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Sample records for nipple aspirate fluid

  1. 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.

  2. 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.

  3. NIPPLE ASPIRATE FLUID AND DUCTOSCOPY TO DETECT BREAST CANCER

    PubMed Central

    Sauter, Edward R.; Klein-Szanto, Andres; MacGibbon, Brenda; Ehya, Hormoz

    2012-01-01

    Background 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. Methods 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. Image analysis was performed on slides with sufficient epithelial cells. Results 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, image analysis 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. Conclusions 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. PMID:19795490

  4. Nipple Aspirate Fluid Hormone Concentrations and Breast Cancer Risk.

    PubMed

    Chatterton, Robert T; Heinz, Richard E; Fought, Angela J; Ivancic, David; Shappell, Claire; Allu, Subhashini; Gapstur, Susan; Scholtens, Denise M; Gann, Peter H; Khan, Seema A

    2016-04-01

    Prior reports identify higher serum concentrations of estrogens and androgens as risk factors for breast cancer, but steroids in nipple aspirate fluid (NAF) may be more related to risk. Incident breast cancer cases and mammography controls were recruited. Sex steroids were measured in NAF from the unaffected breasts of cases and one breast of controls. Menopausal status and menstrual cycle phase were determined. NAF steroids were purified by HPLC and quantified by immunoassays. Conditional logistic regression models were used to examine associations between NAF hormones and case-control status. NAF samples from 160 cases and 157 controls were evaluable for hormones. Except for progesterone and dehydroepiandrosterone (DHEA), the NAF and serum concentrations were not significantly correlated. NAF estradiol and estrone were not different between cases and controls. Higher NAF (but not serum) DHEA concentrations were associated with cases, particularly among estrogen receptor (ER)-positive cases (NAF odds ratio (OR) = 1.18, 95 % confidence interval (CI) 1.02, 1.36). NAF DHEA was highly correlated with NAF estradiol and estrone but not with androstenedione or testosterone. Higher progesterone concentrations in both NAF and serum were associated with a lower risk of ER-negative cancer (NAF OR = 0.69, 95 % CI 0.51, 0.92). However, this finding may be explained by case-control imbalance in the number of luteal phase subjects (2 cases and 19 controls). The significantly higher concentration of DHEA in NAF of cases and its correlation with NAF estradiol indicates a potentially important role of this steroid in breast cancer risk; however, the negative association of progesterone with risk is tentative.

  5. BIOMARKER ASSAYS IN NIPPLE APIRATE FLUID

    EPA Science Inventory

    ABSTRACT

    The noninvasive technique of nipple aspiration as a potential source of biomarkers of breast cancer risk was evaluated. The feasibility of performing mutagenesis assays, amplifying DNA and performing protein electrophoresis on nipple aspirate fluid was explored. ...

  6. Metabolomic Characterization of Nipple Aspirate Fluid by 1H NMR Spectroscopy and GC-MS

    PubMed Central

    Tredwell, Gregory D.; Miller, Jessica A.; Chow, H.-H. Sherry; Thompson, Patricia A.; Keun, Hector C.

    2015-01-01

    Nipple aspirate fluid (NAF) is a noninvasively obtained biofluid from the duct openings of the breast. NAF components are constantly secreted, metabolized, and reabsorbed by the epithelial lining of the lactiferous ducts of the breast. NAF has been studied as a potential breast tissue surrogate for the discovery of novel breast cancer risk, early detection, and treatment response biomarkers. We report the first unsupervised metabolite characterization of nipple aspirate fluid using NMR and GC-MS using convenience samples previously collected from four premenopausal and four postmenopausal women. A total of 38 metabolites were identified using the two analytical techniques, including amino acids, organic acids, fatty acids, and carbohydrates. Analytical reproducibility of metabolites in NAF by GC-MS was high across different extraction and analysis days. Overall, 31 metabolites had a coefficient of variation below 20%. By GC-MS, there were eight metabolites unique to NAF, 19 unique to plasma, and 24 shared metabolites. Correlative analysis of shared metabolites between matched NAF and plasma samples from pre- and postmenopausal women shows almost no correlations, with the exception being lactic acid, which was significantly negatively correlated (R2 = 0.57; P = 0.03). These results suggest that NAF is metabolically distinct from plasma and that the application of metabolomic strategies may be useful for future studies investigating breast cancer risk and intervention response biomarkers. PMID:24364541

  7. Biologic markers of breast cancer in nipple aspirate fluid and nipple discharge are associated with clinical findings1

    PubMed Central

    Sauter, Edward R.; Wagner-Mann, Colette; Ehya, Hormoz; Klein-Szanto, Andres

    2007-01-01

    Background The aim of this prospective study was to assess predictive markers in nipple aspirate fluid (NAF) and pathologic nipple discharge (PND) collected prior to excisional breast biopsy, as well as clinical factors available prior to biopsy, with histopathologic results in women with a radiographically suspicious and/or palpable breast lesion. Methods 208 NAF samples from 191 women were evaluated for the following candidate predictive proteins and cellular markers: prostate-specific antigen (PSA), human glandular kallikrein 2 (hK2), basic fibroblast growth factor (bFGF), S phase fraction (SPF), DNA index, and cytology. Clinical factors included whether or not the lesion was palpable, menopausal status, history of pregnancy, history of birth control or hormone replacement use, and PND. Results Considering all women, bFGF (p=0.005) and SPF (0.031) were associated, and abnormal cytology approached an association (p=0.056) with the presence of breast cancer. Women with PND were less likely to have breast cancer (4 vs. 37%, p<0.001) or palpable lesions (10 vs.43%, p < 0.001), were younger, had lower PSA levels (p=0.046), and were more likely to have atypical NAF cytology (p=0.002). Excluding PND, increased age, postmenopause (both p<0.01), high bFGF (p=0.004) and low PSA (p=0.05) were associated with cancer. The best breast cancer predictive model included cytology, bFGF, and age (88% sensitive and 57% specific). When the data were divided by menopausal status, the optimal models, which included NAF hK2 or PSA and age, were 100% sensitive and 41% specific in pre- vs. 93% sensitive and 12% specific in predicting breast cancer in postmenopausal women. Conclusion NAF and clinical biomarkers are sensitive predictors of whether a breast contains cancer, and may ultimately help guide treatment. Future studies to determine the optimal combination of predictive markers are warranted. PMID:17317033

  8. Characterization of the microbiome of nipple aspirate fluid of breast cancer survivors

    PubMed Central

    Chan, Alfred A.; Bashir, Mina; Rivas, Magali N.; Duvall, Karen; Sieling, Peter A.; Pieber, Thomas R.; Vaishampayan, Parag A.; Love, Susan M.; Lee, Delphine J.

    2016-01-01

    The microbiome impacts human health and disease. Until recently, human breast tissue and milk were presumed to be sterile. Here, we investigated the presence of microbes in the nipple aspirate fluid (NAF) and their potential association with breast cancer. We compared the NAF microbiome between women with a history of breast cancer (BC) and healthy control women (HC) using 16S rRNA gene amplicon sequencing. The NAF microbiome from BC and HC showed significant differences in community composition. Two Operational Taxonomic Units (OTUs) showed differences in relative abundances between NAF collected from BC and HC. In NAF collected from BC, there was relatively higher incidence of the genus Alistipes. By contrast, an unclassified genus from the Sphingomonadaceae family was relatively more abundant in NAF from HC. These findings reflect the ductal source DNA since there were no differences between areolar skin samples collected from BC and HC. Furthermore, the microbes associated with BC share an enzymatic activity, Beta-Glucuronidase, which may promote breast cancer. This is the first report of bacterial DNA in human breast ductal fluid and the differences between NAF from HC and BC. Further investigation of the ductal microbiome and its potential role in breast cancer are warranted. PMID:27324944

  9. Protein identification from dried nipple aspirate fluid on Guthrie cards using mass spectrometry

    PubMed Central

    DELMONICO, LUCAS; AREIAS, VIVIAN RABELLO; PINTO, RODRIGO CÉSAR; MATOS, CINTIA DA SILVA; ROSA, MARCO FELIPE FRANCO; DE AZEVEDO, CAROLINA MARIA; ALVES, GILDA

    2015-01-01

    Nipple aspirate fluid (NAF) requires investigation as a potential source of biomarkers for early diagnosis or risk assessment in breast cancer and other breast disorders. The present study demonstrated that proteins were easily extracted from dried NAF spots on Guthrie cards and were suitable for mass spectrometry analysis. NAF was obtained from 80 women, collected on Guthrie cards, between 2007 and 2010. The NAF-proteins were extracted from the card by incubating the card in water. These proteins were then quantified and separated using one-dimensional, 12% SDS-PAGE, gel electrophoresis and on high-resolution gradient gels at different concentrations (4–12, 8–16 and 4–20%). The bands with the most abundant proteins were excised from the gradient gels and the proteins were identified by liquid chromatography quadrupole time of flight. Immunoglobulins, Zn-α2-glicoprotein, apoliprotein D and prolactin inducible protein were among those identified. The NAF-Guthrie card collection method has not been applied previously, however, NAF proteins have been identified using other collecting techniques, confirming the feasibility of the NAF Guthrie card collection method for analyzing the proteins within NAF. The NAF-Guthrie card collecting method has multiple advantages, including being inexpensive, non-invasive, reliable and painless, and the cards can be stored at room temperature. Examining NAF may assist in identifying individuals at a higher risk of breast cancer and in improving patient prognosis. PMID:25760982

  10. Aluminium, carbonyls and cytokines in human nipple aspirate fluids: Possible relationship between inflammation, oxidative stress and breast cancer microenvironment.

    PubMed

    Mannello, F; Ligi, D; Canale, M

    2013-11-01

    The human breast is likely exposed to Al (aluminium) from many sources including diet and personal care products. Underarm applications of aluminium salt-based antiperspirant provide a possible long-term source of exposure, especially after underarm applications to shaved and abraded skin. Al research in breast fluids likely reflects the intraductal microenvironment. We found increased levels of aluminium in noninvasively collected nipple aspirate fluids (NAF) from 19 breast cancer patients compared with 16 healthy control subjects (268 vs 131 μg/l, respectively; p < 0.0001). In the same NAF samples we found significantly increased levels of protein oxidative carbonyls in cancer patients compared to healthy women (2.35 vs 0.41 nmol/mg prot, respectively; p < 0.0001). Aluminium content and carbonyl levels showed a significant positive linear correlation (r(2) 0.6628, p < 0.0001). In cancer NAF samples (containing higher amounts of aluminium salts) we also found a significantly increased levels of pro-inflammatory cytokines (IL-1β, IL-6, IL-12 p70, and TNF-α) and chemoattractant CC and CXC chemokines (IL-8, MIP-1α and MCP-1). In 12 invasive cancer NAF samples we found a significant positive linear correlation among aluminium, carbonyls and pro-inflammatory IL-6 cytokine (Y = 64.79x-39.63, r(2) 0.8192, p < 0.0005), as well as pro-inflammatory monocyte chemoattractant MCP-1 cytokine (Y = 2026x-866, r(2) 0.9495, p < 0.0001). In addition to emerging evidence, our results support the possible involvement of aluminium ions in oxidative and inflammatory status perturbations of breast cancer microenvironment, suggesting aluminium accumulation in breast microenvironment as a possible risk factor for oxidative/inflammatory phenotype of breast cells.

  11. Analysis of aluminium content and iron homeostasis in nipple aspirate fluids from healthy women and breast cancer-affected patients.

    PubMed

    Mannello, Ferdinando; Tonti, Gaetana A; Medda, Virginia; Simone, Patrizia; Darbre, Philippa D

    2011-04-01

    Aluminium is not a physiological component of the breast but has been measured recently in human breast tissues and breast cyst fluids at levels above those found in blood serum or milk. Since the presence of aluminium can lead to iron dyshomeostasis, levels of aluminium and iron-binding proteins (ferritin, transferrin) were measured in nipple aspirate fluid (NAF), a fluid present in the breast duct tree and mirroring the breast microenvironment. NAFs were collected noninvasively from healthy women (NoCancer; n = 16) and breast cancer-affected women (Cancer; n = 19), and compared with levels in serum (n = 15) and milk (n = 45) from healthy subjects. The mean level of aluminium, measured by ICP-mass spectrometry, was significantly higher in Cancer NAF (268.4 ± 28.1 μg l(-1) ; n = 19) than in NoCancer NAF (131.3 ± 9.6 μg l(-1) ; n = 16; P < 0.0001). The mean level of ferritin, measured through immunoassay, was also found to be higher in Cancer NAF (280.0 ± 32.3 μg l(-1) ) than in NoCancer NAF (55.5 ± 7.2 μg l(-1) ), and furthermore, a positive correlation was found between levels of aluminium and ferritin in the Cancer NAF (correlation coefficient R = 0.94, P < 0.001). These results may suggest a role for raised levels of aluminium and modulation of proteins that regulate iron homeostasis as biomarkers for identification of women at higher risk of developing breast cancer. The reasons for the high levels of aluminium in NAF remain unknown but possibilities include either exposure to aluminium-based antiperspirant salts in the adjacent underarm area and/or preferential accumulation of aluminium by breast tissues.

  12. Carbohydrate antigens in nipple aspirate fluid predict the presence of atypia and cancer in women requiring diagnostic breast biopsy

    PubMed Central

    2010-01-01

    Background The goal of this prospective study was to determine (a) concentrations of the carbohydrate biomarkers Thomsen Friedenreich (TF) antigen and its precursor, Tn antigen, in nipple discharge (ND) collected from women requiring biopsy because of a suspicious breast lesion; and (b) if concentration levels predicted pathologic diagnosis. Methods Adult women requiring biopsy to exclude breast cancer were enrolled and ND obtained. The samples from 124 women were analyzed using an anti-TF and anti-Tn monoclonal antibodies in direct immunoassay. Results The highest median concentration in ND for TF and Tn was in women with ductal carcinoma in situ (DCIS). TF was higher in women with 1) cancer (DCIS or invasive) vs. either no cancer (atypia or benign pathology, p = .048), or benign pathology (p = .018); and 2) abnormal (atypia or cancer) versus benign pathology (p = .016); and was more predictive of atypia or cancer in post- compared to premenopausal women. Tn was not predictive of disease. High TF concentration and age were independent predictors of disease, correctly classifying either cancer or abnormal vs. benign pathology 83% of the time in postmenopausal women. Conclusions TF concentrations in ND were higher in women with precancer and cancer compared to women with benign disease, and TF was an independent predictor of breast atypia and cancer. TF may prove useful in early breast cancer detection. PMID:20920311

  13. 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.

  14. Proteomic analysis of nipple aspirate fluid from women with early-stage breast cancer using isotope-coded affinity tags and tandem mass spectrometry reveals differential expression of vitamin D binding protein

    PubMed Central

    Pawlik, Timothy M; Hawke, David H; Liu, Yanna; Krishnamurthy, Savitri; Fritsche, Herbert; Hunt, Kelly K; Kuerer, Henry M

    2006-01-01

    Background Isotope-coded affinity tag (ICAT) tandem mass spectrometry (MS) allows for qualitative and quantitative analysis of paired protein samples. We sought to determine whether ICAT technology could quantify and identify differential expression of tumor-specific proteins in nipple aspirate fluid (NAF) from the tumor-bearing and contralateral disease-free breasts of patients with unilateral early-stage breast cancer. Methods Paired NAF samples from 18 women with stage I or II unilateral invasive breast carcinoma and 4 healthy volunteers were analyzed using ICAT labeling, sodium dodecyl sulfate-polyacrylamide gel (SDS-PAGE), liquid chromatography, and MS. Proteins were identified by sequence database analysis. Western blot analysis of NAF from an independent sample set from 12 women (8 with early-stage breast cancer and 4 healthy volunteers) was also performed. Results 353 peptides were identified from tandem mass spectra and matched to peptide sequences in the National Center for Biotechnology Information database. Equal numbers of peptides were up- versus down-regulated. Alpha2HS-glycoprotein [Heavy:Light (H:L) ratio 0.63] was underexpressed in NAF from tumor-bearing breasts, while lipophilin B (H:L ratio 1.42), beta-globin (H:L ratio 1.98), hemopexin (H:L ratio 1.73), and vitamin D-binding protein precursor (H:L ratio 1.82) were overexpressed. Western blot analysis of pooled samples of NAF from healthy volunteers versus NAF from women with breast cancer confirmed the overexpression of vitamin D-binding protein in tumor-bearing breasts. Conclusion ICAT tandem MS was able to identify and quantify differences in specific protein expression between NAF samples from tumor-bearing and disease-free breasts. Proteomic screening techniques using ICAT and NAF may be used to find markers for diagnosis of breast cancer. PMID:16542425

  15. 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.

  16. Nipple problems

    MedlinePlus

    ... nipple; Nipple problems Images Female breast Intraductal papilloma Mammary gland Abnormal discharge from the nipple Normal female breast ... PA: Elsevier Saunders; 2011:chap 8. Read More Breast cancer Endocrine glands Intraductal papilloma Review Date 11/16/2014 Updated ...

  17. 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.

  18. 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?

  19. Nipple Discharge

    MedlinePlus

    ... If the ultrasound shows a lesion within a milk duct, you may need a biopsy to confirm that it's a papilloma or to exclude a cancer. Nipple discharge is rarely a sign of breast cancer. But it might be a sign of ...

  20. [Inverted nipples].

    PubMed

    Saltvig, Iselin; Sjøstrand, Helle; Oldenburg, Mette Holmqvist; Matzen, Steen Henrik

    2016-10-17

    Inverted nipples is an anatomical variation which can be uni- or bilateral, congenital or acquired. The degree of inversion can vary from slight to severe. Treatment can be surgical or non-surgical and should depend on the degree of functional problems. Non-surgical treatment can be beneficial, does not risk affecting sensibility, spares the lactiferous ducts, and therefore does not risk any interference with breast-feeding. Surgical options should only be considered when non-surgical treatment is insufficient.

  1. Nipple Retractor to Correct Inverted Nipples.

    PubMed

    Long, Xiao; Zhao, Ru

    2011-12-01

    BACKGROUND: Inverted nipples are a common problem and a challenging clinical condition to repair. Multiple methods have been reported to correct inverted nipples, most of which will destroy breastfeeding function. PATIENTS AND METHODS: We have designed a simple nipple retractor to correct inverted nipples. A total of 53 patients with 95 inverted nipples underwent an operation in which the nipples were retracted into a normal position and fixated with the nipple retractor and wires under local anesthesia. Nipple retractors were to be worn for 6 months. Postoperatively, the patients were invited to follow-up on the 1st day, the 7th day, after 1 month, 3 months and 6 months, and yearly thereafter. Wire adjustments were performed as needed. Mean follow-up was 11.9 months (range 8-18 months). RESULTS: Improvement occurred in all patients and was sustained in all cases throughout the follow-up period. The total complication rate was 5.26% (5/95). The main complications included depigmentation (2.11%, 2/95), areolar ulcer (2.11%, 2/95), and wire dislocation (1.05%, 1/95). CONCLUSION: The nipple retractor is a simple tool with which severely inverted nipples can be successfully corrected with a low complication rate. Close follow-up and careful postoperative care are important to avoid complications.

  2. Breastfeeding - skin and nipple changes

    MedlinePlus

    Inverted nipple; Nipple discharge; Breast feeding - nipple changes; Breastfeeding - nipple changes ... Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl JR, ... and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; ...

  3. Uncertainty in aspiration efficiency estimates from torso simplifications in computational fluid dynamics simulations.

    PubMed

    Anderson, Kimberly R; Anthony, T Renée

    2013-03-01

    Computational fluid dynamics (CFD) has been used to report particle inhalability in low velocity freestreams, where realistic faces but simplified, truncated, and cylindrical human torsos were used. When compared to wind tunnel velocity studies, the truncated models were found to underestimate the air's upward velocity near the humans, raising questions about aspiration estimation. This work compares aspiration efficiencies for particles ranging from 7 to 116 µm using three torso geometries: (i) a simplified truncated cylinder, (ii) a non-truncated cylinder, and (iii) an anthropometrically realistic humanoid body. The primary aim of this work is to (i) quantify the errors introduced by using a simplified geometry and (ii) determine the required level of detail to adequately represent a human form in CFD studies of aspiration efficiency. Fluid simulations used the standard k-epsilon turbulence models, with freestream velocities at 0.1, 0.2, and 0.4 m s(-1) and breathing velocities at 1.81 and 12.11 m s(-1) to represent at-rest and heavy breathing rates, respectively. Laminar particle trajectory simulations were used to determine the upstream area, also known as the critical area, where particles would be inhaled. These areas were used to compute aspiration efficiencies for facing the wind. Significant differences were found in both vertical velocity estimates and the location of the critical area between the three models. However, differences in aspiration efficiencies between the three forms were <8.8% over all particle sizes, indicating that there is little difference in aspiration efficiency between torso models.

  4. Uncertainty in Aspiration Efficiency Estimates from Torso Simplifications in Computational Fluid Dynamics Simulations

    PubMed Central

    Anthony, T. Renée

    2013-01-01

    Computational fluid dynamics (CFD) has been used to report particle inhalability in low velocity freestreams, where realistic faces but simplified, truncated, and cylindrical human torsos were used. When compared to wind tunnel velocity studies, the truncated models were found to underestimate the air’s upward velocity near the humans, raising questions about aspiration estimation. This work compares aspiration efficiencies for particles ranging from 7 to 116 µm using three torso geometries: (i) a simplified truncated cylinder, (ii) a non-truncated cylinder, and (iii) an anthropometrically realistic humanoid body. The primary aim of this work is to (i) quantify the errors introduced by using a simplified geometry and (ii) determine the required level of detail to adequately represent a human form in CFD studies of aspiration efficiency. Fluid simulations used the standard k-epsilon turbulence models, with freestream velocities at 0.1, 0.2, and 0.4 m s−1 and breathing velocities at 1.81 and 12.11 m s−1 to represent at-rest and heavy breathing rates, respectively. Laminar particle trajectory simulations were used to determine the upstream area, also known as the critical area, where particles would be inhaled. These areas were used to compute aspiration efficiencies for facing the wind. Significant differences were found in both vertical velocity estimates and the location of the critical area between the three models. However, differences in aspiration efficiencies between the three forms were <8.8% over all particle sizes, indicating that there is little difference in aspiration efficiency between torso models. PMID:23006817

  5. Clarifying nipple confusion.

    PubMed

    Zimmerman, E; Thompson, K

    2015-11-01

    Nipple confusion, an infant's difficulty with or preference for one feeding mechanism over another after exposure to artificial nipple(s), has been widely debated. This is in part due to conflicting statements, one by the American Academy of Pediatrics in 2005 suggesting that infants should be given a pacifier to protect against Sudden Infant Death Syndrome, and the other by the World Health Organization in 2009 stating that breastfeeding infants should never be given artificial nipples. Despite the limited and inconsistent evidence, nipple confusion is widely believed by practitioners. Therefore, there is a unique opportunity to examine the evidence surrounding nipple confusion by assessing the research that supports/refutes that bottle feeding/pacifier use impedes breastfeeding efficacy/success/duration. This review examined 14 articles supporting and refuting nipple confusion. These articles were reviewed using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale. Based on our review, we have found emerging evidence to suggest the presence of nipple confusion only as it relates to bottle usage and found very little evidence to support nipple confusion with regards to pacifier use. The primary difficulty in conclusively studying nipple confusion is establishing causality, namely determining whether bottles'/pacifiers' nipples are causing infants to refuse the breast or whether they are simply markers of other maternal/infant characteristics. Future research should focus on prospectively examining the causality of nipple confusion.

  6. Computational fluid dynamics investigation of human aspiration in low velocity air: orientation effects on nose-breathing simulations.

    PubMed

    Anderson, Kimberly R; Anthony, T Renée

    2014-06-01

    An understanding of how particles are inhaled into the human nose is important for developing samplers that measure biologically relevant estimates of exposure in the workplace. While previous computational mouth-breathing investigations of particle aspiration have been conducted in slow moving air, nose breathing still required exploration. Computational fluid dynamics was used to estimate nasal aspiration efficiency for an inhaling humanoid form in low velocity wind speeds (0.1-0.4 m s(-1)). Breathing was simplified as continuous inhalation through the nose. Fluid flow and particle trajectories were simulated over seven discrete orientations relative to the oncoming wind (0, 15, 30, 60, 90, 135, 180°). Sensitivities of the model simplification and methods were assessed, particularly the placement of the recessed nostril surface and the size of the nose. Simulations identified higher aspiration (13% on average) when compared to published experimental wind tunnel data. Significant differences in aspiration were identified between nose geometry, with the smaller nose aspirating an average of 8.6% more than the larger nose. Differences in fluid flow solution methods accounted for 2% average differences, on the order of methodological uncertainty. Similar trends to mouth-breathing simulations were observed including increasing aspiration efficiency with decreasing freestream velocity and decreasing aspiration with increasing rotation away from the oncoming wind. These models indicate nasal aspiration in slow moving air occurs only for particles <100 µm.

  7. Fluid dynamic design and experimental study of an aspirated temperature measurement platform used in climate observation

    NASA Astrophysics Data System (ADS)

    Yang, Jie; Liu, Qingquan; Dai, Wei; Ding, Renhui

    2016-08-01

    Due to the solar radiation effect, current air temperature sensors inside a thermometer screen or radiation shield may produce measurement errors that are 0.8 °C or higher. To improve the observation accuracy, an aspirated temperature measurement platform is designed. A computational fluid dynamics (CFD) method is implemented to analyze and calculate the radiation error of the aspirated temperature measurement platform under various environmental conditions. Then, a radiation error correction equation is obtained by fitting the CFD results using a genetic algorithm (GA) method. In order to verify the performance of the temperature sensor, the aspirated temperature measurement platform, temperature sensors with a naturally ventilated radiation shield, and a thermometer screen are characterized in the same environment to conduct the intercomparison. The average radiation errors of the sensors in the naturally ventilated radiation shield and the thermometer screen are 0.44 °C and 0.25 °C, respectively. In contrast, the radiation error of the aspirated temperature measurement platform is as low as 0.05 °C. This aspirated temperature sensor allows the radiation error to be reduced by approximately 88.6% compared to the naturally ventilated radiation shield, and allows the error to be reduced by a percentage of approximately 80% compared to the thermometer screen. The mean absolute error and root mean square error between the correction equation and experimental results are 0.032 °C and 0.036 °C, respectively, which demonstrates the accuracy of the CFD and GA methods proposed in this research.

  8. Fluid dynamic design and experimental study of an aspirated temperature measurement platform used in climate observation.

    PubMed

    Yang, Jie; Liu, Qingquan; Dai, Wei; Ding, Renhui

    2016-08-01

    Due to the solar radiation effect, current air temperature sensors inside a thermometer screen or radiation shield may produce measurement errors that are 0.8 °C or higher. To improve the observation accuracy, an aspirated temperature measurement platform is designed. A computational fluid dynamics (CFD) method is implemented to analyze and calculate the radiation error of the aspirated temperature measurement platform under various environmental conditions. Then, a radiation error correction equation is obtained by fitting the CFD results using a genetic algorithm (GA) method. In order to verify the performance of the temperature sensor, the aspirated temperature measurement platform, temperature sensors with a naturally ventilated radiation shield, and a thermometer screen are characterized in the same environment to conduct the intercomparison. The average radiation errors of the sensors in the naturally ventilated radiation shield and the thermometer screen are 0.44 °C and 0.25 °C, respectively. In contrast, the radiation error of the aspirated temperature measurement platform is as low as 0.05 °C. This aspirated temperature sensor allows the radiation error to be reduced by approximately 88.6% compared to the naturally ventilated radiation shield, and allows the error to be reduced by a percentage of approximately 80% compared to the thermometer screen. The mean absolute error and root mean square error between the correction equation and experimental results are 0.032 °C and 0.036 °C, respectively, which demonstrates the accuracy of the CFD and GA methods proposed in this research.

  9. Prenatal nipple conditioning for breastfeeding.

    PubMed

    Atkinson, L D

    1979-01-01

    Twenty-two primigravida women who planned to breastfeed began conditioning their nipples six weeks before their expected delivery date by nipple rolling twice a day for two minutes each time; providing gentle friction against the nipple with a terry cloth towel for 15 seconds once a day; and nipple airing for two hours a day, allowing outer clothing to rub against the nipple. Each woman served as her own control, conditioning one nipple but not the other. No nipple ointments or soap were used on either nipple during the course of the study. Each woman was given instructions on breastfeeding techniques to be used after delivery. The women completed two checklists: One revealed how consistently they followed the nipple-conditioning regime; with the other, they rated nipple pain on each breast, for every nursing, during the first five days postdelivery. Ratings were: 1--negligible pain or no pain, 2--definite pain, 3--extreme pain. Seventeen women successfully completed the study. Effect of skin color on the amount of nipple pain was also investigated. The prenatal nipple-conditioning regime significantly reduced the amount of total nipple pain experienced during the first few days of breastfeeding. The amount of extreme pain experienced on the conditioned nipple was significantly (p less than .01) reduced compared to the control nipple. Fair-skinned women reported more nipple soreness on unconditioned nipples, and olive-complected women reported significantly (p less than .01) less nipple soreness on unconditioned nipples.

  10. Fluid Forces Enhance the Performance of an Aspirant Leader in Self-Organized Living Groups

    PubMed Central

    De Rosis, Alessandro

    2014-01-01

    In this paper, the performance of an individual aiming at guiding a self-organized group is numerically investigated. A collective behavioural model is adopted, accounting for the mutual repulsion, attraction and orientation experienced by the individuals. Moreover, these represent a set of solid particles which are supposed to be immersed in a fictitious viscous fluid. In particular, the lattice Boltzmann and Immersed boundary methods are used to predict the fluid dynamics, whereas the effect of the hydrodynamic forces on particles is accounted for by solving the equation of the solid motion through the time discontinuous Galerkin scheme. Numerical simulations are carried out by involving the individuals in a dichotomous process. On the one hand, an aspirant leader (AL) additional individual is added to the system. AL is forced to move along a prescribed direction which intersects the group. On the other hand, these tend to depart from an obstacle represented by a rotating lamina which is placed in the fluid domain. A numerical campaign is carried out by varying the fluid viscosity and, as a consequence, the hydrodynamic field. Moreover, scenarios characterized by different values of the size of the group are investigated. In order to estimate the AL's performance, a proper parameter is introduced, depending on the number of individuals following AL. Present findings show that the sole collective behavioural equations are insufficient to predict the AL's performance, since the motion is drastically affected by the presence of the surrounding fluid. With respect to the existing literature, the proposed numerical model is enriched by accounting for the presence of the encompassing fluid, thus computing the hydrodynamic forces arising when the individuals move. PMID:25501965

  11. Fluid forces enhance the performance of an aspirant leader in self-organized living groups.

    PubMed

    De Rosis, Alessandro

    2014-01-01

    In this paper, the performance of an individual aiming at guiding a self-organized group is numerically investigated. A collective behavioural model is adopted, accounting for the mutual repulsion, attraction and orientation experienced by the individuals. Moreover, these represent a set of solid particles which are supposed to be immersed in a fictitious viscous fluid. In particular, the lattice Boltzmann and Immersed boundary methods are used to predict the fluid dynamics, whereas the effect of the hydrodynamic forces on particles is accounted for by solving the equation of the solid motion through the time discontinuous Galerkin scheme. Numerical simulations are carried out by involving the individuals in a dichotomous process. On the one hand, an aspirant leader (AL) additional individual is added to the system. AL is forced to move along a prescribed direction which intersects the group. On the other hand, these tend to depart from an obstacle represented by a rotating lamina which is placed in the fluid domain. A numerical campaign is carried out by varying the fluid viscosity and, as a consequence, the hydrodynamic field. Moreover, scenarios characterized by different values of the size of the group are investigated. In order to estimate the AL's performance, a proper parameter is introduced, depending on the number of individuals following AL. Present findings show that the sole collective behavioural equations are insufficient to predict the AL's performance, since the motion is drastically affected by the presence of the surrounding fluid. With respect to the existing literature, the proposed numerical model is enriched by accounting for the presence of the encompassing fluid, thus computing the hydrodynamic forces arising when the individuals move.

  12. Resolution of lung injury after a single event of aspiration: a model of bilateral instillation of whole gastric fluid.

    PubMed

    Araos, Joaquín D; Ayala, Pedro S; Meneses, Manuel; Contreras, Rafael; Cutiño, Andrea; Montalva, Rebeca M; Tazelaar, Henry D; Borzone, Gisella R

    2015-10-01

    Gastric aspiration is a high-risk condition for lung injury. Consequences range from subclinical pneumonitis to respiratory failure, with fibrosis development in some patients. Little is known about how the lung repairs aspiration-induced injury. By using a rat model of single orotracheal instillation of whole gastric contents, we studied the time course of morphological and biochemical changes during injury and resolution, and evaluated whether repair involved long-term fibrosis. Anesthetized rats received one gastric fluid instillation. At 4, 12, and 24 hours and 4 and 7 days, we performed lung histological studies and biochemical measurements in bronchoalveolar lavage fluid and lung tissue. Physiological measurements were performed at 12 to 24 hours. Long-term outcome was studied histologically at day 60. During the first 24 hours, severe peribronchiolar injury involving edema, intra-alveolar proteinaceous debris, hemorrhage, increased neutrophils and cytokines, and physiological dysfunction were observed. At days 4 and 7, an organizing pneumonia (OP) pattern developed, with foreign-body giant cells and granulomas. Lung matrix metalloproteinase 9 and 2 activities increased, with metalloproteinase-9 linked to early inflammation and metalloproteinase-2 to OP. At day 60, lung architecture was normal. In conclusion, a continuum of alterations starting with severe injury, evolving toward OP and later resolving, characterizes the rat single aspiration event. In addition to identifying markers of staging and severity, this model reveals that OP participates in the repair of aspiration-induced injury.

  13. Supernumerary nipples: an overview.

    PubMed

    Brown, Justin; Schwartz, Robert A

    2003-05-01

    Supernumerary nipples (SNs) are relatively common, minor congenital anomalies. SNs usually arise within the embryonic milk lines, but they have been known to form elsewhere. The prevalence of SNs varies, depending on the population. SNs are normally benign entities, but they are susceptible to hormonal changes and disease processes and may signify internal disease.

  14. Endotracheal aspirate and bronchoalveolar lavage fluid analysis: interchangeable diagnostic modalities in suspected ventilator-associated pneumonia?

    PubMed

    Scholte, Johannes B J; van Dessel, Helke A; Linssen, Catharina F M; Bergmans, Dennis C J J; Savelkoul, Paul H M; Roekaerts, Paul M H J; van Mook, Walther N K A

    2014-10-01

    Authoritative guidelines state that the diagnosis of ventilator-associated pneumonia (VAP) can be established using either endotracheal aspirate (ETA) or bronchoalveolar lavage fluid (BALF) analysis, thereby suggesting that their results are considered to be in accordance. Therefore, the results of ETA Gram staining and semiquantitative cultures were compared to the results from a paired ETA-BALF analysis. Different thresholds for the positivity of ETAs were assessed. This was a prospective study of all patients who underwent bronchoalveolar lavage for suspected VAP in a 27-bed university intensive care unit during an 8-year period. VAP was diagnosed when ≥ 2% of the BALF cells contained intracellular organisms and/or when BALF quantitative culture revealed ≥ 10(4) CFU/ml of potentially pathogenic microorganisms. ETA Gram staining and semiquantitative cultures were compared to the results from paired BALF analysis by Cohen's kappa coefficients. VAP was suspected in 311 patients and diagnosed in 122 (39%) patients. In 288 (93%) patients, the results from the ETA analysis were available for comparison. Depending on the threshold used and the diagnostic modality, VAP incidences varied from 15% to 68%. For the diagnosis of VAP, the most accurate threshold for positivity of ETA semiquantitative cultures was moderate or heavy growth, whereas the optimal threshold for BALF Gram staining was ≥ 1 microorganisms per high power field. The Cohen's kappa coefficients were 0.22, 0.31, and 0.60 for ETA and paired BALF Gram stains, cultures, and BALF Gram stains, respectively. Since the ETA and BALF Gram stains and cultures agreed only fairly, they are probably not interchangeable for diagnosing VAP.

  15. How does a newly born mouse get to the nipple? Odor substrates eliciting first nipple grasping and sucking responses.

    PubMed

    Al Aïn, Syrina; Belin, Laurine; Schaal, Benoist; Patris, Bruno

    2013-12-01

    It is a mammalian female strategy to emit odor cues and signals that direct their inexperienced newborns to the nipple, and optimize their initial sucking success and, hence, viability. Here, natural odorous substrates that contribute to nipple grasping were investigated in mice, a species that has not been much scrutinized on this topic. The response of pups toward the nipples of lactating females (LF) versus nonlactating females (NLF) were first assessed right after watched birth, before and after the first suckling experience, and at 1 day old, after more extended suckling experience. It appeared that only nipples of LF induced grasping at these early ages, leading to take NLF as the baseline setting to present various odor substrates sampled from LF, viz. amniotic fluid, murine milk, LF saliva, pup saliva, LF urine, and an odorless control stimulus (water). Results indicate that: (1) only amniotic fluid and fresh milk induced nipple grasping before the first suckling experience; (2) LF saliva started inducing grasping after the first suckling experience; (3) pup saliva released grasping after 24-36 hr of suckling experience; finally (4) neither LF urine, nor water induced any nipple grasping. In conclusion, the activity of amniotic fluid and murine milk on neonatal pup behavior before any postnatal suckling experience suggests that either prenatal learning and/or predisposed olfactory mechanisms do operate, while the behavioral activation due to maternal and infantile salivas clearly depends on postnatal exposure.

  16. Breast abscess after nipple piercing: sonographic findings with clinical correlation.

    PubMed

    Leibman, A Jill; Misra, Monika; Castaldi, Maria

    2011-09-01

    The purpose of this series was to review the spectrum of clinical and sonographic features associated with infection after nipple piercing. Between 2002 and 2010, 6 patients presented to our breast center with a breast abscess after nipple piercing. A retrospective analysis of the imaging findings was performed with clinical and pathologic correlation. Patients with breast infections after nipple piercing tend to be young, and the timing since piercing varies from 2 weeks to 17 months. Sonography showed a complex or hypoechoic mass in 5 of 6 patients. Treatment of breast abscesses included surgical incision and drainage, percutaneous drainage, and antibiotic therapy. Surgical evacuation is commonly performed; however, sonographically guided aspiration may be an appropriate management strategy.

  17. Nipple care, sore nipples, and breastfeeding: a randomized trial.

    PubMed

    Centuori, S; Burmaz, T; Ronfani, L; Fragiacomo, M; Quintero, S; Pavan, C; Davanzo, R; Cattaneo, A

    1999-06-01

    Sore and cracked nipples are common and may represent an obstacle to successful breastfeeding. In Italy, it is customary for health professionals to prescribe some type of ointment to prevent or treat sore and cracked nipples. The efficacy of these ointments is insufficiently documented. The incidence of sore and cracked nipples was compared between mothers given routine nipple care, including an ointment (control group), and mothers instructed to avoid the use of nipple creams and other products (intervention group). Breastfeeding duration was also compared between the two groups. Eligible mothers were randomly assigned, after informed consent, to one of the two groups. No difference was found between the control (n = 96) and the intervention group (n = 123) in the incidence of sore and cracked nipples and in breastfeeding duration. However, several factors were associated with sore nipples and with breastfeeding duration. The use of a pacifier and of a feeding bottle in the hospital were both associated with sore nipples at discharge (p = 0.02 and p = 0.03, respectively). Full breastfeeding up to 4 months postpartum was significantly associated with the following early practices: breastfeeding on demand, rooming-in at least 20 hours/day, non-use of formula and pacifier, no test-weighing at each breastfeed. The incidence of sore and cracked nipples and the duration of breastfeeding were not influenced by the use of a nipple ointment. Other interventions, such as providing the mother with guidance and support on positioning and latching, and modifications of hospital practices may be more effective in reducing nipple problems.

  18. Nipple areola complex sparing mastectomy

    PubMed Central

    Mingozzi, Matteo; Curcio, Annalisa; Buggi, Federico; Folli, Secondo

    2015-01-01

    Breast conservative therapy (BCT) is established as a safe option for most women with early breast cancer (BC). The best conservative mastectomy that can be performed, when mastectomy is unavoidable, is nipple-areola-complex sparing mastectomy (NSM), which allows the complete glandular dissection preserving the skin envelope and the nipple areola complex. In the treatment of BC, the cosmetic outcomes have become fundamental goals, as well as oncologic control. NSM is nowadays considered an alternative technique to improve the overall quality of life for women allowing excellent cosmetic results because it provides a natural appearing breast. The breast surgeon must pay attention to details and skin incision must be planned to minimize vascular impairment to the skin and the nipple. Preservation of the blood supply to the nipple is one of the most important concern during NSM because nipple or areolar necrosis is a well-described complication of this surgery. Another issue associated with the nipple preservation and the surgical technique is oncological safety related to nipple-areola-complex (NAC) involvement in patients with invasive BC. The authors present their experience on 252 NSM performed in the Breast Surgery Unit in Forlì. Careful selection of patients for this surgical procedure is imperative and many patients are not ideal candidates for this procedure because of concerns about nipple-areolar viability as women with significant large/ptotic breast, pre-existing breast scars and history of active cigarette smoking. To extend the benefits of nipple preservation to patients who are perceived to be at higher risk for nipple necrosis the authors describe technical modifications of NSM to allow nipple preservation and obtain good cosmetic outcomes. PMID:26645007

  19. Levobupivacaine for Spinal Anesthesia in Children: Cerebrospinal Fluid Aspiration Before the Injection Does not Affect the Spread or Duration of the Sensory Block

    PubMed Central

    Kokki, Merja; Heikkinen, Marja; Kumpulainen, Elina; Vähäoja, Aura; Kokki, Hannu

    2016-01-01

    Background Several factors are thought to affect the spread and duration of spinal anesthesia (SA) in adults. These include the volume of cerebrospinal fluid (CSF) in the lumbar spinal canal, which has a negative correlation with both the spread and duration of the sensory block. Objectives We evaluated whether CSF aspiration before an injection of levobupivacaine affected the spread or duration of SA in children. Patients and Methods SA was induced by levobupivacaine (5 mg/mL, 0.25 - 0.5 mg/kg) in 186 children aged 10 months to 18 years (mean of 7.5 years). Two groups were analyzed prospectively: 93 children from which 1 - 3 mL of CSF (CSF-aspiration group) was aspirated before the injection of levobupivacaine to induce SA and 93 children from which no CSF was aspirated (no-CSF-aspiration group) prior to the injection of levobupivacaine. The main outcome measure was regression of the sensory block below T10, cephalic spread of the block, and postpuncture complications after SA. Results There were no between-group differences in the time to regression of the block below T10 or in the cephalic spread of the sensory block: 94 (27) minutes and T4.4 (SD 2.2) in the CSF-aspiration group, respectively, vs. 97 (29) minutes and T4.3 (1.8), respectively, in the no-CSF-aspiration group. Position-dependent headaches developed in 4 of 91 children in the CSF-aspiration group and 5 of 86 children in the no-CSF-aspiration group, but no epidural blood patches were required. Conclusions The aspiration of 1 - 3 mL of CSF before an injection of levobupivacaine did not seem to affect the spread and duration of the sensory block or postpuncture complications in children following SA. PMID:27642576

  20. 21 CFR 880.5630 - Nipple shield.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nipple shield. 880.5630 Section 880.5630 Food and... Nipple shield. (a) Identification. A nipple shield is a device consisting of a cover used to protect the nipple of a nursing woman. This generic device does not include nursing pads intended solely to...

  1. 21 CFR 880.5630 - Nipple shield.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nipple shield. 880.5630 Section 880.5630 Food and... Nipple shield. (a) Identification. A nipple shield is a device consisting of a cover used to protect the nipple of a nursing woman. This generic device does not include nursing pads intended solely to...

  2. 21 CFR 880.5630 - Nipple shield.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nipple shield. 880.5630 Section 880.5630 Food and... Nipple shield. (a) Identification. A nipple shield is a device consisting of a cover used to protect the nipple of a nursing woman. This generic device does not include nursing pads intended solely to...

  3. 21 CFR 880.5630 - Nipple shield.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nipple shield. 880.5630 Section 880.5630 Food and... Nipple shield. (a) Identification. A nipple shield is a device consisting of a cover used to protect the nipple of a nursing woman. This generic device does not include nursing pads intended solely to...

  4. 21 CFR 880.5630 - Nipple shield.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nipple shield. 880.5630 Section 880.5630 Food and... Nipple shield. (a) Identification. A nipple shield is a device consisting of a cover used to protect the nipple of a nursing woman. This generic device does not include nursing pads intended solely to...

  5. Buying and Caring for Baby Bottles and Nipples

    MedlinePlus

    ... htm Buying and Caring for Baby Bottles and Nipples To use the sharing features on this page, ... bottles and nipples. How to Choose Bottles and Nipples The type of nipple and bottle you choose ...

  6. 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.

  7. Usefulness of the nipple-suspension piercing device after correction of inverted nipples.

    PubMed

    Hyakusoku, Hiko; Chin, Takafumi

    2006-01-01

    The authors have devised a new piercing instrument for postoperative nipple suspension of inverted nipples. The instrument can be used not only postsurgically, but also for nipple suspension in light inverted nipple cases without surgical repair. Details of the device and the method of piercing are described.

  8. Bottlefeeding with a Breast-Like Nipple.

    ERIC Educational Resources Information Center

    Field, Tiffany M.; Schanberg, Saul; Davalos, Marisabel; Malphurs, Julie

    1997-01-01

    Compared mothers' and one-month-olds' behaviors during 20-minute bottlefeeding with standard or breastlike nipple. Found that mothers' behaviors did not differ, but infants on breastlike nipples spent less time asleep, more time awake and active and less time fussing and crying than infants on standard nipples; they also exhibited changes in vagal…

  9. 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 ...

  10. Florid papillomatosis of the male nipple.

    PubMed

    Tuveri, Massimiliano; Calò, Pietro Giorgio; Mocci, Cristina; Nicolosi, Angelo

    2010-09-01

    The authors present a case of an adenoma of the nipple in a 61-year-old man who reported a 6-month history of nodularity and itching at his left nipple. Examination revealed a firm, well-defined, vascularized tumor measuring .8 cm that altered the normal anatomy of the nipple. A total excision of the nipple and areola was performed. The histological diagnosis was adenoma of the nipple. No recurrent tumor has been observed during 4 years of postoperative follow-up. An adequate excision of the lesion is curative without any risk of recurrence or development of malignancy.

  11. A Novel Nipple Reconstruction Technique for Maintaining Nipple Projection: The Boomerang Flap

    PubMed Central

    Kim, Young-Eun; Hong, Ki Yong; Minn, Kyung Won

    2016-01-01

    Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up. Several factors might contribute to nipple projection loss, and we tried to overcome these factors by performing nipple reconstructions using a boomerang flap technique, which is a modified C–V flap that utilizes the previous mastectomy scar to maintain long-term nipple projection. PMID:27689057

  12. 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

  13. Nipple Aspirate Test Is No Substitute for Mammogram

    MedlinePlus

    ... Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers ... Need to Know More in Consumer Updates Animal & Veterinary Children's Health Cosmetics Dietary Supplements Drugs Food Medical ...

  14. Breast Cancer Biomarkers Based on Nipple and Fine Needle Aspirates

    DTIC Science & Technology

    2005-05-01

    Concentrations of 18S gene were compared with those of the breast epithelium specific genes fat milk globule membrane antigen and whey acidic protein (Table 2...compared with those of the breast epithelium specific genes fat milk globule membrane antigen and whey acidic protein. Our results led us to conclude that RT

  15. Breast Cancer Biomarkers Based on Nipple and Fine Needle Aspirates

    DTIC Science & Technology

    2000-05-01

    381, 1988. 24 Michael H. Torosian, M.D. Curriculum Vitae Page 15 26. Donoway RB, Torosian MH: Growth hormone inhibits tumor metastasis. Surgical Forum...nutrition and tumor metastasis. Surgery 109:597-601, 1991.32. 32. Torosian MH, Donoway RB: Growth hormone inhibits tumor metastasis. Cancer 67:2280...of tumor growth by nutrition support. Journal of Parenteral and Enteral Nutrition 16:72S-75S, 1992. 37. Torosian MH: Growth hormone and prostate cancer

  16. Retrospective analysis of pathologic nipple discharge.

    PubMed

    Yang, L; Wu, D; Fan, Z-M

    2015-02-13

    The cause of pathologic nipple discharge is mainly benign lesions, but there is still a possibility of malignancy. Pathologic nipple discharge may be the only or the first symptom of breast cancer. This study aimed to investigate the clinical factors associated with lesions in patients with pathologic nipple discharge using a retrospective analysis of clinical data in 207 cases. The univariate analysis showed that age >50 years, breast lumps, or breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Discharge characteristics, duration of disease, and identification of lesions had no clear clinical significance (P > 0.05). The multivariate analysis also showed that age >50 years, breast lumps, and breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Age, breast lumps, and breast calcifications had important clinical significance in identification of benign and malignant nipple discharge.

  17. Sys-BodyFluid: a systematical database for human body fluid proteome research.

    PubMed

    Li, Su-Jun; Peng, Mao; Li, Hong; Liu, Bo-Shu; Wang, Chuan; Wu, Jia-Rui; Li, Yi-Xue; Zeng, Rong

    2009-01-01

    Recently, body fluids have widely become an important target for proteomic research and proteomic study has produced more and more body fluid related protein data. A database is needed to collect and analyze these proteome data. Thus, we developed this web-based body fluid proteome database Sys-BodyFluid. It contains eleven kinds of body fluid proteomes, including plasma/serum, urine, cerebrospinal fluid, saliva, bronchoalveolar lavage fluid, synovial fluid, nipple aspirate fluid, tear fluid, seminal fluid, human milk and amniotic fluid. Over 10,000 proteins are presented in the Sys-BodyFluid. Sys-BodyFluid provides the detailed protein annotations, including protein description, Gene Ontology, domain information, protein sequence and involved pathways. These proteome data can be retrieved by using protein name, protein accession number and sequence similarity. In addition, users can query between these different body fluids to get the different proteins identification information. Sys-BodyFluid database can facilitate the body fluid proteomics and disease proteomics research as a reference database. It is available at http://www.biosino.org/bodyfluid/.

  18. [Ductoscopy for pathologic nipple discharge].

    PubMed

    Waaijer, Laurien; van Diest, Paul J; van der Pol, Carmen C; Verolme, Berna; Hennink, Annelies; Witkamp, Arjen J

    2013-01-01

    Pathologic nipple discharge is a symptom that frequently causes female patients to visit the outpatient breast clinic. In the vast majority of cases, the symptom is caused by a benign intraductal laesion. The options for diagnosis and treatment have long been limited; surgery was not infrequently the treatment of choice. With the advent of breast ductoscopy, a micro-endoscopic procedure, it is possible to visualise abnormalities in the ductal system. Tissue for histopathological investigation can be retrieved from the duct and the condition can be treated. The patient with nipple discharge is consequently prevented from having to undergo an invasive and fairly 'blindly' executed procedure under general anaesthesia. The miniscule dimensions of the duct in which the technique is carried out pose the greatest challenge to the further development of the ductoscope.

  19. Supernumerary nipples in children with hematologic disorders.

    PubMed

    Aslan, D; Gürsel, T; Kaya, Z

    2004-01-01

    The authors report on supernumerary nipples and various hematologic disorders in 7 patients [factor X deficiency (n = 1), factor XI deficiency (n = 2), acute lymphoblastic leukemia (n = 3), and acute myeloblastic leukemia (n = 1)]. They would like to draw attention to the association of supernumerary nipples with hematological disorders, which has not been published before and is considered to be added to the anomalies associated with supernumerary nipples.

  20. Nipple Shields: A Review of the Literature

    PubMed Central

    McKechnie, Anne Chevalier

    2010-01-01

    Abstract Nipple shields have become commonplace in the United States for a wide range of breastfeeding problems. This article is a summary of the current literature describing the evidence for nipple shield use. The authors reviewed all available articles on nipple shields and selected 13 studies for inclusion. The studies were organized into three categories: physiologic responses, premature infants, and mothers' experiences. This review concludes that current published research does not provide evidence for safety or effectiveness of contemporary nipple shield use. PMID:20807104

  1. Seven nipples in a male: World's second case report.

    PubMed

    Goyal, Tarang; Bakshi, S K; Varshney, Anupam

    2012-09-01

    We present a case of seven nipples in a 32-year-old male patient. The patient had two regular nipples along with five supernumerary nipples. Usually, supernumerary nipples develop along the two vertical "milk lines" which start in the arm pit on each side, run down through the typical nipples, and end at the groin. Our patient had six nipples which confirm to the "milk lines" and one nipple which was above the umbilicus in the midline and did not confirm to the "milk lines." To our knowledge, this is the second case report with seven nipples in the world.

  2. Disseminated tuberculosis in an HIV-infected child: rifampicin resistance detected by GeneXpert in a lymph node aspirate but not in cerebrospinal fluid.

    PubMed

    Gamell, Anna; Ntamatungiro, Alex John; Battegay, Manuel; Letang, Emilio

    2015-08-03

    A 9-year-old HIV-infected child previously treated with inadequate doses of antitubercular drugs based on weight was admitted 5 months after initial tuberculosis (TB) diagnosis with acute hemiplegia and inguinal lymphadenopathies in a rural hospital in Tanzania. He was diagnosed with TB meningitis and lymphadenitis using Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay. Rifampicin resistance was detected in the lymph node aspirate but not in the cerebrospinal fluid. His TB therapy was optimised based on available medications and antiretroviral treatment was initiated 6 weeks later. Despite these efforts, the clinical evolution was poor and the child died 12 weeks after admission.

  3. 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

  4. 21 CFR 880.5640 - Lamb feeding nipple.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Lamb feeding nipple. 880.5640 Section 880.5640... Devices § 880.5640 Lamb feeding nipple. (a) Identification. A lamb feeding nipple is a device intended for use as a feeding nipple for infants with oral or facial abnormalities. (b) Classification. Class...

  5. 21 CFR 880.5640 - Lamb feeding nipple.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Lamb feeding nipple. 880.5640 Section 880.5640... Devices § 880.5640 Lamb feeding nipple. (a) Identification. A lamb feeding nipple is a device intended for use as a feeding nipple for infants with oral or facial abnormalities. (b) Classification. Class...

  6. 21 CFR 880.5640 - Lamb feeding nipple.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Lamb feeding nipple. 880.5640 Section 880.5640... Devices § 880.5640 Lamb feeding nipple. (a) Identification. A lamb feeding nipple is a device intended for use as a feeding nipple for infants with oral or facial abnormalities. (b) Classification. Class...

  7. 21 CFR 880.5640 - Lamb feeding nipple.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Lamb feeding nipple. 880.5640 Section 880.5640... Devices § 880.5640 Lamb feeding nipple. (a) Identification. A lamb feeding nipple is a device intended for use as a feeding nipple for infants with oral or facial abnormalities. (b) Classification. Class...

  8. 21 CFR 880.5640 - Lamb feeding nipple.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Lamb feeding nipple. 880.5640 Section 880.5640... Devices § 880.5640 Lamb feeding nipple. (a) Identification. A lamb feeding nipple is a device intended for use as a feeding nipple for infants with oral or facial abnormalities. (b) Classification. Class...

  9. Cancer of the breast with nipple involvement.

    PubMed Central

    Menon, R. S.; van Geel, A. N.

    1989-01-01

    In the absence of gross deformity of the nipple, such as its retraction or Paget's disease, histological examination of this area is often neglected, or at best confined to a cursory look at a single sagittal section. The inadequacy of this approach is illustrated by this study of 33 consecutive cases of carcinoma of the breast treated with mastectomy. Multiple transverse sections showed tumour in 19 nipples (58%) involving one or more levels. Of these, 17 showed non-invasive tumour, either ductal or lobular type. Invasive tumour was seen in only two nipples, one of which was metastatic extension from the underlying breast tumour. Paget's cells were seen in two cases. The most significant finding was the eccentric location of tumour in 14 nipples. A single central sagittal section would have detected only five cases involving the centrally situated duct. An inexplicable finding was a preponderance of right nipple with tumour. No statistically significant correlation between nipple involvement and the size, location, multicentricity, type of tumour in the breast and metastases in axillary lymph nodes could be found. It became evident from this study that malignant changes in the nipple occur more commonly than is realised, and that it is also one of the sites of multicentric origin of the tumour. This factor will have to be taken into account in planning conservative therapeutic programmes. Images Figure 1 Figure 2 Figure 3 PMID:2547416

  10. Is chronic nipple piercing associated with hyperprolactinemia?

    PubMed

    Sun, Grace E Ching; Pantalone, Kevin M; Gupta, Manjula; Kennedy, Laurence; Nasr, Christian; Constantiner, Marigel; Hamrahian, Amir H; Hatipoglu, Betul

    2013-09-01

    Literature on hyperprolactinemia in the setting of a nipple piercing is limited to individuals with concomitant breast/chest wall infection. It is unclear if chronic nipple stimulation from a piercing alone can cause sustained elevations of serum prolactin. Nipple piercing is emerging as a more mainstream societal form of body art, and the answer to this clinical question would potentially alter patient management. Our aim was to assess serum prolactin levels in subjects with nipple piercing. Inclusion criteria were as follows: men and women ≥ 18 years old with nipple piercing(s) present > 6 months. Exclusion criteria included: women who are pregnant, lactating or < 6 months postpartum; subjects on medications known to increase prolactin levels; chest wall/breast infection at the time of phlebotomy or conditions known to be associated with hyperprolactinemia. Three men and eight women were enrolled. Median (range) ages for men and women were 33 (24-42) and 27 years (23-42), respectively. All except one subject had bilateral piercings. The median interval from nipple piercing to blood draw was 4.0 (2.0-12.0) years. None of the subjects had hyperprolactinemia. Median (range) prolactin levels for men and women were 5.6 ng/mL (3.8-7.4) and 8.0 ng/mL (2.8-10.9), respectively. Our results suggest that in the absence of any concomitant infection, chronic nipple piercing is not associated with hyperprolactinemia.

  11. "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.

  12. Anatomy of the nipple and breast ducts

    PubMed Central

    Urban, Cícero; Vallejo, André

    2016-01-01

    Over time, variations of mastectomy came up and started allowing the oncological safety and the possibility of an immediate breast reconstruction. Nipple sparing mastectomy (NSM) procedures have strongly increased in frequency and have become one of the best alternatives to treat breast cancer, also improving overall aesthetic outcomes and the achievement of contralateral breast symmetry. The nipple areola-complex (NAC) must be considered the identity of the breast concerning self-esteem of patients. This paper will remind the main anatomical topics around the nipple and breast ducts. PMID:26855906

  13. Male to male transmission of supernumerary nipples.

    PubMed

    Tsukahara, M; Uchida, M; Uchino, S; Fujisawa, R; Kamei, T; Itoh, T

    1997-03-17

    We report on a father and his son with supernumerary nipples. No male-to-male transmission has previously been described with this trait. This observation confirms that this trait is inherited in an autosomal dominant fashion.

  14. Applicability of a progesterone-based timed artificilal insemination protocol after follicular fluid aspiration using the ovum pick-up technique in suckled beef cows.

    PubMed

    Hirata, Toh-Ichi; Hoshina, Toshinori; Sasaki, Shu-Ichi; Sasaki, Osamu; Osawa, Takeshi

    2007-04-01

    We conducted a progesterone-based timed AI protocol after follicular fluid aspiration using the ovum pick-up (OPU) technique to examine its applicability to the suckled beef cow. A total of 19 beef cows were randomly allocated to one of the following three groups based on the number of days postpartum: 13 to 60 days (Group A: suckled; early postpartum period, n=9), 61 to 150 days (Group B: suckled; mid postpartum period, n=6), or 151 to 281 days (Group C: non-suckled; prolonged open period, n=4) postpartum. These cows were treated with follicular fluid aspiration and insertion of a progesterone-releasing intravaginal device (PRID) on day 0. The PRID was removed and 500 microg of cloprostenol was intramuscularly administered on day 7. A dose (100 microg) of fertirelin acetate was injected intramuscularly 48 hours later, and this was followed by a timed AI (TAI) after another 18 hours (day 10). Serum samples were taken on days 0, 7, 9, 10, 12, 17, 24 and 31 for determination of the estradiol-17beta (E(2)) and progesterone concentrations. Pregnancy diagnosis was made by rectal palpation approximately 60 days after TAI. There was no significant difference in the peripheral E(2) concentrations among the three groups during the period of the hormonal treatment. The average progesterone concentrations in Group A on day 17 were significantly higher than those in Group B and exceeded 1.0 ng/ml on day 17 and thereafter. There was no significant difference in the numbers of collected immature oocytes among the three groups. The pregnancy rates in Groups A, B, and C were 77.8% (7/9), 83.3% (5/6) and 50.0% (2/4), respectively. In conclusion, this timed AI protocol is applicable to suckled beef cows within the period of 60 days postpartum.

  15. Nipple Discharge: A Sign of Breast Cancer?

    PubMed Central

    Richards, T; Hunt, A; Courtney, S; Umeh, H

    2007-01-01

    INTRODUCTION Nipple discharge is regarded a sign of breast cancer. Type of discharge and cytology are unreliable for diagnosis. Most malignant cases have a detectable breast mass. The aim of this study was to assess the association between nipple discharge and breast cancer. PATIENTS AND METHODS Patients who underwent operation for nipple discharge at a district general hospital (population 460,000) over a 3-year period were included. All had normal clinical, radiological and cytological examination. Operation and histopathology reports were reviewed. RESULTS Eighty-six patients underwent operation for nipple discharge. Median age was 54 years (range, 32–84 years). Analysis of nipple discharge revealed red blood cells (RBCs) in 35 patients (40%). At operation, 81 patients underwent radical sub-areola duct excision (Hadfield's procedure) and five microdochectomy. Histopathology reported duct ectasia in 59 patients and benign ductal papilloma in 25. Two patients had occult malignancy – DCIS (1) and LCIS (1). No invasive cancer was found. CONCLUSIONS Nipple discharge alone is not usually a sign of breast cancer. Occult malignancy is rare. A period of ‘watchful waiting’ may prevent patients undergoing unnecessary surgery. PMID:17346403

  16. Improvement in the Detection of Cystic Metastatic Papillary Thyroid Carcinoma by Measurement of Thyroglobulin in Aspirated Fluid.

    PubMed

    Wang, Yong; Zhao, Huan; Wang, Yi-Xiang J; Wang, Min-Jie; Zhang, Zhi-Hui; Zhang, Li; Zhang, Bin; Ahuja, Anil T; Zhou, Chun-Wu; Jiang, Yu-Xin; Guo, Hui-Qin

    2016-01-01

    Cystic change in metastatic lymph nodes of papillary thyroid carcinoma (PTC) is a diagnostic challenge for fine needle aspiration (FNA) because of the scant cellularity. The aim of this study was to evaluate the measurement of thyroglobulin in fine needle aspirate (Tg-FNA) for detecting metastatic PTC in patients with cystic neck lesions and to validate the optimal cutoff value of Tg-FNA. A total of 75 FNA specimens of cystic lesions were identified, including 40 of metastatic PTC. Predetermined threshold levels of 0.04 (minimum detection level), 0.9, 10.0, and 77.0 ng/mL (maximum normal serum-Tg level) were used to evaluate the diagnostic accuracy of Tg-FNA for metastatic PTC detection. The areas under the receiver operating characteristic curve for diagnosing metastatic PTC of Tg-FNA values of 0.04, 0.9, 10.0, and 77.0 ng/mL were 0.5 (95% confidence interval [CI], 0.382-0.618), 0.645 (95% CI, 0.526-0.752), 0.945 (95% CI, 0.866-0.984), and 0.973 (95% CI, 0.907-0.996), respectively. With a cutoff value of 77.0 ng/mL, the combination of Tg-FNA and FNA cytology showed superior diagnostic power (97.5% sensitivity and 100% specificity) compared to FNA cytology alone (80% sensitivity and 100% specificity). We recommend a Tg-FNA cutoff of 77.0 ng/mL, the maximum normal serum-Tg level, for cystic neck lesions.

  17. Nipple Reconstruction with the Biodesign Nipple Reconstruction Cylinder: A Prospective Clinical Study

    PubMed Central

    Collins, Brendan; Williams, Jeremy Z.; Karu, Heather; Hodde, Jason P.; Martin, Victoria A.

    2016-01-01

    Background: Nipple reconstruction is the last stage in cosmetic reconstruction of the breast after mastectomy, but no method produces reliable and consistent aesthetic results. This study examined the use of the Biodesign Nipple Reconstruction Cylinder (NRC) during reconstruction of the nipple after mastectomy. Methods: Patients with a history of breast cancer and mastectomy desiring nipple reconstruction were invited to participate. After obtaining consent, unilateral or bilateral nipple reconstruction was performed. Skin flaps were raised, the NRC was placed beneath the flaps as a stent, and the site was protected for up to 4 weeks with a nipple shield. Nipple projection was measured for 12 months after surgery. Patient satisfaction was measured and adverse events were recorded. Follow-up examinations were performed at 1 week, and then at 1, 3, 6, and 12 months after surgery. Results: Eighty-two nipple reconstructions were performed in 50 patients. Related postoperative adverse events were minor, but reported in 8 reconstructions (9.8%) representing 7 patients (14.0%). Average projection at 6 and 12 months was 4.1 ± 1.6 mm and 3.8 ± 1.5 mm, respectively, compared with 10.5 ± 2.2 mm 1 week after surgery. Of patients completing the satisfaction questionnaire at 12 months, 70/75 (93.3%) of reconstructions were rated “pleased” or “very pleased” with the overall outcome. Overall, 45/46 (97.8%) patients would recommend nipple reconstruction to other women. Conclusions: The Biodesign NRC offers a safe alternative to nipple reconstruction, resulting in stable projection and a high level of patient satisfaction for 12 months after placement. PMID:27622100

  18. Diseases of the male nipple and areola.

    PubMed

    Krause, Walter

    2011-12-01

    The male nipple-areola-complex (NAC) is a residual organ without physiologic functions in the male. It possesses similar hormone sensitivity and sexual sensitivity as the female organ. The location of the NAC on the chest wall with respect to other surface features is relevant for the male appearance. All known disseminated skin diseases may involve the nipple and areola. A number of specific localized diseases have been described in the literature, such as mammillary eczema, demodicidosis, lymphadenosis cutis benigna, nevoid hyperkeratosis, and thelalgia. Special attention is required if nipple discharge is observed. Areolar sebaceous hyperplasia and nearly all kinds of benign cutaneous tumors occur on the nipple and areola. Malignant tumors such as basal cell carcinoma, melanoma, Paget disease and other forms of breast cancer may also be found. In addition, aberrant mammary tissue may occur with a broad clinical spectrum, while absence of the nipple is an unusual observation and occurs in rare syndromes. The association of aberrant mammary tissue with urinary tract malformations has not been confirmed.

  19. Supernumerary nipples and renal malformations: a family study.

    PubMed

    Brown, Justin; Schwartz, Robert A

    2004-01-01

    We describe a family with supernumerary nipples and kidney and urinary tract malformations. The proband is a 59-year-old man with a supernumerary nipple and recently identified hypoplastic kidney, bladder diverticulum, and hypotonic bladder. His mother also has a supernumerary nipple and a recently identified hypoplastic kidney. Of his three children, all male, one has a supernumerary nipple but has not been evaluated for a kidney or urinary tract malformation. This familial disorder is discussed.

  20. Raynaud's phenomenon of the nipples: an elusive diagnosis.

    PubMed

    Morino, Carolyn; Winn, Susan M

    2007-05-01

    Pain and throbbing of the nipples associated with Raynaud's phenomenon often mimics yeast or fungal infections. Breastfeeding mothers with Raynaud's of the nipples are often treated inappropriately for organisms such as Candida Albicans with topical or systemic antifungal agents. This case report describes the eventual diagnosis of Raynaud's phenomenon of the nipples in a breastfeeding mother who was initially treated for yeast.

  1. Optical response from lenslike semiconductor nipple arrays

    NASA Astrophysics Data System (ADS)

    Wu, H.-M.; Lai, C.-M.; Peng, L.-H.

    2008-11-01

    The authors reported the use of recessive size reduction in self-assembled polystyrene sphere mask with anisotropic etching to form lenslike nipple arrays onto the surface of silicon and gallium nitride. These devices are shown to exhibit a filling factor near to an ideal close-packed condition and paraboloidlike etch profile with slope increased proportionally to the device aspect ratio. Specular reflectivity of less than 3% was observed over the visible spectral range for the 0.35-μm-period nipple-lens arrays. Using two-dimensional rigorous coupled-wave analysis, the latter phenomenon can be ascribed to a gradual index matching mechanism accessed by a high surface-coverage semiconductor nipple array structure.

  2. 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.

  3. Detection of BRAF mutation in the cytocentrifugation supernatant fluid from fine-needle aspiration of thyroid lesions may enhance the diagnostic yield

    PubMed Central

    Brown, Ashley E.; Lim, Khin Sandar; Corpus, George; Hustek, Martha T.; Tran, Tien Anh N.; Chang, Chung-Che

    2017-01-01

    Objective: BRAF mutations using cellular DNA from fine-needle aspiration (FNA) specimens are commonly used to support the diagnosis of papillary thyroid carcinoma (PTC). The goal of this study was to preliminarily evaluate the diagnostic utility of detecting BRAF mutations in the routinely discarded FNA specimen supernatant fluid. Materials and Methods: Seventy-eight FNAs of thyroid lesions were evaluated for BRAF mutations using both cellular and supernatant DNA. BRAF mutation data were correlated with cytology and surgical pathology. Results: Of the 78 samples evaluated, 68 (87%) had amplifiable DNA in the supernatant with 2 (3%) positive for BRAF mutations. These two samples showed no mutations in the cellular counterpart. Among the 11 samples showing morphologic findings (FNA/surgical pathology) suspicious/diagnostic of PTC, 6 (55%) samples (one supernatant and five cellulars) were positive for BRAF mutations. This suggests that testing supernatant DNA in FNA specimens may increase the diagnostic yield by 1/11 (9%) in this setting. Conclusions: The vast majority of routinely discarded FNA supernatants contain amplifiable DNA. In addition, profiling the mutations of BRAF and other genes using supernatant DNA may provide valuable diagnostic information to assist the diagnosis of PTC in patients with clinical/morphologic findings suspicious for malignancies and cellular DNA showing no mutations. PMID:28331529

  4. Correction of recurrent inverted nipples with the Sakai method.

    PubMed

    Taneda, Hiroko; Sakai, Shigemi; Kamei, Chihiro

    2013-08-01

    An inverted nipple is a congenital condition that can be corrected with established surgical methods, although recurrence sometimes occurs. The correction of recurrent inverted nipples is challenging because of scars and fibrosis caused by previous surgical treatments. The authors treated 14 patients with 25 recurrent inverted nipples with the Sakai method. All patients were observed for more than 6 months. All of the resulting nipples were acceptable and fit into the normal nipple shapes described by Kim et al (Plast Reconstr Surg. 2006;118:1526-1531) (ie, rectangular, omega, round, cap, or slanting). Although the Sakai method is not new, it may be a useful option not only for ordinary inverted nipples but also for the correction of recurrent inverted nipples.

  5. Management of nipple discharge and the associated imaging findings.

    PubMed

    Patel, Bhavika K; Falcon, Shannon; Drukteinis, Jennifer

    2015-04-01

    Nipple discharge is commonly encountered by health care providers, accounting for 2%-5% of medical visits by women. Because nipple discharge is the presenting symptom in 5% to 12% of breast cancers, it causes considerable anxiety for both patient and providers. Furthermore, the work-up and management of nipple discharge can be confusing. Fortunately, the cause of nipple discharge is usually benign, so the primary goal of evaluation and management is separation of patients with pathologic causes of discharge from those with benign or physiologic causes. The evaluation of nipple discharge requires a thorough history, careful physical examination, and an informed approach that selects the most suitable diagnostic modality. Primary care providers, working with their radiologists and surgeons, are well positioned to design appropriate diagnostic and management protocols to assess and treat nipple discharge. A thoughtful and prudent approach to nipple discharge should alleviate patient anxiety by efficiently and effectively defining the underlying etiology.

  6. Raynaud's phenomenon of the nipple associated with labetalol use.

    PubMed

    McGuinness, Naomi; Cording, Vicky

    2013-02-01

    Raynaud's phenomenon of the nipple is an unusual cause of severe nipple pain. Precipitants for Raynaud's phenomenon of the nipple are known to be cold temperatures, caffeine, and emotional stress. Nipple pain is quoted as the most common cause of cessation of breastfeeding. It is important that lactation consultants and other health care professionals are aware of Raynaud's phenomenon of the nipple and the treatment options available. This is a case of a 37-year-old woman, Gravida 2, Para 1, who was first seen in the antenatal clinic at 34 weeks gestation. A diagnosis of Raynaud's phenomenon of the nipple was made after she began taking labetalol for pregnancy-induced hypertension. The phenomenon had occurred in both of her previous pregnancies on commencing labetalol and resolved postnatally on cessation of the drug. We aim to raise awareness of both the condition itself and the potential role of labetalol in the development of Raynaud's phenomenon of the nipple.

  7. Duplication of the nipples and areolae.

    PubMed

    Hundleby, Christopher J B; Beighton, Peter

    2007-04-01

    A young South African woman has bilateral duplication of the nipples and areolae in an apparently horizontal plane on each breast. She is otherwise normal in every respect, and her family history is negative. This configuration of breast tissue is very unusual and, to the best of our knowledge, it has not previously been reported.

  8. Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments

    PubMed Central

    Kent, Jacqueline C.; Ashton, Elizabeth; Hardwick, Catherine M.; Rowan, Marnie K.; Chia, Elisa S.; Fairclough, Kyle A.; Menon, Lalitha L.; Scott, Courtney; Mather-McCaw, Georgia; Navarro, Katherine; Geddes, Donna T.

    2015-01-01

    Background: Persistent nipple pain is one of the most common reasons given by mothers for ceasing exclusive breastfeeding. We aimed to determine the frequency of nipple pain as a reason for consultation, the most common attributed aetiologies, and the effectiveness of the advice and treatment given. Methods: All consultations at the Breast Feeding Centre of Western Australia (WA) were audited over two six-month periods in 2011 (n = 469) and 2014 (n = 708). Attributed cause(s) of nipple pain, microbiology results, treatment(s) advised, and resolution of pain were recorded. Results: Nipple pain was one of the reasons for consultation in 36% of cases. The most common attributed cause of nipple pain was incorrect positioning and attachment, followed by tongue tie, infection, palatal anomaly, flat or inverted nipples, mastitis, and vasospasm. Advice included correction of positioning and attachment, use of a nipple shield, resting the nipples and expressing breastmilk, frenotomy, oral antibiotics, topical treatments, and cold or warm compresses. Pain was resolving or resolved in 57% of cases after 18 days (range 2–110). Conclusion: The multiple attributed causes of nipple pain, possibly as a result of a cascade of events, suggests that effective early lactation management for prevention of nipple pain and early diagnosis and effective treatment are crucial to avoid early weaning. PMID:26426034

  9. 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.

  10. Manual rupture versus transvaginal ultrasound-guided aspiration of allanto-amniotic fluid in multiple pregnancies: a clinical approach to embryo reduction in dairy cattle.

    PubMed

    Andreu-Vázquez, Cristina; Garcia-Ispierto, Irina; López-Gatius, Fernando

    2012-01-01

    To avoid the problems associated with twinning in dairy cattle, one of the embryos may be eliminated. This study compares the effect on pregnancy maintenance of two embryo reduction techniques, manual rupture (MR) and transvaginal ultrasound-guided aspiration (TUGA) of allanto-amniotic fluid, in Holstein-Friesian cows with multiple pregnancies. In the first experiment, 61 lactating cows bearing unilateral twins (n=27), bilateral twins (n=30) or triplets/quadruplets (n=4) were subjected to MR (n=45) or TUGA using a 17-G neddle (n=16) on day 28-34 of gestation. In 21 and 10 cows undergoing MR and TUGA embryo reduction, respectively, pregnancy loss occurred before day 90 (46.7 vs. 62.5%, P= 0.28). Through binary logistic regression, the type of pregnancy was identified as the only variable significantly affecting pregnancy maintenance (P=0.03). Based on the odds ratio, the risk of pregnancy loss was 4.1 times higher for unilateral twins than for bilateral twins (70.4 vs. 36.7%, respectively, P=0.01). No effect was detected on pregnancy maintenance of the technique used (P=0.17) or of the interaction technique by type of pregnancy (P=0.22). In the second experiment, a 22-G needle was used to perform TUGA on 22 lactating cows. The pregnancy loss rates were 44.4% (4/9), 18.2% (2/11) and 50% (1/2) for cows bearing unilateral twins, bilateral twins and triplets, respectively. The total pregnancy loss rate following TUGA using the 22-G needle tended to be lower than that using the 17-G needle (31.8 vs. 62.5%; P=0.06). Our results suggest that TUGA using a 22-G needle could be the method of choice to perform embryo reduction in cows carrying multiple pregnancies.

  11. Nipple discharge disorders: current diagnostic management and the role of fiber-ductoscopy.

    PubMed

    Okazaki, A; Hirata, K; Okazaki, M; Svane, G; Azavedo, E

    1999-01-01

    Nipple discharge disorders is a field in which there has been both increasing awareness on the part of patients and advances in management. Today secretion from nipples can be classified according to its color, cellularity and biology. To be significant a discharge should be true, spontaneous, persistent and non-lactational. Moreover there are methods to differentiate patients who require surgical intervention from those who do not. Surgically significant nipple discharges are watery, serous (yellow), serosanguineous and bloody. Cytology smears of discharge material have helped to classify the cellular material, providing information about normality, atypia and malignancy and also about papillary formation of the exfoliated cells. Tests such as Hemoccult help to discover occult blood in the secreted fluid. Modern immunological tests can be performed on cytology smears where occurrence of high levels of carcinoembryonic antigen could indicate a latent malignancy. Galactography investigation is today the state-of-the-art approach to investigate patients with nipple discharge disorders and this examination can demonstrate the size, location and extent of an intraductal abnormality. Modern high-resolution ultrasound techniques are helpful in visualizing intraductal disorders and are becoming a good complementary approach if not an alternative to traditional radiology techniques. Recently even MR galactography has been shown to be of diagnostic value, but not as informative as regular galactography. The most sophisticated investigation method, which can also be used therapeutically, is fiber-ductoscopy of the concerned duct in a breast. This technique, although expensive and in its infancy, is a fascinating and promising approach for inspecting the intraductal lumina. In this article the background, current investigation methods and possibilities of the technique are described, as well as the most sophisticated ways to deal with nipple discharge disorders in human

  12. Appropriate location of the nipple-areola complex in males.

    PubMed

    Shulman, O; Badani, E; Wolf, Y; Hauben, D J

    2001-08-01

    Gynecomastia is a common deformity encountered by plastic surgeons. The appropriate location of the nipple-areola complex is a major determinant of the aesthetic success of the procedure. To study the natural location of the nipple-areola complex in the normally built male, 50 nonobese men with no evidence of gynecomastia and an average age of 27.9 years were examined. Three ratios were calculated and found to be relatively constant; they were the ratio between the height of the nipple and the height of the patient, the ratio between the distance between the nipples and chest circumference, and the ratio between the suprasternal notch-to-nipple distance and the height of the patient. Using these three parameters, a method of locating the nipple-areola complex on the male chest wall was devised. The method is advocated as a reliable, simple, and useful technique.

  13. Patient satisfaction following nipple reconstruction incorporating autologous costal cartilage

    PubMed Central

    Lipa, Joan E; Addison, Patrick D; Neligan, Peter C

    2008-01-01

    BACKGROUND: Nipple-areolar reconstruction completes post-mastectomy breast reconstruction. Many techniques for nipple reconstruction have been described, and each has their advocates and critics. One of the frequent failings of most designs is loss of nipple projection with time. OBJECTIVES: To determine the effect of including autologous costal cartilage on patient satisfaction with their nipple reconstruction. METHODS: Sixty-eight patients were identified who had undergone fishtail flap nipple reconstruction following autologous free flap breast reconstruction between 1990 and 2004. Qualitative questionnaires, using Likert scales, were sent to each patient to specifically assess their satisfaction with their nipple reconstruction. RESULTS: Of 26 respondents (mean ± SEM follow-up period 3.7±3.6 years), 13 had undergone nipple reconstruction incorporating costal cartilage banked at the time of initial breast reconstruction, and the other 13 had no cartilage in their nipple reconstructions. While both groups would opt for nipple reconstruction again, patients with cartilage grafts incorporated into their reconstructions had overall satisfaction ratings 1.92 grades higher on average (not significant, P=0.12) than those without. This difference increased to 3.2 grades when the satisfaction of the patient’s partner was taken into account (P<0.05). Improved satisfaction corresponded to higher scores for volume, consistency, texture, and particularly for projection and contour of the nipple (P<0.05). Although nipple morphology changed over time, there was a trend toward improved stability in the cartilage group. CONCLUSIONS: Patient satisfaction with nipple reconstruction can be improved by incorporating costal cartilage beneath the skin flaps. Superior contour and projection are sustained over time. PMID:19554171

  14. Paget disease of the male nipple.

    PubMed

    El Harroudi, T; Tijami, F; El Otmany, A; Jalil, A

    2010-01-01

    Breast cancer occurring in the mammary gland of men is infrequent. It accounts for 0.8% of all breast cancers, which is less than one per cent of all newly diagnosed male cancers and 0.2% of male cancer deaths. However, Paget disease of the male nipple is extremely rare. We report a single case of Paget disease with infiltrative ductal carcinoma of the breast in a 61-year-old man.

  15. Factors Associated with Nipple Lesions in Puerperae

    PubMed Central

    dos Santos, Luana Caroline; Peixoto, Érika Freitas; Lopes, Leonardo Motta Costa; de Andrade, Luiza Barroso; Frois, Marcelo Cançado; Santiago, Michelle Amanda; Bouzada, Maria Cândida Ferrarez

    2016-01-01

    This retrospective cross-sectional study aimed to evaluate the factors associated with nipple lesion development in puerperae. Analyses were performed using the Poisson regression with robust variance. The level of significance was set at 5% (p < 0.05). We evaluated 1270 puerperae, among whom 193 (15.4%) presented with nipple lesions. The condition was more prevalent among the mothers who did not receive information about breastfeeding [PR, 1.69; 95% confidence interval (CI), 1.19–2.42], those who underwent cesarean delivery (PR, 1.48; 95% CI, 1.02–2.16), those who used a pacifier (prevalence ratios (PR), 2.04; 95% CI, 1.05–3.95), those who used baby formula only (PR, 1.61; 95% CI, 4.82–5.36) and those who used baby formula combined with breastfeeding (PR, 1.61; 95% CI, 1.06–2.45). A lower incidence of nipple lesions was observed among those who did not receive information on hand expression of breast milk (PR, 0.65; 95% CI, 0.46–0.93) and those who did not breastfeed in the first hour of life (PR, 0.61; 95% CI, 0.38–0.97). PMID:26330461

  16. Nitric oxide may mediate nipple erection.

    PubMed

    Tezer, Murat; Ozluk, Yasemin; Sanli, Oner; Asoglu, Oktar; Kadioglu, Ates

    2012-01-01

    The nipple is a specialized structure that can become erect by cold, sexual arousal, breast-feeding, or other tactile stimulations, which can induce the milk ejection reflex and sexual arousal because of intense sensory innervation. The studies that have been conducted thus far to identify the mechanism of nipple erection (NE) are not sufficient. It has been stated that NE occurs via activation of the sympathetic nervous system and smooth muscle contraction. The purposes of this study were to investigate the existence of nitric oxide synthase (NOS) in the nipple-areola complex (NAC) to explain the NE mechanism. Considering that smooth muscle relaxation might be effective in NE, endothelial and neuronal NOS expression and localization were investigated via immunohistochemical methods on sagittal sections from 17 human NACs. The results of this study indicate that eNOS is expressed in the vascular endothelium, ductal epithelium, and smooth muscles, whereas nNOS is expressed in the neural fibers, smooth muscles, ductal epithelium, and vascular endothelium in the NAC. Sinusoidal spaces with endothelial layers similar to those found in penile cavernosal tissue are not found in the NAC. Various mediators are known to affect the function of the NAC smooth muscles; however, this study demonstrates that enzymes (eNOS and nNOS) that synthesize nitric oxide are expressed in the NAC.

  17. [Dermatoses of the nipple and the areola].

    PubMed

    Cordoliani, F; Rybojad, M; Verola, O; Espié, M

    1995-01-01

    Dermatoses of the nipple and areola are rare. The commonest dermatosis is Paget's disease, which presents in the form of a well demarcated erythematous area, sometimes erosive, oozing or hyperkeratotic. Histological examination reveals an intraepidermal proliferation of large clear cells, either isolated or grouped in clumps, predominantly in the suprabasal layers. Immunohistochemistry shows that these cells express low molecular weight cytokeratins and the epithelial membrane antigen, fairly frequently carcinoembryonic antigen. In 96% of cases, Paget's disease is associated with underlying breast carcinoma, either in situ or invasive. Erosive adenomatosis presents in the form of an erosion of the nipple, which is sometimes increased in size. Histologically, it consists of a benign tumour which may ulcerate the epidermis, composed of tubes and papillae lined by a double layer of epithelial and myoepithelial cells. The syringomatous tumour is exceptional. In places, it forms rudimentary sweat ducts and is considered to have an intermediate malignancy; its resection must be complete. Other tumours may also be observed in this site: leiomyoma, leiomyosarcoma, benign cutaneous lymphocytoma, basal cell carcinoma, naevoid areolar hyperkeratosis. They are exceptional except areolar neurofibromas in case of neurofibromatosis. Infectious dermatoses (viral warts, molluscum contagiosum, scabies) are accompanied by lesions in other sites. They same applied to the majority of inflammatory dermatoses such as eczema or Fox-Fordyce disease. Supernumerary nipples are situated on a line extending from the anterior part of the axillary crease to the medial part of the inguinal crease.

  18. 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.

  19. Smear of duodenal fluid aspirate

    MedlinePlus

    ... Management by Laboratory Methods . 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 64. Dupont HL. Approach to the ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 283. Fritsche TR, Pritt BS. ...

  20. Nipple preference and contests in suckling kittens of the domestic cat are unrelated to presumed nipple quality.

    PubMed

    Hudson, Robyn; Raihani, Gina; González, Daniel; Bautista, Amando; Distel, Hans

    2009-05-01

    We studied the development of suckling behavior and weight gain in 11 litters (52 kittens) of free-ranging domestic cats until postnatal day 28 just before the start of weaning. In six of these litters, we also recorded milk intake and contests for access to nipples. Already within 12 hr of birth kittens showed a preference for posterior nipples, and by postnatal day 3 each had developed a preference for particular nipples. In fact, 86% of kittens used one particular nipple most often, and even when the mother changed the side she lay on to nurse. Contests for access to nipples occurred throughout the study period at an average rate of one to two contests per kitten per hour of nursing. Contrary to suggestions in the literature that kittens compete for more productive nipples, we found no relation between kittens' use of particular nipples and their weight gain, milk intake, or involvement in contests during suckling. We suggest that kittens' preference for posterior nipples as well as their establishment of an individual "teat order" might function to optimize the number of nipples remaining productive across lactation, and to reduce energetically costly scrambles and potentially injurious contests among littermates.

  1. A possible function of the preference for hind nipples in prairie voles (Microtus ochrogaster).

    PubMed

    McGuire, B

    2001-12-01

    Prairie vole pups (Microtus ochrogaster) in laboratory cages prefer hind nipples. In this research, the author observed 8 litters of prairie voles in a seminatural environment to confirm the preference for hind nipples and to determine if young on hind nipples were groomed more frequently or dislodged less frequently than were young on other nipples. Prairie vole pups in seminatural environments preferred hind nipples; this preference was illustrated by the progressive use of more anterior nipples only as litter size increased and by the reluctance of pups to voluntarily release their hold on hind nipples. Maternal grooming of young did not vary with suckling location. Prairie vole young on hind nipples, however, were dislodged less frequently than were young on other nipples. Less frequent dislodgment from hind nipples during maternal movements may play a role in the preference for hind nipples in prairie voles.

  2. [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.

  3. Temporary Areolar Demarcation for Nipple-areola Complex Reconstruction

    PubMed Central

    Lelli, John L.; Rapp, Derek A.

    2015-01-01

    Summary: We have described a surgical method that enhances the visual aesthetic outcome of the areola periphery in nipple-areola complex reconstruction. This technique is performed immediately following closure of the nipple flap. The created areolar outline can aid the tattoo artist and may result in a more natural-appearing areola periphery than tattooing methods alone. PMID:26495203

  4. [Paget's disease of the nipple and differential diagnosis].

    PubMed

    Geffroy, D; Doutriaux-Dumoulins, I; Labbe-Devilliers, C; Meingan, P; Houdebine, S; Sagan, C; Dejode, M; Ricaud-Couprie, M

    2011-10-01

    Clinical evaluation of the nipple-areolar complex is a routine component of the breast screening examination. All persistent unilateral nipple lesion should be viewed with suspicion and Paget's disease of the nipple should be considered. The diagnosis is established by nipple scrape cytology. It is a rare variant of ductal carcinoma in situ. The breast imaging work-up should include a search for an underlying malignancy, present in over 80% of cases, not infrequently multifocal. Preoperative MRI is useful if breast conservative surgery is contemplated because of the high rate of occult malignancy on mammograms and ultrasound. Erosive adenomatosis of the nipple is a benign process that may simulate Paget's disease isolated to the nipple. Less frequently, pagetoid basal cell carcinoma, Bowen's disease and melanoma may be more difficult to differentiate clinically and share the unilateral and chronic features of Paget's disease. Biopsy is needed for diagnosis. Cutaneous extension of a breast cancer is rare but should be suspected in patients with retraction and/or fixed nipple. Eczema is characterized by the bilateral nature of the process, the absence of nipple deformity, the presence of flare-ups and the favorable response to local steroid therapy.

  5. Normal nipple position in term infants measured on breastfeeding ultrasound.

    PubMed

    Jacobs, Lorili Audrey; Dickinson, Jan E; Hart, Philip David; Doherty, Dorota A; Faulkner, Shani Jean

    2007-02-01

    Nipple position is believed to influence breastfeeding success. To investigate this belief, submental ultrasound images were obtained during breastfeeding of normal term infants. This study measured nipple to hard-soft palate distance (NHSPD) in 18 mother-infant pairs during the first and fourth weeks of life. Median NHSPD was 5 mm (interquartile: 4, 6 mm). There were no significant differences in median NHSPD between first, second, and fifth minutes of feeding (P = .675) or between week 1 and week 4 (P = .320). The nipple was not stationary during feeding, with mean nipple movement of 4.0 -/+ 1.3 mm. Further research is required with more infants to confirm the boundaries of normality for ultrasound measurements of nipple position during successful breastfeeding.

  6. The 4-flap Jester’s Hat Technique for Nipple Reduction

    PubMed Central

    Economides, James M.

    2017-01-01

    Summary: Macrothelia, or nipple hypertrophy, is a condition that may cause severe psychological distress to those who suffer from it. Although effective in their primary goal of reducing nipple diameter and projection, previously reported techniques in nipple reduction suffer from imperfect aesthetic outcomes with noticeable scarring patterns, anatomically anomalous shape, and a smoothing of the natural ruffles of the nipple. We propose a simple technique to nipple reduction that improves upon previous techniques and creates a more naturally appearing nipple. A 4-flap technique resembling a jester’s hat is described whereby suture lines are concealed within the central nipple to recreate the naturally ruffled appearance of a native nipple. Four patients have undergone this technique at a single institution with 100% patient satisfaction and no postoperative complications. Nipple sensation was maintained in all patients postoperatively. A 4-flap nipple reduction technique is a viable alternative to previously described techniques, which may offer more anatomically congruent results. PMID:28280674

  7. Outcomes of Nipple-Sparing Mastectomy: Role of Anatomic Measurements.

    PubMed

    Pairawan, Seyed S; Cody, Derek; Kim, Hahns; Hughes, M Katherine; Solomon, Naveenraj; Senthil, Maheswari; Garberoglio, Carlos; Lum, Sharon

    2016-10-01

    Nipple-sparing mastectomy (NSM) offers improved cosmesis for women undergoing mastectomy; however, there is increased risk for complications with this technique. We sought to determine if standard anatomic measurements could be used to predict complications of NSM. We performed a retrospective review of NSM for which anthropometric measurements of sternal notch to nipple distance, base width, and inframammary fold to nipple distance were available, and compared outcomes by anatomic measurements. We identified 102 cases of NSM with measurements available for study performed in 55 patients. Areola necrosis was associated with base width of greater than 15 cm (42.9% vs 10.9%, P = 0.02), infections were more likely with inframammary fold to nipple distance of more than 10 cm (29.2% vs 10.3%, P = 0.02), hematomas were more likely with sternal notch to nipple distance more than 30 cm (22.2% vs 4.3%, P = 0.03), and delayed wound healing was more likely with sternal notch to nipple distance of more than 25 cm (10.3% vs 1.6%, P = 0.03). There were no significant differences in nipple necrosis, skin flap necrosis, wound care requirements, or operative intervention based on anatomic measurement. Standard anatomic measurements are inconsistent predictors of outcome from NSM and should not be used alone to exclude attempts at NSM.

  8. Left Nipple Preferences in Infant Pan paniscus and P. troglodytes

    PubMed Central

    Hopkins, William D.; De Lathouwers, Mieke

    2007-01-01

    We investigated laterality in nipple preference in 16 mother-infant dyads, 8 bonobos, and 8 chimpanzees via an event sampling procedure in infants 5–55 mo of age. Both bonobo and chimpanzee infants preferred the left nipple, and the results were stable over time. Maternal age, experience, and rearing history did not influence laterality in offspring nipple preferences. We discuss the results in the context of the role of early mother-infant interactions on the development of laterality in primates. PMID:18185838

  9. Paget's Disease of Nipple in Male Breast with Cancer.

    PubMed

    Uthamalingam, Murali; Periyasamy, Karthikkumaran

    2016-02-01

    Carcinoma of the male breast accounts for less than 0.5% of all cases of breast cancer. However, Paget's disease of nipple in male is extremely rare. We report on a case of Paget's disease of nipple with breast cancer in a 51-year-old gentleman. He presented with a ulcerative lesion and lump in the left breast beneath the nipple-areolar region with single mobile ipsilateral central group of axillary nodes. Modified radical mastectomy was performed. On follow up, patient was doing well with no recurrence.

  10. Resolving breast cancer heterogeneity by searching reliable protein cancer biomarkers in the breast fluid secretome

    PubMed Central

    2013-01-01

    Background One of the major goals in cancer research is to find and evaluate the early presence of biomarkers in human fluids and tissues. To resolve the complex cell heterogeneity of a tumor mass, it will be useful to characterize the intricate biomolecular composition of tumor microenvironment (the so called cancer secretome), validating secreted proteins as early biomarkers of cancer initiation and progression. This approach is not broadly applicable because of the paucity of well validated and FDA-approved biomarkers and because most of the candidate biomarkers are mainly organ-specific rather than tumor-specific. For these reasons, there is an urgent need to identify and validate a panel of biomarker combinations for early detection of human tumors. This is especially important for breast cancer, the cancer spread most worldwide among women. It is well known that patients with early diagnosed breast cancer live longer, require less extensive treatment and fare better than patients with more aggressive and/or advanced disease. Results In the frame of searching breast cancer biomarkers (especially using nipple aspirate fluid mirroring breast microenvironment), studies have highlighted an optimal combination of well-known biomarkers: uPA + PAI-1 + TF. When individually investigated they did not show perfect accuracy in predicting the presence of breast cancer, whereas the triple combination has been demonstrated to be highly predictive of pre-cancer and/or cancerous conditions, approaching 97-100% accuracy. Conclusion Despite the heterogeneous composition of breast cancer and the difficulties to find specific breast cancer biomolecules, the noninvasive analysis of the nipple aspirate fluid secretome may significantly improve the discovery of promising biomarkers, helping also the differentiation among benign and invasive breast diseases, opening new frontiers in early oncoproteomics. PMID:23849048

  11. 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 ( ...

  12. Genetics Home Reference: scalp-ear-nipple syndrome

    MedlinePlus

    ... Facebook Share on Twitter Your Guide to Understanding Genetic Conditions Search MENU Toggle navigation Home Page Search ... Conditions Genes Chromosomes & mtDNA Resources Help Me Understand Genetics Home Health Conditions scalp-ear-nipple syndrome scalp- ...

  13. A brother and sister with breast cancer, BRCA2 mutations and bilateral supernumerary nipples

    PubMed Central

    Coad, Ryan

    2017-01-01

    We describe a 54-year-old man with breast cancer and a BRCA2 mutation who was also found to have bilateral supernumerary nipples. His sister, also with a BRCA2 mutation, was diagnosed with breast cancer in her late forties; she also had bilateral supernumerary nipples. We address the significance of breast cancer arising in breast tissue underlying supernumerary nipples; the known association between supernumerary nipples and genitourinary malignancies/malformations and the possible link between BRCA2 and supernumerary nipple development. We believe that this is the first described case of the latter. We then outline an approach to further management for supernumerary nipple cases. PMID:28361071

  14. Detection method of visible and invisible nipples on digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Chae, Seung-Hoon; Jeong, Ji-Wook; Lee, Sooyeul; Chae, Eun Young; Kim, Hak Hee; Choi, Young-Wook

    2015-03-01

    Digital Breast Tomosynthesis(DBT) with 3D breast image can improve detection sensitivity of breast cancer more than 2D mammogram on dense breast. The nipple location information is needed to analyze DBT. The nipple location is invaluable information in registration and as a reference point for classifying mass or micro-calcification clusters. Since there are visible nipple and invisible nipple in 2D mammogram or DBT, the nipple detection of breast must be possible to detect visible and invisible nipple of breast. The detection method of visible nipple using shape information of nipple is simple and highly efficient. However, it is difficult to detect invisible nipple because it doesn't have prominent shape. Mammary glands in breast connect nipple, anatomically. The nipple location is detected through analyzing location of mammary glands in breast. In this paper, therefore, we propose a method to detect the nipple on a breast, which has a visible or invisible nipple using changes of breast area and mammary glands, respectively. The result shows that our proposed method has average error of 2.54+/-1.47mm.

  15. Nipple-sparing mastectomy in modern breast practice.

    PubMed

    Murthy, Vijayashree; Chamberlain, Ronald S

    2013-01-01

    Breast cancer management has evolved from the conventional radical Halsted to a fully integrated multidisciplinary approach. Nipple sparing mastectomy (NSM) is an innovative technique that preserves native breast envelope without mutilation of nipple-areola complex (NAC), thus providing a reasonable alternative for early cancers without NAC involvement and prophylactic high risk patients and avoids multiple surgical procedures required for reconstruction. This article aims to critically review indications, intra-operative protocols, radiotherapy planning and limitations of NSM. Patient selection should be based on study of breast duct anatomy by Magnetic Resonance Imaging, mammographic tumor-nipple distance and obligatory intra-operative frozen section from retro-areolar tissue. Tumor size, axillary lymph node status, lymphovascular invasion and/or degree of intraductal component are factors used to include NSM candidates based on institutional practice. Given the heterogeneity of patients and lack of standardization of preoperative investigations, surgical technique and pathologic sampling of retro-areola tissue so far, mandates a multi-institutional prospective study to define and validate a role for NSM in invasive breast cancer and DCIS. Nipple necrosis is an important NSM complication which can be greatly reduced using alternative skin incisions. Even if the nipple survives, an insensate nipple and lack of sexual function is common and requires preoperative counseling and discussion. Finally the relation and timing of intra-operative versus adjuvant breast radiation and tailoring of dosage and delivery methods has not been fully explored. Although NSM reduces psychological trauma associated with nipple loss, the oncologic safety as well as functional and aesthetic outcomes needs additional investigation.

  16. Pathological evaluation of nipple-sparing mastectomies with emphasis on occult nipple involvement: the Weill-Cornell experience with 325 cases.

    PubMed

    Eisenberg, Rachel E K; Chan, Joanna S Y; Swistel, Alexander J; Hoda, Syed A

    2014-01-01

    Nipple-sparing mastectomy (NSM) is an increasingly utilized surgical option in managing breast carcinoma; however, data on malignant involvement of a separately submitted nipple margin are scant. Consecutive NSM, including those performed for therapeutic and prophylactic purposes, over a 4-year period (2007-2011), were studied. A separately submitted nipple margin was evaluated by permanent H&E preparations and via frozen section evaluation whenever requested. 325 consecutive NSM specimens, 208 (64%) therapeutic-NSM, and 117 (36%) prophylactic-NSM were studied. All nipples were clinically unremarkable. 86% (179/208) of nipple margins from therapeutic-NSM and 100% (117/117) from prophylactic-NSM showed no histopathologic abnormality. 14% (29/208) of nipple margins from therapeutic-NSM and no nipple margin from prophylactic-NSM showed malignancy. Frozen section evaluation was performed in 188/325 NSM (58%) with a sensitivity of 64% and specificity of 99%. Central tumor location and stage N2/N3 lymph node status were significantly associated with nipple margin positivity (χ(2) ≤ 0.05). Subsequent nipple resection was performed in 69% (20/29) of nipple margin-positive cases with residual malignancy found in 40% (8/20, including three cases of invasive carcinoma). In a mean follow-up of 33 months, one invasive carcinoma recurred in the "saved" nipple, 36 months after therapeutic-NSM. 14% (29/208) of nipple margins in therapeutic-NSM and no nipple margin (0/117) in prophylactic-NSM showed malignancy. Central tumor location and N2/N3 stage were significantly associated with nipple margin positivity (χ(2) ≤ 0.05).

  17. Syringocystadenoma papilliferum on the male nipple.

    PubMed

    Shindo, Masahisa; Yamada, Nanako; Yoshida, Yuichi; Yamamoto, Osamu; Morino, Shinichi

    2011-06-01

    Syringocystadenoma papilliferum is a rare benign adnexal tumor that most frequently arises from an organoid nevus on the head and neck. Occurrence of this tumor on the male breast is extremely rare. A 74-year-old Japanese man presented with a nodule on his left nipple. Histopathological findings were typical for syringocystadenoma papilliferum. Ultrastructurally, constituent epithelial cells of the tumor were divided into three types. We focused on one cell type, undifferentiated clear cells, which have been suggested to be pluripotent cells bearing stem cell nature in syringocystadenoma papilliferum. Immunohistochemically, the tumor cells were negative for cytokeratin 15, which is known as a relatively specific marker for multipotent stem cells in the follicular bulge. We speculated that the clear cells are slightly differentiated toward apocrine rather than stem cells. We also ruled out the possibility of a relationship between the clear cells and Toker cells, which have a clear cytoplasm and are present in the areola region. Dermoscopic examination revealed amorphous milky white areas that corresponded to the pathological findings of luminal deposition of the tumor.

  18. 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.

  19. A Review of Anatomy, Physiology, and Benign Pathology of the Nipple.

    PubMed

    Stone, Kimberly; Wheeler, Amanda

    2015-10-01

    The nipple and areola are pigmented areas of modified skin that connect with the underlying gland of the breast via ducts. The fairly common congenital anomalies of the nipple include inversion, clefts, and supernumerary nipples. The anatomy of the nipple areolar complex is discussed as a foundation to review anatomical variants, and the physiologic development of the nipple, including changes in puberty and pregnancy, as well as the basis of normal physiologic discharge, are addressed. Skin conditions affecting the nipple include eczema, which, while similar to eczema occurring elsewhere on the body, poses unique aspects in terms of diagnosis and treatment. This article concludes with discussion on the benign abnormalities that develop within the nipple, including intraductal papilloma and nipple adenoma.

  20. Primary male neuroendocrine adenocarcinoma involving the nipple simulating Merkel cell carcinoma - a diagnostic pitfall.

    PubMed

    Mecca, Patricia; Busam, Klaus

    2008-02-01

    Male breast cancer is a rare entity accounting for < 1% of all breast cancer cases in the United States, but with a rate that has been rising over the last 25 years. Nipple skin/subcutaneous tumors in men are even rarer. Likewise, true neuroendocrine carcinoma of the breast, defined as > 50% of tumor cells staining for either chromogranin or synaptophysin, is not a common entity, usually occurring in older women. We present the case of a 70-year-old man with a slowly growing nipple mass that had enlarged over the previous 1.5 years. The histology consisted of nests, trabeculae and sheets of basaloid cells with rare abortive gland formation and a pushing edge. The case was originally misdiagnosed as a Merkel cell carcinoma, based largely on histologic morphology. Strong staining for synaptophysin (in greater than 50% of cells), CD56, keratins AE1 : AE3 and Cam 5.2, as well as estrogen receptor and progesterone receptor was noted. Myoepithelial cells within in situ areas were identified using stains for calponin and 4A4, supporting a primary mammary duct origin. Additionally, a substantial portion of cells stained for Gross Cystic Disease Fluid Protein-15 (GCDFP-15), confirming some overlap with sweat duct differentiation. To the best of our knowledge, although reported in the male breast, no case of primary nipple neuroendocrine carcinoma in a male patient has been reported in the literature. The gender of the patient and association with the skin of the chest wall probably contributed to the original misdiagnosis of Merkel cell carcinoma in this patient.

  1. Positive effect of HPA lanolin versus expressed breastmilk on painful and damaged nipples during lactation.

    PubMed

    Abou-Dakn, M; Fluhr, J W; Gensch, M; Wöckel, A

    2011-01-01

    Painful and/or damaged nipples associated with breastfeeding are common and represent a challenge for both the persons experiencing nipple pain and/or trauma and for those providing treatment. However, evidence-based data has been insufficient to demonstrably minimize these common reasons for failure to initiate or continue successful breastfeeding. The aim of this study was to evaluate the efficacy of specific-grade highly purified anhydrous (HPA) lanolin versus expressed breastmilk (EBM) for the treatment of painful and damaged nipples associated with breastfeeding in a prospective controlled clinical trial evaluating 84 lactating mothers. Nipple trauma and healing rates were rated by the Nipple Trauma Score. Nipple pain intensity was assessed on a visual analog scale. Outcome parameters were in favor of the HPA lanolin group, reaching statistical significance for healing rates, nipple trauma and nipple pain. In our study, we found HPA lanolin more effective than EBM, inducing faster healing of nipple trauma (absolute risk reduction of 0.43) and reducing nipple pain (absolute risk reduction of 0.61 on day 3). We concluded that HPA lanolin, combined with breastfeeding education, was more effective than EBM, combined with breastfeeding education, in reducing nipple pain and promoting healing of nipple trauma.

  2. Unilateral Nipple Eczema in Children: Report of Five Cases and Literature Review.

    PubMed

    Jenkins, David; Cooper, Susan M; McPherson, Tess

    2015-01-01

    Bilateral nipple eczema on the background of atopy is not an uncommon problem and is a minor criterion in some diagnostic systems for atopic dermatitis (AD), but unilateral atopic nipple eczema is underrecognized and often causes clinical concern. We present the first case series of children with unilateral atopic nipple eczema and discuss the clinical aspects of this unusual distribution.

  3. A Novel Technique of Preserving Internal Mammary Artery Perforators in Nipple Sparing Breast Reconstruction

    PubMed Central

    Swistel, Alexander; Small, Kevin; Dent, Briar; Cohen, Oriana; Devgan, Lara

    2014-01-01

    Summary: As nipple-sparing mastectomy with implant-based reconstruction has increased, attention must be paid to the viability of the nipple-areolar complex. This article describes the use of preoperative Doppler ultrasound to identify the internal mammary artery perforators. Preserving the internal mammary artery improves vascular supply to the nipple-areolar complex. PMID:25426381

  4. 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)

  5. 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…

  6. Computerized nipple identification for multiple image analysis in computer-aided diagnosis

    SciTech Connect

    Zhou Chuan; Chan Heangping; Paramagul, Chintana; Roubidoux, Marilyn A.; Sahiner, Berkman; Hadjiiski, Labomir M.; Petrick, Nicholas

    2004-10-01

    Correlation of information from multiple-view mammograms (e.g., MLO and CC views, bilateral views, or current and prior mammograms) can improve the performance of breast cancer diagnosis by radiologists or by computer. The nipple is a reliable and stable landmark on mammograms for the registration of multiple mammograms. However, accurate identification of nipple location on mammograms is challenging because of the variations in image quality and in the nipple projections, resulting in some nipples being nearly invisible on the mammograms. In this study, we developed a computerized method to automatically identify the nipple location on digitized mammograms. First, the breast boundary was obtained using a gradient-based boundary tracking algorithm, and then the gray level profiles along the inside and outside of the boundary were identified. A geometric convergence analysis was used to limit the nipple search to a region of the breast boundary. A two-stage nipple detection method was developed to identify the nipple location using the gray level information around the nipple, the geometric characteristics of nipple shapes, and the texture features of glandular tissue or ducts which converge toward the nipple. At the first stage, a rule-based method was designed to identify the nipple location by detecting significant changes of intensity along the gray level profiles inside and outside the breast boundary and the changes in the boundary direction. At the second stage, a texture orientation-field analysis was developed to estimate the nipple location based on the convergence of the texture pattern of glandular tissue or ducts towards the nipple. The nipple location was finally determined from the detected nipple candidates by a rule-based confidence analysis. In this study, 377 and 367 randomly selected digitized mammograms were used for training and testing the nipple detection algorithm, respectively. Two experienced radiologists identified the nipple locations

  7. Atopic dermatitis exclusively localized on nipples and areolas.

    PubMed

    Amato, Laura; Berti, Samantha; Chiarini, Caterina; Fabbri, Paolo

    2005-01-01

    We present an 11-year-old girl, with celiac disease, and a 9- month history of itchy and erythemato-edematous lesions with vesicles and exudation on her nipples and areolas. No other lesions or signs of scratching were present on her face or folds. She had no specific lesions of atopic dermatitis in typical sites nor in other body surface during her life. Patch tests showed a positive reaction to nickel and thimerosal that was not significantly related to the clinical appearance. This presentation documents the clinical relevance of atopic dermatitis minor diagnostic criteria. We discuss the importance of nipple eczema in AD and its differential diagnosis.

  8. Human breast biomonitoring and environmental chemicals: use of breast tissues and fluids in breast cancer etiologic research.

    PubMed

    LaKind, Judy S; Wilkins, Amy A; Bates, Michael N

    2007-09-01

    Extensive research indicates that the etiology of breast cancer is complex and multifactorial and may include environmental risk factors. Breast cancer etiology and exposure to xenobiotic compounds, diet, electromagnetic fields, and lifestyle have been the subject of numerous scientific inquiries, but research has yielded inconsistent results. Biomonitoring has been used to explore associations between breast cancer and levels of environmental chemicals in the breast. Research using breast tissues and fluids to cast light on the etiology of breast cancer is, for the most part, predicated on the assumption that the tissue or fluid samples either contain measurable traces of the environmental agent(s) associated with the cancer or that they retain biological changes that are biomarkers of such exposure or precursors of carcinogenic effect. In this paper, we review breast cancer etiology research utilizing breast biomonitoring. We first provide a brief synopsis of the current state of understanding of associations between exposure to environmental chemicals and breast cancer etiology. We then describe the published breast cancer research on tissues and fluids, which have been used for biomonitoring, specifically human milk and its components, malignant and benign breast tissue, nipple aspirate fluid (NAF) and breast cyst fluid. We conclude with a discussion on recommendations for biomonitoring of breast tissues and fluids in future breast cancer etiology research. Both human milk and NAF fluids, and the cells contained therein, hold promise for future biomonitoring research into breast cancer etiology, but must be conducted with carefully delineated hypotheses and a scientifically supportable epidemiological approach.

  9. Half Z-plasty, band release, and cavity filling for correction of inverted nipple.

    PubMed

    Hwang, Kun; Kim, Dong H

    2013-04-01

    The aim of this study was to describe another technique using a half Z-plasty, band release, and cavity filling to correct challenging inverted nipples. In five nipples of three adult Korean female cadavers, the tensile strength of the lactiferous duct was measured. A half Z-plasty was designed below the nipple on the areola using a vertical long axis of 30°, 45°, and 60° for one flap and another of 90° with 15 silicone-made nipple protectors. In six inverted nipples of three women, a half Z-plasty, band release, and cavity filling was performed. The mean breaking strength of each lactiferous was 4.7 ± 2.3 N. The sum of the forces to break three ducts was 14.1 ± 6.5 N. The mean angle change of the nipple projection of the silicone model was 7.2° ± 0.3°, 9.4° ± 0.5°, and 13.4° ± 0.5°, respectively, in the 30°, 45°, and 60° flap. In all three nipples operated on, sufficient eversion of the nipples was satisfactorily obtained postoperatively. Releasing the inverted nipple was performed by severing the underlying tight fibrous tissue bands and canaliculi. The support of the nipple was maintained by propping and obliterating the dead space. This procedure was carried out through a half Z-plasty incision below the nipple on the areola.

  10. Wolf nipple measurements as indices of age and breeding status

    USGS Publications Warehouse

    Mech, L.D.; Meier, T.J.; Seal, U.S.

    1993-01-01

    We measured nipple sizes of 29 captive wolves (Canis lupus), of known breeding histories, throughout the year and tested distinctions among various known breeding statuses of 20 wild wolves examined in northeastern Minnesota from May through September. For ca. 8 mo of the year only breeders and nonbreeders can be classified. Distinctions between current and former breeders were not reliable.

  11. Clinical significance of recent inversion of the nipple: a reappraisal.

    PubMed Central

    Neville, E M; Freeman, A H; Adiseshiah, M

    1982-01-01

    In a retrospective survey of 63 cases of inverted nipple, unaccompanied by a palpable mass, 3 histologically confirmed carcinomas were found on combined clinical and mammographic examination - an incidence of 5%. No carcinoma was found in those patients under 50 years of age. The problem of the false negative mammogram is discussed. PMID:7069669

  12. Proliferating activity in paget disease of the nipple.

    PubMed

    Noel, Jean-Christophe; Fayt, Isabelle; Buxant, Frederic

    2010-03-01

    Paget disease of the nipple is a rare disease characterized by the presence of malignant glandular cells within the squamous epithelium of the nipple. The most common hypothesis to explain the development of Paget disease is an intraepithelial epidermotropic migration of malignant epithelial cells originating from an underlying intraductal carcinoma. If the immunohistochemical properties of the Paget cells in the nipple have been extensively studied, their proliferating characteristics remain paradoxically poorly studied. In the present study we have investigated the proliferating activity of Paget cells in the nipple by using double stain immunohistochemistry with both Ki67 (a protein which is expressed in all active parts of the cell cycle) and cytokeratin 7 (a highly sensitive marker of Paget cells). Ten cases of Paget disease and in their associated intraductal carcinomas (n = 10) and/or invasive carcinomas (n = 4) were tested. The mean Ki67 index was in Paget disease (26% +/- 10), in intraductal carcinomas (23% +/- 8) and/or in invasive carcinomas (20% +/- 8) (p > 0,05). This is the first report to convincingly demonstrate by specific double stain immunohistochemistry that Paget disease and underlying intraductal carcinomas share a close proliferating activity.

  13. Correction of inverted nipple: an alternative method using two triangular areolar dermal flaps.

    PubMed

    Kim, Dae Young; Jeong, Eui Cheol; Eo, Su Rak; Kim, Kwang Seog; Lee, Sam Yong; Cho, Bek Hyun

    2003-12-01

    Inverted nipple, which is defined as a nipple located on a plane lower than the areola, presents both functional and cosmetic problems. It is a source of repeated irritation and inflammation, and interferes with nursing. In addition, its abnormal appearance may cause psychological distress. Inverted nipples are congenital or acquired, and are classified as the umbilicated and invaginated types or divided into 3 groups (grades 1, 2, and 3). With consideration of its underlying pathophysiologic components and severity, various surgical procedures have been proposed. For correcting the inverted nipple, the authors introduce an alternative, simple method using 2 triangular areolar dermal flaps. Compared with other methods using triangular areolar dermal flaps, each triangle is approximately 1 mm shorter than the diameter of the nipple, and the deepithelialized areolar dermal flaps are lodged at the slit in the bundle of the lactiferous ducts in the grade 2 inverted nipple. From August 2000 to December 2001, 11 patients (16 nipples) were treated. Five patients had bilateral inverted nipples. Patient age at operation ranged from 18 to 31 years (mean age, 27 years). All nipples were congenital and they had no previous operation. Thirteen nipples were grade 2 and 3 were grade 3 according to the classification of inverted nipple by Han and Hong. The mean follow-up period was 8.7 months (range, 3-12 months). Follow-up examinations revealed no evidence of recurrence of inversion. There was no complication associated with surgery, such as infection, hematoma, permanent sensory disturbance, or nipple necrosis. The resulting scars were minimal. All patients were satisfied with their results. The authors conclude that their procedure is reliable, preserves the lactiferous ducts in grade 2 inverted nipple, requires no special postoperative care, and leaves minimal scars and no recurrence of inversion. This technique can be applied to any type of inverted nipple as a primary

  14. 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 ...

  15. Persistent Nipple Pain in Breastfeeding Mothers Associated with Abnormal Infant Tongue Movement

    PubMed Central

    McClellan, Holly L.; Kent, Jacqueline C.; Hepworth, Anna R.; Hartmann, Peter E.; Geddes, Donna T.

    2015-01-01

    Background: Infants of breastfeeding mothers with persistent nipple pain have been shown to apply stronger vacuums to the breast and transfer less milk during one monitored feed. This may be associated with differences in the movement of the tongue. The aim was to analyse the intra-oral nipple shape and movement of the tongue of infants of mothers with and without nipple pain. Methods: Breastfeeding infants of mothers with or without nipple pain were monitored using ultrasound and intra-oral vacuum during one breastfeed. From cine clips of the ultrasound scans measurements were made of the depth of the intra-oral space between the hard-soft palate junction (HSPJ) and the mid-tongue; the distance of the tip of the nipple to the HSPJ; and nipple diameters from the tip to the base. Results: During nutritive sucking, tongue movements of infants of mothers with nipple pain resulted in a smaller intra-oral space (p = 0.040) and restricted nipple expansion compared to controls (p < 0.012). Stronger baseline and peak vacuums compared to controls were confirmed (p = 0.002). Conclusion: In these mothers, nipple pain was associated with restricted infant tongue movement. Ultrasound may complement measurement of intra-oral vacuum in monitoring treatment strategies in breastfeeding women experiencing nipple pain. PMID:26404342

  16. The role of breast ductoscopy in evaluation of nipple discharge: a chinese experience of 419 patients.

    PubMed

    Yang, Xiaoqin; Li, Hongjiang; Gou, Juxiang; Tan, Qiuwen; Wang, Liping; Lin, Xiaoyan; Feng, Xiaojuan; Jiang, Yixue; Zhang, Shu; Lv, Qing

    2014-01-01

    The aim of this study is to report our experience with ductoscopic evaluation for screening patients with nipple discharge and evaluate any potential indications and benefits of ductoscopy. From January 2010 to December 2012, 419 female patients with nipple discharge were enrolled in this study. All patients involved in this study showed no mass in ultrasound and mammography. Data concerning age, clinical characteristics of nipple discharge, nipple discharge cytology, ductoscopic and postsurgical diagnosis, and complications were statistically analyzed. Ductoscopy examinations were completed in 405 patients (96.66%). For these 405 patients, there were 519 ductoscopic investigations. 112 (27.65%) patients were found to have intraductal papillary lesions of which 62 were operated in our hospital. Postsurgical diagnosis showed 8 (12.9%) malignancy including 6 DCIS and 2 invasive ductal carcinomas. All of the 8 patients meet at least two criteria of pathologic nipple discharge (single duct, spontaneous, bloody nipple discharge). The other patients with nonpapillary lesions are still under surveillance. By univariate analysis, patients with unilateral, single duct, spontaneous and bloody nipple discharge were more likely to have intraductal papillary lesions. By multivariate analysis, unilateral, spontaneous, and bloody nipple discharge showed statistically significant correlations with intraductal papillary lesions revealed by ductoscopy. Ductoscopy is a safe and efficient investigation in preoperative screening of the patients with nipple discharge. Clinical characteristics have predictive value in selection of patients for ductoscopical investigation. Patients with clinical characteristics of unilateral, spontaneous, and bloody nipple discharge were more likely to have intraductal papillary lesions revealed by ductoscopy.

  17. Crystal identification of synovial fluid aspiration by polarized light microscopy. An online test suggesting that our traditional rheumatologic competence needs renewed attention and training.

    PubMed

    Berendsen, D; Neogi, T; Taylor, W J; Dalbeth, N; Jansen, T L

    2017-03-01

    Testing a reading exercise for identification of several typical crystal such as the negatively birefringent needle-shaped crystals that are under polarized light microscopy is the gold standard for diagnosing gout. The objective of this study was to assess current performance of crystal identification by professionals involved in examining synovial fluid in routine care. Rheumatologists, trainees, lab technicians, and other physicians with an interest in crystal arthritis completed an online test. The test consisted of 30 images: 8 monosodium urate (MSU) crystals, 5 calcium pyrophosphate (CPP), 4 cholesterol, 2 depot methylprednisolone, 2 calcium oxalate, 2 rice bodies, 1 hydroxyapatite, 1 liquid lipid, 1 fibrin, 1 Charcot-Leyden, and 5 different artifacts. Of the 22 non-MSU slides, a subset of 8 was pre-designated that were thought to be clinically important to be identified as non-MSU. The primary outcome was defined as the correct identification of all eight MSU slides plus the identification of all eight pre-defined non-MSU slides as non-MSU. The online test was completed by 110 participants. The primary outcome was achieved by 39%. Correct identification of all MSU images was achieved by 81%, correct identification of all 8 pre-defined non-MSU, CPP images, and all 22 non-MSU images as non-MSU by 68, 68, and 23%, respectively. MSU crystals were well identified, but incorrect identification of non-MSU crystals occurred frequently. This study suggests that there is room for improvement regarding crystal identification of particularly CPP and other non-MSU crystals even in this highly motivated group.

  18. A Revision Restoring Projection after Nipple Reconstruction by Burying Four Triangular Dermal Flaps

    PubMed Central

    Kim, Ji Hun

    2016-01-01

    Background Numerous techniques have been used to achieve long-term projection of the nipple following nipple-areola reconstruction. However, the reconstructed nipple loses projection over time. We describe a technique that uses local flaps to improve the lost projection of reconstructed nipples. Methods Between November 2013 and March 2015, nine patients (11 nipples) underwent revisional nipple reconstruction for lost projection. Only C–H nipple reconstructions were included in this study. The medical history of each patient was reviewed and photographs were taken in front and lateral views. All patients attended routine follow-up visits. Deepithelialized triangular flaps were made on all four sides of the nipple and buried in the opposite corners in order to augment the volume of the nipple. Anchoring sutures were used to attach each triangular flap on the side opposite their point of origin, and the resulting defects were closed directly. Results This procedure was used successfully in nine patients (11 nipples). Adequate projection was achieved in all patients and no complications occurred. The average nipple height was 3 mm before operation, 7 mm one day after operation, 5 mm at the six-month follow-up, and 5 mm at the 12-month follow-up. The average nipple-areolar angle was 164° before the operation, 111° one day after the operation, 130° at the six-month follow-up, and 133° at the 12-month follow-up. Conclusions The method described provides a solution to the loss of projection in reconstructed nipples. We recommend this technique because it leads to better projection, greater volume, and a more natural shape. PMID:27462566

  19. The nipple-areola complex epidermis: a prospective systematic study in adult autopsies.

    PubMed

    Val-Bernal, José Fernando; Diego, Cristina; Rodriguez-Villar, Diana; Garijo, María Francisca

    2010-12-01

    The prevalence of different types of clear cells and of the mite Demodex in the nipple-areola complex of adult autopsies of both sexes not suffering from breast cancer was studied in a total of 140 nipples. The epidermis of the nipple-areola complex shows squamous cells and 3 types of clear cells: Toker cells, pagetoid dyskeratosis cells, and signet ring-like cells. Toker cells were identified by standard light microscopy in 13 of 140 nipples (9.3%). Reactivity of these cells for CK7 was observed in 35 nipples (25%). They are derived from the lactiferous duct epithelium. Pagetoid dyskeratosis cells were identified in 56 of 140 nipples (40%). In 12 nipples, these cells were conspicuous (8.6%). It is suggested that the proliferation of these cells is induced by friction. Signet ring-like cells were identified in 71 nipples (50.7%). In 2 nipples, these cells were conspicuous (1.4%). They are a consequence of artefact related to formalin fixation. The prevalence of all these clear cells has no relationship with gender. Routine histopathological examination is usually enough to distinguish the characteristic features of the clear cells involving the nipple epidermis and permits differentiation of other entities with epidermal pale cells. Demodex mites were observed in 58 nipple-areola complexes (41.4%). They were more common in male nipple-areola complexes (P < 0.05). The prevalence of these mites was seen to remain steady along the years since the third decade. Demodex mites are common parasites of human nipple and are apparently of no pathologic significance.

  20. [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.

  1. 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.

  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. Minimally invasive correction of inverted nipples: a safe and simple technique for reliable, sustainable projection.

    PubMed

    Kolker, Adam R; Torina, Philip J

    2009-05-01

    Numerous techniques have been described for the correction of inverted nipples; their diversity supports the lack of a consistently reliable method. Dermoglandular flaps, open suture, and suction techniques have all been described to combat the "corrected" nipple's propensity to collapse. We present a minimally invasive parenchymal release and percutaneous suture technique that provides sustainable long-term correction of inverted nipples. Thirty-one patients with 58 inverted nipples were treated. The technique, performed under local anesthesia, employs lysis of the foreshortened subareolar fibro-ductal tissue to achieve resting eversion of the nipple using an 18-gauge needle. Through the same needle-access site, a purse-string suture is then placed, exiting the areolar skin and re-entering through the same stitch point every 3 to 5 mm around the circumference of the new nipple-base. An absorbable suture closes the access site over the knot, and 2 crossed absorbable mattress sutures are placed beneath the nipple to complete the correction. Of 27 patients with bilateral and 4 with unilateral, nipple inversion, durable correction was achieved in 1 procedure in 45 of 58 nipples (78%). There were 13 recurrences, of which 11 (19%) were successfully treated under local anesthesia with a second purse-string suture, and 2 (3%) required a third procedure under local anesthesia. There were no late reinversions. There were no cases of infection, nipple ischemia, or other complications. Occasional recurrences are corrected very simply under local anesthesia. Percutaneous release of nipple inversion followed by purse-string suture support performed through "needle-only" access points is a simple, safe, and reliable technique, and should be considered for the correction of inverted nipples.

  4. High incidence of supernumerary nipples and twins in formosan macaques (Macaca cyclopis) at Mt. Longevity, Taiwan.

    PubMed

    Hsu, M J; Moore, J; Lin, J F; Agoramoorthy, G

    2000-12-01

    A population of Formosan macaques at Mt. Longevity exhibits an unusually high incidence of supernumerary nipples (polythelia: between 1-6 accessory nipples and/or areolae on 33% of adults), as well as a high rate of twinning (about 1% of births). The coexistence of these unusual traits suggests a connection, which is further supported by a tendency for mothers of twins to have accessory nipples and for twins to be born in troops with high incidence of polythelia.

  5. Basal cell carcinoma of the nipple - an unusual location in a male patient.

    PubMed

    Avci, Oktay; Pabuççuoğlu, Uğur; Koçdor, M Ali; Unlü, Mehtat; Akin, Ciler; Soyal, Cüneyt; Canda, Tülay

    2008-02-01

    Although basal cell carcinoma is extremely common, it only rarely occurs on the nipple. Men are affected more often than women. Basal cell carcinoma of the nipple-areola complex may be more aggressive as metastases to regional lymph nodes have been reported. We report a basal cell carcinoma of the nipple with features of a fibroepithelioma of Pinkus in a man and review the literature.

  6. 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.

  7. 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 ...

  8. 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…

  9. 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.…

  10. 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 ...

  11. 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 ...

  12. Nipple Reconstruction Using the C-V Flap Technique: Long-Term Outcomes and Patient Satisfaction

    PubMed Central

    Jalini, Lona; Lund, Jonathan; Kurup, Vijay

    2017-01-01

    BACKGROUND Nipple creation using the C-V flap technique is often the final step in breast reconstruction. The aim of this study was to subjectively and objectively assess the cosmetic outcomes and satisfaction of patients undergoing C-V flap nipple reconstruction. METHODS Subjective assessments of patient satisfaction with the neo-nipple were recorded by visual analogue scoring (VAS; 0-10). Objective measurements were performed using a calliper to measure nipple projection relative to the native breast. Descriptive data analysis was performed with differences in projection assessed with the Mann-Whitney test and mean and median VAS scores (with inter-quartile ranges; IQR) calculated to describe satisfaction. RESULTS Thirty-three C-V flap nipple reconstructions were performed. 87.9% received latissimus dorsi (LD) reconstructions with implants and 12.1% had transverse rectus abdominis muscle (TRAM) reconstructions. The median projection of reconstructed nipples was 4.7 mm (range 4-10.2 mm) at 4.6 years mean follow-up, which was not significantly different from the contralateral nipple (p = 0.34). Patient satisfaction was 9 (IQR: 8-10) with shape, 9 (IQR: 7.5-10) with projection, 5 (IQR: 2-9.6) with sensation, and 8.5 (IQR: 6-9.5) with symmetry. Median overall satisfaction was 9 (IQR: 8-10). Three patients had complete nipple loss, of whom two had undergone nipple piercing post procedure and none had received radiotherapy. CONCLUSION C-V flap nipple reconstructions provide a simple and reliable method to reconstruct the nipple that enhances confidence and perception of body image. Satisfaction was high with long-term outcomes in terms of projection equivalent to the contralateral breast. PMID:28289616

  13. 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

  14. Milk Flow Rates From Bottle Nipples Used for Feeding Infants Who Are Hospitalized

    PubMed Central

    Park, Jinhee; Thoyre, Suzanne M.; Estrem, Hayley; Nix, W. Brant

    2015-01-01

    Purpose This study tested the milk flow rates and variability in flow of currently available nipples used for bottle-feeding infants who are hospitalized. Method Clinicians in 3 countries were surveyed regarding nipples available to them for feeding infants who are hospitalized. Twenty-nine nipple types were identified, and 10 nipples of each type were tested by measuring the amount of infant formula expressed in 1 min using a breast pump. Mean milk flow rate (mL/min) and coefficient of variation were used to compare nipples within brand and within category (i.e., Slow, Standard, Premature). Results Flow rates varied widely between nipples, ranging from 2.10 mL/min for the Enfamil Cross-Cut to 85.34 mL/min for the Dr. Brown's Y-Cut Standard Neck. Variability of flow rates among nipples of the same type ranged from a coefficient of variation of 0.05 for Dr. Brown's Level 1 Standard- and Wide-Neck to 0.42 for the Enfamil Cross-Cut. Mean coefficient of variation by brand ranged from 0.08 for Dr. Brown's to 0.36 for Bionix. Conclusions Milk flow is an easily manipulated variable that may contribute to the degree of physiologic instability experienced by infants who are medically fragile during oral feeding. This study provides clinicians with information to guide appropriate selection of bottle nipples for feeding infants who are hospitalized. PMID:26172340

  15. The Use of a Hyaluronic Acid–Carboxymethylcellulose Membrane as an Adhesion Barrier during Nipple Delay before Nipple-preserving Mastectomy

    PubMed Central

    Jablonka, Eric M.; Harmaty, Marco A.; Torina, Philip J.

    2016-01-01

    Summary: The desire for nipple-preserving mastectomies has increased over the past decade as studies have proven that the procedure has comparable oncologic risk as a traditional mastectomy in both therapeutic and prophylactic cases. Partial or complete nipple necrosis is a well-known complication of this procedure with rates in the literature ranging between 1% and 9%. In high-risk patients, surgeons are performing a delay procedure before the mastectomy to help improve nipple vascularity and decrease necrosis rates. We present a technique of using a short-lasting bioresorbable hyaluronate–carboxymethylcellulose membrane (Seprafilm; Genzyme, Cambridge, Mass.) during the delay procedure as an interpositional sheet, which prevents adhesion of the anterior breast skin from the underlying gland to both block revascularization to improve nipple perfusion and prevent the need for redissection of the previously created plane during the final mastectomy. PMID:28293518

  16. Does the aquatic invertebrate nipple array prevent bubble adhesion? An experiment using nanopillar sheets

    PubMed Central

    Hirose, Euichi; Mayama, Hiroyuki; Miyauchi, Akihiro

    2013-01-01

    The nipple array is a submicrometre-scale structure found on the cuticle surfaces of various invertebrate taxa. Corneal nipples are an antiglare surface in nocturnal insects, but the functional significance of the nipple array has not been experimentally investigated for aquatic organisms. Using nanopillar sheets as a mimetic model of the nipple array, we demonstrated that significantly fewer bubbles adhered to the nanopillar surface versus a flat surface when the sheets were hydrophilic. Many more bubbles adhered to the hydrophobic surface than the hydrophilic surfaces. Bubbles on the body surface may cause buoyancy problems, movement interference and water flow occlusion. Here, bubble repellence is proposed as a function of the hydrophilic nipple array in aquatic invertebrates and its properties are considered based on bubble adhesion energy. PMID:23985347

  17. Studying nanostructured nipple arrays of moth eye facets helps to design better thin film solar cells.

    PubMed

    Dewan, Rahul; Fischer, Stefan; Meyer-Rochow, V Benno; Özdemir, Yasemin; Hamraz, Saeed; Knipp, Dietmar

    2012-03-01

    Nipples on the surface of moth eye facets exhibit almost perfect broadband anti-reflection properties. We have studied the facet surface micro-protuberances, known as corneal nipples, of the chestnut leafminer moth Cameraria ohridella by atomic force microscopy, and simulated the optics of the nipple arrays by three-dimensional electromagnetic simulation. The influence of the dimensions and shapes of the nipples on the optics was studied. In particular, the shape of the nipples has a major influence on the anti-reflection properties. Furthermore, we transferred the structure of the almost perfect broadband anti-reflection coatings to amorphous silicon thin film solar cells. The coating that imitates the moth-eye array allows for an increase of the short circuit current and conversion efficiency of more than 40%.

  18. Validation of nipple diameter and tongue movement measurements with B-mode ultrasound during breastfeeding.

    PubMed

    McClellan, Holly L; Sakalidis, Vanessa S; Hepworth, Anna R; Hartmann, Peter E; Geddes, Donna T

    2010-11-01

    Infant feeding problems are extremely common during breastfeeding establishment. To objectively assess infant sucking, consistent methods to analyze ultrasound images of the infant's oral cavity are required. We developed and assessed the reliability of an extensive ultrasound measurement protocol by measuring nipple diameter and placement. Midline submental ultrasound scans of 30 term breastfed infants were analyzed by two raters. Nipple diameter, nipple hard-soft palate junction distance and tongue hard-soft palate junction distance were measured on two frames: tongue-up and tongue-down. No evidence of measurement bias was found between raters and inter-rater agreement and consistency scores were high. The changes in nipple diameter and placement were consistent with previous descriptions; however, the diameter of the nipple was not consistent in either position. This method provides objective measurements representative of tongue movement, and further investigation is required to ensure usefulness when examining sucking difficulties.

  19. The nipple: a simple intersection of mammary gland and integument, but focal point of organ function.

    PubMed

    Koyama, Sachiko; Wu, Hsin-Jung; Easwaran, Teresa; Thopady, Sunil; Foley, John

    2013-06-01

    Having glands that secrete milk to nourish neonatal offspring characterizes all mammals. We provide a brief overview of the development and anatomy of nipples and mammary glands in monotremes, marsupials, and marine mammals, and focus on the nipples and mammary glands in terrestrial eutherian species. We first classify eutherians into three groups: the altricial, precocial, and arboreal types based on their rearing system. We then summarize the physiology of lactation and the cell biology of nipples with specific focus on comparing these in the mouse, cow, and human, which represent the three different groups. Finally we propose that the nipple is an example of specialized epidermis. As specialized epidermis, it is dependent the underlying stroma for development and maintenance in adult life. The development of the nipple and signaling pathways that regulate its formation are described.

  20. Post-operative Seroma Causing Spontaneous Nipple Discharge: Diagnosis by Galactography

    PubMed Central

    Ramirez-Hernandez, Ivan E.; Hardman, Rulon L.; Kirkpatrick, Aaron D.; Sutcliffe, Joseph

    2013-01-01

    Nipple discharge is a common breast complaint in women. Discharge in the post-operative patient for breast cancer is especially concerning, as these women are at higher risk for recurrent or new breast cancer. Galactography is a reliable method to evaluate nipple discharge, attempting to identify a mass that may cause the discharge within the duct of concern. We present two cases of women with spontaneous nipple discharge after lumpectomy for breast cancer. In both cases, evaluation with galactography demonstrated a post-operative seroma that communicated with a native breast duct, causing nipple discharge. This presentation of a post-operative seroma is important to recognize by breast surgeons and breast imagers. Galactography can play an important role in the work up of these patients, demonstrating etiology of the nipple discharge with greater confidence than other imaging modalities. PMID:23705053

  1. Galactography: the diagnostic procedure of choice for nipple discharge

    SciTech Connect

    Tabar, L.; Dean, P.B.; Pentek, Z.

    1983-10-01

    Galactogrpahy was performed in 204 women with a nipple discharge and the secretion confirmed histopathologically. All 116 intraductal tumors (papilloma, papillomatosis, carcinoma), which were associated with a serous or bloody discharge, were detected preoperatively. A palpable mass had little diagnostic significance, and exfoliative cytology was positive in only 11% (2/18) of the patients with carcinoma. The authors recommend that all patients with a spontaneous bloody or serous discharge from a single lactiferous orifice undergo galactography in addition to physical, cytological, and mammographic examination. Intraductal injection of methylene blue dye will demonstrate the affected duct system to the surgeon and can often make surgery less radical or even unnecessary.

  2. Ileal bladder substitute: antireflux nipple or afferent tubular segment?

    PubMed

    Studer, U E; Spiegel, T; Casanova, G A; Springer, J; Gerber, E; Ackermann, D K; Gurtner, F; Zingg, E J

    1991-01-01

    Spheroidal bladder substitutes made from double-folded ileal segments, similar to Goodwin's cup-patch technique, are devoid of major coordinated wall contractions. This, together with the reservoir's direct anastomosis to the membranous urethra, prevents major intraluminal pressure peaks and assures a residue-free voiding of sterile urine. In order to determine whether, under these conditions, an afferent tubular isoperistaltic ileal segment of 20-cm length protects the upper urinary tract as efficiently as an antireflux nipple, 60 male patients who were subjected to radical cystectomy were prospectively randomised to groups in which a bladder substitute was formed together with either of these 2 antireflux devices. An analysis of the results obtained in 20 patients from each group who could be followed for more than 1 year (median observation time 30 and 36 months) showed no differences between the groups in metabolic disturbances, kidney size, reservoir capacity, diurnal and nocturnal urinary continence, the incidence of urinary tract infection or episodes of acute pyelonephritis. Later than 1 year postoperatively, intravenous urograms of the renoureteral units of 25% of the patients with antireflux nipples showed persistent but generally slight dilatation of the upper urinary tracts. This observation was significantly more frequent than it was in patients with afferent tubular segments. Urodynamic and radiographic studies showed that the competence of the antireflux nipples was secured by the raised surrounding intravesical pressure. This, however, also resulted in a transient functional obstruction, and a gradual rise of the basal pressure in the upper urinary tracts was recorded. In patients with afferent ileal tubular segments, contrast medium could be forced upwards into the renal pelvis when the bladder substitutes were overfilled. However, despite raised intravesical pressures, peristalsis in the isoperistaltic afferent tubular segment gradually returned

  3. Nipple Pain, Damage, and Vasospasm in the First 8 Weeks Postpartum

    PubMed Central

    Amir, Lisa H.; Cullinane, Meabh; Donath, Susan M.

    2014-01-01

    Abstract Background: Nipple pain and damage are common in the early postpartum period and are associated with early cessation of breastfeeding and comorbidities such as depression, anxiety, and mastitis. The incidence of nipple vasospasm has not been reported previously. This article describes nipple pain and damage prospectively in first-time mothers and explores the relationship between method of birth and nipple pain and/or damage. Subjects and Methods: A prospective cohort of 360 primiparous women was recruited in Melbourne, Australia, in the interval 2009–2011, and after birth participants were followed up six times. The women completed a questionnaire about breastfeeding practices and problems at each time point. Pain scores were graphically represented using spaghetti plots to display each woman's experience of pain over the 8 weeks of the study. Results: After birth, before they were discharged home from hospital, 79% (250/317) of the women in this study reported nipple pain. Over the 8 weeks of the study 58% (198/336) of women reported nipple damage, and 23% (73/323) reported vasospasm. At 8 weeks postpartum 8% (27/340) of women continued to report nipple damage, and 20% (68/340) were still experiencing nipple pain. Ninety-four percent (320/340) of the women were breastfeeding at the end of the study, and there was no correlation between method of birth and nipple pain and/or damage. Conclusions: Nipple pain is a common problem for new mothers in Australia and often persists for several weeks. Further studies are needed to establish the most effective means of preventing and treating breastfeeding problems in the postnatal period. PMID:24380583

  4. 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

  5. Occurrence of supernumerary nipples in children with kidney and urinary tract malformations.

    PubMed

    Grotto, I; Browner-Elhanan, K; Mimouni, D; Varsano, I; Cohen, H A; Mimouni, M

    2001-01-01

    The reported data on the association of kidney and urinary tract malformations with supernumerary nipples are contradictory. We examined 200 children, ages 1 month-16 years, who were being followed because of recurrent urinary tract infection for supernumerary nipples. The patients were divided into two groups: those who were found to have urinary tract malformations on radiographic studies (n=92) and those who were not (n=108). All children were examined for any abnormal pigmentation along the milk line, and the entire body was examined for ectopic supernumerary nipples. Two of the children with proved urinary tract pathology and two of the children with no urinary tract pathology had supernumerary nipples. The odds ratio for having supernumerary nipples among the first group was 1.18 (95% CI: 0.084-16.53, p=0.627). Our results indicate no association between kidney and urinary tract malformations and supernumerary nipples. We believe the message to the practicing physician is that there is no need for radiographic or ultrasonographic investigation of the urinary tract in asymptomatic children found to have supernumerary nipples on routine physical examination.

  6. Twenty-Year Outcome Following Central Duct Resection for Bloody Nipple Discharge

    PubMed Central

    Nelson, R Scott; Hoehn, James L.

    2006-01-01

    Background: Patients found with pathologic nipple discharge present a diagnostic dilemma to surgeons. No one diagnostic test, including cytology or radiologic imaging, has proved superior to any other in the differentiation of benign versus malignant sources of pathologic nipple discharge. Ductoscopy has been introduced as a way to assist with identification of potential sources of pathologic nipple discharge. Ductoscopy is also useful in the resection of deep or peripheral masses that may be missed with standard blind resection. This report evaluates the risk of missed malignancy following central duct resection (CDR). Methods: Records of 56 patients who underwent CDR for pathologic nipple discharge greater than 15 years previous were reviewed. Data including type of nipple discharge, future biopsy, and pathology reports were all examined. Results: Of the 56 patients, 36 had bloody, 18 serous, and 2 green initial discharges. Fifty-seven percent were found to have intraductal papilloma as the source of discharge, with fibrocystic disease and ductal ectasia providing the next most common causes. One woman was found to have ductal cancer and one lobular carcinoma in situ at time of CDR. Patients were followed for a mean period of 22 years. Fourteen women required future biopsy. Of these, 10 had benign disease and 4 had cancer, 3 on the ipsilateral side. The 3 women with breast cancer were 9, 13, and 17 years from initial resection. Conclusions: CDR for pathologic nipple discharge is an effective way to diagnose and treat pathologic nipple discharge without missing underlying cancers. PMID:16552204

  7. Computerized multiple image analysis on mammograms: performance improvement of nipple identification for registration of multiple views using texture convergence analyses

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M.; Paramagul, Chintana

    2004-05-01

    Automated registration of multiple mammograms for CAD depends on accurate nipple identification. We developed two new image analysis techniques based on geometric and texture convergence analyses to improve the performance of our previously developed nipple identification method. A gradient-based algorithm is used to automatically track the breast boundary. The nipple search region along the boundary is then defined by geometric convergence analysis of the breast shape. Three nipple candidates are identified by detecting the changes along the gray level profiles inside and outside the boundary and the changes in the boundary direction. A texture orientation-field analysis method is developed to estimate the fourth nipple candidate based on the convergence of the tissue texture pattern towards the nipple. The final nipple location is determined from the four nipple candidates by a confidence analysis. Our training and test data sets consisted of 419 and 368 randomly selected mammograms, respectively. The nipple location identified on each image by an experienced radiologist was used as the ground truth. For 118 of the training and 70 of the test images, the radiologist could not positively identify the nipple, but provided an estimate of its location. These were referred to as invisible nipple images. In the training data set, 89.37% (269/301) of the visible nipples and 81.36% (96/118) of the invisible nipples could be detected within 1 cm of the truth. In the test data set, 92.28% (275/298) of the visible nipples and 67.14% (47/70) of the invisible nipples were identified within 1 cm of the truth. In comparison, our previous nipple identification method without using the two convergence analysis techniques detected 82.39% (248/301), 77.12% (91/118), 89.93% (268/298) and 54.29% (38/70) of the nipples within 1 cm of the truth for the visible and invisible nipples in the training and test sets, respectively. The results indicate that the nipple on mammograms can be

  8. Nipple eczema, an indicative manifestation of atopic dermatitis? A clinical, histological, and immunohistochemical study.

    PubMed

    Song, Hyo Sang; Jung, Soo-Eun; Kim, You Chan; Lee, Eun-So

    2015-04-01

    Nipple eczema exhibits as a minor manifestation of atopic dermatitis (AD) or occurs as a single skin symptom on the nipple. To characterize the relationship between nipple eczema and AD, a clinical evaluation and an immunohistochemical study were performed. All cases of nipple eczema were confirmed histopathologically. We divided the patients with nipple eczema into 2 groups, namely, those with AD and those without AD, and compared several clinical features. Upon histological examination, the degree of inflammation was subjectively graded as mild, moderate, or severe by 2 separate investigators. Immunohistochemical stainings were performed by using antiinterleukin (IL)-4, anti-IL-13, anti-CD4, and anti-CD8 antibodies, and the results were scored semiquantitatively. In 43 cases evaluated, 12 were nipple eczema with AD. The clinical analysis and histological examination showed no significant differences between the groups. There were consistent findings of IL-4 expressions throughout the epidermis and IL-13 expression mainly in the perivascular area of the dermis. Although CD4 and CD8 were expressed in the cells in the dermis, CD8 expression was detected in the serocrusts of the epidermis. Expression levels of IL-4, IL-13, CD4, and CD8 exhibited no significant differences between the nipple eczema group with AD and the nipple eczema group without AD. Although nipple eczema may accompany AD, we found no definite differences in the degree or pattern of inflammation and cytokine expression level regardless of whether AD was present or not. Serocrust formation seemed to be mainly a collection of CD8-positive cells.

  9. Detection of duct ectasia of mammary gland by ultrasonography in a neonate with bloody nipple discharge.

    PubMed

    Aydin, Ramazan; Gul, Selim Baris; Polat, Ahmet Veysel

    2014-06-01

    Bloody nipple discharge, a rare finding in infants, is associated most often with benign mammary duct ectasia and commonly resolves spontaneously. Ultrasonography is a useful diagnostic imaging method to detect the cause of discharge. The rarity of this symptom in infants and its association with breast carcinoma in adults can lead to unnecessary investigation and treatment. Here, we describe ultrasonographic and color Doppler ultrasonographic findings of a 20-day-old boy with bilateral bloody nipple discharge that resolved spontaneously without treatment after 15 days. We conclude that bloody nipple discharge is usually a benign and self-limited process in infancy, and that it is advisable to avoid unnecessary invasive investigations initially.

  10. Paget’s Disease of Nipple in Male Breast with Cancer

    PubMed Central

    Periyasamy, Karthikkumaran

    2016-01-01

    Carcinoma of the male breast accounts for less than 0.5% of all cases of breast cancer. However, Paget’s disease of nipple in male is extremely rare. We report on a case of Paget’s disease of nipple with breast cancer in a 51-year-old gentleman. He presented with a ulcerative lesion and lump in the left breast beneath the nipple-areolar region with single mobile ipsilateral central group of axillary nodes. Modified radical mastectomy was performed. On follow up, patient was doing well with no recurrence. PMID:27042526

  11. Light on the moth-eye corneal nipple array of butterflies

    PubMed Central

    Stavenga, D.G; Foletti, S; Palasantzas, G; Arikawa, K

    2005-01-01

    The outer surface of the facet lenses in the compound eyes of moths consists of an array of excessive cuticular protuberances, termed corneal nipples. We have investigated the moth-eye corneal nipple array of the facet lenses of 19 diurnal butterfly species by scanning electron microscopy, transmission electron microscopy and atomic force microscope, as well as by optical modelling. The nipples appeared to be arranged in domains with almost crystalline, hexagonal packing. The nipple distances were found to vary only slightly, ranging from about 180 to 240 nm, but the nipple heights varied between 0 (papilionids) and 230 nm (a nymphalid), in good agreement with previous work. The nipples create an interface with a gradient refractive index between that of air and the facet lens material, because their distance is distinctly smaller than the wavelength of light. The gradient in the refractive index was deduced from effective medium theory. By dividing the height of the nipple layer into 100 thin slices, an optical multilayer model could be applied to calculate the reflectance of the facet lenses as a function of height, polarization and angle of incidence. The reflectance progressively diminished with increased nipple height. Nipples with a paraboloid shape and height 250 nm, touching each other at the base, virtually completely reduced the reflectance for normally incident light. The calculated dependence of the reflectance on polarization and angle of incidence agreed well with experimental data, underscoring the validity of the modelling. The corneal nipples presumably mainly function to reduce the eye glare of moths that are inactive during the day, so to make them less visible for predators. Moths are probably ancestral to the diurnal butterflies, suggesting that the reduced size of the nipples of most butterfly species indicates a vanishing trait. This effect is extreme in papilionids, which have virtually absent nipples, in line with their highly

  12. 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…

  13. 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.

  14. The effect of music reinforcement for non-nutritive sucking on nipple feeding of premature infants.

    PubMed

    Standley, Jayne M; Cassidy, Jane; Grant, Roy; Cevasco, Andrea; Szuch, Catherine; Nguyen, Judy; Walworth, Darcy; Procelli, Danielle; Jarred, Jennifer; Adams, Kristen

    2010-01-01

    In this randomized, controlled multi-site study, the pacifier-activated-lullaby system (PAL) was used with 68 premature infants. Dependent variables were (a) total number of days prior to nipple feeding, (b) days of nipple feeding, (c) discharge weight, and (d) overall weight gain. Independent variables included contingent music reinforcement for non-nutritive sucking for PAL intervention at 32 vs. 34 vs. 36 weeks adjusted gestational age (AGA), with each age group subdivided into three trial conditions: control consisting of no PAL used vs. one 15-minute PAL trial vs. three 15-minute PAL trials. At 34 weeks, PAL trials significantly shortened gavage feeding length, and three trials were significantly better than one trial. At 32 weeks, PAL trials lengthened gavage feeding. Female infants learned to nipple feed significantly faster than male infants. It was noted that PAL babies went home sooner after beginning to nipple feed, a trend that was not statistically significant.

  15. Remarkable crystal and defect structures in butterfly eye nano-nipple arrays.

    PubMed

    Lee, Ken C; Erb, Uwe

    2015-11-01

    The corneal nipple structures on the eyes of two nymphalid butterfly species (Nymphalis antiopa and Polygonia interrogationis) are analyzed in terms of nipple arrangements and associated defects. The nipple arrays in both species have close-packed hexagonal lattices with lattice parameters of about 200 nm. The most abundant defects observed are 5-7 coordination defects that generate dislocations, dislocation-type low angle and structural unit-like high angle grain boundaries, as well as closed-loop defects. These disordered structures are compared with imperfections found in other 2D and 3D crystal structures, and it is concluded that the defects in the nipple arrays are likely not due to random growth accidents. Instead, they could be the result of geometric constraints due to eye curvature or serve a yet undiscovered purpose in the optical properties of these eyes.

  16. Mycosis fungoides mimicking nevoid hyperkeratosis of the nipple and areola in an adolescent.

    PubMed

    Yalçın, Başak; Gür, Güneş; Tabanlıoğlu-Onan, Duru; Ekici, Özlem

    2014-01-01

    Mycosis fungoides is one of the great imitators in dermatology; it can mimic many dermatoses. Nevoid hyperkeratosis of the nipple and areola is a rare idiopathic disease with typical clinical features of verrucous thickening and brownish discoloration of the nipple, areola or both. Here, a 16-year-old male patient with mycosis fungoides mimicking nevoid hyperkeratosis of the nipple and areola has been reported. To our knowledge, this is the first atypical MF patient to have presented with a NHNA-like lesion. Although the clinical appearance of nevoid hyperkeratosis of the nipple and areola is highly characteristic for diagnosis, histopathological examination is recommended, especially in cases with atypical features such as unexpected age, male gender and unilateral location.

  17. Supernumerary nipple and seminoma: case report and review of polythelia and genitourinary cancers.

    PubMed

    Grimshaw, Emily C; Cohen, Philip R

    2013-01-15

    The presence of supernumerary nipples, known as polythelia, is the most common presentation of accessory breast tissue. It is usually considered to be a benign congenital anomaly. However, polythelia may warrant attention for more than mere cosmetic concern because supernumerary nipples have been shown to be associated with an increased risk of genitourinary malignancies. We describe a 53-year-old man with an accessory nipple on the left chest who presented with stage IIA testicular seminoma at the age of 47. Published reports of patients with polythelia and genitourinary malignancies, as well as other neoplasms, are reviewed. Because patients with accessory nipples have a predisposition to develop visceral cancers, polythelia should be considered as a genodermatosis with malignant potential.

  18. The preference for water nipples vs. water bowls in dairy goats

    PubMed Central

    2011-01-01

    Background Previous studies have reported that the design of the water dispensers can influence the water intake in farm animals. Horses and dairy cows seem to prefer to drink from an open surface whereas sheep and pigs apparently prefer water nipples, probably because of the worse water quality in water bowls. The aim of the present study was to examine the preference of dairy goats for water nipples or water bowls. Methods In each of the two experiments (exp. 1, dry goats, exp. 2 lactating goats), 42 dairy goats were allotted into 6 groups of 7 goats. In period 1, the goats had access to a water nipple. In period 2, they had access to a water bowl and in period 3 (preference test) they had access to both a water nipple and a water bowl. Water usage and wastage was recorded and water intake (water usage - water wastage) was calculated for each group for the two last days of each period. In experiment 2, water samples from each dispenser were analyzed for heterotrophy germs at 22°C, Escherichia coli and turbidity. Results Water usage was higher from water nipples than from water bowls both in experiment 1 (dry goats) and experiment 2 (lactating goats). There was however, no difference in water intake from water nipples and water bowls. In the preference test (period 3), the water intake tended to be higher from the water nipple than from the water bowl both for the dry goats (exp. 1) and lactating goats (exp. 2). Especially for the dry goats, the differences between groups were large. Turbidity and heterotrophy germs were much higher in the samples from the water bowls than from the water nipples. Water wastage from the water bowls was negligible compared to the water nipples. From the water nipples the water wastage was 30% and 23% of water usage for the dry and lactating goats respectively. Conclusions We conclude that type of water dispenser (nipple or bowl) was probably of minor importance for water intake in goats, but water bowls had a lower water quality

  19. Mesostructure of Ordered Corneal Nano-nipple Arrays: The Role of 5–7 Coordination Defects

    PubMed Central

    Lee, Ken C.; Yu, Qi; Erb, Uwe

    2016-01-01

    Corneal nano-nipple structures consisting of hexagonally arranged protrusions with diameters around 200 nm have long been known for their antireflection capability and have served as biological blueprint for solar cell, optical lens and other surface designs. However, little is known about the global arrangement of these nipples on the ommatidial surface and their growth during the eye development. This study provides new insights based on the analysis of nano-nipple arrangements on the mesoscale across entire ommatidia, which has never been done before. The most important feature in the nipple structures are topological 5- and 7-fold coordination defects, which align to form dislocations and interconnected networks of grain boundaries that divide the ommatidia into crystalline domains in different orientations. Furthermore, the domain size distribution might be log-normal, and the domains demonstrate no preference in crystal orientation. Both observations suggest that the nipple growth process may be similar to the nucleation and growth mechanisms during the formation of other crystal structures. Our results are also consistent with the most recently proposed Turing-type reaction-diffusion process. In fact, we were able to produce the key structural characteristics of the nipple arrangements using Turing analysis from the nucleation to the final structure development. PMID:27329065

  20. Automatic localization of the nipple in mammograms using Gabor filters and the Radon transform

    NASA Astrophysics Data System (ADS)

    Chakraborty, Jayasree; Mukhopadhyay, Sudipta; Rangayyan, Rangaraj M.; Sadhu, Anup; Azevedo-Marques, P. M.

    2013-02-01

    The nipple is an important landmark in mammograms. Detection of the nipple is useful for alignment and registration of mammograms in computer-aided diagnosis of breast cancer. In this paper, a novel approach is proposed for automatic detection of the nipple based on the oriented patterns of the breast tissues present in mammograms. The Radon transform is applied to the oriented patterns obtained by a bank of Gabor filters to detect the linear structures related to the tissue patterns. The detected linear structures are then used to locate the nipple position using the characteristics of convergence of the tissue patterns towards the nipple. The performance of the method was evaluated with 200 scanned-film images from the mini-MIAS database and 150 digital radiography (DR) images from a local database. Average errors of 5:84 mm and 6:36 mm were obtained with respect to the reference nipple location marked by a radiologist for the mini-MIAS and the DR images, respectively.

  1. Vertical and horizontal coordinates of the nipple-areola complex position in males.

    PubMed

    Atiyeh, Bishara S; Dibo, Saad A; El Chafic, Abdul Hamid

    2009-11-01

    After massive weight loss, male breasts in particular are one of the most disturbing body regions and can be a difficult area to treat often requiring nipple-areola repositioning. The need for bilateral repositioning of the nipple-areola complex is also increasing in other surgical fields such as in female-to-male transsexual patients with large breasts and in patients with severe forms of gynecomastia. Proper configuration and localization of the nipple-areola complex requires both meticulous planning and a thorough understanding of the male anatomy and is essential in determining final aesthetic outcome. Currently available guidelines create areolas that are too large, place the nipple-areola complex too high and too far medially, and/or require complex abstract mathematical calculations. Relying on the recently appreciated aesthetic value of the golden number Phi (phi) we propose an easy and reliable method to determine the horizontal and vertical coordinates of the male nipples. With only 2 easily measurable distances, umbilicus-anterior axillary fold apex and umbilicus-suprasternal notch, the internipple distance and the position of the horizontal nipple plane relative to the suprasternal notch can be calculated. The internipple distance can be determined with 95% accuracy and the distance from the suprasternal notch can be determined in 80% of cases within a range of 3.33 +/- 1.25 cm.

  2. Mesostructure of Ordered Corneal Nano-nipple Arrays: The Role of 5–7 Coordination Defects

    NASA Astrophysics Data System (ADS)

    Lee, Ken C.; Yu, Qi; Erb, Uwe

    2016-06-01

    Corneal nano-nipple structures consisting of hexagonally arranged protrusions with diameters around 200 nm have long been known for their antireflection capability and have served as biological blueprint for solar cell, optical lens and other surface designs. However, little is known about the global arrangement of these nipples on the ommatidial surface and their growth during the eye development. This study provides new insights based on the analysis of nano-nipple arrangements on the mesoscale across entire ommatidia, which has never been done before. The most important feature in the nipple structures are topological 5- and 7-fold coordination defects, which align to form dislocations and interconnected networks of grain boundaries that divide the ommatidia into crystalline domains in different orientations. Furthermore, the domain size distribution might be log-normal, and the domains demonstrate no preference in crystal orientation. Both observations suggest that the nipple growth process may be similar to the nucleation and growth mechanisms during the formation of other crystal structures. Our results are also consistent with the most recently proposed Turing-type reaction-diffusion process. In fact, we were able to produce the key structural characteristics of the nipple arrangements using Turing analysis from the nucleation to the final structure development.

  3. The significance of nipple discharge of the male breast.

    PubMed

    Morrogh, Mary; King, Tari A

    2009-01-01

    Although male breast cancer typically presents as a palpable mass, failure to recognize the significance of other symptoms may lead to a delay in diagnosis. Here we present our experience with male patients presenting with a chief complaint of nipple discharge (ND). Using the ICD-9 code for "breast symptoms," we identified 2,319 patients without a current cancer diagnosis who presented to Memorial Sloan-Kettering Cancer Center for evaluation; 24 (1%) patients were male (1995-2005). Data were collected by retrospective review. Among 24 male patients presenting for evaluation, 14 (58%) presented with a chief complaint of ND, while the remaining 10 (42%) presented for evaluation of a palpable mass in the absence of ND. Among 14 patients presenting with ND, subsequent clinical breast examination identified a breast mass +/- nipple changes in 7 of 14 patients. In total, 8 of 14 (57%) patients had an underlying malignancy; two of seven patients with ND alone had DCIS (median interval from onset of ND to presentation 3 weeks, range 2-4 weeks), and six of seven patients with ND and a palpable mass had invasive disease (median interval between onset of ND and presentation 16 weeks, range 2-52). The remaining 10/24 patients presented with a painless palpable mass of whom 8 (80%) were found to have underlying invasive disease (median interval between onset of mass, and presentation was 4 weeks, range 2-20 weeks). All patients with invasive disease were node-positive. At 23.7 months median follow-up (range, 7.7-88.3 months), 14 of 16 cancer patients remain free of disease and two have died as a direct result of metastatic disease. The incidence of cancer among males presenting with ND was 57%. In the absence of additional clinical findings, ND may be a herald for early, non-invasive disease. Increased awareness of subtle features of malignancy may represent a window of opportunity for early diagnosis and improved outcomes for male breast cancer patients.

  4. 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.

  5. 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.

  6. 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.

  7. MicroRNA analysis of breast ductal fluid in breast cancer patients.

    PubMed

    Do Canto, Luisa Matos; Marian, Catalin; Willey, Shawna; Sidawy, Mary; Da Cunha, Patricia A; Rone, Janice D; Li, Xin; Gusev, Yuriy; Haddad, Bassem R

    2016-05-01

    Recent studies suggest that microRNAs show promise as excellent biomarkers for breast cancer; however there is still a high degree of variability between studies making the findings difficult to interpret. In addition to blood, ductal lavage (DL) and nipple aspirate fluids represent an excellent opportunity for biomarker detection because they can be obtained in a less invasive manner than biopsies and circumvent the limitations of evaluating blood biomarkers with regards to tissue of origin specificity. In this study, we have investigated for the first time, through a real-time PCR array, the expression of 742 miRNAs in the ductal lavage fluid collected from 22 women with unilateral breast tumors. We identified 17 differentially expressed miRNAs between tumor and paired normal samples from patients with ductal breast carcinoma. Most of these miRNAs have various roles in breast cancer tumorigenesis, invasion and metastasis, therapeutic response, or are associated with several clinical and pathological characteristics of breast tumors. Moreover, some miRNAs were also detected in other biological fluids of breast cancer patients such as serum (miR-23b, -133b, -181a, 338-3p, -625), plasma (miR-200a), and breast milk (miR-181a). A systems biology analysis of these differentially expressed miRNAs points out possible pathways and cellular processes previously described as having an important role in breast cancer such as Wnt, ErbB, MAPK, TGF-β, mTOR, PI3K-Akt, p53 signaling pathways. We also observed a difference in the miRNA expression with respect to the histological type of the tumors. In conclusion, our findings suggest that miRNA analysis of breast ductal fluid is feasible and potentially very useful for the detection of breast cancer.

  8. Nipple-areolar complex reconstruction and patient satisfaction: a systematic review and meta-analysis

    PubMed Central

    2017-01-01

    Background Nipple-areola complex (NAC) reconstruction transforms a mound of soft tissue into a breast and often marks the final stage of breast reconstruction after mastectomy. Methods A systematic review and meta-analysis were conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Articles were classified based on the nipple reconstructive technique—either composite nipple sharing or local flap with nipple-sparing mastectomy (NSM) used as a control. A standardized “Satisfaction Score” (SS) for “nipple appearance” and “nipple sensation” was calculated for each technique. A Fisher’s exact test was used to compare the SS with local flap reconstruction with NSM. Results Twenty-three studies met the systematic review inclusion criteria. Nine NSM articles were identified with patient satisfaction data from 473 patients. The weighted average SS for NSM was 80.5%. Fourteen local flap technique articles were identified with satisfaction data from 984 patients and a weighted average SS of 73.9%. This was a statistically significant difference (P=0.0079). C-V and badge local flap techniques were associated with the highest SS, 92.6% and 90.5%, respectively. C-V and modified C-V flap technique was associated with a higher SS when compared to those using one or more other flap techniques (P=0.0001). Conclusions While patient satisfaction with nipple reconstruction is high regardless of technique, it is higher with NSM. When NSM is not an option, local flap reconstruction with a C-V or modified C-V flap may be associated with higher satisfaction than alternative local flap techniques. PMID:28210547

  9. Measurement of tongue-artificial nipple contact force in infants with sucking difficulties.

    PubMed

    Nishi, Eri; Wakamatsu, Yuki; Nagamatsu, Yuiko; Kuroyanagi, Yuichi; Niikawa, Takuya

    2013-01-01

    Infants are known to suckle and ingest breast milk by wrapping the tongue around a nipple, writhing the tongue, and pressing the nipple. However, the dynamic mechanisms of tongue movement are still obscure, and factors related to sucking difficulties of infants are not well understood. We developed an artificial nipple installed with small cantilever-type sensors and directly measured the force applied on the nipple by the tongue. Small force sensors were arranged within the artificial nipple in a two-dimensional matrix of 3 × 2 to measure the force at 6 points. Subjects were 20 healthy infants (Group A) and 5 infants who had difficulty sucking (Group B). The latter could not breastfeed well and were fed from bottles or tubes. Informed consent was provided by the parents or guardians. The measured maximum force at the tip of the nipple was 1.4 ± 0.4 N and 1.2 ± 0.3 N (mean ± SD) in Groups A and B, respectively. At the base of the nipple, the maximum force recorded was 0.8 ± 0.5 N and 0.3 ± 0.3 N (mean ± SD), respectively, showing a statistically significant difference (p<0.05). The sucking period was 0.6 ± 0.1 s (mean ± SD) in both groups. The difference in time necessary to reach the maximum forces between the sensors at the tip and base was 39.7 ± 28.8 ms (mean ± SD) and 37.2 ± 75.9 ms in Groups A and B, respectively.

  10. Prenatal testosterone exposure permanently masculinizes anogenital distance, nipple development, and reproductive tract morphology in female Sprague-Dawley rats.

    PubMed

    Hotchkiss, Andrew K; Lambright, Christy S; Ostby, Joseph S; Parks-Saldutti, Louise; Vandenbergh, John G; Gray, Leon E

    2007-04-01

    In mammals, abnormal increases in fetal androgens disrupt normal development of the female phenotype. Due to the recent concern regarding environmental androgen-active chemicals, there is a need to identify sources of fetal androgen variation and sensitive developmental markers for androgenic activity in female rats. Anogenital distances (AGD), nipple retention, reproductive tract, and external genitalia are morphological parameters organized by prenatal androgens and are predictive of altered masculinized/defeminized phenotype in adult female mice and rats. The objectives of this study were to (1) characterize the natural prenatal androgen environment of rats including the magnitude of the intrauterine position (IUP) effect, (2) characterize the permanent effects of prenatal androgen exposure on female rats, and (3) determine the ability of AGD and areolas to predict these permanent androgenic alterations in female rats. Untreated male fetal rats had higher tissue testosterone (T) concentrations than females in the amniotic fluid, reproductive tract, gonad, and fetal body. The intrauterine position (IUP) of male and female fetuses did not affect T concentrations or AGD in male or female rats at gestational day (GD) 22. Female offspring exposed to 0, 1.5, and 2.5 mg/kg/day testosterone propionate (TP) on GDs 14-18 displayed increased AGD at postnatal day (PND) 2 and decreased nipples at PND 13 and as adults. TP-induced changes in neonatal AGD and infant areola number were reliable indicators of permanently altered adult phenotype in female rats. Further, females in the two high-dose groups displayed increased incidences of external genital malformations and the presence of prostatic tissue, not normally found in female rats.

  11. Mutations in KCTD1 cause scalp-ear-nipple syndrome.

    PubMed

    Marneros, Alexander G; Beck, Anita E; Turner, Emily H; McMillin, Margaret J; Edwards, Matthew J; Field, Michael; de Macena Sobreira, Nara Lygia; Perez, Ana Beatriz A; Fortes, Jose A R; Lampe, Anne K; Giovannucci Uzielli, Maria Luisa; Gordon, Christopher T; Plessis, Ghislaine; Le Merrer, Martine; Amiel, Jeanne; Reichenberger, Ernst; Shively, Kathryn M; Cerrato, Felecia; Labow, Brian I; Tabor, Holly K; Smith, Joshua D; Shendure, Jay; Nickerson, Deborah A; Bamshad, Michael J

    2013-04-04

    Scalp-ear-nipple (SEN) syndrome is a rare, autosomal-dominant disorder characterized by cutis aplasia of the scalp; minor anomalies of the external ears, digits, and nails; and malformations of the breast. We used linkage analysis and exome sequencing of a multiplex family affected by SEN syndrome to identify potassium-channel tetramerization-domain-containing 1 (KCTD1) mutations that cause SEN syndrome. Evaluation of a total of ten families affected by SEN syndrome revealed KCTD1 missense mutations in each family tested. All of the mutations occurred in a KCTD1 region encoding a highly conserved bric-a-brac, tram track, and broad complex (BTB) domain that is required for transcriptional repressor activity. KCTD1 inhibits the transactivation of the transcription factor AP-2α (TFAP2A) via its BTB domain, and mutations in TFAP2A cause cutis aplasia in individuals with branchiooculofacial syndrome (BOFS), suggesting a potential overlap in the pathogenesis of SEN syndrome and BOFS. The identification of KCTD1 mutations in SEN syndrome reveals a role for this BTB-domain-containing transcriptional repressor during ectodermal development.

  12. Nipple Discharge: An Early Warning Sign of Breast Cancer

    PubMed Central

    Parthasarathy, Veda; Rathnam, Usharani

    2012-01-01

    Nipple discharge (ND) can be the earliest presenting symptom of breast cancer. We hereby present two cases of breast cancer with no palpable mass manifesting as isolated ND, which was whitish in color. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. Mammography showed diffuse, extensive microcalcifications. Simple mastectomy with axillary clearance was done. Histology in both cases revealed diffusely spreading intraductal carcinoma, with focus of microinvasion in one case. ND if scanty or not blood stained is often ignored by the patients and at times, the clinicians. This article highlights that ND can be an early warning sign of intraductal carcinomas that are non-invasive in early stage. Irrespective of the color or nature of the discharge, unilateral ND needs to be evaluated. Proper clinical assessment, cytological evaluation of the ND, and mammography ought to be performed in all such cases. Considering the low level of awareness in women regarding the warning signs of breast cancer, the current focus is to create “breast awareness.” Women should be sensitized to recognize any unusual changes in their breasts and report to their health care providers at the earliest. PMID:23189234

  13. 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.

  14. 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.

  15. [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.

  16. Automatic nipple detection on 3D images of an automated breast ultrasound system (ABUS)

    NASA Astrophysics Data System (ADS)

    Javanshir Moghaddam, Mandana; Tan, Tao; Karssemeijer, Nico; Platel, Bram

    2014-03-01

    Recent studies have demonstrated that applying Automated Breast Ultrasound in addition to mammography in women with dense breasts can lead to additional detection of small, early stage breast cancers which are occult in corresponding mammograms. In this paper, we proposed a fully automatic method for detecting the nipple location in 3D ultrasound breast images acquired from Automated Breast Ultrasound Systems. The nipple location is a valuable landmark to report the position of possible abnormalities in a breast or to guide image registration. To detect the nipple location, all images were normalized. Subsequently, features have been extracted in a multi scale approach and classification experiments were performed using a gentle boost classifier to identify the nipple location. The method was applied on a dataset of 100 patients with 294 different 3D ultrasound views from Siemens and U-systems acquisition systems. Our database is a representative sample of cases obtained in clinical practice by four medical centers. The automatic method could accurately locate the nipple in 90% of AP (Anterior-Posterior) views and in 79% of the other views.

  17. The treatment of Staphyloccocus aureus infected sore nipples: a randomized comparative study.

    PubMed

    Livingstone, V; Stringer, L J

    1999-09-01

    Sore, cracked nipples are commonly experienced by breastfeeding mothers. We have previously reported a strong correlation between sore, cracked nipples and S. aureus colonization. A prospective, randomized clinical trial was performed to compare four treatment regimes for S. aureus infected sore nipples. Eighty-four breastfeeding mothers were enrolled in the study. After 5 days to 7 days of treatment, only 8% of mothers showed improvement in the "optimal breastfeeding technique alone" group, 16% improved with topical mupiricin, 29% improved with topical fusidic acid, yet 79% improved with oral antibiotics (p < .0001). Optimal breastfeeding techniques and topical antibiotics ointment failed to heal most infected, sore, cracked nipples. Mastitis developed in 12% to 35% of mothers not treated with systemic antibiotics compared to 5% of mothers treated with systemic antibiotics (p < .005). In conclusion, S. aureus infected sore, cracked nipples should be diagnosed as a potentially widespread impetigo vulgaris and treated aggressively with systemic antibiotics in order to improve healing and decrease the risk of developing mastitis due to an ascending lactiferous duct bacterial infection.

  18. A case report of pigmented mammary Paget's disease mimicking nevus of the nipple.

    PubMed

    Tang, Xiaoyan; Umemura, Shinobu; Kumaki, Nobue; Izumi, Miki; Saito, Yuki; Suzuki, Yasuhiro; Ozawa, Akira; Tokuda, Yutaka

    2014-05-01

    A 43-year-old Japanese woman consulted our hospital for a pigmented lesion on her right nipple. Two years later, the lesion became enlarged, measuring 5 × 5 mm. It was dark brown, had an irregular shape and relatively clear borders. Incisional biopsy yielded a pathological diagnosis of junctional nevus of the skin. An additional 2 years later, a small mass developed under the right nipple area and core needle biopsy yielded a pathologic diagnosis of invasive ductal carcinoma. Partial resection of the right EC areas included the skin of the nipple and sentinel lymph node biopsy was performed. Histologically, the skin of the nipple demonstrated small clusters of pigmented carcinoma cells that were low molecular weight cytokeratin (CAM5.2) positive. Most of the carcinoma cells were small and did not have abundant cytoplasm, but nuclear enlargement and prominent nucleoli indicated malignancy, and the cytoplasm was pale compared with that of the surrounding squamous epithelial cells. Scattered dendritic melanocytes were identified by S-100 protein and HMB-45 immunohistochemically. In the upper dermis, carcinoma cells also involved the lactiferous ducts. A small focus of carcinoma cells that invaded the fat tissues did not contain melanin pigment. The final diagnosis was pigmented mammary Paget's disease. Pigmented lesions on the nipple should be carefully examined, because pigmented mammary Paget's disease sometimes mimics malignant melanoma or junctional nevus.

  19. The value of breast ductoscopy in radiologically negative spontaneous/persistent nipple discharge.

    PubMed

    Tekin, Ercument; Akin, Murat; Kurukahvecioglu, Osman; Tezcaner, Tugan; Gulen, Merter; Anadol, Ahmet Ziya; Taneri, Ferit

    2009-01-01

    Breast ductoscope is a fiberoptic endoscope used for examining the distal breast ducts under direct vision in order to identify the source of pathologic nipple discharge. The purpose of this study was to investigate the reliability of intra-operative breast ductoscopy in patients with pathologic nipple discharge, which could not be identified by radiologic tests. Between April 2002 and March 2007, breast ductoscopy was performed in 34 patients who had pathologic nipple discharge with no radiologic evidence about the source. The procedures were carried out under general anesthesia and ductoscopic findings were as well as the histopathology of the specimens were recorded and documented. In 88%, (30 of 34) of the patients, endoscope was successfully introduced into the external orifice of the ducts at the nipple and proximal breast ducts were successfully visualized. Ductoscopy revealed intraductal lesions (i.e., ductal obstruction, intraductal papilloma, red patches, and erythematoid platter) in 20 patients (66%). Among the 20 patients with visible endoluminal pathology, nine had a papilloma and eight had signs of either acute inflammation (bleeding, erythema) or previous inflammation with healing (adhesions and blocked ducts). In two cases, invasive breast carcinoma was identified, one of which was ductal carcinoma in situ (DCIS) with minimal invasion. In both cases, there had been blocked ducts. In one case DCIS was identified. Breast ductoscopy is a reliable and easy-to-use method to demonstrate the source of pathologic nipple discharge in cases with bleeding and other intraductal lesions.

  20. Oral Touch in Young Infants: Response to Variations of Nipple Characteristics in the First Months of Life.

    ERIC Educational Resources Information Center

    Rochat, Philippe

    1983-01-01

    Examines, in 30 normal infants from three age groups, differences in exploratory and sucking responses to artificial nipples varying in material and shape. Results suggest the existence of a developmental trend influenced by the type of nipple. Findings support the view that the mouth has a perceptual as well as a nutritive function. (Author/RH)

  1. Structural Analysis of Corneal Nano-nipple Arrays in Nymphalidae Butterflies

    NASA Astrophysics Data System (ADS)

    Lee, Ken Chun-Yi

    This study is concerned with the two-dimensional arrangement of corneal nano-nipples on the eyes of two Nymphalid butterflies. While the nano-nipples are predominantly in close-packed ordered arrangements, there are coordination defects known as 5-7 defects that disrupt the local translational symmetry and generate a number of secondary defects. Most often 5-7 defects align in rows to separate nipple domains with different orientations much like grain boundaries in crystalline materials. Surprisingly, the majority of 5-7 defect rows are special low-sigma; boundaries that occur infrequently in random crystalline materials. Such prevalence of low-sigma; boundaries suggests that they may serve specific purposes. Based on the superlattices associated with the observed low-sigma; boundaries, it is tentatively suggested that they could lead to diffraction effects for infrared light.

  2. [Characteristics, frequency and factors present in nipples damage occurence in lactating women].

    PubMed

    Shimoda, Gilcéria Tochika; Silva, Isilia Aparecida; Santos, Jair Lício Ferreira

    2005-01-01

    Our objectives were to verify the occurrence of nipple damage, according to the newborn and mother characteristics; to characterize the suction pattern of newborn, whose mothers present nipple damage. The sample was of 1020 lactating women and their infants, and of them, 84 were followed up by the researcher. It was verified that the gestational age of the newborn, the skin color, parity and the type of anesthesia received by the mothers during the labor were statistically significant for the occurrence of nipple damage. Only 5.95% of the newborn revealed appropriate grasp and dynamic suction, increasing to 43.33% at the first appointment after hospital discharge. The most of women presented complete healing of lesion from 5 to 6 days postpartum, this indicate that this period of a week is critical, when the mother needs stimulation and follow-up to the maintainance of lactation.

  3. Nipple sparing versus skin sparing mastectomy: a systematic review protocol

    PubMed Central

    Agha, Riaz A; Wellstead, Georgina; Sagoo, Harkiran; Al Omran, Yasser; Barai, Ishani; Rajmohan, Shivanchan; Fowler, Alexander J; Orgill, Dennis P; Rusby, Jennifer E

    2016-01-01

    Introduction Breast cancer has a lifetime incidence of one in eight women. Over the past three decades there has been a move towards breast conservation and a focus on aesthetic outcomes while maintaining oncological safety. For some patients, mastectomy is the preferred option. There is growing interest in the potential use of nipple sparing mastectomy (NSM). However, oncological safety remains unproven, and the benefits and indications have not been clearly identified. The objective of this systematic review will be to determine the safety and efficacy of NSM as compared with skin sparing mastectomy (SSM). Methods and analysis All original comparative studies including; randomised controlled trials, cohort studies and case–control studies involving women undergoing either NSM or SSM for breast cancer will be included. Outcomes are primary—relating to oncological outcomes and secondary—relating to clinical, aesthetic, patient reported and quality of life outcomes. A comprehensive electronic literature search, designed by a search specialist, will be undertaken. Grey literature searches will also be conducted. Eligibility assessment will occur in two stages; title and abstract screening and then full text assessment. Each step will be conducted by two trained teams acting independently. Data will then be extracted and stored in a database with standardised extraction fields to facilitate easy and consistent data entry. Data analysis will be undertaken to explore the relationship between NSM or SSM and preselected outcomes, heterogeneity will be assessed using the Cochrane tests. Ethics and dissemination This systematic review requires no ethical approval. It will be published in a peer-reviewed journal. It will also be presented at national and international conferences. Updates of the review will be conducted to inform and guide healthcare practice and policy. PMID:27207622

  4. Psychosocial and Sexual Well-Being Following Nipple-Sparing Mastectomy and Reconstruction

    PubMed Central

    Wei, Cindy H.; Scott, Amie M.; Price, Alison N.; Miller, H. Catherine; Klassen, Anne F.; Jhanwar, Sabrina M.; Mehrara, Babak J.; Disa, Joseph J.; McCarthy, Colleen; Matros, Evan; Cordeiro, Peter G.; Sacchini, Virgilio; Pusic, Andrea L.

    2016-01-01

    Background Nipple-sparing mastectomy (NSM) is considered an oncologically safe option for select patients. As many patients are candidates for nipple-sparing or skin-sparing mastectomy (SSM), reliable patient-reported outcome data are crucial for decision-making. The objective of this study was to determine whether patient satisfaction and/or health-related quality of life (HRQOL) were improved by preservation of the nipple with NSM compared to SSM and nipple reconstruction. Methods Subjects were identified from a prospectively maintained database of patients who completed the BREAST-Q following mastectomy and breast reconstruction between March and October 2011 at Memorial Sloan Kettering Cancer Center. Fifty-two patients underwent NSM followed by immediate expander-implant reconstruction. A comparison group consisted of 202 patients who underwent SSM followed by immediate expander-implant reconstruction and later nipple reconstruction. HRQOL and satisfaction domains as measured by BREAST-Q scores were compared in multivariate linear regression analyses that controlled for potential confounding factors. Results NSM patients reported significantly higher scores in the psychosocial (p=0.01) and sexual well-being (p=0.02) domains compared to SSM patients. There was no significant difference in the BREAST-Q physical well-being, satisfaction with breast, or satisfaction with outcome domains between the NSM and SSM groups. Conclusions NSM is associated with higher psychosocial and sexual well-being compared to SSM and nipple reconstruction. Preoperative discussion of such HRQOL outcomes with patients may facilitate informed decision-making and realistic postoperative expectations. PMID:26782950

  5. Supernumerary nipples in association with Hailey-Hailey disease in a Tunisian family.

    PubMed

    Benmously-Mlika, R; Deghais, S; Bchetnia, M; Charfeddine, C; Mokni, M; Kassar, S; Haouet, S; Boubaker, S; Mokhtar, I; Abdelhak, S; Dhahri, A Ben Osman

    2008-06-15

    Supernumerary nipples (SNs) or polythelia are developmental abnormalities of breast tissue. They are located along the embryonic mammary lines. Polythelia usually occurs as a sporadic abnormality, although familial aggregation has been occasionally reported. Hailey-Hailey disease is a rare autosomal genodermatosis characterized by disturbed keratinocyte adhesion. These cutaneous disorders have been described in correlation with many other abnormalities. We report here the association of Hailey-Hailey disease and supernumerary nipples in a Northern Tunisian family. To our knowledge, this is the first report of such a clinical association.

  6. C-Y Trilobed Flap for Improved Nipple-Areola Complex Reconstruction.

    PubMed

    Butz, Daniel R; Kim, Eun Key; Song, David H

    2015-08-01

    Nipple-areola complex reconstruction has been shown to improve breast reconstruction patients' overall satisfaction. Trilobed flap variations are some of the more commonly used flaps for nipple-areola complex reconstruction. The donor-site scar frequently extends outside the width of an ideal areolar tattoo diameter. There have been many modifications to the original flap design, but none of them addresses the length of the donor-site scar. The technique described uses a triangular stitch in the donor site to limit the length of the scar. This also creates tiny dog-ears within the future areola zone that give a natural wrinkled appearance when tattooed.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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…

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

    SciTech Connect

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

    2011-06-15

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

  13. Evaluation of a formula that categorizes female gray wolf breeding status by nipple size

    USGS Publications Warehouse

    Barber-Meyer, Shannon M.; Mech, L. David

    2015-01-01

    The proportion by age class of wild Canis lupus (Gray Wolf) females that reproduce in any given year remains unclear; thus, we evaluated the applicability to our long-term (1972–2013) data set of the Mech et al. (1993) formula that categorizes female Gray Wolf breeding status by nipple size and time of year. We used the formula to classify Gray Wolves from 68 capture events into 4 categories (yearling, adult non-breeder, former breeder, current breeder). To address issues with small sample size and variance, we created an ambiguity index to allow some Gray Wolves to be classed into 2 categories. We classified 20 nipple measurements ambiguously: 16 current or former breeder, 3 former or adult non-breeder, and 1 yearling or adult non-breeder. The formula unambiguously classified 48 (71%) of the nipple measurements; based on supplemental field evidence, at least 5 (10%) of these were incorrect. When used in conjunction with an ambiguity index we developed and with corrections made for classifications involving very large nipples, and supplemented with available field evidence, the Mech et al. (1993) formula provided reasonably reliable classification of breeding status in wild female Gray Wolves.

  14. Proliferative lesions of intra-epidermal cytokeratin CAM5.2-positive cells in canine nipples.

    PubMed

    Yasuno, K; Nishiyama, S; Kobayashi, R; Yoshimura, H; Takahashi, K; Omachi, T; Kamiie, J; Shirota, K

    2014-01-01

    Non-keratinocyte cells with clear or vacuolated cytoplasm are frequently observed in the epidermis of canine nipples. Most of these cells express cytokeratin (CK) CAM5.2, a marker of luminal epithelial cells. The morphological and immunohistochemical characteristics of these clear cells were investigated. Nipple tissue from 36 dogs of both sexes was collected and labelled immunohistochemically for CAM5.2, CK7, CK14, CK18, CK20, α-smooth muscle actin, p63, melan-A, E-cadherin, epidermal growth factor receptor and oestrogen receptor (OR). The intra-epidermal CAM5.2(+) clear cells were present singly or as small clusters, mostly within the basal layer, in 22 dogs (61%). These cells also expressed CK7, CK18, E-cadherin and OR. Electron microscopy revealed that some of these cells had surface microvilli. Multifocal proliferative lesions consisting of these cells were observed in the nipples of four dogs. In these lesions, proliferating cells formed bilayered tubules with CAM5.2(+) inner and CK14/p63(+) outer cells. This is the first report describing intra-epidermal CAM5.2(+) clear cells, distinct from melanocytes and Merkel cells in dog nipples. These cells might arise from the luminal epithelium of the papillary duct.

  15. Is duct excision still necessary for all cases of suspicious nipple discharge?

    PubMed

    Sabel, Michael S; Helvie, Mark A; Breslin, Tara; Curry, Alida; Diehl, Kathleen M; Cimmino, Vincent M; Chang, Alfred E; Newman, Lisa A

    2012-01-01

    Despite the low likelihood of malignancy, it is recommended that all women with pathologic nipple discharge undergo duct excision based on the inadequate sensitivity of diagnostic modalities. However, these data originates prior to recent improvements in breast imaging. We performed a retrospective review of patients evaluated in the setting of modern diagnostic breast imaging. Of 175 women referred to our breast clinic with a primary complaint of nipple discharge, 142 (81%) had suspicious discharge. Of the 23 patients who opted for observation over duct excision, with a mean follow-up of 3.3 years, none have been diagnosed with cancer. Among patients who proceeded with surgery, cancer was diagnosed in seven patients (5%). Six of the seven patients had either an abnormal mammogram or ultrasound. Among 46 patients with suspicious nipple discharge, a normal physical exam and normal diagnostic mammogram/ultrasound, only one malignancy (2%) was identified in a 79-year-old patient with a personal history of breast cancer. In selected patients with suspicious nipple discharge, but normal physical exam and diagnostic imaging, short-term observation with repeat evaluation seems reasonable for patients who do not desire duct excision.

  16. Two cases of male nipple leiomyoma: idiopathic leiomyoma and gynecomastia-associated leiomyoma.

    PubMed

    Nakamura, Satoshi; Hashimoto, Yoshio; Takeda, Keiko; Nishi, Kaoru; Ishida-Yamamoto, Akemi; Mizumoto, Toshihiro; Iizuka, Hajime

    2012-05-01

    We describe 2 cases of male nipple leiomyoma. A 70-year-old man had a painful subcutaneous tumor on his left nipple of 6 months duration. Histopathology disclosed dermal spindle cells with oval-shaped nuclei forming interlacing bundles with irregular pattern. Glandular elements were absent. The spindle cells were positive to α-smooth muscle actin, desmin, and vimentin. Estrogen receptor (ER) and progesterone receptor (PrR) were negative. We diagnosed this case as male leiomyoma of the nipple. Another patient was a 61-year-old man with gynecomastia induced by spironolactone of 6 months duration. He also had a painful nodule on his left nipple and histopathology disclosed spindle-shaped tumor cells as in the previous patient. The tumor was accompanied by glandular elements in the deep dermis and subcutaneous tissue, which showed apocrine secretion and were positive for α-smooth muscle actin, ER, and PrR. These glandular elements were interpreted as mammary gland. But ER and PrR stain did not show positive results for leiomyoma in the upper dermis. To the best of our knowledge, this is the first report of male idiopathic and gynecomastia-induced leiomyoma with ER and PrR staining.

  17. Mammaplasty with a single, vertical, superiorly-based pedicle to support the nipple-areola.

    PubMed

    Arufe, H N; Erenfryd, A; Saubidet, M

    1977-08-01

    We present our technique for mammaplasty, using a vertical, single-pedicled, flap with a superior base. The procedure is simple, and it allows final determination of the areola and nipple location after the newly shaped and positioned mound is closed.

  18. 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.

  19. [Diagnosis: synovial fluid analysis].

    PubMed

    Gallo Vallejo, Francisco Javier; Giner Ruiz, Vicente

    2014-01-01

    Synovial fluid analysis in rheumatological diseases allows a more accurate diagnosis in some entities, mainly infectious and microcrystalline arthritis. Examination of synovial fluid in patients with osteoarthritis is useful if a differential diagnosis will be performed with other processes and to distinguish between inflammatory and non-inflammatory forms. Joint aspiration is a diagnostic and sometimes therapeutic procedure that is available to primary care physicians.

  20. [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.

  1. 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

  2. Newborns prefer the odor of milk and nipples from females matched in lactation age: Comparison of two mouse strains.

    PubMed

    Al Aïn, Syrina; Goudet, Camille; Schaal, Benoist; Patris, Bruno

    2015-08-01

    Newborn mice are attracted to mammary odor cues carried in murine milk and nipple secretions. However, murine milk odor is not equally attractive along lactation. The present study focuses on the differential response of 2day-old mouse pups of C57Bl/6 (C) and Balb/C (B) strains to the odor of milk (Experiment 1) and nipples (Experiment 2) that are matched/unmatched in terms of pup's age or strain. In Experiment 1, C and B pups were tested in a series of tests simultaneously opposing either murine milk and a blank (water), or two milks collected in early and late lactation (lactation days 2 and 15, respectively) from females belonging to their own or the other strain. Results showed that C and B pups were attracted to the odor of the different milks regardless of the lactation age and the strain of the donor female. Nevertheless, C and B pups preferred the odor conveyed by early- than late-lactation milk of either strain. Moreover, early-lactation milk from C females was more attractive than early-lactation milk from B females for pups of either strain. In Experiment 2, differential nipple grasping response of C and B pups was measured when they were exposed to nipples of females in early or late lactation. The proportion of C pups that grasped a nipple was greater when they were exposed to a nipple in early lactation regardless of the strain of the donor females, whereas the proportion of B pups that grasped a nipple was greater when they were exposed to a nipple in early lactation, but only from own strain. Thus, newborn mice prefer the odor of milk and nipples from females that are matched in lactation age. This result is discussed in terms of reciprocally adaptive mechanisms between lactating females and their newborn offspring.

  3. 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

  4. An evidence-based approach to nipple feeding in a level III NICU: nurse autonomy, developmental care, and teamwork.

    PubMed

    Shaker, Catherine S; Woida, Amy Marie Werner

    2007-01-01

    Historically, nipple feeding in the NICU has been initiated and advanced by physician order based on nursing observation and suggestions. The growing evidence base regarding nipple feeding readiness and progression, contingent caregiving, and nurse autonomy in decision making prompted our Level III NICU to reconsider our process. A literature review and discussions resulted in new protocols for initiating and advancing nipple feedings for three distinct groups: healthy preterm infants, preterm infants with complicated medical courses, and sick term or posttcrm infants. Through incorporating contingent earegiving, greater autonomy for the bedside nurse, developmental support, and collaboration, we expect to improve outcomes, comnuinication, and problem solving.

  5. Levels of volatile N-nitrosamines in baby bottle rubber nipples commercialized in Belo Horizonte, Mina Gerais, Brazil

    SciTech Connect

    Gloria, M.B.A. )

    1991-07-01

    Several reports have been published describing the occurrence of volatile N-nitrosamines in rubber products. The first evidence of the presence of these compounds in baby bottle nipples was published by Ireland et al. Their study showed the presence of N-nitrosamines in elastomers compounded with dialkylamine accelerators and stabilizers. Several countries, through active cooperation with industry, have made considerable progress in eliminating or significantly reducing the levels of N-nitrosamines in baby bottle nipples. The purpose of the present study was to investigate the occurrence of volatile N-nitrosamines in baby bottle rubber nipples in the market of Belo Horizonte, MG, Brazil.

  6. Treatment of the benign inverted nipple: A systematic review and recommendations for future therapy.

    PubMed

    Hernandez Yenty, Q M; Jurgens, W J F M; van Zuijlen, P P M; de Vet, H C W; Verhaegen, P D H M

    2016-10-01

    The inverted nipple is a frequently encountered problem which can cause difficulties with breastfeeding, sexuality, and aesthetic dissatisfaction. Up to now, no consensus exists on a preferred treatment method. We performed a systematic review to identify the best treatment method for correction of benign inverted nipples. Treatment techniques were subdivided in the categories lactiferous duct preserving and lactiferous duct damaging. A systematic review was performed using the PRISMA statement. Inclusion criteria were: female patients with congenital or acquired inverted nipples, a minimum sample size of 10 nipples, and studies reporting recurrence of inversion with a minimum follow-up of six months. Exclusion criteria were nipple inversion caused by malignancy. Thirteen studies met the inclusion criteria which all had a level of evidence IV. No non-invasive treatment techniques were identified. In the duct preserving category eight studies were included with a recurrence rate of 0.6% (2/350) versus 9.9% (16/161) in the duct damaging category (n = 5). Other outcome parameters were not systematically reported in all studies. Because of a small number of low quality studies with heterogeneous interventions and outcomes a meta-analysis could not be performed and no preferred treatment method was identified. Based on the available data there is no statistical evidence that duct damaging treatment is superior to duct preserving treatment. We recommend that the first method of choice should be a duct preserving treatment method. In the future, more studies of better methodological quality are required and recommendations were made on how these could be conducted.

  7. PCR Improves Diagnostic Yield from Lung Aspiration in Malawian Children with Radiologically Confirmed Pneumonia

    PubMed Central

    Carrol, Enitan D.; Mankhambo, Limangeni A.; Guiver, Malcolm; Banda, Daniel L.; Denis, Brigitte; Dove, Winifred; Jeffers, Graham; Molyneux, Elizabeth M.; Molyneux, Malcolm E.; Graham, Stephen M.

    2011-01-01

    Background Accurate data on childhood pneumonia aetiology are essential especially from regions where mortality is high, in order to inform case-management guidelines and the potential of prevention strategies such as bacterial conjugate vaccines. Yield from blood culture is low, but lung aspirate culture provides a higher diagnostic yield. We aimed to determine if diagnostic yield could be increased further by polymerase chain reaction (PCR) detection of bacteria (Streptococcus pneumoniae and Haemophilus influenzae b) and viruses in lung aspirate fluid. Methods A total of 95 children with radiological focal, lobar or segmental consolidation had lung aspirate performed and sent for bacterial culture and for PCR for detection of bacteria, viruses and Pneumocystis jirovecii. In children with a pneumococcal aetiology, pneumococcal bacterial loads were calculated in blood and lung aspirate fluid. Results Blood culture identified a bacterial pathogen in only 8 patients (8%). With the addition of PCR on lung aspirate samples, causative pathogens (bacterial, viral, pneumocystis) were identified singly or as co-infections in 59 children (62%). The commonest bacterial organism was S.pneumoniae (41%), followed by H. influenzae b (6%), and the commonest virus identified was adenovirus (16%), followed by human bocavirus (HBoV) (4%), either as single or co-infection. Conclusions In a select group of African children, lung aspirate PCR significantly improves diagnostic yield. Our study confirms a major role of S.pneumoniae and viruses in the aetiology of childhood pneumonia in Africa. PMID:21695128

  8. Acellular Dermal Matrix as a Core Strut for Projection in Nipple Reconstruction: Approaches for Three Different Methods of Breast Reconstruction

    PubMed Central

    Park, Gui-Yong; Cho, Hee-Eun; Lee, Byung-Il; Park, Seung-Ha

    2016-01-01

    Background The objective of this paper was to describe a novel technique for improving the maintenance of nipple projection in primary nipple reconstruction by using acellular dermal matrix as a strut in one of three different configurations, according to the method of prior breast reconstruction. The struts were designed to best fill the different types of dead spaces in nipple reconstruction depending on the breast reconstruction method. Methods A total of 50 primary nipple reconstructions were performed between May 2012 and May 2015. The prior breast reconstruction methods were latissimus dorsi (LD) flap (28 cases), transverse rectus abdominis myocutaneous (TRAM) flap (10 cases), or tissue expander/implant (12 cases). The nipple reconstruction technique involved the use of local flaps, including the C-V flap or star flap. A 1×2-cm acellular dermal matrix was placed into the core with O-, I-, and L-shaped struts for prior LD, TRAM, and expander/implant methods, respectively. The projection of the reconstructed nipple was measured at the time of surgery and at 3, 6, and 9 months postoperatively. Results The nine-month average maintenance of nipple projection was 73.0%±9.67% for the LD flap group using an O-strut, 72.0%±11.53% for the TRAM flap group using an I-strut, and 69.0%±10.82% for the tissue expander/implant group using an L-strut. There were no cases of infection, wound dehiscence, or flap necrosis. Conclusions The application of an acellular dermal matrix with a different kind of strut for each of 3 breast reconstruction methods is an effective addition to current techniques for improving the maintenance of long-term projection in primary nipple reconstruction. PMID:27689049

  9. 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.

  10. 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: ...

  11. 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?

  12. 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.

  13. Comparison of the Effects of Lanolin, Peppermint, and Dexpanthenol Creams on Treatment of Traumatic Nipples in Breastfeeding Mothers

    PubMed Central

    Shanazi, Mahnaz; Farshbaf Khalili, Azizeh; Kamalifard, Mahin; Asghari Jafarabadi, Mohammad; Masoudin, Kazhal; Esmaeli, Fariba

    2015-01-01

    Introduction: Traumatic nipple is among the most common problems of the breastfeeding period which leads to early cessation of breastfeeding. The study aimed to compare the effects of the lanolin, peppermint, and dexpanthenol creams on the treatment of traumatic nipples. Methods: This double-blind randomized controlled trial was carried out on 126 breastfeeding mothers. The mothers had visited at the health centers and children’s hospitals in Sanandaj City. The selected participants were randomly divided into the following three groups of lanolin, peppermint, and dexpanthenol cream groups. Nipple pain was measured using the Store scale while trauma was measured with the Champion scale. Analyses were carried out through the Kruskal–Wallis test, Chi-square, ANOVA, and repeated measures ANOVA by using SPSS software ver. 13. Results: The result showed that the mean score of nipple pain and nipple trauma at the prior to intervention stage, third, seventh, and fourteenth days of intervention was not significantly different between three groups. But, repeated measures ANOVA showed a significant difference in comparison of the four time periods of intervention in each group. Conclusion: Results of this study revealed that the lanolin, peppermint, and dexpanthenol medicines had similar therapeutic effects on traumatic nipple. PMID:26744729

  14. Olfactory guidance of nipple attachment and suckling in kittens of the domestic cat: Inborn and learned responses.

    PubMed

    Raihani, Gina; González, Daniel; Arteaga, Lourdes; Hudson, Robyn

    2009-12-01

    In 60 kittens (11 litters) from free-ranging domestic cats we investigated the role of chemical cues in facilitating nipple attachment and suckling during the first month of postnatal life when kittens are totally dependent on the mother's milk. Kittens were tested both together and individually on sedated females in different reproductive states. We found (1) that newborn kittens with no suckling experience responded to the ventrum of lactating but not to the ventrum of nonlactating females with search behavior and attached to nipples within minutes; (2) that even in older kittens, nipple attachment depended on females' reproductive state, with virtually no attachments on nonreproducing females, some on pregnant females, the greatest number on early-lactating females, followed by a decline on late-lactating females; and (3) that kittens could locate their particular, most used nipple on their mother but not on a female of similar lactational age, even after eye opening. We suggest that kittens respond from birth with efficient nipple-search behavior to inborn olfactory cues on the mother's ventrum, that emission of these is under hormonal control, but that kittens also quickly learn olfactory cues specific to their own mother and to their own particular nipples.

  15. Levels of CEA, CA153, CA199, CA724 and AFP in nipple discharge of breast cancer patients

    PubMed Central

    Zhao, Song; Mei, Yu; Wang, Yongmei; Zhu, Jiang; Zheng, Guixi; Ma, Rong

    2015-01-01

    The distinction between breast cancer and benign breast diseases with nipple discharge remains an important diagnostic challenge. The purpose of this study was to predict the potential usefulness of tumor markers in nipple discharge and to investigate the relationship of tumor markers and clinical characteristics with breast cancer.One hundred and eleven patients with nipple discharge received breast surgery from November 2013 to December 2014 were included in the study. We evaluated levels of five tumor markers (CEA, CA153, CA199, CA724 and AFP) prior to treatment. Patients were divided into two groups according to postoperative pathological results: 30 cases in breast cancer group and 81 cases in benign group. The relationships of clinical characteristics with breast cancer were investigated by multivariate analysis with a logistic regression model.It showed significant differences in levels of nipple discharge CEA (P < 0.001) and CA153 (P = 0.014), but not CA199 (P = 0.856), CA724 (P = 0.171), AFP (P = 0.834) among two groups. Logistic regression analysis demonstrated complaint, age, menopause, abnormal palpable mass, CEA and CA153 were associated with breast cancer. In summary, measurements of CA199, CA724 and AFP in nipple discharge are not of great clinical value. Detecting CEA and CA153 in nipple dischargecould potentially be used for the early detection of breast cancer with in high-risk populations. PMID:26885008

  16. Duct Excision is Still Necessary to Rule out Breast Cancer in Patients Presenting with Spontaneous Bloodstained Nipple Discharge

    PubMed Central

    Foulkes, R. E.; Heard, G.; Boyce, T.; Skyrme, R.; Holland, P. A.; Gateley, C. A.

    2011-01-01

    Introduction. Spontaneous nipple discharge is the third most common reason for presentation to a symptomatic breast clinic. Benign and malignant causes of spontaneous nipple discharge continue to be difficult to distinguish. We analyse our experience of duct excisions for spontaneous nipple discharge to try to identify features that raise suspicion of breast cancer and to identify features indicative of benign disease that would be suitable for nonoperative management. Methods. Details of one hundred and ninety-four patients who underwent duct excision for spontaneous nipple discharge between 1995 and 2005 were analysed. Results. Malignant disease was identified in 11 (5.7%) patients, 4 invasive and 7 insitu, which was 10.2% of those presenting with bloodstained discharge. All patients with malignant disease had bloodstained discharge. Discharge due to malignant disease was more likely to be bloodstained than that due to benign causes (Fisher's exact test, 2-tailed P value = 0.00134). Conclusion. Our findings do not support a policy of conservative management of spontaneous bloodstained nipple discharge. Cases of demonstrable spontaneous bloodstained nipple discharge should undergo duct excision to prevent malignant lesions being missed. PMID:22295227

  17. Levels of CEA, CA153, CA199, CA724 and AFP in nipple discharge of breast cancer patients.

    PubMed

    Zhao, Song; Mei, Yu; Wang, Yongmei; Zhu, Jiang; Zheng, Guixi; Ma, Rong

    2015-01-01

    The distinction between breast cancer and benign breast diseases with nipple discharge remains an important diagnostic challenge. The purpose of this study was to predict the potential usefulness of tumor markers in nipple discharge and to investigate the relationship of tumor markers and clinical characteristics with breast cancer.One hundred and eleven patients with nipple discharge received breast surgery from November 2013 to December 2014 were included in the study. We evaluated levels of five tumor markers (CEA, CA153, CA199, CA724 and AFP) prior to treatment. Patients were divided into two groups according to postoperative pathological results: 30 cases in breast cancer group and 81 cases in benign group. The relationships of clinical characteristics with breast cancer were investigated by multivariate analysis with a logistic regression model.It showed significant differences in levels of nipple discharge CEA (P < 0.001) and CA153 (P = 0.014), but not CA199 (P = 0.856), CA724 (P = 0.171), AFP (P = 0.834) among two groups. Logistic regression analysis demonstrated complaint, age, menopause, abnormal palpable mass, CEA and CA153 were associated with breast cancer. In summary, measurements of CA199, CA724 and AFP in nipple discharge are not of great clinical value. Detecting CEA and CA153 in nipple dischargecould potentially be used for the early detection of breast cancer with in high-risk populations.

  18. Cytological diagnosis of sialadenosis, sialadenitis, and parotid cysts by fine-needle aspiration biopsy.

    PubMed

    Droese, M

    1981-01-01

    This analysis permits the following conclusions: The value of punctate cytology consists in the possibility to verify the clinical diagnosis of a cyst by aspiration of fluid, and to make a preoperative assessment of the necessity of an operation and its type and extent, if proof of a benign or malignant tumor was obtained by microscopic examination. The diagnostic value of punctate cytology can be increased if after aspiration of cyst fluid also solid tissue components from the region of the cyst are included. Patients whose biopsy aspirates did not give evidence for the presence of a tumor should be reexamined 2-4 weeks later. Operative treatment will not be necessary if the follow-up examination reveals that the parotid swelling has subsided. Without this control investigation, recommended by Zajicek [80], morphological aspects always indicate an operation if tumor-negative biopsies cannot be etiologically classified even though clinical data were included in the diagnostic procedure.

  19. 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…

  20. Bilateral bloody nipple discharge in a male infant: sonographic findings and proposed diagnostic approach.

    PubMed

    Djilas-Ivanovic, Dragana; Boban, Jasmina; Katanic, Dragan; Ivkovic-Kapicl, Tatjana; Lucic, Milos Alexandar

    2012-01-01

    Bloody nipple discharge is an uncommon finding in the pediatric population, without clear diagnostic and therapeutic guidelines established. We noted a case of a 3-month-old male infant who presented with bilateral blood-stained nipple discharge, with unremarkable medical history. Sonographic findings revealed bilaterally dilated ducts and cysts with mixed iso- and hypoechoic intraductal content. Possible causes of this condition include hyperlaxity syndrome with decreased function of elastic fibers and fibrocystic changes in breasts, and unusual response to maternal hormones, transferred to the neonate either transplacentally or through breastfeeding. Given the most probable benign etiology and self-limiting nature of the described condition, a conservative approach is suggested. Unnecessary invasive procedures should be avoided.

  1. 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.

  2. 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.

  3. Identification of breast contour for nipple segmentation in breast magnetic resonance images

    SciTech Connect

    Gwo, Chih-Ying; Gwo, Allen; Wei, Chia-Hung; Huang, Pai Jung

    2014-02-15

    Purpose: The purpose of this study is to develop a method to simulate the breast contour and segment the nipple in breast magnetic resonance images. Methods: This study first identifies the chest wall and removes the chest part from the breast MR images. Subsequently, the cleavage and its motion artifacts are removed, distinguishing the separate breasts, where the edge points are sampled for curve fitting. Next, a region growing method is applied to find the potential nipple region. Finally, the potential nipple region above the simulated curve can be removed in order to retain the original smooth contour. Results: The simulation methods can achieve the least root mean square error (RMSE) for certain cases. The proposed YBnd and (Dmin+Dmax)/2 methods are significant due toP = 0.000. The breast contour curve detected by the two proposed methods is closer than that determined by the edge detection method. The (Dmin+Dmax)/2 method can achieve the lowest RMSE of 1.1029 on average, while the edge detection method results in the highest RMSE of 6.5655. This is only slighter better than the comparison methods, which implies that the performance of these methods depends upon the conditions of the cases themselves. Under this method, the maximal Dice coefficient is 0.881, and the centroid difference is 0.36 pixels. Conclusions: The contributions of this study are twofold. First, a method was proposed to identify and segment the nipple in breast MR images. Second, a curve-fitting method was used to simulate the breast contour, allowing the breast to retain its original smooth shape.

  4. Renal tubular dysgenesis, absent nipples, and multiple malformations in three brothers: a new, lethal syndrome.

    PubMed

    Hisama, F M; Reyes-Mugica, M; Wargowski, D S; Thompson, K J; Mahoney, M J

    1998-12-04

    We report on three brothers with renal tubular dysgenesis and absent nipples, each also had other malformations including pre-auricular pits and a preauricular tag, branchial clefts, choanal atresia, pulmonary lobation anomaly, ventricular septal defect, type IIB interrupted aortic arch, absent gallbladder, absent thymus, parathyroid gland, accessory spleen, imperforate anus, clinodactyly, and broad digits and small nails. All three infants died neonatally. This pattern of clinical malformations appears to be a previously unreported syndrome.

  5. Nipple-sparing mastectomy in breast cancer patients: The role of adjuvant radiotherapy (Review).

    PubMed

    Janssen, Stefan; Holz-Sapra, Edna; Rades, Dirk; Moser, Alexander; Studer, Gabriela

    2015-06-01

    The present study aimed to evaluate the role of adjuvant radiotherapy (RT) following nipple-sparing mastectomy (NSM) for patients with ductal carcinoma in situ and invasive breast cancer, based on the published literature. Currently, there is no standard for RT following NSM. NSM aims to spare the nipple areola complex (NAC) without compromising locoregional control. Long-term follow-up studies have begun to show promising results. A search of the English literature was performed using the Medline database and Cochrane central library, with the keywords 'nipple/areola-sparing mastectomy', 'whole skin mastectomy' and 'NAC preservation'. A total of 32 original studies with data on NSM in terms of locoregional control, NAC control, NAC necrosis and adjuvant RT were identified. The median locoregional and NAC recurrence rates were 3.2 and 1.4% (range, 0-28.4% and 0-3.7%), respectively. The volume of remaining breast tissue following NSM was reported inconsistently. In 15 studies, RT was not mentioned. In the remaining 17 studies, RT was administered in 0-100% of patients. Only 7 studies provided detailed information regarding the use of adjuvant RT. Adjuvant thoracic wall irradiation was not used in certain studies, not even for locoregionally advanced tumors. Overall, NSM appears a feasible treatment without increased risk of locoregional recurrence for selected patients. The role of adjuvant RT following NSM requires further clarification. The decision regarding adjuvant RT must be made in interdisciplinary tumor boards and with consideration of the individual situation of the patient.

  6. Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality?

    PubMed

    Didier, F; Radice, D; Gandini, S; Bedolis, R; Rotmensz, N; Maldifassi, A; Santillo, B; Luini, A; Galimberti, V; Scaffidi, E; Lupo, F; Martella, S; Petit, J Y

    2009-12-01

    We investigated the influence of nipple areolar complex (NAC) sparing in mastectomy, on patient satisfaction with cosmetic results, body-image, sexuality and psychological well-being. We developed a specific questionnaire and compared two groups of women who underwent radical mastectomy with immediate breast reconstruction (IBR). Between 2004 and 2006, 310 women with NAC preservation and 143 patients with successive NAC reconstruction were mailed the questionnaire at follow-up 1 year after definitive complete breast reconstruction surgery. 256 questionnaires was available. Our results showed significant differences in favour of the NAC sparing group regarding body image (difficulty in looking at themselves naked and being seen naked by their partners after surgery, P = 0.001 and P = 0.003, respectively); regarding satisfaction with the appearance of the nipple (P < .0001) and with the sensitivity of the nipple (P = 0.001); regarding the feeling of mutilation (P = 0.003). NAC sparing in mastectomy has a positive impact on patient satisfaction, body image and psychological adjustment.

  7. Gli activity is critical at multiple stages of embryonic mammary and nipple development.

    PubMed

    Chandramouli, Anupama; Hatsell, Sarah J; Pinderhughes, Alicia; Koetz, Lisa; Cowin, Pamela

    2013-01-01

    Gli3 is a transcriptional regulator of Hedgehog (Hh) signaling that functions as a repressor (Gli3(R)) or activator (Gli3(A)) depending upon cellular context. Previously, we have shown that Gli3(R) is required for the formation of mammary placodes #3 and #5. Here, we report that this early loss of Gli3 results in abnormal patterning of two critical regulators: Bmp4 and Tbx3, within the presumptive mammary rudiment (MR) #3 zone. We also show that Gli3 loss leads to failure to maintain mammary mesenchyme specification and loss of epithelial Wnt signaling, which impairs the later development of remaining MRs: MR#2 showed profound evagination and ectopic hairs formed within the presumptive areola; MR#4 showed mild invagination defects and males showed inappropriate retention of mammary buds in Gli3(xt/xt) mice. Importantly, mice genetically manipulated to misactivate Hh signaling displayed the same phenotypic spectrum demonstrating that the repressor function of Gli3(R) is essential during multiple stages of mammary development. In contrast, positive Hh signaling occurs during nipple development in a mesenchymal cuff around the lactiferous duct and in muscle cells of the nipple sphincter. Collectively, these data show that repression of Hh signaling by Gli3(R) is critical for early placodal patterning and later mammary mesenchyme specification whereas positive Hh signaling occurs during nipple development.

  8. A Rare Case of a 15-Year-Old Boy with Two Accessory Nipples: One in the Forearm and One in the Milk Line

    PubMed Central

    Tauchen, Alexander J.; Kueberuwa, Essie; Schiffman, Kenneth; Mudaliar, Kumaran M.; Noland, Shelley S.

    2015-01-01

    A 15-year-old male presented for evaluation of a volar forearm mass that he noticed four years before. The mass was not painful and his main concern was cosmesis. The mass was two centimeters in diameter with a pinpoint central sinus and scant drainage. After excision, the pathology report noted pilosebaceous units and smooth muscle bundles, consistent with an accessory nipple. In addition, the patient had another accessory nipple in the “milk line” on his torso. While accessory nipples and breast tissue have been reported in numerous locations throughout the body, this is the first reported case of an accessory nipple on the forearm. PMID:26783489

  9. A Rare Case of a 15-Year-Old Boy with Two Accessory Nipples: One in the Forearm and One in the Milk Line.

    PubMed

    Tauchen, Alexander J; Kueberuwa, Essie; Schiffman, Kenneth; Mudaliar, Kumaran M; Noland, Shelley S

    2015-01-01

    A 15-year-old male presented for evaluation of a volar forearm mass that he noticed four years before. The mass was not painful and his main concern was cosmesis. The mass was two centimeters in diameter with a pinpoint central sinus and scant drainage. After excision, the pathology report noted pilosebaceous units and smooth muscle bundles, consistent with an accessory nipple. In addition, the patient had another accessory nipple in the "milk line" on his torso. While accessory nipples and breast tissue have been reported in numerous locations throughout the body, this is the first reported case of an accessory nipple on the forearm.

  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. 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

  12. 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…

  13. 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 ...

  14. 21 CFR 884.1550 - Amniotic fluid sampler (amniocentesis tray).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Amniotic fluid sampler (amniocentesis tray). 884... Diagnostic Devices § 884.1550 Amniotic fluid sampler (amniocentesis tray). (a) Identification. The amniotic fluid sampler (amniocentesis tray) is a collection of devices used to aspirate amniotic fluid from...

  15. 21 CFR 884.1550 - Amniotic fluid sampler (amniocentesis tray).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Amniotic fluid sampler (amniocentesis tray). 884... Diagnostic Devices § 884.1550 Amniotic fluid sampler (amniocentesis tray). (a) Identification. The amniotic fluid sampler (amniocentesis tray) is a collection of devices used to aspirate amniotic fluid from...

  16. 21 CFR 884.1550 - Amniotic fluid sampler (amniocentesis tray).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Amniotic fluid sampler (amniocentesis tray). 884... Diagnostic Devices § 884.1550 Amniotic fluid sampler (amniocentesis tray). (a) Identification. The amniotic fluid sampler (amniocentesis tray) is a collection of devices used to aspirate amniotic fluid from...

  17. 21 CFR 884.1550 - Amniotic fluid sampler (amniocentesis tray).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Amniotic fluid sampler (amniocentesis tray). 884... Diagnostic Devices § 884.1550 Amniotic fluid sampler (amniocentesis tray). (a) Identification. The amniotic fluid sampler (amniocentesis tray) is a collection of devices used to aspirate amniotic fluid from...

  18. 21 CFR 884.1550 - Amniotic fluid sampler (amniocentesis tray).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Amniotic fluid sampler (amniocentesis tray). 884... Diagnostic Devices § 884.1550 Amniotic fluid sampler (amniocentesis tray). (a) Identification. The amniotic fluid sampler (amniocentesis tray) is a collection of devices used to aspirate amniotic fluid from...

  19. 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.

  20. The Bone Marrow Stem Cell Origin of Human Breast Cancer Using Transgenic Mouse Models

    DTIC Science & Technology

    2008-10-01

    Kurtis Yearsley Intraductal "foam cells" are the most commonly encountered cells in spontaneous nipple discharge, nipple aspirate fluid and ductal...female as well as male recipients. The numbers may actually have been higher than observed because some cancers of male origin spontaneously lost

  1. 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

  2. Quantitative Evaluation of DNA Hypermethylation in Malignant and Benign Breast Tissue and Fluids

    PubMed Central

    Zhu, Weizhu; Qin, Wenyi; Hewett, John E.; Sauter, Edward R.

    2012-01-01

    The assessment of DNA had demonstrated altered methylation in malignant compared to benign breast tissue.The purpose of our study was to 1) confirm the predictive ability of methylation assessment in breast tissue, and 2) use the genes found to be cancer predictive in tissue to evaluate the diagnostic potential of hypermethylation assessment in nipple aspirate fluid (NAF) and mammary ductoscopic (MD) samples. Quantitative methylation specific (qMS)-PCR was conducted on three specimen sets: 44 malignant (CA) and 34 normal (NL) tissue specimens, 18 matched CA, adjacent normal (ANL) tissue and NAF specimens, and 119 MD specimens. Training and validation tissue sets were analyzed to determine the optimal group of cancer predictive genes for NAF and MD analysis. NAF and MD cytologic review were also performed. Methylation of CCND-2, p16, RAR-β and RASSF-1a was significantly more prevalent in tumor than in normal tissue specimens. Receiver operating characteristic curve analysis demonstrated an area under the curve of 0.96. For the 18 matched CA, ANL and NAF specimens, the four predictive genes identified in cancer tissue contained increased methylation in CA vs. ANL tissue; NAF samples had higher methylation than ANL specimens. Methylation frequency was higher in MD specimens from breasts with cancer than benign samples for p16 and RASSF-1a. In summary, 1) routine quantitative DNA methylation assessment in NAF and MD samples is possible, and 2) genes hypermethylated in malignant breast tissue are also altered in matched NAF and in MD samples, and may be useful to assist in early breast cancer detection. PMID:19618401

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Does Smoking History Confer a Higher Risk for Reconstructive Complications in Nipple-Sparing Mastectomy?

    PubMed

    Frey, Jordan D; Alperovich, Michael; Levine, Jamie P; Choi, Mihye; Karp, Nolan S

    2017-01-18

    History of smoking has been implicated as a risk factor for reconstructive complications in nipple-sparing mastectomy (NSM), however there have been no direct analyses of outcomes in smokers and nonsmokers. All patients undergoing NSM at New York University Langone Medical Center from 2006 to 2014 were identified. Outcomes were compared for those with and without a smoking history and stratified by pack-year smoking history and years-to-quitting (YTQ). A total of 543 nipple-sparing mastectomies were performed from 2006 to 2014 with a total of 49 in patients with a history of smoking. Reconstructive outcomes in NSM between those with and without a smoking history were equivalent. Those with a smoking history were not significantly more likely to have mastectomy flap necrosis (p = 0.6251), partial (p = 0.8564), or complete (p = 0.3365) nipple-areola complex (NAC) necrosis. Likewise, active smokers alone did not have a higher risk of complications compared to nonsmokers or those with smoking history. Comparing nonsmokers and those with a less or greater than 10 pack-year smoking history, those with a > 10 pack-year history had significantly more complete NAC necrosis (p = 0.0114, <0.0001). Those with <5 YTQ prior to NSM trended toward an increased rate of complete NAC necrosis (p = 0.0752). Outcomes for those with a < 10 pack-year smoking history or >5 YTQ prior to NSM were equivalent to those without a smoking history. We demonstrate that NSM may be safely offered to those with a smoking history although a > 10 pack-year smoking history or <5 YTQ prior to NSM may impart a higher risk of reconstructive complications, including complete NAC necrosis.

  8. The Rightful Role of MRI after Negative Conventional Imaging in the Management of Bloody Nipple Discharge.

    PubMed

    Sanders, Linda M; Daigle, Megan

    2016-01-01

    Nipple discharge is a frequent presenting complaint at breast clinics. Bloody nipple discharge (BND) has the highest risk of malignancy, albeit low. If mammogram and ultrasound are unrevealing, central duct excision (CDE) has been considered the gold standard in its management. Magnetic resonance imaging (MRI) has been widely confirmed as a highly sensitive test for detection of breast cancer, with an accompanying high negative predictive value. This article presents a retrospective review of patients with BND and negative conventional imaging, comparing outcome of patients who went directly to CDE without MRI to those patients who underwent preoperative MRI. Of 115 patients who underwent mammography and US alone prior to CDE, eight cancers were detected (seven ductal carcinoma in situ [DCIS] and 1 IDC, 7 mm [T1b]; incidence: 7%). Of 85 patients who underwent conventional imaging followed by MRI prior to surgery, eight cancers were detected (all DCIS; incidence: 9.4%), seven of which were identified by MRI. The one false-negative MRI had subtle findings which, in retrospect, were misinterpreted; however, a clinically apparent nipple lesion prompted surgical biopsy. Of 56 patients with a negative or benign MRI, CDE was negative for malignancy in all but that one patient. Sensitivity and specificity were 87.5%/71.4%. Positive predictive value and negative predictive value (NPV) were 24.1%/98.2%. MRI should be performed in all patients with BND and negative conventional imaging. The extremely high NPV of MRI suggests that a negative study could obviate CDE in most patients unless overriding clinical factors prevail.

  9. A Comparison of Ductoscopy-Guided and Conventional Surgical Excision in Women With Spontaneous Nipple Discharge

    PubMed Central

    Moncrief, Robyn M.; Nayar, Ritu; Diaz, Leslie K.; Staradub, Valerie L.; Morrow, Monica; Khan, Seema A.

    2005-01-01

    Introduction: Radiologic imaging is routinely used to evaluate women with spontaneous nipple discharge (SND), but definitive diagnosis is usually only achieved by surgical terminal duct excision (TDE). Ductoscopy has been reported to result in improved localization of intraductal lesions and may avoid surgery in women with endoscopically normal ducts. Materials and Methods: We conducted a retrospective review of the records of 117 consecutive women who underwent ductoscopy to guide ductal excision (scope-DE) or received conventional TDE without ductoscopy. Two women had atypical ductal lavage cytology and the remainder presented with SND from 1 or more duct. Preoperative evaluation included radiologic imaging as clinically indicated. Results: Fifty-nine women underwent scope-DE, and 58 underwent conventional TDE. There were no significant differences in age, race, discharge characteristics, or radiologic findings. The proportion of women with intraductal neoplasia was slightly greater in the group undergoing scope-DE (88% vs. 81%, P = 0.2). In the conventional TDE group, 8.5% were found to have atypical hyperplasia or duct carcinoma in situ compared with 18.6% in the scope-DE group. In the ductoscopy group, 22 of 59 (37.3%) had lesions >5 cm from the nipple, compared with 1 of 17 women for whom distance of the lesion from the nipple was known in the conventional group (P = 0.02). Of the ductoscopy-detected cancers, 5 of 6 had no symptoms other than SND, whereas 1 of the 4 malignancies in the conventional group presented as SND alone. Discussions: Ductoscopy identifies intraductal lesions in a high proportion of women with SND, and it may contribute to more accurate resection of these. A prospective study is required to obtain an unbiased assessment of these possible advantages. PMID:15798458

  10. Fiberoptic ductoscopy combined with cytology testing in the patients of spontaneous nipple discharge.

    PubMed

    Liu, Guang-Yu; Lu, Jing-Song; Shen, Kun-Wei; Wu, Jiong; Chen, Can-Ming; Hu, Zhen; Shen, Zhen-Zhou; Zhang, Ting-Qiu; Shao, Zhi-Min

    2008-03-01

    Fiberoptic ductoscopy system (FDS) offers a safe alternative to ductography in diagnosing intraductal lesions and serves as a guide for subsequent surgery in women with nipple discharge. In this article, we reported the outcomes of FDS combined with cytology testing for diagnosis of spontaneous nipple discharge. From 1997 to 2005, 1,048 women (1,093 breasts total) in the outpatient department underwent successful diagnostic FDS. Discharge was unilateral (86.8%), single ductal (93.4%), and serous (57.9%) or bloody (36.0%). Among 437 (40.0%) of the FDS-positive breasts, we revealed 49 (11.2%) breast carcinomas, 228 (52.2%) central papillomas, and 5 (1.1%) cases of atypical ductal hyperplasia. Ten patients with positive cytology testing received microdochectomy in spite of having a negative FDS, which revealed two additional ductal carcinomas in situ (DCIS), and four papillomas. About 489 breasts were negative for both FDS and cytology testing and were subjected to follow up. About 77 (15.7%) of the breasts underwent tissue diagnosis within a median follow-up time span of 19 months, and one DCIS was detected. The sensitivity of FDS for detection of malignant lesions was 94.2% and increased to 98.1% when combined with cytology testing. Nevertheless, it was less sensitive (p<0.01) if we used cytology testing only (58.3%), mammography (48.6%), high-frequency sonography (36.4%), or combination of mammography and sonography (56.8%) to detect these malignant lesions. These data confirmed the value of FDS combined with cytology testing as a diagnostic procedure in women with nipple discharge.

  11. Different Levels of CEA, CA153 and CA125 in Milk and Benign and Malignant Nipple Discharge

    PubMed Central

    Zhao, Song; Mei, Yu; Wang, Jianli; Zhang, Kai; Ma, Rong

    2016-01-01

    Background The aim of this study was to assess the diagnostic values of three breast tumor markers (i.e., CEA, CA153 and CA125) in milk and nipple discharge in the prediction of different breast diseases diagnoses. Methods Three hundred thirty-six patients (96 breast cancer and 240 benign disease patients) with nipple discharge and a control group of 56 healthy parturient participants were enrolled in the present study. Nipple discharge samples were preoperatively collected from the patients, and milk was collected from the colostrum of the parturient participants. The samples were assayed for the CEA, CA153 and CA125 levels. Cutoff values were determined for the detection of breast diseases using ROC curves. Results The levels of CEA, CA153 and CA125 were significantly different between the nipple discharge and the milk (all ps < 0.001). In the nipple discharge, the CEA and CA153 levels in the breast cancer group were significantly greater than those in the benign group (all ps < 0.001), and cutoff values of 263.3 ng/mL and 1235.3 U/mL, respectively, were established. However, the expression of CA125 did not differ significantly between the breast cancer and benign groups. Conclusion Differences in the apparent expression levels of CEA, CA153 and CA125 in patients with nipple discharge and healthy persons were validated. The present data suggest that CEA and CA153 might potentially be useful in the differential diagnoses of benign tumors and breast cancer. CA125 did not seem to be useful for breast cancer detection. PMID:27327081

  12. Feeding an infant with high arched palate by high flow rate bottle nipple.

    PubMed

    Eren, Abdulkadir; Bilgin, Huseyin; Kara, Semra

    2015-01-01

    For infants with high arched palate, feeding is one of the most immediate challenges faced by parents and caretakers. General suggestions for feeding in infants with cleft palate may be adapted to infants with high arched palate. These include oral feeding facilitation techniques and special feeding tools. Here we present a newborn with a high arched palate and serious feeding problems who was fed easily by a large size and a large hole nipple, ordinarily used for infants older than 6 months, instead of specialized feeding equipment.

  13. Usefulness of MRI in detecting occult breast cancer associated with Paget's disease of the nipple-areolar complex.

    PubMed

    Echevarria, J J; Lopez-Ruiz, J A; Martin, D; Imaz, I; Martin, M

    2004-12-01

    MRI allows for the detection of mammographically and clinically occult breast neoplasms. We analysed the ability of MRI to detect occult breast cancer in three patients with Paget's disease of the nipple-areolar complex, proven histologically. In all three cases we observed differences in the morphological and dynamic features of healthy and pathological nipples, and we also found enhancement foci in breast tissue, with suspicious kinetic and morphological characteristics, which in the case of two patients corresponded to ductal carcinoma in situ. The detection and location with MRI of underlying neoplastic foci may be of help in choosing the most reasonable and conservative treatment in these patients.

  14. Spondylocostal dysostosis associated with type I split cord malformation and double nipple on one side: a case report.

    PubMed

    Yilmaz, Muhammet Bahadır; Kaymak, Aysegul; Kurt, Gokhan; Percin, Ferda Emriye; Baykaner, Kemali

    2013-01-01

    Jarcho Levin syndrome is a rare genetic disorder characterized by multipl vertebral and costal anomalies at birth. Jarcho Levin syndrome includes two phenotypic groups: spondylothoracic dysostosis and spondylocostal dysostosis. The prognosis of spondylothoracic dysostosis has worse than spondylocostal dysostosis, because of respiratory complications. Associated malformations include those of the congenital heart disease, urogenital malformation, skeletal anomalies and neural tube defects. We present a patient with spondylocostal dysostosis, who also had type I split cord malformation, tethered cord, scoliosis and double nipple on the right. Although the association of spondylocostal dysostosis and type I split cord malformation is very rare, double nipples on one side is no previously reported.

  15. 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…

  16. Silicone rubber nipples: effects of sesame-oil extract on reproduction in mice.

    PubMed

    Al-Khatim, Al-Ser A Gader; Suliaman, Mansour I; Abdel-Galil, Khidir A

    2005-01-01

    The authors investigated a type of silicone rubber (SR) nipple for toxicity, caused by chemical migrants, on reproduction and pregnancy outcomes. They followed an extraction method (set forth in the 20th revised edition of the United States Pharmacopeia) in which sesame oil was a vehicle. They prepared the extract daily and administered it orally (50 ml/kg of body weight) into pregnant Swiss albino mice from gestation Day 0 until delivery. They gave a control group of mice the pure vehicle that was subjected to the same conditions. The authors recorded pregnancy weight gain, gestation period, litter size, stillbirths, and offspring sex ratio. They performed an enzyme-linked immunosorbent assay for pregnancy hormones (progesterone, estradiol, and prolactin) for each trimester and monitored birth weight, growth rate, and sex hormone levels (follicle-stimulating hormone, luteinizing hormone, and estradiol in females; testosterone in males) in offspring. The authors detected SR-extractable chemicals by means of gas chromatography and mass spectrometry. The decrease in weight gain from Day 6 of gestation until delivery and the shortness in the gestation period were significant in dams (p< or = .05). Newly born pups demonstrated a significantly (p < or = .05) lower body weight that continued with age, and this became highly significant (p< or = .01) from Day 6. Blood hormone levels in dams and offspring indicated no significance. In conclusion, the studied SR nipples indicated leachability, which could affect reproduction, without a manifest endocrine modulation.

  17. Biofilm formation by Candida species on silicone surfaces and latex pacifier nipples: an in vitro study.

    PubMed

    da Silveira, Luiz Cezar; Charone, Senda; Maia, Lucianne Cople; Soares, Rosangela Maria de Araújo; Portela, Maristela Barbosa

    2009-01-01

    The present study assessed the growth and development of biofilm formation by isolates of C. albicans, C. glabrata and C. parapsilosis on silicone and latex pacifier nipples. The silicone and latex surfaces were evaluated by scanning electronic microscopy (SEM). The plastic component of the nipple also seems to be an important factor regarding the biofilm formation by Candida spp. The biofilm growth was measured using the MTT reduction reaction. C. albicans was found to have a slightly greater capacity of forming biofilm compared to the other Candida species. Analysis of the pattern of biofilm development by C. albicans, C. glabrata and C. parapsilosis on latex and silicon pacifier shields showed an increased biofilm formation regarding the latter substrate. Silicone was shown to be more resistant to fungal colonization, particularly in the case of C. parapsilosis, despite the lack of any statistically significant differences (P > 0.05). In addition, silicone has a smoother surface compared to latex, whose surface was found to be rugose and irregular.

  18. 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

  19. 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

  20. Fluid imbalance

    MedlinePlus

    ... up in the body. This is called fluid overload (volume overload). This can lead to edema (excess fluid in ... Water imbalance; Fluid imbalance - dehydration; Fluid buildup; Fluid overload; Volume overload; Loss of fluids; Edema - fluid imbalance; ...

  1. 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

  2. Pigmented Basal cell carcinoma of nipple and areola in a male breast - a case report with review of literature.

    PubMed

    Kalyani, R; Vani, B R; Srinivas, Murthy V; Veda, P

    2014-03-01

    Basal cell carcinoma is a common skin cancer worldwide. However basal cell carcinoma of nipple and areola complex is rare, commonly seen in males in elderly age group. The tumor has aggressive behavior with increased tendency for metastasis. We present a case in a 78 year male in the left breast.

  3. A second case of contractures, webbed neck, micrognathia, hypoplastic nipples, and distinctive facial features: confirmation of the Dinno syndrome.

    PubMed

    Wall, Nerilee; McGaughran, Julie

    2012-04-01

    We report on a child with micrognathia, a short, webbed neck, joint contractures, hypoplastic nipples, and a number of other anomalies. There are striking similarities to a patient reported by [Dinno and Weisskopf (1976); Synd Ident, 4:10-12], and we postulate that this child represents the second patient with this condition.

  4. Identification of specific relaxin-binding cells in the cervix, mammary glands, nipples, small intestine, and skin of pregnant pigs.

    PubMed

    Min, G; Sherwood, O D

    1996-12-01

    We previously demonstrated that relaxin promotes growth and softening of the cervix and development of the mammary glands in the pregnant pig. An important aspect of understanding relaxin's mechanism of action in these tissues is to identify the specific cell type(s) that contains relaxin receptors, that is, to identify those cells that initiate relaxin's effects. The objective of the present study was to identify relaxin-binding cells in tissues known to respond to relaxin (cervix and mammary gland) as well as in tissues suspected of being responsive to relaxin (nipple, small intestine, and skin) in the pregnant pig. To accomplish that objective we developed an in vitro modification of an immunohistochemical technique recently developed for identification of relaxin-binding cells. Two groups of pregnant gilts were used: intact control (group C) and ovariectomized progesterone-treated (group OP). Group OP was ovariectomized on Day 40 of gestation (Day 40) and treated with progesterone (50 mg/2 ml corn oil i.m., twice daily) until Day 110 to maintain pregnancy. On Day 110, tissues from both groups were removed, cut into cubes (2-3 cm3), frozen in liquid nitrogen, and cryosectioned (8 microns). Specific cell types that bind relaxin were identified by sequential application of a biotinylated relaxin probe, antibiotin immunoglobulin G conjugated to 1 nm colloidal gold, and silver for signal amplification. The study demonstrates for the first time that relaxin binds with specificity to 1) blood vessels (cervix, mammary glands, nipples, small intestine); 2) smooth muscles in small intestine (circular, longitudinal, muscularis mucosa); and 3) skin from sites other than the mammary nipples (back, ear, thigh, leg). In addition, consistent with previous findings in the rat, prominent labeling was observed in epithelial cells in the cervix, mammary glands, and nipples; in smooth muscle cells in the cervix and mammary nipples; and in the skin of the nipples. There were no

  5. [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.

  6. [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.

  7. Chronic mucocutaneous candidiasis: a case with exuberant cutaneous horns in nipples.

    PubMed

    Chambô Filho, Antônio; Souza Filho, João Basilio de; Pignaton, Christine Chambô; Zon, Ingrid; Fernandes, Alan Santos; Cardoso, Lia Quintaes

    2014-01-01

    Chronic mucocutaneous candidiasis is a rare disorder characterized by persistent and recurrent infections by Candida due to changes in cellular immunity and may be associated with autoimmune endocrine disorders. It is refractory to the usual antifungal treatments, which merely control it with imidazole derivatives. This reports the case of a 50-year-old female patient who referred vaginal discharge associated with vulvar ulcerated lesions and whitish plaques on oral and genital mucous membranes of onset in adolescence besides cutaneous horns in nipples. The clinical picture, family history, culture and anatomopathological studies were consistent with chronic infection by candida. Treatment with systemic antifungals obtained partial response of lesions characterizing a clinical picture of Chronic Mucocutaneous Candidiasis.

  8. [Model of genetic control of the number and location of nipples in domestic pig].

    PubMed

    Nikitin, S V; Kniazev, S P; Ermolaev, V I

    2012-11-01

    In domestic pig, the number and location of nipples is considered a single quantitative trait, which has a complex spatial structure that includes bilaterality and a linear sequence of repetitive elements. According to this hypothesis, six inadherent biallelic loci are sufficient for a variety of traits observed in domestic pig populations. Verification of representative samplings from five domestic pig populations of different origin (about 20 000 individuals) confirmed the theses of the hypothesis, this fact allows considering it as a model of the studied bilateral trait. Using the model, the intraclass pheno- and genotypic diversity was examined and the relationship of the trait manifestation asymmetry with heterozygosity of loci that control it was shown.

  9. Chronic mucocutaneous candidiasis: a case with exuberant cutaneous horns in nipples*

    PubMed Central

    Chambô, Antônio; de Souza, João Basilio; Pignaton, Christine Chambô; Zon, Ingrid; Fernandes, Alan Santos; Cardoso, Lia Quintaes

    2014-01-01

    Chronic mucocutaneous candidiasis is a rare disorder characterized by persistent and recurrent infections by Candida due to changes in cellular immunity and may be associated with autoimmune endocrine disorders. It is refractory to the usual antifungal treatments, which merely control it with imidazole derivatives. This reports the case of a 50-year-old female patient who referred vaginal discharge associated with vulvar ulcerated lesions and whitish plaques on oral and genital mucous membranes of onset in adolescence besides cutaneous horns in nipples. The clinical picture, family history, culture and anatomopathological studies were consistent with chronic infection by candida. Treatment with systemic antifungals obtained partial response of lesions characterizing a clinical picture of Chronic Mucocutaneous Candidiasis. PMID:25054753

  10. Fiberoptic ductoscopy-guided intraductal biopsy improve the diagnosis of nipple discharge.

    PubMed

    Ling, Hong; Liu, Guang-yu; Lu, Jin-song; Love, Susan; Zhang, Jia-xin; Xu, Xiao-li; Xu, Wei-ping; Shen, Kun-wei; Shen, Zhen-zhou; Shao, Zhi-min

    2009-01-01

    Fiberoptic ductoscopy (FDS)-guided intraductal biopsy is a minimally invasive technique developed to obtain pathologic diagnoses for patients with spontaneous nipple discharge. We performed biopsies of 53 intraductal lesions from March 2006 to April 2007 followed by surgical microdochectomy. FDS-guided intraductal biopsy was shown to be a minimally invasive, safe, and convenient technique with a high ability (90.6%) to get adequate samples. Twenty-seven solitary papillomas, 12 multiple intraductal papilloma, five ductal hyperplasia, three ductal carcinoma in situ, and one invasive ductal carcinoma were diagnosed. Compared with conventional microdochectomy, FDS-guided intraductal biopsy can significantly increase the detection rate of solitary papilloma (40.7% versus 92.6%, p < 0.05). It should be a routine procedure after intraductal lesion found by screening FDS. Since it would underestimate all multiple intraductal papilloma and some (50%) cancer, microdochectomy is inevitable if biopsies show atypical ductal hyperplasia.

  11. 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

  12. 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.

  13. 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…

  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. Reconstructive techniques for creation of catheterizable channels: tunneled and nipple valve channels.

    PubMed

    Levy, Mya E; Elliott, Sean P

    2016-02-01

    Cutaneous catheterizable channels allow for continent bladder emptying when an alternate route is desired. The goals of channel creation in the neurogenic bladder population are successful urine elimination, renal preservation, continence and lastly cosmesis. In addition to a particular surgeon's comfort and experience with a given procedure, individual patient factors such as medical comorbidities, anatomic factors, and occupational function should be central to the selection of a surgical approach. An ideal channel is one that is short, straight, and well supported by associated blood supply and surrounding adventitia, so as to minimize difficulty with catheterization. Two types of channel continence mechanisms are discussed at length in this review-the tunneled channel, and the nipple valve. The appendicovesicostomy (Mitrofanoff), and reconfigured ileum (Yang-Monti) are both tunneled channels. The ileocecal valve is a commonly used nipple valve and provides continence when reinforced. The continent catheterizable ileal cecocystoplasty (CCIC) is an example of this channel technique. This method couples a tapered ileal limb as a catheterizable channel, the ileocecal valve as the continence mechanism, and the cecum and ascending colon as a bladder augmentation. While this procedure has higher perioperative complications relative to a simple tunneled channel, it has increased channel length flexibility and is also coupled with a bladder augment, which is completely performed using one bowel segment. Continent channel creation in adults can improve quality of life and minimize morbidity associated with neurogenic bladder. However, the decision to proceed with creation of a catheterizable channel should be made only after careful consideration of the patient's medical comorbidities, physical abilities social support, and surgeon experience.

  20. Nipple-areola-complex sparing mastectomy: five years of experience in a single centre.

    PubMed

    Tancredi, Antonio; Ciuffreda, Luigi; Petito, Lucia; Natale, Francesca; Murgo, Roberto

    2013-12-01

    This study aimed at assessing the outcomes of nipple-areola-complex-sparing mastectomy (NSM) of breast cancer in a single-centre and single-surgeon series after 5 years of experience. From June 2007 to January 2012, 58 female patients with breast cancer were admitted for NSM at our unit and 55 of these underwent NSM. All patients underwent a preoperative clinical and instrumental evaluation. The clinical evaluation consisted of physical examination by taking measurements of the prosthesis and through anamnesis. The instrumental evaluation used were mammography, chest X-ray, abdominal and breast ultrasound, blood test and, if necessary, magnetic resonance imaging. Specific inclusion criteria have been met in recruiting patients: clinically negative axillas, tumours < 3 cm in any of the quadrants, tumours more than 1 cm away from the NAC. The patients underwent a surgical and oncological follow-up. The surgical follow-up consisted in treating wounds, managing drainages and tissue expanders and then planning the replacement surgeries. The oncological follow-up consisted of periodical medical (such as blood tests including cancer markers) and radiological evaluations (such as mammography, chest X-ray, abdominal and transvaginal ultrasound scan and/or thorax-abdomen computed tomography) to assess the disease progression, and, if necessary the patients underwent chemotherapy or hormonal therapy. Out of 58 recruited patients undergoing NSM, only 3 patients (5.1 %) had an occult tumour in the NAC at intraoperative extemporaneous histological examination and required the NAC removal. The other 55 patients (94.9 %) did not have neoplastic involvement of NAC and at an average follow-up period of 21.7 months (range 3-55 months) only 4 (7.2 %) had disease progression. Nipple-Sparing Mastectomy is a highly specialized and oncologically sure procedure to be performed only in reference centres on selected patients.

  1. Guinea pig (Cavia porcellus) drinking preferences: do nipple drinkers compensate for behaviourally deficient diets?

    PubMed

    Balsiger, A; Clauss, M; Liesegang, A; Dobenecker, B; Hatt, J-M

    2016-07-23

    When offered diets with hay ad libitum, rabbits (Oryctolagus cuniculus) clearly prefer open dishes over nipple drinkers, but whether this preference also applies in guinea pigs (Cavia porcellus) is unsure. We tested the drinker preference of 10 guinea pigs when offered open dishes (OD) and nipple drinkers (ND) simultaneously and measured the amount of water consumed by each animal on four different diets (grass hay 100%, or as 10% of intake on diets of fresh parsley, seed mix or pelleted complete feed, respectively) on either of the drinking systems. All animals ingested the hay portion of the combined diets first. The amount of water consumed differed significantly between individual animals. Animals drank less water on parsley than on the other diets. Nine of 10 animals clearly preferred ND when having a choice, and eight of these drank more when on ND only. The difference between the drinking systems was not consistent across all diets: on hay, similar amounts of water were drunk when on OD or ND only. Differences in water intake were reflected in urine production. Because drinking from ND in guinea pigs involves jaw movements similar to those in chewing, the results could suggest that when motivation for oral processing behaviour is not satisfied by a diet, animals may respond in using ND beyond physiological water necessity. Whereas physiological water requirements are probably better investigated with other drinking systems due to a possible overestimation when using ND, offering ND to pet guinea pigs most likely offers a form of behavioural enrichment that at the same time may increase water intake and hence act as prophylaxis against urolithiasis.

  2. [Extracapsular fluid dynamics and suction-irrigation cannulas. A model observation].

    PubMed

    Brandl, H; Hindelang, F; Hardt, F J; Fath, H

    1993-08-01

    The ECCE technique often requires additional removal of lens residues remaining attached to the capsular bag after lens nucleus extraction. These residual lens substances in the form of a visco-elastic fluid are detached and removed by means of various types of irrigation-aspiration cannulas. During the aspiration process the elastic properties of the fluid are utilized. The aim of the investigations presented was modification and optimization of the geometric design of the irrigation-aspiration cannulas to improve the flow efficiency, facilitate the detachment and reduce the amount of rinsing fluid required. The fluid mechanic properties of various type of irrigation-aspiration cannulas were investigated and compared in an eye model. Some of the commercially available irrigation-aspiration cannulas give good results, being convenient to handle and functional. Our experimental data indicate that canalization of the rinsing fluids and the special location of the irrigation-aspiration openings will improve the flow-field. An adjustable valve has been developed, which enables safe aspiration/irrigation changeover if it should be necessary. Two models of the newly designed irrigation-aspiration probes are presented and discussed.

  3. 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…

  4. 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

  5. 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.

  6. 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.

  7. [Effect of the vacuum stimuli on length nipple-areola complex of the woman lactation mammary gland].

    PubMed

    Il'in, V I; Alekseev, N P

    2014-02-01

    The aim of this study was to determine the effect of vacuum stimuli on time increasing and decreasing of the length areola-nipple complex lactating women. At the maximum comfortable vacuum (140-160 mm Hg) length areola increases for 90-100 ms to maximum length. After vacuum stimuli were off a length of areola was decreased and reach the rest level for 120-150 ms. The length of the nipple was unchanged. This data it is necessary to optimize work breast pump with tactile component. The temporal characteristics of the length of areola under the influence of physiologically acceptable vacuum indicate that in breast pump with tactile component compression stimuli should act on the areola not less that 100 ms after the beginning of vacuum stimuli.

  8. Basal cell carcinoma of the nipple in male patients with gastric cancer recurrence: report of a case.

    PubMed

    Takeno, Shinsuke; Kikuchi, Nobuyuki; Miura, Takashi; Anami, Kentaro; Takahashi, Yoshiaki; Hashimoto, Takafumi; Moroga, Toshihiko; Akizuki, Shin-ichiro; Kamei, Mirei; Suehiro, Shuji; Yamashita, Shin-ichi; Kawahara, Katsunobu

    2014-01-01

    Although basal cell carcinoma (BCC) is the most common dermatological malignancy arising from sun exposed skin, BCC of the nipple is extremely rare. To our knowledge only 34 cases have been reported. We report a 78-year-old man who was undergoing chemotherapy for liver metastasis of gastric cancer 1 year after surgery. The chief complaint was exudation and oozing from the nipple. A mass lesion was palpable and detected on mammography and enhanced computed tomography, and atypical cells were detected on cytological examination. Simple resection was performed because histopathological diagnosis of an intraoperative frozen section revealed BCC. Final pathological diagnosis was also BCC. The authors report this case and review the previous reports, and discuss the clinicopathologic characteristics and adequate treatment for this disease.

  9. Contralateral Breast Symmetrisation in Immediate Prosthetic Breast Reconstruction after Unilateral Nipple-Sparing Mastectomy: The Tailored Reduction/Augmentation Mammaplasty

    PubMed Central

    Visconti, Giuseppe; Barone-Adesi, Liliana; Franceschini, Gianluca; Masetti, Riccardo

    2015-01-01

    Background In the literature on nipple-sparing mastectomy (NSM) with one-stage immediate implant reconstruction, contralateral symmetrisation has drawn little attention, with many surgeons still performing standard cosmetic mammaplasty procedures. However, standard implant-based mammaplasty usually does not result in proper symmetry with the mastectomy side, especially regarding breast projection, overall shape, and volume distribution. Methods We retrospectively reviewed 19 consecutive patients undergoing unilateral NSM with immediate prosthetic reconstruction and contralateral simultaneous symmetrisation by using the tailored reduction/augmentation mammaplasty technique between June 2012 and August 2013. Results The average follow-up time was 13 months (range, 10-24 months). No major complications, such as infection, haematoma, and nipple-areola complex necrosis, were experienced. Conclusions Our experience suggests that simultaneous contralateral symmetrisation with tailored reduction/augmentation mammaplasty after unilateral immediate implant reconstruction after NSM facilitates durable and pleasant symmetric outcomes. PMID:26015885

  10. A nomogram based on mammary ductoscopic indicators for evaluating the risk of breast cancer in intraductal neoplasms with nipple discharge.

    PubMed

    Lian, Zhen-Qiang; Wang, Qi; Zhang, An-Qin; Zhang, Jiang-Yu; Han, Xiao-Rong; Yu, Hai-Yun; Xie, Si-Mei

    2015-04-01

    Mammary ductoscopy (MD) is commonly used to detect intraductal lesions associated with nipple discharge. This study investigated the relationships between ductoscopic image-based indicators and breast cancer risk, and developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge. A total of 879 consecutive inpatients (916 breasts) with nipple discharge who underwent selective duct excision for intraductal neoplasms detected by MD from June 2008 to April 2014 were analyzed retrospectively. A nomogram was developed using a multivariate logistic regression model based on data from a training set (687 cases) and validated in an independent validation set (229 cases). A Youden-derived cut-off value was assigned to the nomogram for the diagnosis of breast cancer. Color of discharge, location, appearance, and surface of neoplasm, and morphology of ductal wall were independent predictors for breast cancer in multivariate logistic regression analysis. A nomogram based on these predictors performed well. The P value of the Hosmer-Lemeshow test for the prediction model was 0.36. Area under the curve values of 0.812 (95 % confidence interval (CI) 0.763-0.860) and 0.738 (95 % CI 0.635-0.841) was obtained in the training and validation sets, respectively. The accuracies of the nomogram for breast cancer diagnosis were 71.2 % in the training set and 75.5 % in the validation set. We developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge based on MD image findings. This model may aid individual risk assessment and guide treatment in clinical practice.

  11. Pattern of nipple use by puppies: A comparison of the dingo (Canis dingo) and the domestic dog (Canis familiaris).

    PubMed

    Hudson, Robyn; Rödel, Heiko G; Elizalde, Marise Trejo; Arteaga, Lourdes; Kennedy, Gerard A; Smith, Bradley P

    2016-08-01

    Surprisingly little information is available about the behavior of newborn mammals in the functionally vital context of suckling. We have previously reported notable differences in the pattern of nipple use by kittens of the domestic cat and puppies of the domestic dog. Whereas kittens rapidly develop a "teat order," with each individual using principally 1 or 2 particular nipples, puppies show no such pattern. We asked whether the more "chaotic" behavior seen in puppies of the domestic dog (Canis familiaris) could be the result of relaxed selection due to domestication. In a first test of this hypothesis, we studied suckling behavior in 4 litters of wild-type captive dingoes (Canis dingo), a canid species that has inhabited the Australian mainland in substantial numbers for at least 5,000 years with minimal human influence. On all measures of individual puppies' behavior-time spent attached to nipples, lack of individual use of particular nipples and consequent absence of a teat order, lack of synchronized suckling with other littermates, lack of agonistic behavior-we found no differences between the 2 species. In conclusion, we suggest that the difference between the pattern of suckling behavior of kittens of the domestic cat (and other felids) and the domestic dog is not an artifact of domestication, but rather reflects phylogenetic differences between felids and canids as a consequence of their different lifestyles and associated patterns of parental care. These findings emphasize the need for comparative studies to avoid simplistic generalizations from 1 or 2 species across broad taxonomic groups. (PsycINFO Database Record

  12. Numerical simulation of interaction between organs and food bolus during swallowing and aspiration.

    PubMed

    Kikuchi, Takahiro; Michiwaki, Yukihiro; Koshizuka, Seiichi; Kamiya, Tetsu; Toyama, Yoshio

    2017-01-01

    The mechanism of swallowing is still not fully understood, because the process of swallowing is a rapid and complex interaction among several involved organs and the food bolus. In this work, with the aim of studying swallowing and aspiration processes noninvasively and systematically, a computer simulation method for analyzing the involved organs and water (considered as the food bolus) is proposed. The shape and motion of the organs involved in swallowing are modeled in the same way as in our previous study, by using the Hamiltonian moving particle simulation (MPS) method and forced displacements on the basis of motion in a healthy volunteer. The bolus flow is simulated using the explicit MPS method for fluid analysis. The interaction between the organs and the bolus is analyzed using a fluid-structure coupling scheme. To validate the proposed method, the behavior of the simulated bolus flow is compared qualitatively and quantitatively with corresponding medical images. In addition to the healthy motion model, disorder motion models are constructed for reproducing the aspiration phenomenon by computer simulation. The behaviors of the organs and the bolus considered as the food bolus in the healthy and disorder motion models are compared for evaluating the mechanism of aspiration.

  13. 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

  14. Bronchogenic Cyst Rupture and Pneumonia after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Case Report

    PubMed Central

    Hong, Goohyeon; Song, Junwhi; Lee, Kyung-Jong; Jeon, Kyeongman; Koh, Won-Jung; Suh, Gee Young; Chung, Man Pyo; Kim, Hojoong; Kwon, O Jung

    2013-01-01

    We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA. PMID:23678359

  15. 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

  16. Immunohistochemical localization of specific relaxin-binding cells in the cervix, mammary glands, and nipples of pregnant rats.

    PubMed

    Kuenzi, M J; Sherwood, O D

    1995-04-01

    Previously, we demonstrated that endogenous circulating relaxin promotes the growth and softening of the cervix, the development of the mammary glands, and the growth and development of nipples. Due to the remarkably similar modifications in the histological appearance of the extracellular matrix in the cervix, mammary glands, and nipples, we hypothesized that there may be a common mechanism(s) of action of relaxin in these tissues. A fundamental step toward understanding this mechanism is to identify specific cells that contain relaxin receptors, that is to identify those cells that initiate relaxin's effects within relaxin target tissues. To identify specific relaxin-binding cells in the cervix, mammary glands, and nipples of the pregnant rat, a biologically active biotinylated relaxin probe was prepared. This probe for putative relaxin receptors was administered to intact rats on day 18 of pregnancy. After 1 h, the animals were killed, and tissues were fixed by immersion in 4% paraformaldehyde for 10 h. Fixed tissues were rinsed in 0.1 M phosphate buffer (pH 7.4) and cryoprotected in an ascending series of 5%, 10%, and 20% sucrose solutions. The tissues were frozen in Tissue-Tek O.C.T. compound and stored at -70 C until sectioning. Frozen sections (12 microns) were cut on a Tissue Tek II cryostat at -24 C and thaw mounted on slides coated with 0.01% poly-l-lysine (mol wt, 300-6000). The biotinylated relaxin was localized in cryosections with an antibiotin immunoglobulin G conjugated to colloidal gold, which was subsequently visualized for light microscopy with silver intensification. Specific binding of the biotinylated relaxin was localized in the epithelial and smooth muscle cells of the cervix, the epithelial cells of the mammary glands, and the epithelial cells, smooth muscle cells, and skin of the nipples. We conclude that those cells exhibiting specific relaxin binding probably contain relaxin receptors and, therefore, mediate relaxin's effects in these

  17. The lateral inframammary fold incision for nipple-sparing mastectomy: outcomes from over 50 immediate implant-based breast reconstructions.

    PubMed

    Blechman, Keith M; Karp, Nolan S; Levovitz, Chaya; Guth, Amber A; Axelrod, Deborah M; Shapiro, Richard L; Choi, Mihye

    2013-01-01

    Nipple-sparing mastectomy (NSM) as a therapeutic or prophylactic procedure for breast cancer is rapidly gaining popularity as the literature continues to support it safety. The lateral inframammary fold (IMF) approach provides adequate exposure and eliminates visible scars on the anterior surface of the breast, making this incision cosmetically superior to radial or periareolar approaches. We reviewed 55 consecutive NSMs performed through a lateral IMF incision with immediate implant-based reconstruction, with or without tissue expansion, between June 2008 and June 2011. Prior to incision, breasts were lightly infiltrated with dilute anesthetic solution with epinephrine. Sharp dissection, rather than electrocautery, was used as much as possible to minimize thermal injury to the mastectomy flap. When indicated, acellular dermal matrix was placed as an inferolateral sling. Subsequent fat grafting to correct contour deformities was performed in select patients. Three-dimensional (3D) photographs assessed changes in volume, antero-posterior projection, and ptosis. Mean patient age was 46 years, and mean follow-up time was 12 months. Twelve mastectomies (22%) were therapeutic, and the remaining 43 (78%) were prophylactic. Seven of the nine sentinel lymph node biopsies (including one axillary dissection) (78%) were performed through the lateral IMF incision without the need for a counter-incision. Acellular dermal matrix was used in 34 (62%) breasts. Average permanent implant volume was 416 cc (range 176-750 cc), and average fat grafting volume was 86 cc (range 10-177 cc). In one patient a positive intraoperative subareolar biopsy necessitated resection of the nipple-areola complex (NAC), and in two other patients NAC resection was performed at a subsequent procedure based on the final pathology report. Mastectomy flap necrosis, requiring operative debridement, occurred in two breasts (4%), both in the same patient. One of these breasts required a salvage latissimus

  18. Preoperative Ultrasound Guided Fine Needle Aspiration Cytology of Ovarian Lesions- Is It a Rapid and Effective Diagnostic Modality?

    PubMed Central

    Datta, Saikat; Chaudhuri, Snehamay; Paul, Prabir Chandra; Khandakar, Binny; Mandal, Sonali

    2016-01-01

    Introduction The deep seated ovarian lesions unapproachable by unguided aspiration cytology were easily done under ultrasound guidance. It gave a before hand cytological diagnosis of the lesion to the surgeon determining the modality of treatment for the patient. Aim To find the diagnostic accuracy of the method of ultrasound guided cytological assessment of ovarian lesion. Materials and Methods The study was conducted as a prospective observational study over a period of one year, in hospital setting, where ultrasound guided fine needle aspiration had been used to aspirate ovarian lesions, giving a rapid cytological diagnosis. In 43 sample cases, aspiration of fluid done from ovarian lesions were followed by cyto-centrifugation and staining by May-Grunwald-Giemsa (MGG) and Papanicolaou (Pap) stain providing a cytological opinion regarding benign/malignant nature of the lesion and further categorization. Later the cytological diagnosis was compared with final histopathological diagnosis, taking it as a gold standard. Results The overall sensitivity, specificity, and diagnostic accuracy of ultrasound guided aspiration and cytological analysis were high, 96%, 76.92% and 89.47% respectively as calculated by comparing the cytological diagnosis with histological diagnosis, taking it as gold standard. Conclusion This method has evolved as a highly sensitive, rapid, simple and effective modality for screening and as well as accurate preoperative diagnosis of ovarian lesions. PMID:27134878

  19. 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.

  20. Prophylactic Bilateral Nipple-sparing Mastectomy and a Staged Breast Reconstruction Technique: Preliminary Results

    PubMed Central

    Tondu, Thierry; Thiessen, Filip; Tjalma, Wiebren A.A.

    2016-01-01

    More high-risk women with breast cancer are identified using genetic testing at a younger age. These young women often opt for prophylactic surgery. Most patients are reluctant for extra donor-site scars besides infections and necrosis. In order to reduce these risks, a two-stage breast reconstruction technique is used for high-risk women with large or ptotic breasts. We presume that this procedure will reduce the risk of skin envelope and nipple–areola complex (NAC) necrosis to less than 1%. In the first stage, an inferior pedicle reduction is performed to obtain large volume reduction with maximal safety for the NAC. The ptosis, skin excess, and malpositioning of the NAC are corrected safely at this stage. In the second stage, the skin-sparing mastectomy is performed with or without nipple sparing. During this procedure, the areola is never removed. A bilateral breast reconstruction is then performed with an immediate subpectoral prothesis or delayed with the use of a subpectoral tissue expander. In this way, we aim to meet the patient’s wish to undergo bilateral risk reducing mastectomy in breasts that need ptosis correction without donor-site scarring. This article describes the procedure and reports the preliminary data. PMID:27867298

  1. [Tattooing of the nipple-areola complex in breast reconstruction: Technical note].

    PubMed

    Riot, S; Devinck, F; Aljudaibi, N; Duquennoy-Martinot, V; Guerreschi, P

    2016-04-01

    The reconstruction of the nipple-areola complex is an essential step in breast reconstruction. It announces the end of the reconstruction process, which is often long and sometimes difficult to live for the patient and will significantly improve the perception of body image. Concerning the reconstruction of the areola, tattooing is one of the preferred techniques. It's a simple, quick and safe procedure with a high satisfaction rate. This technique is still perfectible in our opinion, because the random lifetime of pigmentation is a recognized disadvantage of this procedure. We propose a modification of the conventional technique for improving the quality of dermopigmentation while reducing its completion time. Our method is to perform a dermabrasion before starting the tattoo. Indeed, dermabrasion allows better penetration of the pigments inside the dermis and thus offers two advantages: a more durable result over time and reduced operation time by reducing the number of passing of the machine tattoo. Finally, our tattooing technique seems relevant and totally appropriate: its realization is simple, reproducible, does not increase the overall cost of reconstruction, provides timesavings and gives a better long-term result.

  2. Selective microdochectomy after ductoscopic wire marking in women with pathological nipple discharge

    PubMed Central

    2009-01-01

    Background To investigate the diagnostic reliability of selective microdochectomy after direct ductoscopic wire marking of suspect lesions in patients with pathological nipple discharge. Methods Selective microdochectomy due to pathological discharge was performed in 33 patients with mean age of 51.7 years. Ductoscopes of 0.9 and 1.1 mm in diameter with a channel for wire marking were used. Only patients without sonographic or mammographic correlation for the discharge were included. The pathologic mammary duct was wire marked and extirpated under direct visual guidance via the ductoscope. The histological results were compared with cytology, galactography and ductoscopy. Results In 24 out of 33 cases (72%) an intraductal, epithelial proliferation was found histologically. The following sensitivities for intraductal, epithelial proliferations could be determined: cytology 4%, galactography 74%, and ductoscopy 78%. Conclusion The method allows selective microdochectomy of the pathological duct and the intraductal proliferation under visual guidance. The resection volume can be reduced in contrast to the unselective ductectomy after injection of methylene blue. PMID:19445720

  3. Mammary ductoscopy and ductal washings for the evaluation of patients with pathologic nipple discharge.

    PubMed

    Vaughan, Aislinn; Crowe, Joseph P; Brainard, Jennifer; Dawson, Andrea; Kim, Julian; Dietz, Jill R

    2009-01-01

    The majority of breast diseases result from lesions of the ductal epithelium. Mammary ductoscopy allows for visualization of intraductal abnormalities, and ductoscopic lavage provides thousands of cells for analysis. We reviewed our experience of 89 cases of patients with pathologic nipple discharge (PND) undergoing ductoscopy-directed duct excision and collection of ductal washings. Patients undergoing ductoscopy-directed duct excision with ductal washings had an 88% abnormal pathology rate. Most abnormalities were benign (71% papillomas), but the atypia rate for this group was 62%. The combination of visualization and pathologic analysis of washings provided the highest predictive value for the diagnosis of papilloma. Cellular yields for this technique were excellent with most specimens yielding >5,000 epithelial cells per high powered field and with evaluable ductal cells in 82% of specimens. Mammary ductoscopy offers the advantage of a high lesion localization rates with intraoperative guidance. The most accurate tool was the combination of ductal washings and ductoscopic visualization, but preoperative use of these techniques is not helpful in most cases. Greater than 90% of patients with PND are found to have a lesion on pathologic examination when using this technique for directed duct excision. Of interest, ductal washings obtained from symptomatic patients with benign diseases are often atypical.

  4. 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

  5. Invasive Paget disease of the nipple: a brief review of the literature and report of the first case with axillary nodal metastases.

    PubMed

    Ozerdem, Ugur; Swistel, Alexander; Antonio, Lilian B; Hoda, Syed A

    2014-09-01

    Although Paget disease of the nipple (PDN) is a well-established clinical and pathological neoplastic process, invasive PDN (IPDN) is a relatively newly described disease. The latter entity is characterized by invasive carcinoma that is localized to the nipple and is associated with PDN as well as with either intraductal and/or invasive carcinoma in the underlying breast. To our knowledge, only 17 cases of IPDN, all node negative, have been reported. Here, we report the case of a 68-year-old woman with invasive Paget disease of the left nipple. The patient had a history of intraductal carcinoma, treated by lumpectomy alone. She presented 6 years later with "eczematous" lesion of the ipsilateral nipple, a punch biopsy of which showed a superficially IPDN as well as conventional PDN. The subsequently performed wide excision of the nipple, areola, and underlying breast tissue showed the invasive carcinoma to span 0.6 cm. Then, 3 months later, the patient presented with ipsilateral palpable axillary lymphadenopathy. Axillary dissection revealed metastatic carcinoma in 7 of 19 lymph nodes. This case of IPDN not only represents the deepest extent of invasion reported thus far but also the only one known to be node positive.

  6. [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.

  7. 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.

  8. 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.

  9. 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)

  10. 21 CFR 880.6740 - Vacuum-powered body fluid suction apparatus.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vacuum-powered body fluid suction apparatus. 880... Personal Use Miscellaneous Devices § 880.6740 Vacuum-powered body fluid suction apparatus. (a) Identification. A vacuum-powered body fluid suction apparatus is a device used to aspirate, remove, or...

  11. 21 CFR 880.6740 - Vacuum-powered body fluid suction apparatus.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Vacuum-powered body fluid suction apparatus. 880... Personal Use Miscellaneous Devices § 880.6740 Vacuum-powered body fluid suction apparatus. (a) Identification. A vacuum-powered body fluid suction apparatus is a device used to aspirate, remove, or...

  12. 21 CFR 880.6740 - Vacuum-powered body fluid suction apparatus.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Vacuum-powered body fluid suction apparatus. 880... Personal Use Miscellaneous Devices § 880.6740 Vacuum-powered body fluid suction apparatus. (a) Identification. A vacuum-powered body fluid suction apparatus is a device used to aspirate, remove, or...

  13. 21 CFR 880.6740 - Vacuum-powered body fluid suction apparatus.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Vacuum-powered body fluid suction apparatus. 880... Personal Use Miscellaneous Devices § 880.6740 Vacuum-powered body fluid suction apparatus. (a) Identification. A vacuum-powered body fluid suction apparatus is a device used to aspirate, remove, or...

  14. 21 CFR 880.6740 - Vacuum-powered body fluid suction apparatus.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Vacuum-powered body fluid suction apparatus. 880... Personal Use Miscellaneous Devices § 880.6740 Vacuum-powered body fluid suction apparatus. (a) Identification. A vacuum-powered body fluid suction apparatus is a device used to aspirate, remove, or...

  15. 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.

  16. 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

  17. Sialyl Lewis(x) hybridized complement receptor type 1 moderates acid aspiration injury.

    PubMed

    Kyriakides, C; Wang, Y; Austen, W G; Favuzza, J; Kobzik, L; Moore, F D; Hechtman, H B

    2001-12-01

    The potentially enhanced anti-inflammatory effects of the sialyl Lewis(x) (sLe(x))-decorated version of soluble complement receptor type 1 (sCR1) in moderating acid aspiration injury are examined. HCl was instilled in tracheostomy tubes placed in mice, and extravasation of (125)I-labeled albumin in bronchoalveolar lavage (BAL) fluid was used to calculate the vascular permeability index (PI). Neutrophil counts in BAL fluid and immunohistochemistry were performed. PI was moderated by 82% after treatment with sCR1sLe(x) compared with 54% in sCR1-untreated mice (P < 0.05). Respective reductions in PI in mice treated 0.5 and 1 h after acid aspiration with sCR1sLe(x) of 70 and 57% were greater than the decreases in PI of 45 and 38% observed in respective sCR1-treated groups (P < 0.05). BAL fluid neutrophil counts in sCR1sLe(x)-treated mice were significantly less than those in sCR1-treated animals, which were similar to those in untreated mice. Immunohistochemistry stained for sCR1 only on the pulmonary vascular endothelium of sCR1sLe(x)- but not sCR1-treated mice. In conclusion, sCR1sLe(x) moderates permeability by antagonizing complement activation and neutrophil adhesion. Delayed complement and neutrophil antagonism significantly reduces injury.

  18. Adding Ultrasound to the Evaluation of Patients with Pathologic Nipple Discharge to Diagnose Additional Breast Cancers: Preliminary Data.

    PubMed

    Yoon, Haesung; Yoon, Jung Hyun; Kim, Eun-Kyung; Moon, Hee Jung; Park, Byeong-Woo; Kim, Min Jung

    2015-08-01

    The aim of this study was to assess the malignancy yield of ultrasound Breast Imaging Reporting and Data System (BI-RADS) classification and the diagnostic value of adding ultrasound to diagnosis of breast cancer in patients with pathologic nipple discharge. Of 267 patients with pathologic nipple discharge seen from February 2003 to March 2011, 198 with histopathologic confirmation and follow-up data were included. Ultrasound images and mammograms were analyzed according to BI-RADS. The malignancy rate for each BI-RADS category and the difference in diagnostic performance resulting from the addition of ultrasound to mammography were calculated. Of the 198 enrolled patients, 34 were diagnosed with a malignancy. The malignancy rates obtained with the addition of ultrasound to mammography were 0.0% (0 of 27) for category 1, 5.9% (1/17) for category 2, 9.4% (5/53) for category 3, 21.5% (20/93) for category 4 and 100% (8/8) for category 5. The malignancy rates for mammography alone were 7.7%-9.0% for categories 1-3, 68.5% (13/19) for category 4 and 100.0% (5/5) for category 5. Adding US to mammography did not significantly increase sensitivity compared with mammography alone. Other diagnostic performance markers such as specificity and positive predictive value were not improved. Among patients for whom mammograms were available, ultrasound detected 5 breast cancers (26.3%) in addition to the 19 breast cancers found by positive mammography. Although it did not increase overall diagnostic performance in patients with pathologic nipple discharge, addition of ultrasound to mammography did detect an additional 26.3% of malignant lesions.

  19. 3D-MR Ductography and Contrast-Enhanced MR Mammography in Patients with Suspicious Nipple Discharge; a Feasibility Study.

    PubMed

    Nicholson, Brandi T; Harvey, Jennifer A; Patrie, James T; Mugler, John P

    2015-01-01

    We evaluated contrast-enhanced magnetic resonance (ce-MR) imaging and an indirect MR galactogram (MRG) sequence against conventional galactography (CG) in women with suspicious nipple discharge who underwent histologic diagnosis. This study was Institutional Review Board approved and HIPAA compliant. Women with suspicious nipple discharge recommended for CG were recruited for our study. Patients underwent both a ce-MR as well as MRG (MRG-1 and MRG-2, variations in isotropic spatial resolution) followed by CG within 60 days. The ce-MR and MRG studies were interpreted together by a single radiologist separately from CG. Pathology was used as our gold standard and was obtained via image-guided core needle biopsy or surgery with papilloma, atypia, and malignancy considered positive. Of the 21 patients recruited for the study, 20 patients had known histology results for 26 lesions; 18 patients (90.0%) had successful CG, 20 (100.0%) ce-MRI, 20 (100.0%) MRG-1, and 19 (95.0%) MRG-2. Histology showed 5 cancers (4 women), 15 papillomas (2 with atypia) (11 women), and 6 additional benign lesions (6 women). Five patients (25.0%) had additional lesions detected by ce-MR that influenced surgical management. Sensitivity, specificity, positive (PPV), and negative predicted values (NPV) for CG, ce-MRI, MRG-1 were 65.0, 33.3, 76.5, and 22.2; 95.0, 66.7, 90.5, and 80.8; 55.0, 66.7, 84.6, and 30.8, respectively. ce-MR had the highest sensitivity, PPV, and NPV compared with CG or MRG. Our MRG protocols show promise, but were not as sensitive as ce-MRI for women with suspicious nipple discharge.

  20. Characterisation of zinc delivery from a nipple shield delivery system using a breastfeeding simulation apparatus

    PubMed Central

    Bruggraber, Sylvaine F. A.; Gerrard, Stephen E.; Kendall, Richard A.; Tuleu, Catherine; Slater, Nigel K. H.

    2017-01-01

    Zinc delivery from a nipple shield delivery system (NSDS), a novel platform for administering medicines to infants during breastfeeding, was characterised using a breastfeeding simulation apparatus. In this study, human milk at flow rates and pressures physiologically representative of breastfeeding passed through the NSDS loaded with zinc-containing rapidly disintegrating tablets, resulting in release of zinc into the milk. Inductively coupled plasma optical emission spectrometry was used to detect the zinc released, using a method that does not require prior digestion of the samples and that could be applied in other zinc analysis studies in breast milk. Four different types of zinc-containing tablets with equal zinc load but varying excipient compositions were tested in the NSDS in vitro. Zinc release measured over 20 minutes ranged from 32–51% of the loaded dose. Total zinc release for sets tablets of the same composition but differing hardness were not significantly different from one another with P = 0.3598 and P = 0.1270 for two tested pairs using unpaired t tests with Welch’s correction. By the same test total zinc release from two sets of tablets having similar hardness but differing composition were also not significantly significant with P = 0.2634. Future zinc tablet composition and formulation optimisation could lead to zinc supplements and therapeutics with faster drug release, which could be administered with the NSDS during breastfeeding. The use of the NSDS to deliver zinc could then lead to treatment and prevention of some of the leading causes of child mortality, including diarrheal disease and pneumonia. PMID:28158283

  1. Bloody nipple discharge in children: possible etiologies and selection of appropriate therapy.

    PubMed

    Imamoglu, Mustafa; Cay, Ali; Reis, Abdülkadir; Ozdemir, Oğuzhan; Sapan, Levent; Sarihan, Haluk

    2006-02-01

    An understanding of underlying causes of bloody nipple discharge (BND) is necessary to be able to advise treatment guidelines of this rare symptom in the pediatric age group. Of 11 patients with 14 breasts that had BND, data regarding age, sex, side and duration of BND, physical examination findings, laboratory values, culture reports, ultrasonography (US) findings, treatment approach, histopathologic details, and outcomes were obtained, and also, literature was reviewed. The patients were between 3 months and 12 years of age. There were six males and five females. The BND was located in the right breast in six patients, in the left in two, and it was bilateral in three. On physical examinations, seven patients had palpable cystic nodules located at the areolar area and three had a diffuse breast enlargement without skin findings. Laboratory investigations showed normal hormone levels in all patients. At US examinations, seven breasts had cystic lesions, three had hypoechoic tissue in the subareolar region, and others had normal US findings. In a girl with positive culture for Staphylococcus aureus, BND resolved after oral antibiotics. Two cases resolved spontaneously, with 6 months and 4 months follow-up periods, respectively. Surgical intervention was performed for the remaining eight patients, and mean time to operation after onset of symptoms was 10 months (range = 1-34 months). Histopathologic findings showed that the underlying cause of BND was duct ectasia in five breasts, gynecomastia in three, and fibrocystic change in two. Their follow-up periods ranged between 3 months and 6 years, and no recurrences were observed. Classification of breasts with BND for selecting appropriate therapy on the basis of results of careful physical examination, with an US evaluation in selected cases, is effective, and prevents unnecessary investigations.

  2. Correlation between nipple elevation and breast resection weight: How to preoperatively plan breast reduction.

    PubMed

    Moio, Mariagrazia; Schonauer, Fabrizio

    2015-08-01

    Breast hypertrophy is often associated with functional limitations. Beyond the aesthetic concerns, breast reduction can improve symptoms and self-esteem. In different countries, health-care system regulations have fixed the threshold for reimbursement in 500 g of predicted tissue resection for each breast. Different preoperative measurements have been proposed to predict breast-tissue weight to be removed, showing a variable correlation with post-operative evaluation. We describe a reliable, simple measurement to predict the quantity of breast reduction in grams, which can be applicable to any surgical technique. A total of 128 patients undergoing bilateral breast reduction were evaluated. The correlation between the preoperative nipple-areola complex (NAC) lift distance and the weight of removed breast tissue was tested with linear regression and Pearson's test. Other anthropometric measurements were tested as a control. The ratio between resected grams and lift distance was explored to find a multiplication coefficient to be used at preoperative planning. The mean resection weight was 686.65 g. The mean NAC-lift distance was 7.6 cm. Positive correlation between the NAC-lift distance and the weight of breast tissue removed was found (r: 0.87; p < 0.001). The mean weight of the removed breast tissue (g) per centimetre of NAC lift was 81 g/cm in the group between 6 and 12 cm and 70 g/cm in the group with >12 cm of lift distance. The NAC-lift distance is a single, objective, repeatable measure that can provide a reliable prediction of breast-tissue grams to be removed; it helps in classifying breast-reduction indications.

  3. Characterisation of zinc delivery from a nipple shield delivery system using a breastfeeding simulation apparatus.

    PubMed

    Scheuerle, Rebekah L; Bruggraber, Sylvaine F A; Gerrard, Stephen E; Kendall, Richard A; Tuleu, Catherine; Slater, Nigel K H

    2017-01-01

    Zinc delivery from a nipple shield delivery system (NSDS), a novel platform for administering medicines to infants during breastfeeding, was characterised using a breastfeeding simulation apparatus. In this study, human milk at flow rates and pressures physiologically representative of breastfeeding passed through the NSDS loaded with zinc-containing rapidly disintegrating tablets, resulting in release of zinc into the milk. Inductively coupled plasma optical emission spectrometry was used to detect the zinc released, using a method that does not require prior digestion of the samples and that could be applied in other zinc analysis studies in breast milk. Four different types of zinc-containing tablets with equal zinc load but varying excipient compositions were tested in the NSDS in vitro. Zinc release measured over 20 minutes ranged from 32-51% of the loaded dose. Total zinc release for sets tablets of the same composition but differing hardness were not significantly different from one another with P = 0.3598 and P = 0.1270 for two tested pairs using unpaired t tests with Welch's correction. By the same test total zinc release from two sets of tablets having similar hardness but differing composition were also not significantly significant with P = 0.2634. Future zinc tablet composition and formulation optimisation could lead to zinc supplements and therapeutics with faster drug release, which could be administered with the NSDS during breastfeeding. The use of the NSDS to deliver zinc could then lead to treatment and prevention of some of the leading causes of child mortality, including diarrheal disease and pneumonia.

  4. Nipple-areolar Complex Reconstruction following Postmastectomy Breast Reconstruction: A Comparative Utility Assessment Study

    PubMed Central

    Ibrahim, Ahmed M. S.; Sinno, Hani H.; Izadpanah, Ali; Vorstenbosch, Joshua; Dionisopoulos, Tassos; Mureau, Marc A. M.; Tobias, Adam M.; Lee, Bernard T.

    2015-01-01

    Background: Nipple-areola complex (NAC) reconstruction occurs toward the final stage of breast reconstruction; however, not all women follow through with these procedures. The goal of this study was to determine the impact of the health state burden of living with a reconstructed breast before NAC reconstruction. Methods: A sample of the population and medical students at McGill University were recruited to establish the utility scores [visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG)] of living with an NAC deformity. Utility scores for monocular and binocular blindness were determined for validation and comparison. Linear regression and Student’s t test were used for statistical analysis, and significance was set at P < 0.05. Results: There were 103 prospective volunteers included. Utility scores (VAS, TTO, and SG) for NAC deformity were 0.84 ± 0.18, 0.92 ± 0.11, and 0.92 ± 0.11, respectively. Age, gender, and ethnicity were not statistically significant independent predictors of utility scores. Income thresholds of <$10,000 and >$10,000 revealed a statistically significant difference for VAS (P = 0.049) and SG (P = 0.015). Linear regression analysis showed that medical education was directly proportional to the SG and TTO scores (P < 0.05). Conclusions: The absence of NAC in a reconstructed breast can be objectively assessed using utility scores (VAS, 0.84 ± 0.18; TTO, 0.92 ± 0.11; SG, 0.92 ± 0.11). In comparison to prior reported conditions, the quality of life in patients choosing to undergo NAC reconstruction is similar to that of persons living with a nasal deformity or an aging neck requiring rejuvenation. PMID:25973358

  5. Mammary ductoscopy in the evaluation and treatment of pathologic nipple discharge: a Canadian experience

    PubMed Central

    Simpson, Jory S.; Connolly, Elizabeth M.; Leong, Wey L.; Escallon, Jamie; McCready, David; Reedijk, Michael; Easson, Alexandra M.

    2009-01-01

    Background Mammary ductoscopy allows direct visualization of ductal epithelium using a fibreoptic microendoscope. As the first centre in Canada to apply ductoscopy to surgical practice, we report our experience with this technology. Methods Between 2004 and 2008, 65 women with pathologic nipple discharge underwent ductoscopy before surgical duct excision under general anesthetic. Prospective data collection included cannulation and complication rates, procedure length and lesion visualization rate compared with preoperative ductography, if performed. In addition, we classified the endoscopic appearance according to Makita and colleagues and correlated it with surgical pathology. Results It took longer than 6 months to overcome technical problems before the routine use of ductoscopy in the operating room. The ductoscope was easy to use: we achieved cannulation in 63 of 66 breast ducts (95%) and we visualized a lesion in 52 of 63 breast ducts (83%). The mean procedure length was 5.1 minutes, with no complications. Lesions seen on ductography were seen endoscopically 30 of 33 (91%) times. All 3 malignancies were seen: invasive carcinoma in 1 of 62 (1.6%) and in situ disease in 2 of 62 (3.2%) patients. Surgeons found ductoscopy helpful in defining the extent of duct excision. Except for the “polypoid solitary” class, which accurately predicted a papilloma (23/23), we found poor correlation between Makita and colleague’s endoscopic classification and final pathology. Conclusion Ductoscopy is feasible, safe and practical. Our surgeons routinely use it to identify the location and extent of duct excision without ordering preoperative ductography. Identifying pathology based on the endoscopic appearance is unreliable unless the lesion is solitary and polypoid. PMID:20011159

  6. Nipple-sparing Mastectomy and Sub-areolar Biopsy: To Freeze or not to Freeze? Evaluating the Role of Sub-areolar Intraoperative Frozen Section.

    PubMed

    Alperovich, Michael; Choi, Mihye; Karp, Nolan S; Singh, Baljit; Ayo, Diego; Frey, Jordan D; Roses, Daniel F; Schnabel, Freya R; Axelrod, Deborah M; Shapiro, Richard L; Guth, Amber A

    2016-01-01

    Use of nipple-sparing mastectomy (NSM) for risk-reduction and therapeutic breast cancer resection is growing. The role for intraoperative frozen section of the nipple-areolar complex remains controversial. Records of patients undergoing NSM at our institution from 2006 to 2013 were reviewed. Records from 501 nipple-sparing mastectomies were reviewed (216 therapeutic, 285 prophylactic). Of the 480 breasts with sub-areolar biopsies, 307 had intraoperative frozen sections and 173 were evaluated with permanent paraffin section only. Among the 307 intraoperative frozen sections, 12 biopsies were positive on permanent paraffin section (3.9% or 12/307). Of the 12 positive permanent biopsies, five were false negative and the remaining seven concordant intraoperatively. Sensitivity and specificity of sub-areolar frozen section were 0.58 and 1, respectively. Positive sub-areolar biopsies consisted primarily of ductal carcinoma in situ (62% or 13/21). The nipples or nipple-areolar complex were resected in a separate procedure following mastectomy (10/21), intraoperatively following frozen section results (7/21) or during second-stage breast reconstruction (3/21; 1 additional scheduled). Only 30% (6/20) of resected specimens had abnormal residual pathology. Intraoperative frozen section is highly specific and moderately sensitive for the detection of positive sub-areolar biopsies in NSM. Its use can help guide intraoperative reconstructive planning. The presence of positive sub-areolar biopsies in both contralateral and high-risk prophylactic mastectomy specimens emphasizes the need to perform sub-areolar biopsies in all nipple-sparing mastectomies.

  7. Long-term follow-up of nipple-sparing mastectomy without radiotherapy: a single center study at a Japanese institution.

    PubMed

    Sakurai, Teruhisa; Zhang, Ning; Suzuma, Takaomi; Umemura, Teiji; Yoshimura, Goro; Sakurai, Takeo; Yang, Qifeng

    2013-03-01

    Recent reports have suggested that nipple-sparing mastectomy (NSM) is a potential alternative to mastectomy (MT). The aim of our study was to investigate the oncological and technical outcomes of NSM compared with MT using long-term follow-up data. A total of 932 patients between April 1985 and March 2004 were enrolled in our study. Among them, 788 patients received NSM, whereas 144 patients received the routine mastectomy. The median follow-up time was 78 months. No significant difference in the probability of local recurrence between the NSM cohort and the MT cohort was found (8.2 vs. 7.6 %, p = 0.81). The rate of nipple-areola complex (NAC) relapse was low (3.7 %), and all of the nipple and/or areola recurrence cases were treated with NAC removal. Furthermore, nipple and/or areola recurrence was associated with a significantly better prognosis than that of skin flap recurrences and local lymph node recurrences. For the 21-year disease-free survival and the 21-year overall survival, no significant difference between the NSM and MT cohorts was observed. There was no occurrence of nipple necrosis in our trial. This was the first study to investigate the long-term follow-up of NSM in a large Japanese population. We reported the NSM could be performed without nipple necrosis and is oncologically as safe as mastectomy without radiotherapy. Therefore, we suggest that NSM without radiotherapy is a potential alternative to mastectomy for breast cancer patients for both outcome and aesthetic benefits.

  8. 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…

  9. 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…

  10. 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…

  11. 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...

  12. 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...

  13. 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.

  14. 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…

  15. 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.

  16. 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…

  17. 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…

  18. 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,…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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

  4. 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…

  5. 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…

  6. 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.

  7. 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.

  8. 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

  9. [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)

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. Amniotic fluid

    MedlinePlus

    ... carefully. Removing a sample of the fluid through amniocentesis can provide information about the sex, health, and development of the fetus. Images Amniocentesis Amniotic fluid Polyhydramnios Amniotic fluid References Cunningham FG, ...

  17. Bile acid aspiration associated with lung chemical profile linked to other biomarkers of injury after lung transplantation.

    PubMed

    Neujahr, D C; Uppal, K; Force, S D; Fernandez, F; Lawrence, C; Pickens, A; Bag, R; Lockard, C; Kirk, A D; Tran, V; Lee, K; Jones, D P; Park, Y

    2014-04-01

    Aspiration of gastrointestinal contents has been linked to worse outcomes following lung transplantation but uncertainty exists about underlying mechanisms. We applied high-resolution metabolomics of bronchoalveolar lavage fluid (BALF) in patients with episodic aspiration (defined by bile acids in the BALF) to identify potential metabolic changes associated with aspiration. Paired samples, one with bile acids and another without, from 29 stable lung transplant patients were studied. Liquid chromatography coupled to high-resolution mass spectroscopy was used to interrogate metabolomic contents of these samples. Data were obtained for 7068 ions representing intermediary metabolites, environmental agents and chemicals associated with microbial colonization. A substantial number (2302) differed between bile acid positive and negative samples when analyzed by false discovery rate at q = 0.01. These included pathways associated with microbial metabolism. Hierarchical cluster analysis defined clusters of chemicals associated with bile acid aspiration that were correlated to previously reported biomarkers of lung injury including T cell granzyme B level and the chemoattractants CXCL9 and CXCL10. These data specifically link bile acids presence in lung allografts to inflammatory pathways known to segregate with worsening allograft outcome, and provide additional mechanistic insight into the association between reflux and lung allograft injury.

  18. In vitro delivery of anti-breast cancer agents directly via the mammary papilla (nipple).

    PubMed

    Lee, Lay Ming; Davison, Zoë; Heard, Charles M

    2010-03-15

    The objective of this study was to investigate, in vitro, the plausibility of a novel method for delivering a combination of anti-breast cancer agents to the breast via the mammary papilla (nipple). Mammary papillae were prepared from freshly excised strips of porcine sow breasts by blunt dissection. Permeation studies were performed using all glass Franz diffusion cells in both upright and lateral position, with drugs examined individually and in combination. Donor phase was comprised of equimolar PD98059, LY294002 and tamoxifen; 2.54x10(-4) mol dissolved in 950 microL fish oil (containing approximately 23% (w/v) eicosapentaenoic acid, EPA), 25 microL DMSO and 25 microL 1,8-cineole. Also, 4 or 10% Cabosil M5P (w/v) was added to thicken the formulation. After 6 h, the papillae were recovered, cleaned, centrifuged and extracted thrice with methanol. Pooled extracts were analysed by reversed-phase HPLC. The significance of the papilla orientation was also investigated. When applied singly and laterally, the amount extracted from the porcine breast tissue for PD98059, LY294002 and tamoxifen were 1.83+/-0.30, 10.67+/-1.78 and 0.74+/-0.19x10(-2) micromol g(-1) respectively; applied simultaneously and laterally, 2.03+/-0.14, 4.86+/-0.47 and 0.22+/-0.04x10(-2) micromol g(-1) respectively. With 4% Cabosil formulation, amount extracted for PD98059 and LY294002 were 5.71+/-0.95 and 9.91+/-0.92x10(-2) micromol g(-1) respectively; with 10% formulation, 2.64+/-0.5 and 3.90+/-0.78x10(-2) micromol g(-1) respectively. Tamoxifen was below its limit of detection in both Cabosil M5P formulations. To conclude, localized passive delivery via the mammary papilla is a plausible non-invasive means of delivering anti-breast cancer drugs directly to the breast, in levels that have previously been shown to markedly inhibit the growth of breast cancer cell lines, in vitro. The amounts deliverable may be influenced by differential interactions with the thickening agent and patient orientation.

  19. The effects of pentoxifylline on lung inflammation in a rat model of meconium aspiration syndrome.

    PubMed

    Turhan, Ali Haydar; Atıcı, Aytuğ; Muşlu, Necati; Polat, Ayşe; Helvacı, İlter

    2012-06-01

    To examine the effects of pentoxifylline (PTX) on regional pulmonary and systemic inflammation after meconium aspiration, we studied 26 anesthetized and ventilated adult rats for 3 hours. Seventeen rats were instilled with human meconium (1.5 mL/kg, 65 mg/mL) intratracheally. After instillation of meconium, PTX (20 mg/kg, i.a.; n = 9) or saline (n = 8) was given to the subjects. Nine rats that were ventilated and not instilled with meconium served as sham group. Meconium instillation resulted in increased bronchoalveolar lavage (BAL) fluid tumor necrosis factor-α (TNF-α; P = 0.004 and P = 0.002, respectively), protein (P = 0.005 and P = 0.001, respectively) levels, and arterial oxygenation index (OI) in PTX and saline groups. PTX treatment prevented the increase of BAL fluid TNF-α, protein concentrations, and OI in the meconium-instilled lungs but had no statistically significant effect. These results indicate that meconium aspiration induces severe inflammation in the lung. PTX treatment affects the TNF-α production in the lungs and it may attenuate meconium-induced derangements.

  20. GERD related micro-aspiration in chronic mustard-induced pulmonary disorder

    PubMed Central

    Aliannejad, Rasoul; Hashemi-Bajgani, Seyed-Mehdi; Karbasi, Asharaf; Jafari, Mahvash; Aslani, Jafar; Salehi, Maryam; Ghanei, Mostafa

    2012-01-01

    Background and Aim: Bronchiolitis obliterans (BO) is the main pulmonary involvement resulting from sulfur mustard (SM) gas exposure that was used against Iranian civilians and military forces during the Iran-Iraq war. The present study aimed to investigate the prevalence of gastro-esophageal reflux (GER) and gastric micro-aspiration in SM gas injured patients with chronic pulmonary diseases and recurrent episodes of exacerbations. Materials and Methods: This cross-sectional study was done at Baqiyatallah University of Medical Sciences, Tehran, Iran. Gastric micro-aspiration and GER were assessed in the enrolled patients by assessing bile acids, pepsin and trypsin in their bronchoalveolar lavage fluid. Results: Our result showed that bile acids were found to be high in 21.4% patients, and low in 53.6% of patients. Only in 16% patients, no bile was detected in the BALF. Trypsin and pepsin were detected in BAL fluid of all patients. Conclusion: Most of BO patients after exposure to SM suffer GER, while none the etiologic factors of GER in post lung transplant BO are present. It would be hypothesized that GER per se could be considered as an aggregative factor for exacerbations in patients. Further studies will provide more advances to better understanding of pathophysiological mechanism regarding GER and BO and treatment. PMID:23798946

  1. Invasive Paget Disease of the Nipple of Luminal-B Subtype With Axillary Lymph Node Metastasis in a 60-Year-Old White Woman.

    PubMed

    Saluja, Karan; Sahoo, Sunati

    2015-01-01

    Herein, we report a rare case of invasive Paget disease of the nipple with axillary-lymph-node metastasis in a 60-year-old white woman. The patient had intermittent, bloody nipple discharge without skin changes of the nipple-areolar region. We considered the clinical diagnosis of intraductal papilloma. A subareolar core biopsy revealed invasive ductal carcinoma in deep dermal tissue without the overlying epidermis biopsied. The patient underwent total mastectomy and axillary sentinel lymph-node biopsy that demonstrated invasive Paget disease of the nipple with 3.5-mm depth of invasion, ductal carcinoma in-situ in the underlying breast parenchyma, and macrometastasis (5.0 mm) in the sentinel lymph node. Prognostic marker studies of the metastatic site revealed a profile similar to that in the invasive mammary Paget disease (estrogen receptor [ER]+/progesterone receptor [PR]+/human epidermal growth factor receptor 2 [HER2]-/proliferation index [Ki-67] of 30%). The patient received adjuvant chemotherapy and experienced no disease recurrence at 20-months of follow-up. This case of luminal-B subtype invasive Paget disease as the source of regional metastasis is unique in the literature, to our knowledge.

  2. [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.

  3. 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

  4. [A micro-education programme for breastfeeding women: a pilot study to investigate the educations' effect on injured and painful nipples].

    PubMed

    Berlepsch-Schreiner, H; Jeitziner, M-M; Jähnke, A; Bischofberger, I

    2012-10-01

    Injured and painful nipples are frequently occurring events in nursing women during the first days after giving birth. These problems often result in a premature termination of breastfeeding despite the mother's wish to nurse. Unsystematic instructions given to women regarding correct breastfeeding increase the risk that these complications will arise. The objective of the study was to investigate the effect of a systematic micro-education programme for nursing women by means of a pilot study or a quasi-experiment. The study included 100 mother and child pairs each in the experimental group and in the control group (N = 200). The pain experienced by all women during nursing was measured using the Visual Analogue Scale (VAS) and the degree of injury to the nipples after nursing was measured with a tool specially developed for this purpose, the Nipple Wound Score (NWS). Women who received instructions by means of the micro-education programme exhibited significantly less injured nipples (on the third day: experimental group 55 % and control group 77 %, p < 0.00; on the fourth day: 56 % and 80 %, p < 0.00).No differences were observed between the study groups in regard to the occurrence of pain (on the fourth day p = 0.68). The variables of birthing method, parity, age or nationality of the women had no effect on the degree of injury of the nipples or on the intensity of pain. The results of this pilot study suggest that repeated micro-education for breastfeeding women should be implemented during the first days after giving birth.

  5. Low Risk of Skin and Nipple Sensitivity and Lactation Issues After Primary Breast Augmentation with Form-Stable Silicone Implants: Follow-Up in 4927 Subjects

    PubMed Central

    Lund, Herluf G.; Turkle, Janet; Jewell, Mark L.; Murphy, Diane K.

    2016-01-01

    Background Natrelle 410 implants (Allergan, Inc., Irvine, CA) are approved in the United States for breast augmentation, reconstruction, and revision. Objectives To assess the risk of nipple and skin sensation changes and lactation issues in subjects receiving implants for primary breast augmentation and ascertain whether differences based on incision site exist. Methods We used 410 Continued Access study data to assess safety and effectiveness of devices implanted via inframammary or periareolar incision sites. Subjects were evaluated preoperatively and at 4 weeks, 6 months, and annually up to 10 years postoperatively. Lactation issues and nipple and skin sensation changes (hypersensitivity/paresthesia, loss of sensation) were assessed. Results The inframammary and periareolar cohorts comprised 9217 and 610 implanted devices, with mean follow-up of 4.1 years (range, 0-10.1 years) and 4.8 years (range, 0-10.1 years), respectively. In the inframammary cohort, risk of first occurrence of nipple sensation changes was 0.3% (95% CI: 0.2-0.5) at week 4 and month 6, and 0.4% (0.3-0.7) at year 10. Risk of skin sensation changes was 0.0% (95% CI: 0.0-0.2) at week 4, 0.1% (0.0-0.2) at month 6, and 0.1% (0.0-0.3) at all subsequent time points. No nipple or skin changes occurred in the periareolar cohort. Incidence of lactation issues was similar to that reported in postpartum women who did not have breast implants. Conclusions We found that the risk of nipple or skin sensation changes and lactation issues is low and provide long-term safety and effectiveness data on subjects receiving implants for primary breast augmentation. Level of Evidence: 3 Therapeutic PMID:27118002

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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…

  14. 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…

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. Inframammarial Giant Fibroadenoma Removing and a Nipple-sparing Breast Reconstruction in an Adolescent: A Case Report.

    PubMed

    Ciftci, Ilhan; Sekmenli, Tamer; Ozbek, Seda; Karamese, Mehtap; Ugras, Serdar

    2015-01-01

    Fibroadenomas are common, benign breast tumors that usually affect women in the second and third decade of life. Giant fibroadenomas often cause significant concern for the patient or family regarding malignant potential and altered breast development. Most fibroadenomas are benign. Local excision of small lesions through a circumareolar or inframammary incision rather than radical surgery is appropriate. Breast ultrasound represents the most commonly used imaging modality for the study of pediatric female breast masses and fibroadenomas. Detailed descriptions of the sonographic appearances of fibroadenomas in young girls are sparse. We believe that surgical treatment for the patient should include tumor extirpation and immediate restoration of breast appearance, minimizing visible scars, protection of the developing breast bud, nipple, and areola. This modality reduces psychosocial comorbidity.

  1. Lying behaviour and IgG-levels of newborn calves after feeding colostrum via tube and nipple bottle feeding.

    PubMed

    Bonk, Stephanie; Nadalin, Audrey; Heuwieser, Wolfgang; Veira, Douglas

    2016-08-01

    Oesophageal tube feeding colostrum is used to ensure sufficient colostrum intake in newborn calves but the impact of tube feeding on animal behaviour is unclear. Therefore the objective of this study was to compare lying behaviour of tube-fed or bottle-fed dairy calves. Calves (n = 37) in 3 groups were offered 3·5 l colostrum 2 h after birth. Calves of the bottle group were fed with a nipple bottle. Calves of the placebo tubing group were tubed for 4 min but no colostrum was given and they were then fed with a nipple bottle. Calves of the tubing group received 3·5 l colostrum via tube feeding. Consumed amount of bottle and placebo tubing calves was recorded. If they refused some of the offered 3·5 l the rest was offered in a second feeding 2 h later. Lying behaviour was measured by data loggers fitted to right hind leg for 3 d. Blood samples were taken 24 h after birth for determination of IgG concentration. The voluntary colostrum intake differed significantly between bottle-fed and placebo tubed calves at first feeding. Considering both colostrum feedings, bottle-fed calves consumed 3·44 ± 0·14 l and placebo tubed calves consumed 3·20 ± 0·38 l colostrum. ImmunoglobulinG intake (255·6 ± 77·5 g IgG), serum IgG concentration 24 h after birth (22·8 ± 6·7 g/l) and total serum protein concentration (6·1 ± 0·6 g/dl) did not differ between groups. None of the calves had a failure of passive transfer. There was no effect of tubing on lying behaviour.

  2. 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

  3. Safety and Feasibility of Quantitative Multiplexed Cytokine Analysis From Office-Based Vitreous Aspiration

    PubMed Central

    Ghodasra, Devon H.; Fante, Ryan; Gardner, Thomas W.; Langue, Michael; Niziol, Leslie M.; Besirli, Cagri; Cohen, Steven R.; Dedania, Vaidehi S.; Demirci, Hakan; Jain, Nieraj; Jayasundera, K. Thiran; Johnson, Mark W.; Kalyani, Partho S.; Rao, Rajesh C.; Zacks, David N.; Sundstrom, Jeffrey M.

    2016-01-01

    Purpose The goals of this study were to evaluate the safety of office-based vitreous sampling, and determine the utility of these samples with multiplex cytokine analysis. Methods Vitreous samples were collected from office-based needle aspiration and the rate of adverse events during follow-up was reviewed. The vitreous cytokine concentrations in a subset of patients with diabetic macular edema (DME) were analyzed using a 42 plex-cytokine bead array. These results were compared with vitreous cytokine concentrations in proliferative diabetic retinopathy (PDR) and controls (macular hole, epiretinal membrane, symptomatic vitreous floaters) from pars plana vitrectomy. Results An adequate volume of vitreous fluid (100–200 μL) was obtained in 52 (88%) of 59 office-based sampling attempts. The average length of follow-up was 300 days (range, 42–926 days). There were no complications, including cataract, retinal tear or detachment, and endophthalmitis. Two patients (3%) had posterior vitreous detachments within 3 months. Vitreous cytokine concentrations were measured in 44 patients: 14 controls, 13 with DME, and 17 with PDR. The concentration of ADAM11, CXCL-10, IL-8, and PDGF-A were higher in PDR compared with controls and DME. The concentration of IL-6 was higher in PDR compared with controls, but not compared with DME. Conclusions Office-based vitreous aspiration is safe and yields high-quality samples for multiplex vitreous cytokine analysis. Significant elevations of vitreous cytokines were found in PDR compared with DME and controls, including the novel finding of elevated ADAM11. As such, office-based aspiration is a safe and effective means to identify vitreous factors associated with vitreoretinal disease. PMID:27273720

  4. 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

  5. Fluid Mechanics.

    ERIC Educational Resources Information Center

    Drazin, Philip

    1987-01-01

    Outlines the contents of Volume II of "Principia" by Sir Isaac Newton. Reviews the contributions of subsequent scientists to the physics of fluid dynamics. Discusses the treatment of fluid mechanics in physics curricula. Highlights a few of the problems of modern research in fluid dynamics. Shows that problems still remain. (CW)

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Melatonin in human preovulatory follicular fluid

    NASA Technical Reports Server (NTRS)

    Brzezinski, Amnon; Seibel, Machelle M.; Lynch, Harry J.; Deng, Mei-Hua; Wurtman, Richard J.

    1987-01-01

    Melatonin, the major hormone of the pineal gland, has antigonadotrophic activity in many mammals and may also be involved in human reproduction. Melatonin suppresses steroidogenesis by ovarian granulosa and luteal cells in vitro. To determine if melatonin is present in the human ovary, preovulatory follicular fluids (n = 32) from 15 women were assayed for melatonin by RIA after solvent extraction. The fluids were obtained by laparoscopy or sonographically controlled follicular puncture from infertile women undergoing in vitro fertilization and embryo transfer. All patients had received clomiphene citrate, human menopausal gonadotropin, and hCG to stimulate follicle formation. Blood samples were obtained by venipuncture 30 rain or less after follicular aspiration. All of the follicular fluids contained melatonim, in concentrations substantially higher than those in the corresponding serum. A positive correlation was found between follicular fluid and serum melatonin levels in each woman; these observations indicate that preovulatory follicles contain substantial amounts of melatonin that may affect ovarian steroidogenesis.

  13. Surfactant therapy for meconium aspiration syndrome: current status.

    PubMed

    Dargaville, Peter A; Mills, John F

    2005-01-01

    Meconium aspiration syndrome (MAS) is an important cause of respiratory distress in the term infant. Therapy for the disease remains problematic, and newer treatments such as high-frequency ventilation and inhaled nitric oxide are being applied with increasing frequency. There is a significant disturbance of the pulmonary surfactant system in MAS, with a wealth of experimental data indicating that inhibition of surfactant function in the alveolar space is an important element of the pathophysiology of the disease. This inhibition may be mediated by meconium, plasma proteins, haemoglobin and oedema fluid, and, at least in vitro, can be overcome by increasing surfactant phospholipid concentration. These observations have served as the rationale for administration of exogenous surfactant preparations in MAS, initially as standard bolus therapy and, more recently, in association with therapeutic lung lavage. Bolus surfactant therapy in ventilated infants with MAS has been found to improve oxygenation in most studies, although there are a significant proportion of nonresponders and in many cases the effect is transient. Pooled data from randomised controlled trials of surfactant therapy suggest a benefit in terms of a reduction in the requirement for extracorporeal membrane oxygenation (relative risk 0.48 in surfactant-treated infants) but no diminution of air leak or ventilator days. Current evidence would support the use of bolus surfactant therapy on a case by case basis in nurseries with a relatively high mortality associated with MAS, or the lack of availability of other forms of respiratory support such as high-frequency ventilation or nitric oxide. If used, bolus surfactant should be administered as early as practicable to infants who exhibit significant parenchymal disease, at a phospholipid dose of at least 100 mg/kg, rapidly instilled into the trachea. Natural surfactant or a third-generation synthetic surfactant should be used and the dosage repeated every 6

  14. Electrorheological fluids

    SciTech Connect

    Adolf, D.; Anderson, R.; Garino, T.; Halsey, T.C.; Hance, B.; Martin, J.E.; Odinek, J.

    1996-10-01

    An Electrorheological fluid is normally a low-viscosity colloidal suspension, but when an electric field is applied, the fluid undergoes a reversible transition to a solid, being able to support considerable stress without yield. Commercial possibilities for such fluids are enormous, including clutches, brakes, valves,shock absorbers, and stepper motors. However, performance of current fluids is inadequate for many proposed applications. Our goal was to engineer improved fluids by investigating the key technical issues underlying the solid-phase yield stress and the liquid to solid switching time. Our studies focused on field-induced interactions between colloidal particles that lead to solidification, the relation between fluid structure and performance (viscosity, yield stress), and the time evolution of structure in the fluid as the field is switched on or off.

  15. Skin–Areola, Nipple Sparing, and Subcutaneous Mastectomy and Immediate Implant-Based Breast Reconstruction Using a Titanium-Coated Polypropylene Mesh

    PubMed Central

    Özel, Leyla; Kara, V. Melih; Sunamak, Oğuzhan; Karagüllü, Hikmet; Sağıroğlu, Jülide; İlhan, Onur; Aker, Fügen

    2015-01-01

    Skin sparing and nipple areola complex sparing subcutaneous mastectomies are both oncologically safe surgical procedures. Although autologuous breast reconstruction has been considered as a standard means of surgical approach, excellent cosmetic results have been obtained by implant based breast reconstruction. In this report, we present the result of titanium coated polypropylene mesh (Tiloop Bra; Pfm Medical, Cologne, Germany), an ultimate support material utilized in the reconstruction of a patient with breast cancer.

  16. Brachycephaly, cutis aplasia congenita, blue sclerae, hypertelorism, polydactyly, hypoplastic nipples, failure to thrive, and developmental delay: a distinct autosomal recessive syndrome?

    PubMed

    Teebi, A S; Druker, H A

    2001-01-01

    We report a 6-year-old male of first cousin parents with the unique constellation of frontal bossing with brachycephaly, cutis aplasia congenita, blue sclerae, hypertelorism, hypoplastic nipples, rudimentary unilateral post-axial polydactyly of the hand, failure to thrive, mild to moderate developmental delay and sociable personality. Knoblock-Layer syndrome and Smith-Lemli-Opitz syndrome were considered in the differential diagnosis and were excluded. No similar cases were found in LDDB or other databases.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Optimizing the nipple-areola sparing mastectomy with double concentric periareolar incision and biodimensional expander-implant reconstruction: aesthetic and technical refinements.

    PubMed

    Munhoz, Alexandre Mendonça; Aldrighi, Claudia; Montag, Eduardo; Arruda, Eduardo; Aldrighi, José Mendes; Filassi, José Roberto; Ricci, Marcos; Brasil, Jose Augusto; Rezende, Valdemir; Ferreira, Marcus Castro

    2009-12-01

    Although the biodimensional anatomical expander-implant system (BEIS) is a reliable technique, little information has been available regarding outcome following nipple-areola sparing mastectomy (NSM). To perform the resection of glandular tissue, while improving the surgical access and maintaining the nipple-areola vascularization we have developed a new approach for NSM based on the double concentric periareolar incision (DCPI). The purpose of this study is to analyze the feasibility, surgical planning and its outcome following NSM. 18 patients underwent NSM reconstructions. Mean time of follow-up was 29 months. The technique was indicated in patients with small/moderate volume breasts. Flap complications were evaluated and information on aesthetic results and patient satisfaction were collected. 83.3% had tumors measuring 2cm or less (T1) and 72.1% were stage 0 and I. All patients presented peripherally tumors located (at least 5cm from the nipple). Skin complications occurred in 11.1%. One patient (5.5%) presented small skin necrosis and a wound dehiscence was observed in one patient (5.5%). The aesthetic result was good/very good in 94.4 percent and the majority of patients were very satisfied/satisfied. No local recurrences were observed. All complications except one were treated by a conservative approach. DCPI-BEIS is a simple and reliable technique for NSM reconstruction. The success depends on patient selection, coordinated planning with the oncologic surgeon and careful intra-operative and post-operative management.

  5. Barium sulfate aspiration: Severe chemical pneumonia induced by a massive reflux of contrast medium during small bowel barium enema.

    PubMed

    Zhang, Lin; Yang, Yi; Zhang, Ji; Zhou, Xiaowei; Dong, Hongmei; Zhou, Yiwu

    2015-08-01

    Barium contrast radiography is a conventional procedure aimed at revealing lesions of the alimentary tract using barium sulfate on X-ray irradiation. Although it is widely used in clinics, adverse effects and complications are observed, such as anaphylaxis, granuloma, fecalithes, abdomen-leaking, embolism, bacterial contamination, and aspiration. We report a case of death due to a massive barium sulfate aspiration resulted from an air-barium double contrast enema radiography. A 25-year-old female patient was hospitalized with symptoms of abdominal distention, nausea, vomiting and diarrhea for three days. A progressive respiratory distress presented only 1h after a small bowel air-barium double contrast enema. The patient died 11h later. The result of autopsy revealed the cause of death to be severe chemical pneumonitis induced by gastric fluid which was aspirated into her lungs. Barium sulfate is generally recognized to be chemically inert for the respiratory system, but a mixture of barium sulfate with gastric contents is fatal. Here we intend to suggest that, when determining the potential cause of death, medical examiners should consider a patient's status quo as well as the possible adverse effects and complications caused by the barium sulfate preparation during gastrointestinal radiography.

  6. 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.

  7. 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

  8. 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.

  9. 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 .

  10. 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

  11. The relationship between positioning, the breastfeeding dynamic, the latching process and pain in breastfeeding mothers with sore nipples.

    PubMed

    Blair, Anna; Cadwell, Karin; Turner-Maffei, Cindy; Brimdyr, Kajsa

    2003-07-01

    In recognition of the irrefutable disadvantages of not breastfeeding to the mother, baby, society and the environment, increasing the duration of breastfeeding has become a focus of national and international health objectives. However, many mothers experience such painful sore nipples that they stop breastfeeding before they intended. The purpose of this study is to examine the relationship between various aspects of optimal breastfeeding (e.g. the positioning of the baby at the mother's breast, the positioning of the baby's head and mouth, the breastfeeding dynamic and the latching process) using a guided assessment and documentation tool and the breastfeeding mother's level of reported pain on a five-point verbal descriptor scale. Ninety-five healthy postpartum breastfeeding mothers who sequentially reported sore nipples within ten days of giving birth to healthy, term babies in a hospital in Latvia participated in the study. Each mother's midwife observed, assessed and documented a breastfeed using a guidance assessment form, the Lactation Assessment Tool (LAT). Each mother scored her own pain during breastfeeding. Four attribute categories were scored and examined as related to the pain levels of the mother: the baby's face position (chin and nose and head position, cheekline, lip flange and angle of mouth opening); the baby's body position (height at the breast, body rotation and body in relation to mother's body); the breastfeeding dynamic (change in breastfeeding pattern (suck vs swallow) and movement of mother's breast) and the latching process of the baby (root, gape, seal and suck). No significant difference was found between the mother's level of reported pain and the assessed head position, body position or breastfeeding dynamic attributes of the baby. However, more optimal latching process behaviour of the baby (rooting, gaping, sealing, and sucking behaviour) are slightly related to lower levels of reported pain (r(88) = -0.09, p > 0.05). This should

  12. Prediction of Breast Cancer Risk by Aberrant Methylation in Mammary Duct Lavage

    DTIC Science & Technology

    2006-07-01

    retinoic acid receptor-beta2 gene in breast ca 2001;92:826-832. Clark SJ, Harrison J, Paul CL, Frommer M. High sensitivity mapping of methylated...USA. 2000;97:2779–2784. 15. Mitchell G, Trott PA, Morris L, Coleman N, Sauter E, Eeles RA. Cellular characteristics of nipple aspiration fluid during

  13. 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.

  14. 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…

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. 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.

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. 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,…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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.

  1. 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…

  2. 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…

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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…

  10. 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

  11. 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…

  12. 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…

  13. 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…

  14. Oncoplastic breast conserving surgery with nipple-areolar preservation for centrally located breast cancer: a retrospective cohort study.

    PubMed

    Ren, Zhao-Jun; Li, Xiu-Juan; Xu, Xin-Yu; Xia, Lei; Tang, Jin-Hai

    2014-01-01

    A compariosn was made of survival outcomes of oncoplastic breast conserving therapy (oBCT) with nipple- areolar (NAC) preservation in women with centrally located breast cancer (CLBC) undergoing modified radical mastectomy (MRM) in China in a matched retrospective cohort study. We used a database including patients who received oBCT (n=91) or MRM (n=182) from 2003 to 2013 in our hospital. Matching was conducted according to five variables: age at diagnosis, axillary lymph node status, hormone receptor status, human epidermal growth factor-like receptor 2 status (HER-2) and tumor stage. The match ratio was 1:2. Median follow-up times for the oBCT and MRM groups were 83 and 81 months, respectively. There were no significant differences in 87-month overall, local, or distant recurrence-free survival between patients with oBCT and MRM (89%vs.90%; 93%vs.95%; 91%vs.92%;). For appropriate breast cancer patients, oBCT for CLBC is oncologically safe, oncoplastic techniques improving cosmetic outcomes.

  15. Endoscopic nipple sparing mastectomy with immediate implant-based reconstruction versus breast conserving surgery: a long-term study

    PubMed Central

    Du, Junze; Liang, Quankun; Qi, Xiaowei; Ming, Jia; Liu, Jing; Zhong, Ling; Fan, Linjun; Jiang, Jun

    2017-01-01

    To evaluate the differences between endoscopic nipple sparing mastectomy (ENSM) with immediate implant-based reconstruction and breast conserving surgery(BCS) applied to early-stage breast cancer in postoperative outcomes, function, and cosmesis. we made a prospective, non-randomized study reviewed a total of 346 cases of breast cancer from January 2007 to December 2011, including 189 cases of BCS and 157 cases of ENSM. All the patients were followed up to April 2016, with a median follow-up time of 74 months. The operative time, blood loss and drainage, postoperative complications, postoperative cosmesis, local recurrence rate, disease-free survival rate and overall survival rate of the two groups were compared. we found out that the operative time of ENSM was longer than that of BCS. There was no difference in blood loss and drainage, the postoperative complications, the disease-free survival rate and overall survival rate between the two groups. In regarding to cosmesis, patients in the ENSM group were more likely to get a satisfactory postoperative breast appearance. we reached a conclusion that ENSM is a safe and effective operative method retainingadvantages of TSSM to further improve the postoperative cosmetic effect, without increasing other risks. The surgery provides a new choice for patients with early-stage breast cancer. PMID:28361955

  16. 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…

  17. 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…

  18. 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…

  19. 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)

  20. 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…

  1. 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…

  2. 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…

  3. 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,…

  4. Diagnostic values of thyroglobulin measurement in fine-needle aspiration of lymph nodes in patients with thyroid cancer.

    PubMed

    Pak, Kyoungjune; Suh, Sunghwan; Hong, Hyunsook; Cheon, Gi Jeong; Hahn, Seo Kyung; Kang, Keon Wook; Kim, E Edmund; Lee, Dong Soo; Chung, June-Key

    2015-05-01

    We aimed to evaluate the diagnostic performance of measuring the concentration of thyroglobulin (Tg) in the washout fluid of the needle aspiration (FNA-Tg). We performed a systematic search of MEDLINE (inception to October 2013) and EMBASE (inception to October 2013) for English publications using keywords "thyroid", "aspiration", "washout", and "thyroglobulin". All searches were limited to human studies. We included studies of FNA-Tg measurement in the washout fluid rinsed with 1 ml of normal saline. Eight studies including 843 lymph nodes (LNs) were eligible for this study. The pooled sensitivity and specificity of preoperative studies are 0.89 [95 % CI 0.82-0.95], 0.60 [0.49-0.70], and those of postoperative studies are 1.0 [0.83-1.0], 1.0 [0.92-1.0]. To determine best cutoffs from each preoperative and postoperative study, the distance between the point (0, 1) and each observed cutoff values (1-specificity, sensitivity) was calculated, and the distance is minimal when the cutoff value of 32.04 for preoperative studies and of 0.9 for postoperative one are selected. FNA-Tg can be used for both preoperative and postoperative evaluation of LN metastasis. Although the cutoff values for the FNA-Tg has not been standardized, preoperative values of 32.04 ng/ml and postoperative values of 0.9 ng/ml are recommended for identifying neck LN metastasis.

  5. Fluid Shifts

    NASA Technical Reports Server (NTRS)

    Stenger, M.; Hargens, A.; Dulchavsky, S.; Ebert, D.; Lee, S.; Lauriie, S.; Garcia, K.; Sargsyan, A.; Martin, D.; Ribeiro, L.; Lui, J.; Macias, B.; Arbeille, P.; Danielson, R.; Chang, D.; Johnston, S.; Ploutz-Snyder, R.; Smith, S.

    2016-01-01

    NASA is focusing on long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low-Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but more than 50% of ISS astronauts experienced more profound, chronic changes with objective structural and functional findings such as papilledema and choroidal folds. Globe flattening, optic nerve sheath dilation, and optic nerve tortuosity also are apparent. This pattern is referred to as the visual impairment and intracranial pressure (VIIP) syndrome. VIIP signs and symptoms, as well as postflight lumbar puncture data, suggest that elevated intracranial pressure (ICP) may be associated with the spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight, and to correlate these findings with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as the VIIP-related effects of those shifts, is predicted by the crewmember's preflight conditions and responses to acute hemodynamic manipulations (such as head-down tilt). Lastly, we will evaluate the patterns of fluid distribution in ISS astronauts during acute reversal of fluid shifts through application of lower body negative pressure (LBNP) interventions to characterize and explain general and individual responses. METHODS: We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the Figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, calcaneus tissue thickness (by

  6. Wellbore fluid

    SciTech Connect

    Dorsey, D.L.; Corley, W.T.

    1983-12-27

    A clay-based or clay-free aqueous thixotropic wellbore fluid having improved fluid loss control, desirable flow characteristics and low shale sensitivity for use in drilling a well comprising water or a brine base including an effective amount of an additive comprising a crosslinked potato starch, a heteropolysaccharide derived from a carbohydrate by bacteria of the genus Xanthomonas, and hydroxyethylcellulose or carboxymethylcellulose, is disclosed. This drilling fluid has been found to be nondamaging to the formations through which the well is drilled.

  7. Fluid Shifts

    NASA Technical Reports Server (NTRS)

    Stenger, M. B.; Hargens, A.; Dulchavsky, S.; Ebert, D.; Lee, S.; Laurie, S.; Garcia, K.; Sargsyan, A.; Martin, D.; Lui, J.; Macias, B.; Arbeille, P.; Danielson, R.; Chang, D.; Gunga, H.; Johnston, S.; Westby, C.; Ribeiro, L.; Ploutz-Snyder, R.; Smith, S.

    2015-01-01

    INTRODUCTION: Mechanisms responsible for the ocular structural and functional changes that characterize the visual impairment and intracranial pressure (ICP) syndrome (VIIP) are unclear, but hypothesized to be secondary to the cephalad fluid shift experienced in spaceflight. This study will relate the fluid distribution and compartmentalization associated with long-duration spaceflight with VIIP symptoms. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as the VIIP-related effects of those shifts, can be predicted preflight with acute hemodynamic manipulations, and also if lower body negative pressure (LBNP) can reverse the VIIP effects. METHODS: Physiologic variables will be examined pre-, in- and post-flight in 10 International Space Station crewmembers including: fluid compartmentalization (D2O and NaBr dilution); interstitial tissue thickness (ultrasound); vascular dimensions and dynamics (ultrasound and MRI (including cerebrospinal fluid pulsatility)); ocular measures (optical coherence tomography, intraocular pressure, ultrasound); and ICP measures (tympanic membrane displacement, otoacoustic emissions). Pre- and post-flight measures will be assessed while upright, supine and during 15 deg head-down tilt (HDT). In-flight measures will occur early and late during 6 or 12 month missions. LBNP will be evaluated as a countermeasure during HDT and during spaceflight. RESULTS: The first two crewmembers are in the preflight testing phase. Preliminary results characterize the acute fluid shifts experienced from upright, to supine and HDT postures (increased stroke volume, jugular dimensions and measures of ICP) which are reversed with 25 millimeters Hg LBNP. DISCUSSION: Initial results indicate that acute cephalad fluid shifts may be related to VIIP symptoms, but also may be reversible by LBNP. The effect of a chronic fluid shift has yet to be evaluated. Learning Objectives: Current spaceflight VIIP research is described

  8. Electrorheological fluids

    SciTech Connect

    Halsey, T.C.; Martin, J.E.

    1993-10-01

    An electrorheological fluid is a substance whose form changes in the presence of electric fields. Depending on the strength of the field to which it is subjected, an electrorheological fluid can run freely like water, ooze like honey or solidify like gelatin. Indeed, the substance can switch from ne state to another within a few milliseconds. Electrorheological fluids are easy to make; they consist of microscopic particles suspended in an insulating liquid. Yet they are not ready for most commercial applications. They tend to suffer from a number of problems, including structural weakness as solids, abrasiveness as liquids and chemical breakdown, especially at high temperatures. Automotive engineers could imagine, for instance, constructing an electrorheological clutch. It was also hoped that electrorheological fluids would lead to valveless hydraulic systems, in which solidifying fluid would shut off flow through a thin section of pipe. Electrorheological fluids also offer the possibility of a shock absorber that provides response times of milliseconds and does not require mechanical adjustments. 3 refs.

  9. 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

  10. Diagnostic Value of Nasopharyngeal Aspirates in Children with Lower Respiratory Tract Infections

    PubMed Central

    Lu, Ai-Zhen; Shi, Peng; Wang, Li-Bo; Qian, Li-Ling; Zhang, Xiao-Bo

    2017-01-01

    Background: The accuracy of nasopharyngeal aspirate (NPA) specimens in detecting lower respiratory pathogens remains controversial. The objective of this study was to evaluate the diagnostic accuracy of aspirates (NPAs) specimen in lower respiratory tract infections (LRTIs) in children. Methods: The prospective study was designed to collect the data of paired NPAs and bronchoalveolar lavage fluids from children with acute LRTIs from January 2013 to December 2015. All specimens were subjected to pathogen detection: bacterial detection by culture, Mycoplasma pneumoniae (Mp) detection by polymerase chain reaction assay and virus (influenza A and B viruses, parainfluenza virus [PIV] Types 1 and 3, respiratory syncytial virus, and adenovirus) detection by immunofluorescence assay. The diagnostic accuracy analysis of NPAs was stratified by age ≤3 years (n = 194) and >3 years (n = 294). Results: We collected paired specimens from 488 children. The positive rate of pathogen was 61.6%. For Streptococcus pneumoniae, NPA culture had the specificity of 89.9% and negative predictive value of 100% in age ≤3 years, the specificity of 97.2% and negative predictive value of 98.9% in age >3 years. For Mp, the positive predictive values of NPA was 77.4% in children ≤3 years, and 89.1% in children >3 years. For PIV III, NPA specimen had the specificity of 99.8% and negative predictive value of 96.5% in children ≤3 years. For adenovirus, NPA had the specificity of 97.8% and negative predictive value of 98.4% in age ≤3 years, the specificity of 98.9% and negative predictive value of 99.3% in age >3 years. Conclusions: NPAs are less invasive diagnostic respiratory specimens, a negative NPA result is helpful in “rule out” lower airway infection; however, a positive result does not reliably “rule in” the presence of pathogens. PMID:28303845

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. [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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.