration pneumonia is a leading cause of morbidity and mortality of elderly residents in long-term care facilities. The microflora present in the oral cavity because of poor oral hygiene has been associated with aspiration pneumonia. There is evidence that improved oral care can reduce the risk of developing aspiration pneumonia in the elderly. The purpose of this paper is to review aspiration pneumonia and provide oral health care guidelines in an effort to help reduce the risk of aspiration pneumonia in the elderly residing in long-term care facilities.

  11. The Above-and-Beyond Experience

    ERIC Educational Resources Information Center

    Chicoine, David L.

    2015-01-01

    Today's young people are sophisticated consumers in the higher education marketplace. They are seeking "above and beyond" academic experiences such as study abroad and undergraduate research. They are looking for a personalized academic experience, and they aspire to be in community with others who share a similar sense of purpose and…

  12. Performance of a thrombectomy device for aspiration of thrombus with various sizes based on a computational fluid dynamic modeling.

    PubMed

    Soleimani, Sajjad; Dubini, Gabriele; Pennati, Giancarlo

    2016-06-01

    It is important to thoroughly remove the thrombus within the course of aspiration thrombectomy; otherwise, it may lead to further embolization. The performance of the aspiration thrombectomy device with a generic geometry is studied through the computational approach. In order to model the thrombus aspiration, a real left coronary artery is chosen while thrombi with various sizes are located at the bifurcation area of the coronary artery and, depending on the size of the thrombus, it is stretched toward the side branches. The thrombus occupies the artery resembling the blood current obstruction in the coronary vessel similar to the situation that leads to heart attack. It is concluded that the aspiration ability of the thrombectomy device is not linked to the thrombus size; it is rather linked to the aspiration pressure and thrombus age (organized versus fresh thrombus). However, the aspiration time period correlates to the thrombus size. The minimum applicable aspiration pressure is also investigated in this study.

  13. A new motor-driven surgical probe and its in vitro comparison with the Cavitron Ultrasonic Surgical Aspirator.

    PubMed

    Chan, K K; Watmough, D J; Hope, D T; Moir, K

    1986-04-01

    The Cavitron Ultrasonic Surgical Aspirator (CUSA) has been applied in neurosurgery for several years, but its mode of action is not yet clear and its efficiency at removing soft tissue has not been quantified. We describe here how we have measured the rate of removing soft tissue per unit time, taking ox-liver tissue as the test material. A motor-driven vibrator/aspirator has been developed in our laboratory. It has permitted us to examine the effect of varying independently frequency, amplitude of the vibration, and suction pressure on the removal rate. The results of this investigation show that beyond a certain tip acceleration amplitude (about 100 g) the removal rate does not increase significantly. Also the removal rate is more or less independent of vibration amplitude within the range between 300 micron and 1 mm. Our in vitro experiments with the new probe show that a tip acceleration of about 100 g is enough to remove ox-liver tissue and then the rate of removal is comparable to that obtained with the CUSA operating at maximum vibration amplitude. Analysis of the particle size of the debris collected from CUSA and from our motor-driven device shows that the particle size distribution is similar over the range of 0.5 micron less than d less than 250 micron.

  14. Successful aspiration and ethanol sclerosis of a large, symptomatic, simple liver cyst: case presentation and review of the literature.

    PubMed

    Blonski, Wojciech C; Campbell, Mical S; Faust, Thomas; Metz, David C

    2006-05-14

    Simple liver cysts are congenital with a prevalence of 2.5%-4.25%. Imaging, whether by US, CT or MRI, is accurate in distinguishing simple cysts from other etiologies, including parasitic, neoplastic, duct-related, and traumatic cysts. Symptomatic simple liver cysts are rare, and the true frequency of symptoms is not known. Symptomatic simple liver cysts are predominantly large (> 4 cm), right-sided, and more common in women and older patients. The vast majority of simple hepatic cysts require no treatment or follow-up, though large cysts (> 4 cm) may be followed initially with serial imaging to ensure stability. Attribution of symptoms to a large simple cyst should be undertaken with caution, after alternative diagnoses have been excluded. Aspiration may be performed to test whether symptoms are due to the cyst; however, cyst recurrence should be expected. Limited experience with both laparoscopic deroofing and aspiration, followed by instillation of a sclerosing agent has demonstrated promising results for the treatment of symptomatic cysts. Here, we describe a patient with a large, symptomatic, simple liver cyst who experienced complete resolution of symptoms following cyst drainage and alcohol ablation, and we present a comprehensive review of the literature.

  15. Cytopathologic diagnosis of fine needle aspiration biopsies of thyroid nodules

    PubMed Central

    Misiakos, Evangelos P; Margari, Niki; Meristoudis, Christos; Machairas, Nickolas; Schizas, Dimitrios; Petropoulos, Konstantinos; Spathis, Aris; Karakitsos, Petros; Machairas, Anastasios

    2016-01-01

    Fine-needle aspiration (FNA) cytology is an important diagnostic tool in patients with thyroid lesions. Several systems have been proposed for the cyropathologic diagnosis of the thyroid nodules. However cases with indeterminate cytological findings still remain a matter of debate. In this review we analyze all literature regarding Thyroid Cytopathology Reporting systems trying to identify the most suitable methodology to use in clinical practice for the preoperative diagnosis of thyroid nodules. A review of the English literature was conducted, and data were analyzed and summarized and integrated from the authors’ perspective. The main purpose of thyroid FNA is to identify patients with higher risk for malignancy, and to prevent unnecessary surgeries for benign conditions. The Bethesda System for Reporting Thyroid Cytopathology is the most widely used system for the diagnosis of thyroid FNA specimens. This system also contains guidelines for the diagnosis and treatment of indeterminate or suspicious for malignancy cases. In conclusion, patients who require repeated FNAs for indeterminate diagnoses will be resolved by repeat FNA in a percentage of 72%-80%. PMID:26881190

  16. Transthoracic needle aspiration: the past, present and future

    PubMed Central

    Chockalingam, Arun

    2015-01-01

    Transthoracic needle aspiration (TTNA) has been used to diagnose disease in the lung for many decades. Thanks to advances in technology and cytopathology, the diagnostic power, accuracy, safety, and efficacy of TTNA are constantly improving. The transition from fluoroscopy to computed tomography (CT) has yielded better visualization, and ability to enhance sophistication of tools used to biopsy. In addition, needles are being refined for obtaining better biopsy samples and increased capabilities. Because of the minimally invasive nature of TTNA, it is becoming a strong alternative to surgical intervention. In the future, these developments will continue and TTNA will become more efficient, and potentially open a door to personalized medicine. However, there are complications due to this procedure, which include pneumothorax, hemorrhage, air embolism, and others which are very rare. Probability of complication increases when patients are older, have significant past medical history, have larger lesions, and are uncooperative during procedure. Indications, contraindications, and other considerations should be contemplated before a patient is elected for TTNA. PMID:26807277

  17. Uterine aspiration using the Karman cannula and syringe.

    PubMed

    Ekwempu, C C

    1990-01-01

    A research project took place at the Department of Obstetrics and Gynaecology of Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria, Nigeria, between April 1987 and May 1988 to determine the efficacy, safety, and acceptability of the manual vacuum aspiration (MVA) procedure using the Karman cannula in an outpatient facility without anesthesia to manage incomplete abortions and to determine the suitability of endometrial biopsy specimens obtained with MVA. All patients who arrived in the daytime for evacuation and all patients requiring endometrial biopsy were included in the study. 375 cases were recorded; there were 272 endometrial biopsies, 89 nonseptic abortions, 10 missed abortions, and 4 septic abortions. These subjects were interviewed for their history, treated with MVA, observed, given the contraceptive of their choice, and then discharged. The mean duration of the procedure was 3.5 minutes, with evacuation taking as long as 5-7 minutes and endometrial biopsies taking approximately 1 minute or less. Most patients spent 10-15 minutes in the hospital before discharge; no patient required hospitalization. There were very few complications (n = 6), none of them serious. Over 98% of the endometrial biopsy specimens were deemed suitable. Fewer than 5% of the patients had mild to moderate discomfort, usually during the endometrial biopsy procedures; the evacuations were virtually without discomfort. The author concluded that MVA using the Karman cannula and syringe is effective, safe, reliable, convenient, and economical for use in an outpatient setting. In addition, this procedure reduced the waiting list for dilation and curettage procedures.

  18. Toward improving fine needle aspiration cytology by applying Raman microspectroscopy

    NASA Astrophysics Data System (ADS)

    Becker-Putsche, Melanie; Bocklitz, Thomas; Clement, Joachim; Rösch, Petra; Popp, Jürgen

    2013-04-01

    Medical diagnosis of biopsies performed by fine needle aspiration has to be very reliable. Therefore, pathologists/cytologists need additional biochemical information on single cancer cells for an accurate diagnosis. Accordingly, we applied three different classification models for discriminating various features of six breast cancer cell lines by analyzing Raman microspectroscopic data. The statistical evaluations are implemented by linear discriminant analysis (LDA) and support vector machines (SVM). For the first model, a total of 61,580 Raman spectra from 110 single cells are discriminated at the cell-line level with an accuracy of 99.52% using an SVM. The LDA classification based on Raman data achieved an accuracy of 94.04% by discriminating cell lines by their origin (solid tumor versus pleural effusion). In the third model, Raman cell spectra are classified by their cancer subtypes. LDA results show an accuracy of 97.45% and specificities of 97.78%, 99.11%, and 98.97% for the subtypes basal-like, HER2+/ER-, and luminal, respectively. These subtypes are confirmed by gene expression patterns, which are important prognostic features in diagnosis. This work shows the applicability of Raman spectroscopy and statistical data handling in analyzing cancer-relevant biochemical information for advanced medical diagnosis on the single-cell level.

  19. Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma.

    PubMed

    Viguer, José M; Jiménez-Heffernan, José A; López-Ferrer, Pilar; Banaclocha, Marcos; Vicandi, Blanca

    2005-04-01

    Cytological features of nasopharyngeal carcinoma (NPC) were reviewed in an attempt to select cytological criteria that permit a specific recognition of metastases. For this purpose, 54 fine-needle aspiration (FNA) procedures from 43 patients with NPC were analyzed. Thirty-two (59.3%) procedures were performed before the histological diagnosis. In 25 (46.3%) procedures, smears showed many neoplastic single cells, clusters, and abundant lymphoid cells (mixed pattern). A dissociated (single cell) pattern consisting of individual neoplastic and lymphoid cells was seen in 18 (33.3%) cases. Finally, 11 (20.4%) cases showed cohesive epithelial clusters (cohesive pattern) without relevant cellular dissociation or lymphoid cells. Squamous-cell differentiation was seen in three of these cases. Most single neoplastic cells presented as large, pleomorphic naked nuclei. Other interesting findings were granulomas (n = 3), prominent eosinophilic infiltrates (n = 4), and suppurative changes (n = 5). In most smears with mixed and dissociated patterns, a nasopharyngeal origin could be suggested. On the contrary, those smears with a cohesive pattern were indistinguishable from other head and neck carcinomas. The presence (on cervical lymph nodes) of a dissociated or mixed (single cells and groups) architectural pattern of large, anaplastic cells and naked nuclei accompanied by an abundant lymphoid component is highly suggestive of undifferentiated NPC. Cytology offers a rapid diagnosis, establishes the necessity of a complete cavum examination, and helps in avoiding unnecessary and harmful biopsies.

  20. Nipple aspirate fluid and ductoscopy to detect breast cancer.

    PubMed

    Sauter, Edward R; Klein-Szanto, Andres; Macgibbon, Brenda; Ehya, Hormoz

    2010-04-01

    We prospectively performed cytologic assessment and image analysis (IA) on matched nipple aspirate fluid (NAF) and mammary ductoscopy (MD) specimens to determine (1) the accuracy of these methods in cancer detection and (2) whether the two collection methods provide complementary information.NAF and MD specimens were collected from 84 breasts from 75 women (nine bilateral samples) who underwent breast surgery. Cytologic evaluation was performed on all samples. IA was performed on slides with sufficient epithelial cells.Cytologic evaluation proved more accurate in patients without pathologic spontaneous nipple discharge (PND) than those with PND, mainly because of the potential false positive diagnosis in the latter. While the sensitivity of NAF and MD cytology was low (10% and 14%, respectively), both were 100% specific in cancer detection in the non-PND cohort. Combining NAF and MD cytology information improved sensitivity (24%) without sacrificing specificity. Similar to cytology, IA was more accurate in patients without PND having high specificity (100% for aneuploid IA), but relatively low sensitivity (36%). Combining NAF and MD cytology with aneuploid IA improved the sensitivity (45%) while maintaining high specificity (100%). The best predictive model was positive NAF cytology and/or MD cytology combined with IA aneuploidy, which resulted in 55% sensitivity and 100% specificity in breast cancer detection.Cytologic evaluation and IA of NAF and MD specimens are complementary. The presence of atypical cells arising from an intraductal papilloma in ductoscopic specimens is a potential source of false positive diagnosis in patients with nipple discharge.