Formulation and Immunogenicity studies of Type III Secretion System needle antigens as Vaccine Candidates

PubMed Central

Barrett, Brooke S.; Markham, Aaron P.; Esfandiary, Reza; Picking, Wendy L.; Picking, William D.; Joshi, Sangeeta B.; Middaugh, C. Russell

2013-01-01

Bacterial infections caused by Shigella flexneri, Salmonella typhimurium and Burkholderia pseudomallei are currently difficult to prevent due to the lack of a licensed vaccine. Here we present formulation and immunogenicity studies for the three type III secretion system (TTSS) needle proteins MxiHΔ5, PrgIΔ5 and BsaLΔ5 (each truncated by five residues at its C terminus) as potential candidates for vaccine development. These antigens are found to be thermally stabilized by the presence of carbohydrates and polyols. Additionally, all adsorb readily to aluminum hydroxide apparently through a combination of hydrogen bonds and/or Van der Waals forces. The interaction of these proteins with the aluminum-based adjuvant changes with time to resulting in varying degrees of irreversible binding. Peptide maps of desorbed protein, however, suggest that chemical changes are not responsible for this irreversible association. The ability of MxiHΔ5 and PrgIΔ5 to elicit strong humoral immune responses was tested in a murine model. When administered intramuscularly as monomers, the needle components exhibited dose dependent immunogenic behavior. The polymerized version of MxiH was exceptionally immunogenic even at low doses. The responses of both monomeric and polymerized forms were boosted by adsorption to an aluminum salt adjuvant. PMID:20845448

Robot-Assisted Needle Steering

PubMed Central

Reed, Kyle B.; Majewicz, Ann; Kallem, Vinutha; Alterovitz, Ron; Goldberg, Ken; Cowan, Noah J.; Okamura, Allison M.

2012-01-01

Needle insertion is a critical aspect of many medical treatments, diagnostic methods, and scientific studies, and is considered to be one of the simplest and most minimally invasive medical procedures. Robot-assisted needle steering has the potential to improve the effectiveness of existing medical procedures and enable new ones by allowing increased accuracy through more dexterous control of the needle tip path and acquisition of targets not accessible by straight-line trajectories. In this article, we describe a robot-assisted needle steering system that uses three integrated controllers: a motion planner concerned with guiding the needle around obstacles to a target in a desired plane, a planar controller that maintains the needle in the desired plane, and a torsion compensator that controls the needle tip orientation about the axis of the needle shaft. Experimental results from steering an asymmetric-tip needle in artificial tissue demonstrate the effectiveness of the system and its sensitivity to various environmental and control parameters. In addition, we show an example of needle steering in ex vivo biological tissue to accomplish a clinically relevant task, and highlight challenges of practical needle steering implementation. PMID:23028210

Accuracy Study of a Robotic System for MRI-guided Prostate Needle Placement

PubMed Central

Seifabadi, Reza; Cho, Nathan BJ.; Song, Sang-Eun; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Fichtinger, Gabor; Iordachita, Iulian

2013-01-01

Background Accurate needle placement is the first concern in percutaneous MRI-guided prostate interventions. In this phantom study, different sources contributing to the overall needle placement error of a MRI-guided robot for prostate biopsy have been identified, quantified, and minimized to the possible extent. Methods and Materials The overall needle placement error of the system was evaluated in a prostate phantom. This error was broken into two parts: the error associated with the robotic system (called before-insertion error) and the error associated with needle-tissue interaction (called due-to-insertion error). The before-insertion error was measured directly in a soft phantom and different sources contributing into this part were identified and quantified. A calibration methodology was developed to minimize the 4-DOF manipulator’s error. The due-to-insertion error was indirectly approximated by comparing the overall error and the before-insertion error. The effect of sterilization on the manipulator’s accuracy and repeatability was also studied. Results The average overall system error in phantom study was 2.5 mm (STD=1.1mm). The average robotic system error in super soft phantom was 1.3 mm (STD=0.7 mm). Assuming orthogonal error components, the needle-tissue interaction error was approximated to be 2.13 mm thus having larger contribution to the overall error. The average susceptibility artifact shift was 0.2 mm. The manipulator’s targeting accuracy was 0.71 mm (STD=0.21mm) after robot calibration. The robot’s repeatability was 0.13 mm. Sterilization had no noticeable influence on the robot’s accuracy and repeatability. Conclusions The experimental methodology presented in this paper may help researchers to identify, quantify, and minimize different sources contributing into the overall needle placement error of an MRI-guided robotic system for prostate needle placement. In the robotic system analyzed here, the overall error of the studied system

Accuracy study of a robotic system for MRI-guided prostate needle placement.

PubMed

Seifabadi, Reza; Cho, Nathan B J; Song, Sang-Eun; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M; Fichtinger, Gabor; Iordachita, Iulian

2013-09-01

Accurate needle placement is the first concern in percutaneous MRI-guided prostate interventions. In this phantom study, different sources contributing to the overall needle placement error of a MRI-guided robot for prostate biopsy have been identified, quantified and minimized to the possible extent. The overall needle placement error of the system was evaluated in a prostate phantom. This error was broken into two parts: the error associated with the robotic system (called 'before-insertion error') and the error associated with needle-tissue interaction (called 'due-to-insertion error'). Before-insertion error was measured directly in a soft phantom and different sources contributing into this part were identified and quantified. A calibration methodology was developed to minimize the 4-DOF manipulator's error. The due-to-insertion error was indirectly approximated by comparing the overall error and the before-insertion error. The effect of sterilization on the manipulator's accuracy and repeatability was also studied. The average overall system error in the phantom study was 2.5 mm (STD = 1.1 mm). The average robotic system error in the Super Soft plastic phantom was 1.3 mm (STD = 0.7 mm). Assuming orthogonal error components, the needle-tissue interaction error was found to be approximately 2.13 mm, thus making a larger contribution to the overall error. The average susceptibility artifact shift was 0.2 mm. The manipulator's targeting accuracy was 0.71 mm (STD = 0.21 mm) after robot calibration. The robot's repeatability was 0.13 mm. Sterilization had no noticeable influence on the robot's accuracy and repeatability. The experimental methodology presented in this paper may help researchers to identify, quantify and minimize different sources contributing into the overall needle placement error of an MRI-guided robotic system for prostate needle placement. In the robotic system analysed here, the overall error of the studied system

Teleoperated master-slave needle insertion.

PubMed

Abolhassani, Niki; Patel, Rajni V

2009-12-01

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

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

PubMed

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

2012-06-01

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

Structure of the heterotrimeric complex that regulates type III secretion needle formation

PubMed Central

Quinaud, Manuelle; Plé, Sophie; Job, Viviana; Contreras-Martel, Carlos; Simorre, Jean-Pierre; Attree, Ina; Dessen, Andréa

2007-01-01

Type III secretion systems (T3SS), found in several Gram-negative pathogens, are nanomachines involved in the transport of virulence effectors directly into the cytoplasm of target cells. T3SS are essentially composed of basal membrane-embedded ring-like structures and a hollow needle formed by a single polymerized protein. Within the bacterial cytoplasm, the T3SS needle protein requires two distinct chaperones for stabilization before its secretion, without which the entire T3SS is nonfunctional. The 2.0-Å x-ray crystal structure of the PscE-PscF55–85-PscG heterotrimeric complex from Pseudomonas aeruginosa reveals that the C terminus of the needle protein PscF is engulfed within the hydrophobic groove of the tetratricopeptide-like molecule PscG, indicating that the macromolecular scaffold necessary to stabilize the T3SS needle is totally distinct from chaperoned complexes between pilus- or flagellum-forming molecules. Disruption of specific PscG–PscF interactions leads to impairment of bacterial cytotoxicity toward macrophages, indicating that this essential heterotrimer, which possesses homologs in a wide variety of pathogens, is a unique attractive target for the development of novel antibacterials. PMID:17470796

Differences in Proteins Synthesized in Needles of Unshaded and Shaded Pinus ponderosa var Scopulorum Seedlings during Prolonged Drought 1

PubMed Central

Vance, Nan C.; Copes, Donald O.; Zaerr, Joe B.

1990-01-01

Proteins were radiolabeled and extracted from needles of Pinus ponderosa var scopulorum (Dougl. ex Laws.) seedlings progressively drought-stressed for about 1 month. A set of novel, low molecular weight proteins was detected in fluorographs of two-dimensional gels when relative water content of needles fell below 70%. Their synthesis was undetectable in the fully recovered seedlings within 48 hours after rewatering. In similarly stressed seedlings that were shaded to 10% full light, the low molecular weight polypeptides were not detected or appeared at very low levels. The shaded seedlings, in which drought tolerance was reduced, did not recover upon termination of the drought. The results suggest that protein synthesis induced by water deficit in drought-tolerant seedlings may contribute to resisting the effects of cellular dehydration. Images Figure 1 Figure 2 PMID:16667397

Transbronchial needle aspiration with a new electromagnetically-tracked TBNA needle

NASA Astrophysics Data System (ADS)

Choi, Jae; Popa, Teo; Gruionu, Lucian

2009-02-01

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

An ultra-high field strength MR image-guided robotic needle delivery system for in-bore small animal interventions.

PubMed

Gravett, Matthew; Cepek, Jeremy; Fenster, Aaron

2017-11-01

The purpose of this study was to develop and validate an image-guided robotic needle delivery system for accurate and repeatable needle targeting procedures in mouse brains inside the 12 cm inner diameter gradient coil insert of a 9.4 T MR scanner. Many preclinical research techniques require the use of accurate needle deliveries to soft tissues, including brain tissue. Soft tissues are optimally visualized in MR images, which offer high-soft tissue contrast, as well as a range of unique imaging techniques, including functional, spectroscopy and thermal imaging, however, there are currently no solutions for delivering needles to small animal brains inside the bore of an ultra-high field MR scanner. This paper describes the mechatronic design, evaluation of MR compatibility, registration technique, mechanical calibration, the quantitative validation of the in-bore image-guided needle targeting accuracy and repeatability, and demonstrated the system's ability to deliver needles in situ. Our six degree-of-freedom, MR compatible, mechatronic system was designed to fit inside the bore of a 9.4 T MR scanner and is actuated using a combination of piezoelectric and hydraulic mechanisms. The MR compatibility and targeting accuracy of the needle delivery system are evaluated to ensure that the system is precisely calibrated to perform the needle targeting procedures. A semi-automated image registration is performed to link the robot coordinates to the MR coordinate system. Soft tissue targets can be accurately localized in MR images, followed by automatic alignment of the needle trajectory to the target. Intra-procedure visualization of the needle target location and the needle were confirmed through MR images after needle insertion. The effects of geometric distortions and signal noise were found to be below threshold that would have an impact on the accuracy of the system. The system was found to have negligible effect on the MR image signal noise and geometric distortion

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

PubMed

Ziegler, Andreas

2007-08-01

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

An Innovative Needle-free Injection System: Comparison to 1 ml Standard Subcutaneous Injection.

PubMed

Kojic, Nikola; Goyal, Pragun; Lou, Cheryl Hamer; Corwin, Michael J

2017-11-01

A needle-free delivery system may lead to improved satisfaction and compliance, as well as reduced anxiety among patients requiring frequent or ongoing injections. This report describes a first-in-man assessment comparing Portal Instruments' innovative needle-free injection system with subcutaneous injections using a 27G needle. Forty healthy volunteer participants each received a total of four injections of 1.0 mL sterile saline solution, two with a standard subcutaneous injection using a 27G needle, and two using the Portal injection system. Perception of pain was measured using a 100-mm visual analog scale (VAS). Injection site reactions were assessed at 2 min and at 20-30 min after each injection. Follow-up contact was made 24-48 h after the injections. Subject preference regarding injection type was also assessed. VAS pain scores at Portal injection sites met the criteria to be considered non-inferior to the pain reported at 27G needle injection sites (i.e., upper 95% confidence bound less than +5 mm). Based on a mixed effects model, at time 0, accounting for potential confounding variables, the adjusted difference in VAS scores indicated that Portal injections were 6.5 mm lower than the 27G needle injections (95% CI -10.5, -2.5). No clinically important adverse events were noted. Portal injections were preferred by 24 (60%) of the subjects (P = 0.0015). As an early step in the development of this new needle-free delivery system, the current study has shown that a 1.0-mL saline injection can be given with less pain reported than a standard subcutaneous injection using a 27G needle.

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

PubMed

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

2014-01-01

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

Enterobacter aerogenes Needle Stick Leads to Improved Biological Management System

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

Johanson, Richard E.

2004-08-01

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

Proteomic analysis of Pinus radiata needles: 2-DE map and protein identification by LC/MS/MS and substitution-tolerant database searching.

PubMed

Valledor, Luis; Castillejo, Maria A; Lenz, Christof; Rodríguez, Roberto; Cañal, Maria J; Jorrín, Jesús

2008-07-01

Pinus radiata is one of the most economically important forest tree species, with a worldwide production of around 370 million m (3) of wood per year. Current selection of elite trees to be used in conservation and breeding programes requires the physiological and molecular characterization of available populations. To identify key proteins related to tree growth, productivity and responses to environmental factors, a proteomic approach is being utilized. In this paper, we present the first report of the 2-DE protein reference map of physiologically mature P. radiata needles, as a basis for subsequent differential expression proteomic studies related to growth, development, biomass production and responses to stresses. After TCA/acetone protein extraction of needle tissue, 549 +/- 21 well-resolved spots were detected in Coommassie-stained gels within the 5-8 pH and 10-100 kDa M(r) ranges. The analytical and biological variance determined for 450 spots were of 31 and 42%, respectively. After LC/MS/MS analysis of in-gel tryptic digested spots, proteins were identified by using the novel Paragon algorithm that tolerates amino acid substitution in the first-pass search. It allowed the confident identification of 115 out of the 150 protein spots subjected to MS, quite unusual high percentage for a poor sequence database, as is the case of P. radiata. Proteins were classified into 12 or 18 groups based on their corresponding cell component or biological process/pathway categories, respectively. Carbohydrate metabolism and photosynthetic enzymes predominate in the 2-DE protein profile of P. radiata needles.

360-degree 3D transvaginal ultrasound system for high-dose-rate interstitial gynaecological brachytherapy needle guidance

NASA Astrophysics Data System (ADS)

Rodgers, Jessica R.; Surry, Kathleen; D'Souza, David; Leung, Eric; Fenster, Aaron

2017-03-01

Treatment for gynaecological cancers often includes brachytherapy; in particular, in high-dose-rate (HDR) interstitial brachytherapy, hollow needles are inserted into the tumour and surrounding area through a template in order to deliver the radiation dose. Currently, there is no standard modality for visualizing needles intra-operatively, despite the need for precise needle placement in order to deliver the optimal dose and avoid nearby organs, including the bladder and rectum. While three-dimensional (3D) transrectal ultrasound (TRUS) imaging has been proposed for 3D intra-operative needle guidance, anterior needles tend to be obscured by shadowing created by the template's vaginal cylinder. We have developed a 360-degree 3D transvaginal ultrasound (TVUS) system that uses a conventional two-dimensional side-fire TRUS probe rotated inside a hollow vaginal cylinder made from a sonolucent plastic (TPX). The system was validated using grid and sphere phantoms in order to test the geometric accuracy of the distance and volumetric measurements in the reconstructed image. To test the potential for visualizing needles, an agar phantom mimicking the geometry of the female pelvis was used. Needles were inserted into the phantom and then imaged using the 3D TVUS system. The needle trajectories and tip positions in the 3D TVUS scan were compared to their expected values and the needle tracks visualized in magnetic resonance images. Based on this initial study, 360-degree 3D TVUS imaging through a sonolucent vaginal cylinder is a feasible technique for intra-operatively visualizing needles during HDR interstitial gynaecological brachytherapy.

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

PubMed Central

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

2017-01-01

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

Cancer cell profiling by barcoding allows multiplexed protein analysis in fine-needle aspirates.

PubMed

Ullal, Adeeti V; Peterson, Vanessa; Agasti, Sarit S; Tuang, Suan; Juric, Dejan; Castro, Cesar M; Weissleder, Ralph

2014-01-15

Immunohistochemistry-based clinical diagnoses require invasive core biopsies and use a limited number of protein stains to identify and classify cancers. We introduce a technology that allows analysis of hundreds of proteins from minimally invasive fine-needle aspirates (FNAs), which contain much smaller numbers of cells than core biopsies. The method capitalizes on DNA-barcoded antibody sensing, where barcodes can be photocleaved and digitally detected without any amplification steps. After extensive benchmarking in cell lines, this method showed high reproducibility and achieved single-cell sensitivity. We used this approach to profile ~90 proteins in cells from FNAs and subsequently map patient heterogeneity at the protein level. Additionally, we demonstrate how the method could be used as a clinical tool to identify pathway responses to molecularly targeted drugs and to predict drug response in patient samples. This technique combines specificity with ease of use to offer a new tool for understanding human cancers and designing future clinical trials.

Cancer cell profiling by barcoding allows multiplexed protein analysis in fine needle aspirates

PubMed Central

Ullal, Adeeti V.; Peterson, Vanessa; Agasti, Sarit S.; Tuang, Suan; Juric, Dejan; Castro, Cesar M.; Weissleder, Ralph

2014-01-01

Immunohistochemistry-based clinical diagnoses require invasive core biopsies and use a limited number of protein stains to identify and classify cancers. Here, we introduce a technology that allows analysis of hundreds of proteins from minimally invasive fine needle aspirates (FNA), which contain much smaller numbers of cells than core biopsies. The method capitalizes on DNA-barcoded antibody sensing where barcodes can be photo-cleaved and digitally detected without any amplification steps. Following extensive benchmarking in cell lines, this method showed high reproducibility and achieved single cell sensitivity. We used this approach to profile ~90 proteins in cells from FNAs and subsequently map patient heterogeneity at the protein level. Additionally, we demonstrate how the method could be used as a clinical tool to identify pathway responses to molecularly targeted drugs and to predict drug response in patient samples. This technique combines specificity with ease of use to offer a new tool for understanding human cancers and designing future clinical trials. PMID:24431113

MRI-guided prostate focal laser ablation therapy using a mechatronic needle guidance system

NASA Astrophysics Data System (ADS)

Cepek, Jeremy; Lindner, Uri; Ghai, Sangeet; Davidson, Sean R. H.; Trachtenberg, John; Fenster, Aaron

2014-03-01

Focal therapy of localized prostate cancer is receiving increased attention due to its potential for providing effective cancer control in select patients with minimal treatment-related side effects. Magnetic resonance imaging (MRI)-guided focal laser ablation (FLA) therapy is an attractive modality for such an approach. In FLA therapy, accurate placement of laser fibers is critical to ensuring that the full target volume is ablated. In practice, error in needle placement is invariably present due to pre- to intra-procedure image registration error, needle deflection, prostate motion, and variability in interventionalist skill. In addition, some of these sources of error are difficult to control, since the available workspace and patient positions are restricted within a clinical MRI bore. In an attempt to take full advantage of the utility of intraprocedure MRI, while minimizing error in needle placement, we developed an MRI-compatible mechatronic system for guiding needles to the prostate for FLA therapy. The system has been used to place interstitial catheters for MRI-guided FLA therapy in eight subjects in an ongoing Phase I/II clinical trial. Data from these cases has provided quantification of the level of uncertainty in needle placement error. To relate needle placement error to clinical outcome, we developed a model for predicting the probability of achieving complete focal target ablation for a family of parameterized treatment plans. Results from this work have enabled the specification of evidence-based selection criteria for the maximum target size that can be confidently ablated using this technique, and quantify the benefit that may be gained with improvements in needle placement accuracy.

A magnetic resonance image-guided breast needle intervention robot system: overview and design considerations.

PubMed

Park, Samuel Byeongjun; Kim, Jung-Gun; Lim, Ki-Woong; Yoon, Chae-Hyun; Kim, Dong-Jun; Kang, Han-Sung; Jo, Yung-Ho

2017-08-01

We developed an image-guided intervention robot system that can be operated in a magnetic resonance (MR) imaging gantry. The system incorporates a bendable needle intervention robot for breast cancer patients that overcomes the space limitations of the MR gantry. Most breast coil designs for breast MR imaging have side openings to allow manual localization. However, for many intervention procedures, the patient must be removed from the gantry. A robotic manipulation system with integrated image guidance software was developed. Our robotic manipulator was designed to be slim, so as to fit between the patient's side and the MR gantry wall. Only non-magnetic materials were used, and an electromagnetic shield was employed for cables and circuits. The image guidance software was built using open source libraries. In situ feasibility tests were performed in a 3-T MR system. One target point in the breast phantom was chosen by the clinician for each experiment, and our robot moved the needle close to the target point. Without image-guided feedback control, the needle end could not hit the target point (distance = 5 mm) in the first experiment. Using our robotic system, the needle hits the target lesion of the breast phantom at a distance of 2.3 mm from the same target point using image-guided feedback. The second experiment was performed using other target points, and the distance between the final needle end point and the target point was 0.8 mm. We successfully developed an MR-guided needle intervention robot for breast cancer patients. Further research will allow the expansion of these interventions.

Needle Biopsy

MedlinePlus

... needle biopsy procedures include fine-needle aspiration and core needle biopsy. Needle biopsy may be used to ... hollow needle to draw cells from your body. Core needle biopsy. This type of needle biopsy uses ...

Effect of dietary protein level and quebracho tannin on consumption of pine needles (Pinus ponderosa) by beef cows

USDA-ARS?s Scientific Manuscript database

Ponderosa pine trees occupy over 15 million hectares of rangeland in western North America. Pregnant cows often consume pine needles (PN), and subsequently abort. The protein-to-energy ratio may be important in the ability of cattle to tolerate dietary terpenes. Tannins often co-occur with terpenes ...

Treatment feasibility study of osteoporosis using minimal invasive laser needle system

NASA Astrophysics Data System (ADS)

Kang, Dongyeon; Ko, Chang-Yong; Ryu, Yeon-Hang; Park, Sunwook; Kim, Han-Sung; Jung, Byungjo

2010-02-01

Although the mechanism of laser stimulation effect in bone has not completely understood, laser stimulation is recommended in the treatment of osteoporosis due to positive treatment efficacy. In this study, a minimal invasive laser needle system (MILNS) was developed using a fine hollow needle in order to stimulate directly bone site by guiding an optical fiber. In order to evaluate the MILNS as a treatment method, in-vivo animal experiment study was performed using osteopenic mice. Twelve virginal ICR mice were employed and divided two groups: SHAM-group and LASERgroup. SHARM-group was stimulated by only fine hollow needle and LASER-group by fine hollow needle combined with laser stimulation. All mice were served in-vivo micro-CT images before and after treatment. Three dimensional (3D) structural parameters and vBMD (volume bone mineral density, g/cm3) in the trabecular bone were measured. After 2 weeks of stimulation, the vBMD, BV/TV, Tb.Th and Tb.N in LASER-group were significantly higher than those in SHAM-group (p<0.05). Potentially, this study suggested that the MILNS might prevent the bone loss and maintains the bone mineral density of osteopenic mice.

Randomized, open trial comparing a modified double-lumen needle follicular flushing system with a single-lumen aspiration needle in IVF patients with poor ovarian response.

PubMed

von Horn, Kyra; Depenbusch, Marion; Schultze-Mosgau, Askan; Griesinger, Georg

2017-04-01

Is a modified double-lumen aspiration needle system with follicular flushing able to increase the mean oocyte yield by at least one in poor response IVF patients as compared to single-lumen needle aspiration without flushing? Follicular flushing with the modified flushing system did not increase the number of oocytes, but increased the procedure duration. Most studies on follicular flushing were performed with conventional double-lumen needles in patients who were normal responders. Overall, these studies indicated no benefit of follicular flushing. Prospective, single-centre, randomized, controlled, open, superiority trial comparing the 17 G Steiner-Tan Needle® flushing system with a standard 17 G single-lumen aspiration needle (Gynetics®); time frame February 2015-March 2016. Eighty IVF patients, 18-45 years, BMI >18 kg/m2 to <35 kg/m2, presenting with ≤ five follicles >10 mm in both ovaries at the end of the follicular phase were randomized to either aspirating and flushing each follicle 3× with the Steiner-Tan-Needle® automated flushing system (n = 40) or a conventional single-lumen needle aspiration (n = 40). Primary outcome was the number of cumulus-oocyte-complexes (COCs). Procedure duration, burden (Depression Anxiety and Stress Scale; DASS-21) and post-procedure pain were also assessed. Flushing was not superior with a mean (SD) number of COCs of 2.4 (2.0) and 3.1 (2.3) in the Steiner-Tan Needle® and in the Gynectics® group, respectively (mean difference -0.7, 95% CI: 0.3 to -1.6; P = 0.27). Likewise no differences were observed in metaphase II  oocytes, two pronuclear oocytes, number of patients having an embryo transfer and DASS 21 scores. The procedure duration was significantly 2-fold increased. Testing for differences in the number of patients achieving an embryo transfer or differences in pregnancy rate would require a much larger sample size. The use of follicular flushing is unlikely to benefit the prognosis of patients with poor ovarian

The research of knitting needle status monitoring setup

NASA Astrophysics Data System (ADS)

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

2013-09-01

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

Compact system with handheld microfabricated optoelectronic probe for needle-based tissue sensing applications

NASA Astrophysics Data System (ADS)

Lee, Seung Yup; Na, Kyounghwan; Pakela, Julia M.; Scheiman, James M.; Yoon, Euisik; Mycek, Mary-Ann

2017-02-01

We present the design, development, and bench-top verification of an innovative compact clinical system including a miniaturized handheld optoelectronic sensor. The integrated sensor was microfabricated with die-level light-emitting diodes and photodiodes and fits into a 19G hollow needle (internal diameter: 0.75 mm) for optical sensing applications in solid tissues. Bench-top studies on tissue-simulating phantoms have verified system performance relative to a fiberoptic based tissue spectroscopy system. With dramatically reduced system size and cost, the technology affords spatially configurable designs for optoelectronic light sources and detectors, thereby enabling customized sensing configurations that would be impossible to achieve with needle-based fiber-optic probes.

Effect of body condition on consumption of pine needles (Pinus ponderosa) by beef cows.

PubMed

Pfister, J A; Panter, K E; Gardner, D R; Cook, D; Welch, K D

2008-12-01

We determined whether cows in low (LBC) or high body condition (HBC) would consume different amounts of green pine needles (Pinus ponderosa). Cows (mature; open Hereford and Hereford x Angus) were fed a maintenance basal diet (alfalfa pellets) for Exp. 1 and 2; during Exp. 3 and 4, cows were fed high-protein and high-energy diets, respectively. Experiment 5 was a grazing study on rangeland during winter in South Dakota; diets were determined by using bite counts. Mean BCS (1 = emaciated, 9 = obese) was 7.5 for HBC cows and <4.0 for LBC cows during the experiments. During Exp. 1, LBC cows consumed more (P = 0.001) pine needles than did HBC cows (5.5 +/- 0.25 vs. 1.0 +/- 0.14 g/kg of BW daily, respectively). During Exp. 2, there was a day x treatment interaction (P = 0.001) as LBC cows consumed variable, but greater, amounts of pine needles than did HBC cows (3.7 +/- 0.19 vs. 1.3 +/- 0.12 g/kg of BW daily, respectively). When fed a high-protein/low-energy diet, LBC cows ate more (P = 0.04) pine needles than did HBC cows. When fed a low-protein/high-energy diet, there was a day x treatment interaction (P = 0.001) because LBC cows consumed more pine needles than did HBC cows for the first 3 d of the study, and then consumption by LBC animals decreased during the last 4 d. These experiments suggest that the protein:energy ratio may be an important factor in the ability of cows to tolerate terpenes, and that cows were not able to sustain an increased quantity of needle consumption on a low-protein diet. During the 25-d grazing study, there was a day x treatment interaction (P = 0.001) as LBC animals selected more pine needles (up to 25% of daily bites) on some days compared with HBC cows. Weather influenced pine needle consumption because pine needle bites by LBC cows were related (r(2) = 0.60; P = 0.001) to days of greater snow depth and lower minimum daily temperatures. Both LBC and HBC cows increased selection of pine needles from trees during cold, snowy weather, but

Physical characterization of MxiH and PrgI, the needle component of the type III secretion apparatus from Shigella and Salmonella.

PubMed

Darboe, Numukunda; Kenjale, Roma; Picking, Wendy L; Picking, William D; Middaugh, C Russell

2006-03-01

Shigella and Salmonella use similar type III secretion systems for delivering effector proteins into host cells. This secretion system consists of a base anchored in both bacterial membranes and an extracellular "needle" that forms a rod-like structure exposed on the pathogen surface. The needle is composed of multiple subunits of a single protein and makes direct contact with host cells to facilitate protein delivery. The proteins that make up the needle of Shigella and Salmonella are MxiH and PrgI, respectively. These proteins are attractive vaccine candidates because of their essential role in virulence and surface exposure. We therefore isolated, purified, and characterized the monomeric forms of MxiH and PrgI. Their far-UV circular dichroism spectra show structural similarities with hints of subtle differences in their secondary structure. Both proteins are highly helical and thermally unstable, with PrgI having a midpoint of thermal unfolding (Tm) near 37 degrees C and MxiH having a value near 42 degrees C. The two proteins also have comparable intrinsic stabilities as measured by chemically induced (urea) unfolding. MxiH, however, with a free energy of unfolding (DeltaG degrees 0,un) of 1.6 kcal/mol, is slightly more stable than PrgI (1.2 kcal/mol). The relatively low m-values obtained for the urea-induced unfolding of the proteins suggest that they undergo only a small change in solvent-accessible surface area. This argues that when MxiH and PrgI are incorporated into the needle complex, they obtain a more stable structural state through the introduction of protein-protein interactions.

The epidural needle guidance with an intelligent and automatic identification system for epidural anesthesia

NASA Astrophysics Data System (ADS)

Kao, Meng-Chun; Ting, Chien-Kun; Kuo, Wen-Chuan

2018-02-01

Incorrect placement of the needle causes medical complications in the epidural block, such as dural puncture or spinal cord injury. This study proposes a system which combines an optical coherence tomography (OCT) imaging probe with an automatic identification (AI) system to objectively identify the position of the epidural needle tip. The automatic identification system uses three features as image parameters to distinguish the different tissue by three classifiers. Finally, we found that the support vector machine (SVM) classifier has highest accuracy, specificity, and sensitivity, which reached to 95%, 98%, and 92%, respectively.

Teleoperation System with Hybrid Pneumatic-Piezoelectric Actuation for MRI-Guided Needle Insertion with Haptic Feedback

PubMed Central

Shang, Weijian; Su, Hao; Li, Gang; Fischer, Gregory S.

2014-01-01

This paper presents a surgical master-slave tele-operation system for percutaneous interventional procedures under continuous magnetic resonance imaging (MRI) guidance. This system consists of a piezoelectrically actuated slave robot for needle placement with integrated fiber optic force sensor utilizing Fabry-Perot interferometry (FPI) sensing principle. The sensor flexure is optimized and embedded to the slave robot for measuring needle insertion force. A novel, compact opto-mechanical FPI sensor interface is integrated into an MRI robot control system. By leveraging the complementary features of pneumatic and piezoelectric actuation, a pneumatically actuated haptic master robot is also developed to render force associated with needle placement interventions to the clinician. An aluminum load cell is implemented and calibrated to close the impedance control loop of the master robot. A force-position control algorithm is developed to control the hybrid actuated system. Teleoperated needle insertion is demonstrated under live MR imaging, where the slave robot resides in the scanner bore and the user manipulates the master beside the patient outside the bore. Force and position tracking results of the master-slave robot are demonstrated to validate the tracking performance of the integrated system. It has a position tracking error of 0.318mm and sine wave force tracking error of 2.227N. PMID:25126446

Teleoperation System with Hybrid Pneumatic-Piezoelectric Actuation for MRI-Guided Needle Insertion with Haptic Feedback.

PubMed

Shang, Weijian; Su, Hao; Li, Gang; Fischer, Gregory S

2013-01-01

This paper presents a surgical master-slave tele-operation system for percutaneous interventional procedures under continuous magnetic resonance imaging (MRI) guidance. This system consists of a piezoelectrically actuated slave robot for needle placement with integrated fiber optic force sensor utilizing Fabry-Perot interferometry (FPI) sensing principle. The sensor flexure is optimized and embedded to the slave robot for measuring needle insertion force. A novel, compact opto-mechanical FPI sensor interface is integrated into an MRI robot control system. By leveraging the complementary features of pneumatic and piezoelectric actuation, a pneumatically actuated haptic master robot is also developed to render force associated with needle placement interventions to the clinician. An aluminum load cell is implemented and calibrated to close the impedance control loop of the master robot. A force-position control algorithm is developed to control the hybrid actuated system. Teleoperated needle insertion is demonstrated under live MR imaging, where the slave robot resides in the scanner bore and the user manipulates the master beside the patient outside the bore. Force and position tracking results of the master-slave robot are demonstrated to validate the tracking performance of the integrated system. It has a position tracking error of 0.318mm and sine wave force tracking error of 2.227N.

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

PubMed

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

2011-01-01

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

Needle Steering in 3-D Via Rapid Replanning

PubMed Central

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

2014-01-01

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

Real-time ultrasound-guided spinal anesthesia using the SonixGPS® needle tracking system: a case report.

PubMed

Wong, Simon W; Niazi, Ahtsham U; Chin, Ki J; Chan, Vincent W

2013-01-01

The SonixGPS® is an electromagnetic needle tracking system for ultrasound-guided needle intervention. Both current and predicted needle tip position are displayed on the ultrasound screen in real-time, facilitating needle-beam alignment and guidance to the target. This case report illustrates the use of the SonixGPS system for successful performance of real-time ultrasound-guided spinal anesthesia in a patient with difficult spinal anatomy. A 67-yr-old male was admitted to our hospital to undergo revision of total right hip arthroplasty. His four previous arthroplasties for hip revision were performed under general anesthesia because he had undergone L3-L5 instrumentation for spinal stenosis. The L4-L5 interspace was viewed with the patient in the left lateral decubitus position. A 19G 80-mm proprietary needle (Ultrasonix Medical Corp, Richmond, BC, Canada) was inserted and directed through the paraspinal muscles to the ligamentum flavum in plane to the ultrasound beam. A 120-mm 25G Whitacre spinal needle was then inserted through the introducer needle in a conventional fashion. Successful dural puncture was achieved on the second attempt, as indicated by a flow of clear cerebrospinal fluid. The patient tolerated the procedure well, and the spinal anesthetic was adequate for the duration of the surgery. The SonixGPS is a novel technology that can reduce the technical difficulty of real-time ultrasound-guided neuraxial blockade. It may also have applications in other advanced ultrasound-guided regional anesthesia techniques where needle-beam alignment is critical.

Cloned foal derived from in vivo matured horse oocytes aspirated by the short disposable needle system.

PubMed

Lee, Wonyou; Song, Kilyoung; Lee, Inhyung; Shin, Hyungdo; Lee, Byeong Chun; Yeon, Seongchan; Jang, Goo

2015-01-01

Transvaginal ultrasound-guided follicle aspiration is one method of obtaining recipient oocytes for equine somatic cell nuclear transfer (SCNT). This study was conducted: (1) to evaluate the possibility of oocyte aspiration from pre-ovulatory follicles using a short disposable needle system (14-G) by comparing the oocyte recovery rate with that of a long double lumen needle (12-G); (2) to investigate the developmental competence of recovered oocytes after SCNT and embryo transfer. The recovery rates with the short disposable needle vs. the long needle were not significantly different (47.5% and 35.0%, respectively). Twenty-six SCNT embryos were transferred to 13 mares, and one mare delivered a live offspring at Day 342. There was a perfect identity match between the cloned foal and the cell donor after analysis of microsatellite DNA, and the mitochondrial DNA of the cloned foal was identical with that of the oocyte donor. These results demonstrated that the short disposable needle system can be used to recover oocytes to use as cytoplasts for SCNT, in the production of cloned foals and for other applications in equine embryology.

Toward a 3D transrectal ultrasound system for verification of needle placement during high-dose-rate interstitial gynecologic brachytherapy.

PubMed

Rodgers, Jessica Robin; Surry, Kathleen; Leung, Eric; D'Souza, David; Fenster, Aaron

2017-05-01

Treatment for gynecologic cancers, such as cervical, recurrent endometrial, and vaginal malignancies, commonly includes external-beam radiation and brachytherapy. In high-dose-rate (HDR) interstitial gynecologic brachytherapy, radiation treatment is delivered via hollow needles that are typically inserted through a template on the perineum with a cylinder placed in the vagina for stability. Despite the need for precise needle placement to minimize complications and provide optimal treatment, there is no standard intra-operative image-guidance for this procedure. While some image-guidance techniques have been proposed, including magnetic resonance (MR) imaging, X-ray computed tomography (CT), and two-dimensional (2D) transrectal ultrasound (TRUS), these techniques have not been widely adopted. In order to provide intra-operative needle visualization and localization during interstitial brachytherapy, we have developed a three-dimensional (3D) TRUS system. This study describes the 3D TRUS system and reports on the system validation and results from a proof-of-concept patient study. To obtain a 3D TRUS image, the system rotates a conventional 2D endocavity transducer through 170 degrees in 12 s, reconstructing the 2D frames into a 3D image in real-time. The geometry of the reconstruction was validated using two geometric phantoms to ensure the accuracy of the linear measurements in each of the image coordinate directions and the volumetric accuracy of the system. An agar phantom including vaginal and rectal canals, as well as a model uterus and tumor, was designed and used to test the visualization and localization of the interstitial needles under idealized conditions by comparing the needles' positions between the 3D TRUS scan and a registered MR image. Five patients undergoing HDR interstitial gynecologic brachytherapy were imaged using the 3D TRUS system following the insertion of all needles. This image was manually, rigidly registered to the clinical

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

PubMed Central

Aye, Tandy

2011-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-05-01

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

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

PubMed

Aye, Tandy

2011-11-01

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

Cloned foal derived from in vivo matured horse oocytes aspirated by the short disposable needle system

PubMed Central

Lee, Wonyou; Song, Kilyoung; Lee, Inhyung; Shin, Hyungdo; Lee, Byeong Chun

2015-01-01

Transvaginal ultrasound-guided follicle aspiration is one method of obtaining recipient oocytes for equine somatic cell nuclear transfer (SCNT). This study was conducted: (1) to evaluate the possibility of oocyte aspiration from pre-ovulatory follicles using a short disposable needle system (14-G) by comparing the oocyte recovery rate with that of a long double lumen needle (12-G); (2) to investigate the developmental competence of recovered oocytes after SCNT and embryo transfer. The recovery rates with the short disposable needle vs. the long needle were not significantly different (47.5% and 35.0%, respectively). Twenty-six SCNT embryos were transferred to 13 mares, and one mare delivered a live offspring at Day 342. There was a perfect identity match between the cloned foal and the cell donor after analysis of microsatellite DNA, and the mitochondrial DNA of the cloned foal was identical with that of the oocyte donor. These results demonstrated that the short disposable needle system can be used to recover oocytes to use as cytoplasts for SCNT, in the production of cloned foals and for other applications in equine embryology PMID:26119166

Development of CMTD (Curved Multi-Tubed Device) -system III and its application to the needle-insertion for liver.

PubMed

Furusho, Junji; Kobayashi, Hiroshi; Kikuchi, Takehito; Yamamoto, Tatsuro; Tanaka, Hidekazu; Terayama, Motokazu; Monden, Morito

2008-01-01

The purpose of this study is to realize the mechanically-controllable needle-insertion system using the CMTD (Curved Multi-Tube Device) which was developed by Furusho Laboratory. A CMTD, was developed for minimally-invasive surgery and needle insertion. And we use ultrasonograph as a sensing device to detect the position of bible duct or tumor and the orientation and position of the needle which is inserted into liver. This system makes safe minimally-invasive surgery possible, because all complex mechanisms are arranged outside of the body.

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

PubMed

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

2014-01-01

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

How Placebo Needles Differ From Placebo Pills?

PubMed Central

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

2018-01-01

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

Jammed systems of oriented needles always percolate on square lattices

NASA Astrophysics Data System (ADS)

Kondrat, Grzegorz; Koza, Zbigniew; Brzeski, Piotr

2017-08-01

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

a Computational Approach to Explore Protein Translocation Through Type III Secretion Apparatus

NASA Astrophysics Data System (ADS)

Rathinavelan, Thenmalarchelvi; Im, Wonpil

2010-01-01

Many Gram-negative bacteria initiate infections by injecting effector proteins into host cells through the type III secretion apparatus (TTSA) that is comprised of a basal body, a needle, and a tip. The needle channel is formed by the assembly of a single needle protein. To explore the export mechanisms of MxiH needle protein through the needle of Shigella flexneri, an essential step during needle assembly, we have performed steered molecular dynamics simulations in implicit solvent. Interestingly, the electronegative channel interior creates an energy barrier for MxiH to enter the channel, while the same may facilitate the ejection of the effectors into host cells. Structurally-known basal regions and ATPase underneath the basal region have also such electronegative interior, while effector proteins have considerable electronegative patches on their surfaces. Based on these observations, we propose a repulsive electrostatic mechanism for protein translocation through the TTSA. This mechanism is supported by the suggestion that an ATPase is required for protein translocation through these nanomachines, which may provide the energy to overcome the initial electrostatic energy barrier. A similar mechanism may be applicable to macromolecular channels in other secretion systems or viruses through which proteins or nucleic acids are transported.

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

PubMed

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

2015-01-01

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

Does a paresthesia during spinal needle insertion indicate intrathecal needle placement?

PubMed

Pong, Ryan P; Gmelch, Benjamin S; Bernards, Christopher M

2009-01-01

Paresthesias are relatively common during spinal needle insertion, however, the clinical significance of the paresthesia is unknown. A paresthesia may result from needle-to-nerve contact with a spinal nerve in the epidural space, or, with far lateral needle placement, may result from contact with a spinal nerve within the intervertebral foramen. However, it is also possible and perhaps more likely, that paresthesias occur when the spinal needle contacts a spinal nerve root within the subarachnoid space. This study was designed to test this latter hypothesis. Patients (n = 104) scheduled for surgery under spinal anesthesia were observed during spinal needle insertion. If a paresthesia occurred, the needle was fixed in place and the stylet removed to observe whether cerebrospinal fluid (CSF) flowed from the hub. The presence of CSF was considered proof that the needle had entered the subarachnoid space. Paresthesias occurred in 14/103 (13.6%) of patients; 1 patient experienced a paresthesia twice. All paresthesias were transient. Following a paresthesia, CSF was observed in the needle hub 86.7% (13/15) of the time. Our data suggest that the majority of transient paresthesias occur when the spinal needle enters the subarachnoid space and contacts a spinal nerve root. Therefore, when transient paresthesias occur during spinal needle placement it is appropriate to stop and assess for the presence of CSF in the needle hub, rather than withdraw and redirect the spinal needle away from the side of the paresthesia as some authors have suggested.

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

PubMed Central

Seifabadi, Reza; Iordachita, Iulian; Fichtinger, Gabor

2013-01-01

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

[An Introduction to A Newly-developed "Acupuncture Needle Manipulation Training-evaluation System" Based on Optical Motion Capture Technique].

PubMed

Zhang, Ao; Yan, Xing-Ke; Liu, An-Guo

2016-12-25

In the present paper, the authors introduce a newly-developed "Acupuncture Needle Manipulation Training-evaluation System" based on optical motion capture technique. It is composed of two parts, sensor and software, and overcomes some shortages of mechanical motion capture technique. This device is able to analyze the data of operations of the pressing-hand and needle-insertion hand during acupuncture performance and its software contains personal computer (PC) version, Android version, and Internetwork Operating System (IOS) Apple version. It is competent in recording and analyzing information of any ope-rator's needling manipulations, and is quite helpful for teachers in teaching, training and examining students in clinical practice.

Comparison of Battery-Powered and Manual Bone Biopsy Systems for Core Needle Biopsy of Sclerotic Bone Lesions.

PubMed

Cohen, Micah G; McMahon, Colm J; Kung, Justin W; Wu, Jim S

2016-05-01

The purpose of this study was to compare manual and battery-powered bone biopsy systems for diagnostic yield and procedural factors during core needle biopsy of sclerotic bone lesions. A total of 155 consecutive CT-guided core needle biopsies of sclerotic bone lesions were performed at one institution from January 2006 to November 2014. Before March 2012, lesions were biopsied with manual bone drill systems. After March 2012, most biopsies were performed with a battery-powered system and either noncoaxial or coaxial biopsy needles. Diagnostic yield, crush artifact, CT procedure time, procedure radiation dose, conscious sedation dose, and complications were compared between the manual and battery-powered core needle biopsy systems by Fisher exact test and t test. One-way ANOVA was used for subgroup analysis of the two battery-powered systems for procedure time and radiation dose. The diagnostic yield for all sclerotic lesions was 60.0% (93/155) and was significantly higher with the battery-powered system (73.0% [27/37]) than with the manual systems (55.9% [66/118]) (p = 0.047). There was no significant difference between the two systems in terms of crush artifact, procedure time, radiation dose, conscious sedation administered, or complications. In subgroup analysis, the coaxial battery-powered biopsies had shorter procedure times (p = 0.01) and lower radiation doses (p = 0.002) than the coaxial manual systems, but the noncoaxial battery-powered biopsies had longer average procedure times and higher radiation doses than the coaxial manual systems. In biopsy of sclerotic bone lesions, use of a battery-powered bone drill system improves diagnostic yield over use of a manual system.

Physical characterization of MxiH and PrgI, the needle component of the type III secretion apparatus from Shigella and Salmonella

PubMed Central

Darboe, Numukunda; Kenjale, Roma; Picking, Wendy L.; Picking, William D.; Middaugh, C. Russell

2006-01-01

Shigella and Salmonella use similar type III secretion systems for delivering effector proteins into host cells. This secretion system consists of a base anchored in both bacterial membranes and an extracellular “needle” that forms a rod-like structure exposed on the pathogen surface. The needle is composed of multiple subunits of a single protein and makes direct contact with host cells to facilitate protein delivery. The proteins that make up the needle of Shigella and Salmonella are MxiH and PrgI, respectively. These proteins are attractive vaccine candidates because of their essential role in virulence and surface exposure. We therefore isolated, purified, and characterized the monomeric forms of MxiH and PrgI. Their far-UV circular dichroism spectra show structural similarities with hints of subtle differences in their secondary structure. Both proteins are highly helical and thermally unstable, with PrgI having a midpoint of thermal unfolding (Tm) near 37°C and MxiH having a value near 42°C. The two proteins also have comparable intrinsic stabilities as measured by chemically induced (urea) unfolding. MxiH, however, with a free energy of unfolding (ΔG°0,un) of 1.6 kcal/mol, is slightly more stable than PrgI (1.2 kcal/mol). The relatively low m-values obtained for the urea-induced unfolding of the proteins suggest that they undergo only a small change in solvent-accessible surface area. This argues that when MxiH and PrgI are incorporated into the needle complex, they obtain a more stable structural state through the introduction of protein–protein interactions. PMID:16501225

Dimensions of stabident intraosseous perforators and needles.

PubMed

Ramlee, R A; Whitworth, J

2001-09-01

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

Limited retention of micro-organisms using commercialized needle filters.

PubMed

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

2015-03-01

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

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

USGS Publications Warehouse

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

2008-01-01

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

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

PubMed

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

2018-06-01

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

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

PubMed

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

2008-01-01

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

Needle free injection technology: A complete insight

PubMed Central

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

2015-01-01

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

A Repulsive Electrostatic Mechanism for Protein Export through the Type III Secretion Apparatus

PubMed Central

Rathinavelan, Thenmalarchelvi; Zhang, Lingling; Picking, Wendy L.; Weis, David D.; De Guzman, Roberto N.; Im, Wonpil

2010-01-01

Abstract Many Gram-negative bacteria initiate infections by injecting effector proteins into host cells through the type III secretion apparatus, which is comprised of a basal body, a needle, and a tip. The needle channel is formed by the assembly of a single needle protein. To explore the export mechanisms of MxiH needle protein through the needle of Shigella flexneri, an essential step during needle assembly, we have performed steered molecular dynamics simulations in implicit solvent. The trajectories reveal a screwlike rotation motion during the export of nativelike helix-turn-helix conformations. Interestingly, the channel interior with excessive electronegative potential creates an energy barrier for MxiH to enter the channel, whereas the same may facilitate the ejection of the effectors into host cells. Structurally known basal regions and ATPase underneath the basal region also have electronegative interiors. Effector proteins also have considerable electronegative potential patches on their surfaces. From these observations, we propose a repulsive electrostatic mechanism for protein translocation through the type III secretion apparatus. Based on this mechanism, the ATPase activity and/or proton motive force could be used to energize the protein translocation through these nanomachines. A similar mechanism may be applicable to macromolecular channels in other secretion systems or viruses through which proteins or nucleic acids are transported. PMID:20141759

Design and evaluation of a computed tomography (CT)-compatible needle insertion device using an electromagnetic tracking system and CT images.

PubMed

Shahriari, Navid; Hekman, Edsko; Oudkerk, Matthijs; Misra, Sarthak

2015-11-01

Percutaneous needle insertion procedures are commonly used for diagnostic and therapeutic purposes. Although current technology allows accurate localization of lesions, they cannot yet be precisely targeted. Lung cancer is the most common cause of cancer-related death, and early detection reduces the mortality rate. Therefore, suspicious lesions are tested for diagnosis by performing needle biopsy. In this paper, we have presented a novel computed tomography (CT)-compatible needle insertion device (NID). The NID is used to steer a flexible needle (φ0.55 mm) with a bevel at the tip in biological tissue. CT images and an electromagnetic (EM) tracking system are used in two separate scenarios to track the needle tip in three-dimensional space during the procedure. Our system uses a control algorithm to steer the needle through a combination of insertion and minimal number of rotations. Noise analysis of CT images has demonstrated the compatibility of the device. The results for three experimental cases (case 1: open-loop control, case 2: closed-loop control using EM tracking system and case 3: closed-loop control using CT images) are presented. Each experimental case is performed five times, and average targeting errors are 2.86 ± 1.14, 1.11 ± 0.14 and 1.94 ± 0.63 mm for case 1, case 2 and case 3, respectively. The achieved results show that our device is CT-compatible and it is able to steer a bevel-tipped needle toward a target. We are able to use intermittent CT images and EM tracking data to control the needle path in a closed-loop manner. These results are promising and suggest that it is possible to accurately target the lesions in real clinical procedures in the future.

Reduced variability and execution time to reach a target with a needle GPS system: Comparison between physicians, residents and nurse anaesthetists.

PubMed

Fevre, Marie-Cécile; Vincent, Caroline; Picard, Julien; Vighetti, Arnaud; Chapuis, Claire; Detavernier, Maxime; Allenet, Benoît; Payen, Jean-François; Bosson, Jean-Luc; Albaladejo, Pierre

2018-02-01

Ultrasound (US) guided needle positioning is safer than anatomical landmark techniques for central venous access. Hand-eye coordination and execution time depend on the professional's ability, previous training and personal skills. Needle guidance positioning systems (GPS) may theoretically reduce execution time and facilitate needle positioning in specific targets, thus improving patient comfort and safety. Three groups of healthcare professionals (41 anaesthesiologists and intensivists, 41 residents in anaesthesiology and intensive care, 39 nurse anaesthetists) were included and required to perform 3 tasks (positioning the tip of a needle in three different targets in a silicon phantom) by using successively a conventional US-guided needle positioning and a needle GPS. We measured execution times to perform the tasks, hand-eye coordination and the number of repositioning occurrences or errors in handling the needle or the probe. Without the GPS system, we observed a significant inter-individual difference for execution time (P<0.05), hand-eye coordination and the number of errors/needle repositioning between physicians, residents and nurse anaesthetists. US training and video gaming were found to be independent factors associated with a shorter execution time. Use of GPS attenuated the inter-individual and group variability. We observed a reduced execution time and improved hand-eye coordination in all groups as compared to US without GPS. Neither US training, video gaming nor demographic personal or professional factors were found to be significantly associated with reduced execution time when GPS was used. US associated with GPS systems may improve safety and decrease execution time by reducing inter-individual variability between professionals for needle-handling procedures. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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

PubMed

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

2001-10-01

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

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

PubMed

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

2018-06-01

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

Enabling freehand lateral scanning of optical coherence tomography needle probes with a magnetic tracking system

PubMed Central

Yeo, Boon Y.; McLaughlin, Robert A.; Kirk, Rodney W.; Sampson, David D.

2012-01-01

We present a high-resolution three-dimensional position tracking method that allows an optical coherence tomography (OCT) needle probe to be scanned laterally by hand, providing the high degree of flexibility and freedom required in clinical usage. The method is based on a magnetic tracking system, which is augmented by cross-correlation-based resampling and a two-stage moving window average algorithm to improve upon the tracker's limited intrinsic spatial resolution, achieving 18 µm RMS position accuracy. A proof-of-principle system was developed, with successful image reconstruction demonstrated on phantoms and on ex vivo human breast tissue validated against histology. This freehand scanning method could contribute toward clinical implementation of OCT needle imaging. PMID:22808429

Protein Export According to Schedule: Architecture, Assembly, and Regulation of Type III Secretion Systems from Plant- and Animal-Pathogenic Bacteria

PubMed Central

2012-01-01

Summary: Flagellar and translocation-associated type III secretion (T3S) systems are present in most Gram-negative plant- and animal-pathogenic bacteria and are often essential for bacterial motility or pathogenicity. The architectures of the complex membrane-spanning secretion apparatuses of both systems are similar, but they are associated with different extracellular appendages, including the flagellar hook and filament or the needle/pilus structures of translocation-associated T3S systems. The needle/pilus is connected to a bacterial translocon that is inserted into the host plasma membrane and mediates the transkingdom transport of bacterial effector proteins into eukaryotic cells. During the last 3 to 5 years, significant progress has been made in the characterization of membrane-associated core components and extracellular structures of T3S systems. Furthermore, transcriptional and posttranscriptional regulators that control T3S gene expression and substrate specificity have been described. Given the architecture of the T3S system, it is assumed that extracellular components of the secretion apparatus are secreted prior to effector proteins, suggesting that there is a hierarchy in T3S. The aim of this review is to summarize our current knowledge of T3S system components and associated control proteins from both plant- and animal-pathogenic bacteria. PMID:22688814

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

PubMed

Kajikawa, Natsuki; Maeno, Takami; Maeno, Tetsuhiro

2014-09-01

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

Simulation and experimental studies in needle-tissue interactions.

PubMed

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

2017-08-01

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

A clinical evaluation of four non-Luer spinal needle and syringe systems.

PubMed

Kinsella, S M; Goswami, A; Laxton, C; Kirkham, L; Wharton, N; Bowen, M

2012-11-01

We performed an evaluation of non-Luer spinal devices supplied by four manufacturers or suppliers: Polymedic; Pajunk; Sarstedt; and Smiths. For each supplier, 100 evaluations were performed using a 25-G 90-mm spinal needle, 3-ml syringe, 5-ml syringe and filter needle; for comparison, 100 evaluations were performed with our standard Luer equipment. The non-Luer devices were associated with more qualitative problems compared with the Luer devices, for example, poor feel of dural puncture (9-32% vs 10%, respectively), poor observation of cerebrospinal fluid in the hub (3-27% vs 0%), and connection problem of the syringe to the spinal needle (7-33% vs 0%). There was also more frequent failure to achieve the spinal injection due to equipment-related causes (4-7% vs 0%, respectively). Median (IQR [range]) numeric satisfaction scores for the spinal needles were: Luer 10 (9-10 [7-10]); Polymedic 7 (4-8 [0-10]; Pajunk 7 (5-8 [0-10]); Sarstedt 7 (6-8 [0-10]); and Smiths 9 (7-10 [0-10]) (p<0.0001). Satisfaction scores for all spinal equipment were: Luer 10 (9-10 [5-10]); Polymedic 8 (6-8 [0-10]); Pajunk 7 (5-7 [1-9]); Sarstedt 8 (6-8 [0-10]); and Smiths 8 (8-9 [2-10]) (p<0.0001). Between 21% and 75% of non-Luer evaluations were rated with satisfaction worse than the usual Luer needle compared with 0-10% rated better, depending on the needle type. Between 22% and 76% of non-Luer evaluations were rated with satisfaction worse than the usual Luer equipment compared with 0-14% rated better. Specific concerns included poor feel of tissue planes and observation of cerebrospinal fluid (Polymedic), difficulty with connection of the syringe to the spinal needle and trocar removal (Pajunk), poor feel of tissue planes and needle flexibility (Sarstedt) and difficulty with connection of the syringe to the spinal needle (Smiths). We could not demonstrate a short-term learning curve for the new devices. Decisions on purchasing and implementation of the new non-Luer equipment will have to

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

PubMed

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

2014-01-01

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

Development of an MRI-Guided Intra-Prostatic Needle Placement System

DTIC Science & Technology

2011-07-01

and intra-operative imaging using techniques such as those described by Haker , et al. [18]. Target points for the needle insertion are selected... Haker , S., Fichtinger, G., Tem- pany, C.: Transperineal prostate biopsy under magnetic resonance image guid- ance: A needle placement accuracy study 26...clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 42(3), 507–515 (1998) 9. DiMaio, S.P., Pieper, S., Chinzei, K., Hata, N., Haker , S.J

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

PubMed Central

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

Methods for Improving the Curvature of Steerable Needles in Biological Tissue

PubMed Central

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

2016-01-01

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

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

PubMed

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

2017-11-01

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

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

PubMed

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

2006-07-01

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

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

DTIC Science & Technology

2016-06-01

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

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

PubMed

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

2014-09-01

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

Does Needle Rotation Improve Lesion Targeting?

PubMed Central

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

2011-01-01

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

Numerical modelling of needle-grid electrodes for negative surface corona charging system

NASA Astrophysics Data System (ADS)

Zhuang, Y.; Chen, G.; Rotaru, M.

2011-08-01

Surface potential decay measurement is a simple and low cost tool to examine electrical properties of insulation materials. During the corona charging stage, a needle-grid electrodes system is often used to achieve uniform charge distribution on the surface of the sample. In this paper, a model using COMSOL Multiphysics has been developed to simulate the gas discharge. A well-known hydrodynamic drift-diffusion model was used. The model consists of a set of continuity equations accounting for the movement, generation and loss of charge carriers (electrons, positive and negative ions) coupled with Poisson's equation to take into account the effect of space and surface charges on the electric field. Four models with the grid electrode in different positions and several mesh sizes are compared with a model that only has the needle electrode. The results for impulse current and surface charge density on the sample clearly show the effect of the extra grid electrode with various positions.

Comparison of sealer penetration using the EndoVac irrigation system and conventional needle root canal irrigation.

PubMed

Kara Tuncer, Aysun; Unal, Bayram

2014-05-01

The aim of this study was to compare the effect of the EndoVac irrigation system (SybronEndo, Orange, CA) and conventional endodontic needle irrigation on sealer penetration into dentinal tubules. Forty single-rooted, recently extracted human maxillary central incisors were randomly divided into 2 groups according to the irrigation technique used: conventional endodontic needle irrigation and EndoVac irrigation. All teeth were instrumented using the ProFile rotary system (Dentsply Maillefer, Ballaigues, Switzerland) and obturated with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) labeled with fluorescent dye. Transverse sections at 1, 3, and 5 mm from the root apex were examined using confocal laser scanning microscopy. The total percentage and maximum depth of sealer penetration were then measured. Mann-Whitney test results showed that EndoVac irrigation resulted in a significantly higher percentage of sealer penetration than conventional irrigation at both the 1- and 3-mm levels (P < .05). However, no difference was found at the 5-mm level. The 5-mm sections in each group showed a significantly higher percentage and maximum depth of sealer penetration than did the 1- and 3-mm sections (P < .05). The EndoVac irrigation system significantly improved the sealer penetration at the 1- to 3-mm level over that of conventional endodontic needle irrigation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2015-01-01

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

Needle phobia during pregnancy.

PubMed

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

2006-01-01

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

Needle bar for warp knitting machines

DOEpatents

Hagel, Adolf; Thumling, Manfred

1979-01-01

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

Infrared needle mapping to assist biopsy procedures and training.

PubMed

Shar, Bruce; Leis, John; Coucher, John

2018-04-01

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

[Effects of acupotomy, electroacupuncture or round-sharp acupuncture needle interventions on expression of Bcl-2, Bax, Caspase-3 proteins of rectus femoris in rabbits with knee ostarthritis].

PubMed

Huang, Yi-Ran; Jin, Ying-Li; Li, Na; Lei, Lin-Dan; Yu, Fei; Li, Yu-Bo; Tao, Lin; Zhang, Qian; Guo, Chang-Qing

2014-04-01

To observe the effect of acupotomy, electroacupuncture (EA) or round-sharp acupuncture needle intervention on the expression of Bcl-2,Bax and Caspase-3 proteins in the rectus femoris in rabbits with knee ostarthritis (KOA), so as to explore their mechanisms underlying improvement of braking-induced joint damage from the cellular apoptosis. Forty-five New Zealand rabbits were equally and randomized into control group, model group, acupotomy (AP) group, EA group and round-sharp acupuncture needle (RSAN) group (n = 9 in each group). The knee-joint injury model was established by fixing the left knee joint in extention position with plaster bandage. EA (2 Hz/100 Hz, 3 mA, 20 min each time) was applied to the left "Yanglingquan" (GB 34)- "Yinlingquan" (SP 9) and left "Neixiyan" (EX-LE 4)- "Waixiyan"(ST 35) for rabbits in the EA group. The EA treatment was given once daily, 3 times a week, 3 weeks in total. For rabbits of the AP group, a needle-knife was held to insert into the front edge of the midpoint, the starting point and the stopping point of the left medial collateral ligamen, lateral collateral ligament and the patellar ligament of the knee to make a loosening manipulation for 5 times in a session of treatment, once a week, 3 times altogether. For rabbits of the RSAN group, a round-sharp needle was performed in the same way to the needle-knife including the stimulation point, the manipulation method and treatment sessions. At the end of the experiment, the left rectus femoris was taken out for detecting the expression of Bcl-2, Bax and Caspase-3 proteins with Western blot. In comparison with the control group, the passive range of motion (PROM) level was significantly decreased 4, 8 and 12 weeks after modeling (P < 0.01), and the expression levels of Bax and Caspase-3 proteins in the rectus femoris were considerably upregulated in the model group (P < 0.05), while the ratio of Bcl-2/Bax was notably down-regulated (P < 0.05) in the model group. Compared with the

Histological observation for needle-tissue interactions.

PubMed

Nakagawa, Yoshiyuki; Koseki, Yoshihiko

2013-01-01

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

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

PubMed Central

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

2013-01-01

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

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

PubMed

Yin, Tao; Ni, Jinxia; Zhu, Wenzeng

2015-10-01

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

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

PubMed

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

2005-02-01

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

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

PubMed

Balwan, Akshu

2018-05-16

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

Biomedical engineering meets acupuncture - development of a miniaturized 48-channel skin impedance measurement system for needle and laser acupuncture

PubMed Central

2010-01-01

Background Due to controversially discussed results in scientific literature concerning changes of electrical skin impedance before and during acupuncture a new measurement system has been developed. Methods The prototype measures and analyzes the electrical skin impedance computer-based and simultaneously in 48 channels within a 2.5×3.5 cm matrix. Preliminary measurements in one person were performed using metal needle and violet laser (405 nm) acupuncture at the acupoint Kongzui (LU6). The new system is an improvement on devices previously developed by other researchers for this purpose. Results Skin impedance in the immediate surroundings of the acupoint was lowered reproducibly following needle stimulation and also violet laser stimulation. Conclusions A new instrumentation for skin impedance measurements is presented. The following hypotheses suggested by our results will have to be tested in further studies: Needle acupuncture causes significant, specific local changes of electrical skin impedance parameters. Optical stimulation (violet laser) at an acupoint causes direct electrical biosignal changes. PMID:21092296

Comparison of the EndoVac system to needle irrigation of root canals.

PubMed

Nielsen, Benjamin A; Craig Baumgartner, J

2007-05-01

Past studies have shown that current irrigation methods are effective at cleaning root canals coronally but less effective apically. To be effective, endodontic irrigants should ideally be delivered near working length. The purpose of this study was to compare the efficacy of the EndoVac irrigation system and needle irrigation to debride root canals at 1 and 3 mm from working length. One tooth of each matched pair was instrumented and irrigated by using the EndoVac, which uses negative pressure to deliver irrigating solutions to working length. The other tooth of the matched pair was instrumented and irrigated with a 30-gauge ProRinse irrigating needle. All teeth were irrigated with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) for a predetermined amount of time, and total volume of irrigant used was recorded. After instrumentation and irrigation, the teeth were fixed, decalcified, and sectioned at 1 mm and 3 mm from working length. Serial sections were made and digitally photographed. The amount of remaining debris was determined as a percentage of the area of the canal lumen. Remaining debris and total irrigant were analyzed by using the Wilcoxon signed rank test at the 5% confidence level. At the 1-mm level, significantly less debris was found in the EndoVac group (p=0.0347). At the 3-mm level, there was no significant difference between groups. Significantly more irrigant was delivered with the EndoVac (p<0001). This study showed significantly better debridement at 1 mm from working length by using the EndoVac compared with needle irrigation.

Is point of access to needles and syringes related to needle sharing? Comparing data collected from pharmacies and needle and syringe programs in south-east Sydney.

PubMed

Bryant, Joanne; Topp, Libby; Hopwood, Max; Iversen, Jenny; Treloar, Carla; Maher, Lisa

2010-07-01

The comprehensive needle and syringe distribution system in New South Wales is partly based on the premise that different points of access to injecting equipment may attract different groups of injecting drug users. This paper examines patterns of equipment acquisition and risk for blood-borne virus transmission among injecting drug users who use pharmacies and needle and syringe programs (NSP) in south-east Sydney. Clients obtaining injecting equipment from four NSP (n = 147) and eight pharmacies (n = 227) in 2006 voluntarily completed a self-administered questionnaire. Respondents were grouped into three categories based on their needle and syringe acquisition patterns: exclusive use of NSP, exclusive use of pharmacies and use of both. Although it was common for respondents to report using both pharmacies and NSP to obtain needles and syringes (57%), a proportion reported exclusive use of pharmacies (17%) and NSP (14%). Exclusive pharmacy users were more likely to have never received treatment for their drug use and the least likely to have had a recent test for hepatitis C. Compared with respondents who exclusively used NSP, respondents who exclusively used pharmacies were more likely to report receptive sharing of injecting equipment (adjusted odds ratio 5.9, 95% confidence interval 2.02-17.14), as were respondents who reported using both sources (adjusted odds ratio 5.8, 95% confidence interval 2.35-14.40). The high prevalence of receptive equipment sharing among pharmacy clients indicates a need to improve access to needles and syringes and ancillary equipment, possibly by including ancillary equipment at no cost in existing pre-packaged pharmacy products.

Comparison of a GPS needle-tracking system, multiplanar imaging and 2D imaging for real-time ultrasound-guided epidural anaesthesia: A randomized, comparative, observer-blinded study on phantoms.

PubMed

Menacé, Cécilia; Choquet, Olivier; Abbal, Bertrand; Bringuier, Sophie; Capdevila, Xavier

2017-04-01

The real-time ultrasound-guided paramedian sagittal oblique approach for neuraxial blockade is technically demanding. Innovative technologies have been developed to improve nerve identification and the accuracy of needle placement. The aim of this study was to evaluate three types of ultrasound scans during ultrasound-guided epidural lumbar punctures in a spine phantom. Eleven sets of 20 ultrasound-guided epidural punctures were performed with 2D, GPS, and multiplanar ultrasound machines (660 punctures) on a spine phantom using an in-plane approach. For all punctures, execution time, number of attempts, bone contacts, and needle redirections were noted by an independent physician. Operator comfort and visibility of the needle (tip and shaft) were measured using a numerical scale. The use of GPS significantly decreased the number of punctures, needle repositionings, and bone contacts. Comfort of the physician was also significantly improved with the GPS system compared with the 2D and multiplanar systems. With the multiplanar system, the procedure was not facilitated and execution time was longer compared with 2D imaging after Bonferroni correction but interaction between the type of ultrasound system and mean execution time was not significant in a linear mixed model. There were no significant differences regarding needle tip and shaft visibility between the systems. Multiplanar and GPS needle-tracking systems do not reduce execution time compared with 2D imaging using a real-time ultrasound-guided paramedian sagittal oblique approach in spine phantoms. The GPS needle-tracking system can improve performance in terms of operator comfort, the number of attempts, needle redirections and bone contacts. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Learning Ultrasound-Guided Needle Insertion Skills through an Edutainment Game

NASA Astrophysics Data System (ADS)

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

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

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

PubMed

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

2014-06-01

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

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

PubMed

Karadsheh, Zeid; Al-Haddad, Mohammad

2014-01-01

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

Comparison of the EndoVac system and conventional needle irrigation on removal of the smear layer in primary molar root canals.

PubMed

Buldur, B; Kapdan, A

2017-09-01

This study aimed to compare the EndoVac system and conventional needle irrigation in removing smear layer (SR) from primary molar root canals. Fifty extracted human primary second molar roots were instrumented up to an apical size of 0.04/35 and randomly divided into two main groups; Group 1: EndoVac system (n = 25) and Group 2: Conventional needle irrigation (n = 25) and three subgroups (a) NaOCl + ethylenediaminetetraacetic acid (EDTA) (n = 20) (b) ozonated water (OW) + EDTA (n = 20) and (c) saline (control, n = 10). After a standardized final irrigation protocol performed for all teeth, scanning electron microscope images were taken at ×1000 magnification for each thirds of each root canal. Data were analyzed by the weighted kappa, Kruskal-Wallis, and Wilcoxon signed rank tests. EndoVac was more effective than conventional needle in the removal of SR from the apical third of the root canal system (P < 0.05). The OW + EDTA regimen provided similar SR removal compared with NaOCl + EDTA. EndoVac has better performance than conventional needle irrigation in the removal of the SR in the apical thirds of the primary molar root canals. As a final irrigation regimen, the OW + EDTA regimen is as effective as the NaOCl + EDTA regimen.

From the Cover: Microfabricated needles for transdermal delivery of macromolecules and nanoparticles: Fabrication methods and transport studies

NASA Astrophysics Data System (ADS)

McAllister, Devin V.; Wang, Ping M.; Davis, Shawn P.; Park, Jung-Hwan; Canatella, Paul J.; Allen, Mark G.; Prausnitz, Mark R.

2003-11-01

Arrays of micrometer-scale needles could be used to deliver drugs, proteins, and particles across skin in a minimally invasive manner. We therefore developed microfabrication techniques for silicon, metal, and biodegradable polymer microneedle arrays having solid and hollow bores with tapered and beveled tips and feature sizes from 1 to 1,000 μm. When solid microneedles were used, skin permeability was increased in vitro by orders of magnitude for macromolecules and particles up to 50 nm in radius. Intracellular delivery of molecules into viable cells was also achieved with high efficiency. Hollow microneedles permitted flow of microliter quantities into skin in vivo, including microinjection of insulin to reduce blood glucose levels in diabetic rats. transdermal drug delivery | skin | microelectromechanical systems | solid microneedle | hollow needle injection

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

PubMed

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

2009-08-01

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

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

PubMed

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

2017-07-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-02-01

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

21 CFR 880.5580 - Acupuncture needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Needle tip visibility in 3D ultrasound images

NASA Astrophysics Data System (ADS)

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

2017-03-01

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

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

PubMed

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

2015-03-01

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

[On-site fine-needle aspiration cytology of thyroid nodules. Quality assurance of the Bethesda System for Reporting Thyroid Cytopathology (2008)].

PubMed

Bak, Mihály; Péter, Ilona; Nyári, Tibor; Simon, Péter; Újlaky, Mátyás; Boér, András; Kásler, Miklós

2015-10-11

The methods available for the diagnosis of thyroid nodules include physical examination, imaging, laboratory and fine-needle aspiration cytology tests. The aim of this study was to determine the quality assurance of fine-needle aspiration cytology of thyroid nodules. Cytology results were rated to 6 categories according to the Bethesda System for Reporting Thyroid Cytopathology (2008) (I. nondiagnostic; II. benign; III. atypia of undetermined significance; IV. follicular neoplasia; V. suspicious for malignancy; VI. malignant). All cytology reports were compared with the final histology diagnosis. A total of 1384 patient with thyroid nodule underwent fine-needle aspiration biopsy cytology. Smears were classified I. inadequate in 214 (15.9%); II. benign 986; III. atypical 56; IV. follicular neoplasm 41; V. suspicious for malignancy 18; VI. malignant 33 cases. Two hundred and twenty seven (16.8%) of the cases were operated and histologically verified. The positive predictive value in the benign category was 98.25% and in the malignant 88.46%. The sensitivity of the follicular neoplasm was 66.67%. The results suggest that fine-needle aspiration cytology of thyroid nodules using the Bethesda System for Reporting Thyroid Cytopathology has a high diagnostic accuracy. The auditing values of the results meet the proposed threshold values.

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

PubMed Central

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

2012-01-01

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

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

PubMed

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

2017-07-01

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

Veres needle in the pleural space.

PubMed

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

1983-11-01

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

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

PubMed

Mignon, Paul; Poignet, Philippe; Troccaz, Jocelyne

2018-05-29

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

[Design and application of silver needle-knife].

PubMed

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

2015-04-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-03-01

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

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

PubMed

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

2016-01-01

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

Premature Needle Loss of Spruce

Treesearch

Jennifer Juzwik; Joseph G. O Brien

1990-01-01

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

Needle path planning and steering in a three-dimensional non-static environment using two-dimensional ultrasound images

PubMed Central

Vrooijink, Gustaaf J.; Abayazid, Momen; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2015-01-01

Needle insertion is commonly performed in minimally invasive medical procedures such as biopsy and radiation cancer treatment. During such procedures, accurate needle tip placement is critical for correct diagnosis or successful treatment. Accurate placement of the needle tip inside tissue is challenging, especially when the target moves and anatomical obstacles must be avoided. We develop a needle steering system capable of autonomously and accurately guiding a steerable needle using two-dimensional (2D) ultrasound images. The needle is steered to a moving target while avoiding moving obstacles in a three-dimensional (3D) non-static environment. Using a 2D ultrasound imaging device, our system accurately tracks the needle tip motion in 3D space in order to estimate the tip pose. The needle tip pose is used by a rapidly exploring random tree-based motion planner to compute a feasible needle path to the target. The motion planner is sufficiently fast such that replanning can be performed repeatedly in a closed-loop manner. This enables the system to correct for perturbations in needle motion, and movement in obstacle and target locations. Our needle steering experiments in a soft-tissue phantom achieves maximum targeting errors of 0.86 ± 0.35 mm (without obstacles) and 2.16 ± 0.88 mm (with a moving obstacle). PMID:26279600

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

PubMed

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

2017-12-25

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

Development of a high frequency single-element ultrasound needle transducer for anesthesia delivery

NASA Astrophysics Data System (ADS)

Ameri, Golafsoun; Son, Jungik; Liang, Jingwei; Foster, F. Stuart; Ganapathy, Sugantha; Peters, Terry M.

2017-03-01

Epidural anesthesia is one of the most commonly used and yet challenging techniques employed for pain management and anesthesia delivery. The major complications of this procedure are due to accidental dural puncture, with an incidence of 1-3%, which could lead to both temporary and irreversible permanent neurological complications. Needle placement under ultrasound (US) guidance has received increasing interest for improving needle placement accuracy. However, poor needle visibility in US, difficulties in displaying relevant anatomical structure such as dura mater due to attenuation and bone shadowing, and image interpretation variability among users pose significant hurdles for any US guidance system. As a result, US guidance for epidural injections has not been widely adopted for everyday use for the performance of neuraxial blocks. The difficulties in localizing the ligamentum flavum and dura with respect to the needle tip can be addressed by integrating A-mode US, provided by a single-element transducer at the needle tip, into the B-mode US guidance system. We have taken the first steps towards providing such a guidance system. Our goal is to improve the safety of this procedure with minimal changes to the clinical workflow. This work presents the design and development of a 20 MHz single-element US transducer housed at the tip of a 19 G needle hypodermic tube, which can fit inside an epidural introducer needle. In addition, the results from initial transducer characterization tests and performance evaluation of the transducer in a euthanized porcine model are provided.

Percutaneous needle placement using laser guidance: a practical solution

NASA Astrophysics Data System (ADS)

Xu, Sheng; Kapoor, Ankur; Abi-Jaoudeh, Nadine; Imbesi, Kimberly; Hong, Cheng William; Mazilu, Dumitru; Sharma, Karun; Venkatesan, Aradhana M.; Levy, Elliot; Wood, Bradford J.

2013-03-01

In interventional radiology, various navigation technologies have emerged aiming to improve the accuracy of device deployment and potentially the clinical outcomes of minimally invasive procedures. While these technologies' performance has been explored extensively, their impact on daily clinical practice remains undetermined due to the additional cost and complexity, modification of standard devices (e.g. electromagnetic tracking), and different levels of experience among physicians. Taking these factors into consideration, a robotic laser guidance system for percutaneous needle placement is developed. The laser guidance system projects a laser guide line onto the skin entry point of the patient, helping the physician to align the needle with the planned path of the preoperative CT scan. To minimize changes to the standard workflow, the robot is integrated with the CT scanner via optical tracking. As a result, no registration between the robot and CT is needed. The robot can compensate for the motion of the equipment and keep the laser guide line aligned with the biopsy path in real-time. Phantom experiments showed that the guidance system can benefit physicians at different skill levels, while clinical studies showed improved accuracy over conventional freehand needle insertion. The technology is safe, easy to use, and does not involve additional disposable costs. It is our expectation that this technology can be accepted by interventional radiologists for CT guided needle placement procedures.

Properties of southern pine needles

Treesearch

E.T. Howard

1973-01-01

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

Secure Container For Discarded Hypodermic Needles

NASA Technical Reports Server (NTRS)

Lee, Angelene M.

1992-01-01

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

An Optical Actuation System and Curvature Sensor for a MR-compatible Active Needle

PubMed Central

Ryu, Seok Chang; Quek, Zhan Fan; Renaud, Pierre; Black, Richard J.; Daniel, Bruce L.; Cutkosky, Mark R.

2015-01-01

A side optical actuation method is presented for a slender MR-compatible active needle. The needle includes an active region with a shape memory alloy (SMA) wire actuator, where the wire generates a contraction force when optically heated by a laser delivered though optical fibers, producing needle tip bending. A prototype, with multiple side heating spots, demonstrates twice as fast an initial response compared to fiber tip heating when 0.8 W of optical power is applied. A single-ended optical sensor with a gold reflector is also presented to measure the curvature as a function of optical transmission loss. Preliminary tests with the sensor prototype demonstrate approximately linear response and a repeatable signal, independent of the bending history. PMID:26509099

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

PubMed

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

2016-06-01

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

An alternative and inexpensive percutaneous access needle in pediatric patients.

PubMed

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

2012-10-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-04-01

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

[Needling technique of Professor Li Yan-Fang].

PubMed

Li, Li-Jun

2014-01-01

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

Radiofrequency Cauterization with Biopsy Introducer Needle

PubMed Central

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

2014-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

A new posterior iliac puncture/aspiration needle.

PubMed

Islam, Anwarul

2016-03-25

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

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

PubMed

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

2017-08-01

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

The N-terminus of IpaB provides a potential anchor to the Shigella type III secretion system tip complex protein IpaD

PubMed Central

Dickenson, Nicholas E.; Arizmendi, Olivia; Patil, Mrinalini K.; Toth, Ronald T.; Middaugh, C. Russell; Picking, William D.; Picking, Wendy L.

2014-01-01

The type III secretion system (T3SS) is an essential virulence factor for Shigella flexneri, providing a conduit through which host-altering effectors are injected directly into a host cell to promote uptake. The type III secretion apparatus (T3SA) is comprised of a basal body, external needle, and regulatory tip complex. The nascent needle is a polymer of MxiH capped by a pentamer of invasion plasmid antigen D (IpaD). Exposure to bile salts (e.g. deoxycholate) causes a conformational change in IpaD and promotes recruitment of IpaB to the needle tip. It has been proposed that IpaB senses contact with host cell membranes, recruiting IpaC and inducing full secretion of T3SS effectors. While the steps of T3SA maturation and their external triggers have been identified, details of specific protein interactions and mechanisms have remained difficult to study due to the hydrophobic nature of the IpaB and IpaC translocator proteins. Here we explored the ability for a series of soluble N-terminal IpaB peptides to interact with IpaD. We found that DOC is required for the interaction and that a region of IpaB between residues 11–27 is required for maximum binding, which was confirmed in vivo. Furthermore, intramolecular FRET measurements indicated that movement of the IpaD distal domain away from the protein core accompanied the binding of IpaB11-226. Together these new findings provide important new insight into the interactions and potential mechanisms that define the maturation of the Shigella T3SA needle tip complex and provide a foundation for further studies probing T3SS activation. PMID:24236510

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

PubMed

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

2017-11-01

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

An augmented reality haptic training simulator for spinal needle procedures.

PubMed

Sutherland, Colin; Hashtrudi-Zaad, Keyvan; Sellens, Rick; Abolmaesumi, Purang; Mousavi, Parvin

2013-11-01

This paper presents the prototype for an augmented reality haptic simulation system with potential for spinal needle insertion training. The proposed system is composed of a torso mannequin, a MicronTracker2 optical tracking system, a PHANToM haptic device, and a graphical user interface to provide visual feedback. The system allows users to perform simulated needle insertions on a physical mannequin overlaid with an augmented reality cutaway of patient anatomy. A tissue model based on a finite-element model provides force during the insertion. The system allows for training without the need for the presence of a trained clinician or access to live patients or cadavers. A pilot user study demonstrates the potential and functionality of the system.

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

PubMed

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

2018-01-01

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

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

PubMed Central

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

2018-01-01

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

Evaluation of Needle Gun and Abrasive Blasting Technologies in Bridge Paint Removal Practices.

PubMed

Randall, Paul M; Kranz, Paul B; Sonntag, Mary L; Stadelmaier, James E

1998-03-01

This paper reviews the results of a U.S. Environmental Protection Agency (EPA) study that assessed needle gun technology as an alternative to conventional abrasive blasting technology to remove lead-based paint from steel bridges in western New York State. The study analyzed the operational and logistical aspects as they relate to worker health and safety, environmental protection, hazardous waste generation, and costs as compared to those arising from conventional abrasive blasting. In this 1992 EPA study, the costs and the product quality aspects favored conventional abrasive blasting over the needle gun technology for removing lead paint. However, abrasive blasting exposed workers to airborne lead levels that exceeded Permissible Exposure Limits (PELs) as established by the Occupational Safety and Health Administration (OSHA), as well as emitting high levels of lead-contaminated dusts and debris into the environment. It was estimated that more than 500 lbs of lead-contaminated spent abrasives and paint waste were released into the environment during paint removal operations. The needle gun system reduced (up to 97.5%) the generation of hazardous waste and the airborne concentrations (up to 99%) of respirable dusts and lead-containing particulates generated during paint removal operations. However, labor costs for the needle gun were three times higher than those for abrasive blasting primarily because of slower production rates that necessitated more operating personnel. The higher labor costs of the needle gun are partially offset by the increased costs associated with the expendable abrasive blast media and hazardous waste disposal. In the EPA study, the productivity of the needle gun system was 12.2 ft 2 /hr vs. 147.5 ft 2 /hr for abrasive blasting. A post blast was needed for the needle gun system to meet surface preparation specifications. When factoring in the costs of full containment structures to meet OSHA's 1993 Lead Exposure in Construction regulation

Modeling and Control of Needles with Torsional Friction

PubMed Central

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

2010-01-01

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

Stunting of southern pine seedlings by a needle nematode (Longidorus sp.)

Treesearch

M.M. Cram; S.W. Fraedrich; J. Fields

2003-01-01

An undescribed needle nematode (Longidorus sp.) was consistently associated with stunted loblolly pine seedlings at the Flint River Nursery in south Georgia. Seedlings in affected areas had root systems that were greatly reduced in size, and lacked lateral and fine roots. In a growth chamber experiment, the needle nematode significantly reduced the...

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

PubMed

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

2014-12-01

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

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

NASA Astrophysics Data System (ADS)

Ueno, Hideki; Kawahara, Shintaro; Nakayama, Hiroshi

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

Comparison of the Antimicrobial Efficacy of the EndoVac System and Conventional Needle Irrigation in Primary Molar Root Canals.

PubMed

Buldur, Burak; Kapdan, Arife

The purpose of this study was to compare the antimicrobial efficacy of the EndoVac system and conventional needle irrigation to eliminate E faecalis in primary molar root canals. 60 extracted human primary second molar roots were instrumented up to an apical size .04/35 and randomly divided into two groups; Group 1: conventional needle (n=30) and Group 2: EndoVac (n=30), and four subgroups (two experimental subgroups; (a) 2.5% sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA) (n=20), (b) ozonated water (OW) + EDTA (n=20), and control groups (c) 5.25% NaOCl (n=10) and (d) saline (n=10). All roots were sterilized and then inoculated with E.faecalis. Before and after final irrigation procedures, root canals were sampled and the grown colony forming units (CFUs) were counted. Data were analyzed by Kruskall-Wallis and Mann-Whitney U tests using a 0.05 significance level. The EndoVac reduced more bacteria than the conventional needle did but it was not statistically significant (p>0.05). NaOCl alone or followed by EDTA totally eliminated bacteria. OW + EDTA showed higher reduction of bacteria but could not totally eliminate bacterias. In the context of bacterial elimination, the EndoVac was not significantly better than the conventional needle. Although, there were fewer CFU/mg when using EndoVac, there was not any statistically significant superiority to conventional needle irrigation. An OW+EDTA regimen showed antibacterial effect in the primary molar root canals but it was significantly less effective than NaOCl+EDTA.

Development of Repulsive Barrier Discharge from Twin Needles

NASA Astrophysics Data System (ADS)

Ueno, Hideki; Hata, Koji; Nakayama, Hiroshi

2007-03-01

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

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

PubMed Central

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

2016-01-01

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

Development of Needle Insertion Manipulator for Central Venous Catheterization

NASA Astrophysics Data System (ADS)

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

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

[Infraoccipital needle-knife for cervical vertigo].

PubMed

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

2017-03-12

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

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

PubMed

Bigeleisen, Paul E

2017-05-15

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

Laser Generated Leaky Acoustic Waves for Needle Visualization.

PubMed

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

2018-04-01

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

Needle puncture in rabbit functional spinal units alters rotational biomechanics.

PubMed

Hartman, Robert A; Bell, Kevin M; Quan, Bichun; Nuzhao, Yao; Sowa, Gwendolyn A; Kang, James D

2015-04-01

An in vitro biomechanical study for rabbit lumbar functional spinal units (FSUs) using a robot-based spine testing system. To elucidate the effect of annular puncture with a 16 G needle on mechanical properties in flexion/extension, axial rotation, and lateral bending. Needle puncture of the intervertebral disk has been shown to alter mechanical properties of the disk in compression, torsion, and bending. The effect of needle puncture in FSUs, where intact spinal ligaments and facet joints may mitigate or amplify these changes in the disk, on spinal motion segment stability subject to physiological rotations remains unknown. Rabbit FSUs were tested using a robot testing system whose force/moment and position precision were assessed to demonstrate system capability. Flexibility testing methods were developed by load-to-failure testing in flexion/extension, axial rotation, and lateral bending. Subsequent testing methods were used to examine a 16 G needle disk puncture and No. 11 blade disk stab (positive control for mechanical disruption). Flexibility testing was used to assess segmental range-of-motion (degrees), neutral zone stiffness (N m/degrees) and width (degrees and N m), and elastic zone stiffness before and after annular injury. The robot-based system was capable of performing flexibility testing on FSUs-mean precision of force/moment measurements and robot system movements were <3% and 1%, respectively, of moment-rotation target values. Flexibility moment targets were 0.3 N m for flexion and axial rotation and 0.15 N m for extension and lateral bending. Needle puncture caused significant (P<0.05) changes only in flexion/extension range-of-motion and neutral zone stiffness and width (N m) compared with preintervention. No. 11 blade-stab significantly increased range-of-motion in all motions, decreased neutral zone stiffness and width (N m) in flexion/extension, and increased elastic zone stiffness in flexion and lateral bending. These findings suggest that

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

PubMed Central

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

2017-01-01

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

Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver

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

Cornelis, F.; Takaki, H.; Laskhmanan, M.

PurposeTo compare CT fluoroscopy-guided manual and CT-guided robotic positioning system (RPS)-assisted needle placement by experienced IR physicians to targets in swine liver.Materials and MethodsManual and RPS-assisted needle placement was performed by six experienced IR physicians to four 5 mm fiducial seeds placed in swine liver (n = 6). Placement performance was assessed for placement accuracy, procedure time, number of confirmatory scans, needle manipulations, and procedure radiation dose. Intra-modality difference in performance for each physician was assessed using paired t test. Inter-physician performance variation for each modality was analyzed using Kruskal–Wallis test.ResultsPaired comparison of manual and RPS-assisted placements to a target by the samemore » physician indicated accuracy outcomes was not statistically different (manual: 4.53 mm; RPS: 4.66 mm; p = 0.41), but manual placement resulted in higher total radiation dose (manual: 1075.77 mGy/cm; RPS: 636.4 mGy/cm; p = 0.03), required more confirmation scans (manual: 6.6; RPS: 1.6; p < 0.0001) and needle manipulations (manual: 4.6; RPS: 0.4; p < 0.0001). Procedure time for RPS was longer than manual placement (manual: 6.12 min; RPS: 9.7 min; p = 0.0003). Comparison of inter-physician performance during manual placement indicated significant differences in the time taken to complete placements (p = 0.008) and number of repositions (p = 0.04) but not in other study measures (p > 0.05). Comparison of inter-physician performance during RPS-assisted placement suggested statistically significant differences in procedure time (p = 0.02) and not in other study measures (p > 0.05).ConclusionsCT-guided RPS-assisted needle placement reduced radiation dose, number of confirmatory scans, and needle manipulations when compared to manual needle placement by experienced IR physicians, with equivalent accuracy.« less

High-Temperature Nonequilibrium Bose Condensation Induced by a Hot Needle.

PubMed

Schnell, Alexander; Vorberg, Daniel; Ketzmerick, Roland; Eckardt, André

2017-10-06

We investigate theoretically a one-dimensional ideal Bose gas that is driven into a steady state far from equilibrium via the coupling to two heat baths: a global bath of temperature T and a "hot needle," a bath of temperature T_{h}≫T with localized coupling to the system. Remarkably, this system features a crossover to finite-size Bose condensation at temperatures T that are orders of magnitude larger than the equilibrium condensation temperature. This counterintuitive effect is explained by a suppression of long-wavelength excitations resulting from the competition between both baths. Moreover, for sufficiently large needle temperatures ground-state condensation is superseded by condensation into an excited state, which is favored by its weaker coupling to the hot needle. Our results suggest a general strategy for the preparation of quantum degenerate nonequilibrium steady states with unconventional properties and at large temperatures.

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

PubMed

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

2006-12-01

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

The effects of needle deformation during lumbar puncture

PubMed Central

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

2015-01-01

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

The effects of needle deformation during lumbar puncture.

PubMed

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

2015-01-01

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

Automatic needle segmentation in 3D ultrasound images using 3D Hough transform

NASA Astrophysics Data System (ADS)

Zhou, Hua; Qiu, Wu; Ding, Mingyue; Zhang, Songgeng

2007-12-01

3D ultrasound (US) is a new technology that can be used for a variety of diagnostic applications, such as obstetrical, vascular, and urological imaging, and has been explored greatly potential in the applications of image-guided surgery and therapy. Uterine adenoma and uterine bleeding are the two most prevalent diseases in Chinese woman, and a minimally invasive ablation system using an RF button electrode which is needle-like is being used to destroy tumor cells or stop bleeding currently. Now a 3D US guidance system has been developed to avoid accidents or death of the patient by inaccurate localizations of the electrode and the tumor position during treatment. In this paper, we described two automated techniques, the 3D Hough Transform (3DHT) and the 3D Randomized Hough Transform (3DRHT), which is potentially fast, accurate, and robust to provide needle segmentation in 3D US image for use of 3D US imaging guidance. Based on the representation (Φ , θ , ρ , α ) of straight lines in 3D space, we used the 3DHT algorithm to segment needles successfully assumed that the approximate needle position and orientation are known in priori. The 3DRHT algorithm was developed to detect needles quickly without any information of the 3D US images. The needle segmentation techniques were evaluated using the 3D US images acquired by scanning water phantoms. The experiments demonstrated the feasibility of two 3D needle segmentation algorithms described in this paper.

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

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

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

2009-09-15

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

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

PubMed

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

2006-01-01

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

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

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

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

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

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

PubMed

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

2003-01-01

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

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

PubMed

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

2013-01-01

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

Virtual remote center of motion control for needle placement robots.

PubMed

Boctor, Emad M; Webster, Robert J; Mathieu, Herve; Okamura, Allison M; Fichtinger, Gabor

2004-01-01

We present an algorithm that enables percutaneous needle-placement procedures to be performed with unencoded, unregistered, minimally calibrated robots while removing the constraint of placing the needle tip on a mechanically enforced Remote Center of Motion (RCM). The algorithm requires only online tracking of the surgical tool and a five-degree-of-freedom (5-DOF) robot comprising three prismatic DOF and two rotational DOF. An incremental adaptive motion control cycle guides the needle to the insertion point and also orients it to align with the target-entry-point line. The robot executes RCM motion without having a physically constrained fulcrum point. The proof-of-concept prototype system achieved 0.78 mm translation accuracy and 1.4 degrees rotational accuracy (this is within the tracker accuracy) within 17 iterative steps (0.5-1 s). This research enables robotic assistant systems for image-guided percutaneous procedures to be prototyped/constructed more quickly and less expensively than has been previously possible. Since the clinical utility of such systems is clear and has been demonstrated in the literature, our work may help promote widespread clinical adoption of this technology by lowering system cost and complexity.

Qualifciation test series of the indium needle FEEP micro-propulsion system for LISA Pathfinder

NASA Astrophysics Data System (ADS)

Scharlemann, C.; Buldrini, N.; Killinger, R.; Jentsch, M.; Polli, A.; Ceruti, L.; Serafini, L.; DiCara, D.; Nicolini, D.

2011-11-01

The Laser Interferometer Space Antenna project (LISA) is a co-operative program between ESA and NASA to detect gravitational waves by measuring distortions in the space-time fabric. LISA Pathfinder is the precursor mission to LISA designed to validate the core technologies intended for LISA. One of the enabling technologies is the micro-propulsion system based on field emission thrusters necessary to achieve the uniquely stringent propulsion requirements. A consortium consisting of Astrium GmbH and the University of Applied Sciences Wiener Neustadt (formerly AIT) was commissioned by ESA to develop and qualify the micro-propulsion system based on the Indium Needle FEEP technology. Several successful tests have verified the proper Needle Field Emission Electric Propulsion (FEEP) operation and the thermal and mechanical design of subcomponents of the developed system. For all functional tests, the flight representative Power Control Unit developed by SELEX Galileo S.p.A (also responsible for the Micro-Propulsion Subsystem (MPS) development) was used. Measurements have shown the exceptional stability of the thruster. An acceptance test of one Thruster Cluster Assembly (TCA) over 3600 h has shown the stable long term operation of the developed system. During the acceptance test compliance to all the applicable requirements have been shown such as a thrust resolution of 0.1 μN, thrust range capability between 0 and 100 μN, thrust overshoot much lower than the required 0.3 μN+3% and many others. In particular important is the voltage stability of the thruster (±1% over the duration of the testing) and the confirmation of the very low thrust noise. Based on the acceptance test the lifetime of the thruster is expected to exceed 39,000 h generating a total impulse bit of 6300 Ns at an average thrust level of 50 μN. A flight representative qualification model of the Needle FEEP Cluster Assembly (DM1) equipped with one active TCA has performed a qualification program

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

NASA Astrophysics Data System (ADS)

Pekárek, Stanislav

2014-12-01

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

Seasonal changes in amino acids, protein and total nitrogen in needles of fertilized Scots pine trees.

PubMed

Näsholm, T; Ericsson, A

1990-09-01

Seasonal changes in amino acids, protein and total nitrogen in needles of 30-year-old, fertilized Scots pine (Pinus sylvestris L.) trees growing in Northern Sweden were investigated over two years in field experiments. The studied plots had been fertilized annually for 17 years with (i) a high level of N, (ii) a medium level of N, or (iii) a medium level of N, P and K. Trees growing on unfertilized plots served as controls. In control trees, glutamine, glutamic acid, gamma-aminobutyric acid, aspartic acid and proline represented 50-70% of the total free amino acids determined. Arginine was present only in low concentrations in control trees throughout the year, but it was usually the most abundant amino acid in fertilized trees. Glutamine concentrations were high during the spring and summer in both years of study, whereas proline concentrations were high in the spring but otherwise low throughout the year. In the first year of study, glutamic acid concentrations were high during the spring and summer, whereas gamma-aminobutyric acid was present in high concentrations during the winter months. This pattern was less pronounced in the second year of investigation. The concentrations of most amino acids, except glutamic acid, increased in response to fertilization. Nitrogen fertilization increased the foliar concentration of arginine from < 1 micromol g(dw) (-1) in control trees to a maximum of 110 micromol g(dw) (-1). Trees fertilized with nitrogen, phosphorus and potassium had significantly lower arginine concentrations than trees fertilized with the same amount of nitrogen only. Protein concentrations were similar in all fertilized trees but higher than those in control trees. For all treatments, protein concentrations were high in winter and at a minimum in early spring. In summer, the protein concentration remained almost constant except for a temporary decrease which coincided with the expansion of new shoots. Apart from arginine, the amino acid composition of

Needle-free and microneedle drug delivery in children: a case for disease-modifying antirheumatic drugs (DMARDs).

PubMed

Shah, Utpal U; Roberts, Matthew; Orlu Gul, Mine; Tuleu, Catherine; Beresford, Michael W

2011-09-15

Parenteral routes of drug administration have poor acceptability and tolerability in children. Advances in transdermal drug delivery provide a potential alternative for improving drug administration in this patient group. Issues with parenteral delivery in children are highlighted and thus illustrate the scope for the application of needle-free and microneedle technologies. This mini-review discusses the opportunities and challenges for providing disease-modifying antirheumatic drugs (DMARDs) currently prescribed to paediatric rheumatology patients using such technologies. The aim is to raise further awareness of the need for age-appropriate formulations and drug delivery systems and stimulate exploration of these options for DMARDs, and in particular, rapidly emerging biologics on the market. The ability of needle-free and microneedle technologies to deliver monoclonal antibodies and fusion proteins still remains largely untested. Such an understanding is crucial for future drug design opportunities. The bioavailability, safety and tolerance of delivering biologics into the viable epidermis also need to be studied. Copyright © 2011 Elsevier B.V. All rights reserved.

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

PubMed

Tarkkila, P; Huhtala, J; Salminen, U

1994-08-01

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

Pinyon Needle Scale (FIDL)

Treesearch

William F. McCambridge

1994-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2012-02-01

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

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

PubMed

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

2008-01-01

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

A needle-free reconstitution and transfer system for compounded sterile intravenous drug solutions in compliance with United States Pharmacopeia Chapter <797> standards.

PubMed

Marks, Zach

2014-01-01

Today's health-system pharmacists and those in independent practice face risks, including exposure to potent cytotoxic drugs via needlesticks, that are associated with preparing intravenous compounded sterile preparations for immediate use. Healthcare givers who administer such medications also risk exposure to needlesticks. Those hazards can be minimized when the pharmacist thoroughly understands and complies with current standard operating procedures for preparing intravenous compounded sterile preparations and the healthcare giver uses a needle-free system for drug reconstitution and administration. The components of an overall needlestick risk-reduction strategy to ensure safety in the preparation (and eventual administration) of intravenous compounded sterile preparations should therefore include the use of needle-free connection and administration devices as well as hand-hygiene training, aseptic technique competency evaluation and training, and the maximum use of commercially available or ready-to-use dosage forms. This article, which focuses on the pharmacist's use of a needle-free reconstitution and transfer system for compounded sterile intravenous drug solutions, uses as an example the Vial2Bag (Medimop Medical Projects, Ltd., [a subsidiary of West Pharmaceutical Services, Inc., Exton, Pennsylvania], Ra'anana, Israel), which complies with United States Pharmacopeia Chapter <797> standards. Features of that system are summarized for easy reference.

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

PubMed Central

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

2010-01-01

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

Dry needling — peripheral and central considerations

PubMed Central

Dommerholt, Jan

2011-01-01

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

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

PubMed Central

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

2013-01-01

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

Smart surgical needle actuated by shape memory alloys for percutaneous procedures

NASA Astrophysics Data System (ADS)

Konh, Bardia

. Design parameters influencing the steerability include the needle's diameter, wire diameter, pre-strain, and its offset from the needle. A simplified model was developed to decrease the computation time in iterative analyses of the optimization algorithm. In the fourth part of this work a design of an active needling system was proposed where actuation forces of SMAs as well as shape memory polymers (SMPs) were incorporated. SMP elements provide two major additional advantages to the design: (i) recovery of the SMP's plastic deformation by heating the element above its glass transition temperature, and (ii) achieving a higher needle deflection by having a softer stage of SMP at higher temperatures with less amount of actuation force. Finally, in the fifth and last part of this study, an Arbitrary-Lagrangian-Eulerian formulation in LS-DYNA software was used to model the solid-fluid interactions between the needle and tissue. A 150mm long needle was considered to bend within the tissue due to the interacting forces on its asymmetric bevel tip. Some additional assumptions were made to maintain a reasonable computational time, with no need of parallel processing, while having practical accuracies. Three experimental tests of needle steering in a soft phantom were performed to validate the simulation. Results: The finite element model of the active needle was first validated experimentally with developed prototypes. Several design parameters affecting the needle's deflection such as the needle's Young's modulus, the SMA's pre-strain and its offset from the neutral axis of the cannula were studied using the FE model. Then by the integration of the SMA characteristics with the automated optimization schemes an improved design of the active needle was obtained. Real-time experiments with different prototypes showed that the quickest response and the maximum deflection were achieved by the needle with two sections of actuation compared to a single section of actuation. Also the

Evaluation of a Veress needle for the fluid egress system of stifle arthroscopy in toy dog breeds.

PubMed

Cha, Jae-Gwan; Lee, Hae Beom; Cheong, Hye-Yeon; Heo, Su-Young; Ragetly, Guillaume R

2016-01-01

The aim of this study was to evaluate the use of a Veress needle as a fluid egress system for stifle arthroscopy in toy dog breeds. Cadaveric canine stifle joints (n = 32) were prepared to induce an artificial intra-articular haemorrhagic effect, followed by stifle arthroscopy. The stifles were randomly assigned to one of three groups, and a fluid egress portal was established using a Veress needle (VN), a standard egress cannula (SE), or an intravenous catheter stylet (CS). Time to establish the egress portal, arthroscopic visibility, and egress portal performance were evaluated during the arthroscopy. After the arthroscopic examinations, iatrogenic cartilage lesions were identified and analysed using the percentage area of cartilage damage (%ACD). The overall arthroscopic visibility and egress portal performance were not significantly different among the groups. The egress portal establishment was faster for the VN (33 sec) and the CS (34 sec) groups than for the SE (43 sec) group (p = 0.001). On gross joint examination, no iatrogenic laceration was found in the VN group, whereas four out of 10 of the SE and two out of 10 of the CS specimens had linear cartilage excoriation on the stifle joints. The %ACD score of the VN group was lower than those of the SE group (p = 0.009) and the CS group (p = 0.001). The Veress needle method used in this study was useful to establish a fluid egress system and limit iatrogenic cartilage excoriations. This technique could become the method of choice for stifle arthroscopy, especially in smaller dogs.

COMBINED EFFECTS OF CO2 AND O3 ON ANTIOXIDATIVE AND PHOTOPROTECTIVE DEFENSE SYSTEMS IN NEEDLES OF PONDEROSA PINE

EPA Science Inventory

To determine interactive effects of important environmental stresses on biochemical defense mechanisms of tree seedlings, we studied responses to elevated O3 and elevated atmospheric CO2 on antioxidative and photoprotective systems in needles of ponderosa pine (Pinus ponderosa Do...

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

PubMed

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

2014-07-01

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

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

Probable Mechanisms of Needling Therapies for Myofascial Pain Control

PubMed Central

Chou, Li-Wei; Kao, Mu-Jung; Lin, Jaung-Geng

2012-01-01

Myofascial pain syndrome (MPS) has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP) can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM) theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed. PMID:23346211

Comparison of Spinal Needle Deflection in a Ballistic Gel Model.

PubMed

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

2016-10-01

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

Comparison of Spinal Needle Deflection in a Ballistic Gel Model

PubMed Central

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

2016-01-01

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

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

PubMed

Zhang, Ning; Wang, Bing; Zhou, Yu

2016-08-12

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2018-05-01

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

The incidence of coring with blunt versus sharp needles.

PubMed

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

2014-03-01

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

Method to Reduce Target Motion Through Needle-Tissue Interactions.

PubMed

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

2015-11-01

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

Pneumatically Operated MRI-Compatible Needle Placement Robot for Prostate Interventions.

PubMed

Fischer, Gregory S; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; Mewes, Philip W; Tempany, Clare M; Hata, Nobuhiko; Fichtinger, Gabor

2008-06-13

Magnetic Resonance Imaging (MRI) has potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. The strong magnetic field prevents the use of conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intra-prostatic needle placement inside closed high-field MRI scanners. The robot performs needle insertion under real-time 3T MR image guidance; workspace requirements, MR compatibility, and workflow have been evaluated on phantoms. The paper explains the robot mechanism and controller design and presents results of preliminary evaluation of the system.

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

21 CFR 872.4730 - Dental injecting needle.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

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

PubMed

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

2016-09-01

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

Initial clinical results with a new needle screen storage phosphor system in chest radiograms.

PubMed

Körner, M; Wirth, S; Treitl, M; Reiser, M; Pfeifer, K-J

2005-11-01

To evaluate image quality and anatomical detail depiction in dose-reduced digital plain chest radiograms using a new needle screen storage phosphor (NIP) in comparison to full dose conventional powder screen storage phosphor (PIP) images. 24 supine chest radiograms were obtained with PIP at standard dose and compared to follow-up studies of the same patients obtained with NIP with dose reduced to 50 % of the PIP dose (all imaging systems: AGFA-Gevaert, Mortsel, Belgium). In both systems identical versions of post-processing software supplied by the manufacturer were used with matched parameters. Six independent readers blinded to both modality and dose evaluated the images for depiction and differentiation of defined anatomical regions (peripheral lung parenchyma, central lung parenchyma, hilum, heart, diaphragm, upper mediastinum, and bone). All NIP images were compared to the corresponding PIP images using a five-point scale (- 2, clearly inferior to + 2, clearly superior). Overall image quality was rated for each PIP and NIP image separately (1, not usable to 5, excellent). PIP and dose reduced NIP images were rated equivalent. Mean image noise impression was only slightly higher on NIP images. Mean image quality for NIP showed no significant differences (p > 0.05, Mann-Whitney U test). With the use of the new needle structured storage phosphors in chest radiography, dose reduction of up to 50 % is possible without detracting from image quality or detail depiction. Especially in patients with multiple follow-up studies the overall dose can be decreased significantly.

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

PubMed

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

2015-06-01

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

Pine needle abortion biomarker detected in bovine fetal fluids

USDA-ARS?s Scientific Manuscript database

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

Coaxial needle insertion assistant with enhanced force feedback.

PubMed

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

2013-02-01

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

NMR identification of the binding surfaces involved in the Salmonella and Shigella Type III secretion tip-translocon protein-protein interactions.

PubMed

McShan, Andrew C; Kaur, Kawaljit; Chatterjee, Srirupa; Knight, Kevin M; De Guzman, Roberto N

2016-08-01

The type III secretion system (T3SS) is essential for the pathogenesis of many bacteria including Salmonella and Shigella, which together are responsible for millions of deaths worldwide each year. The structural component of the T3SS consists of the needle apparatus, which is assembled in part by the protein-protein interaction between the tip and the translocon. The atomic detail of the interaction between the tip and the translocon proteins is currently unknown. Here, we used NMR methods to identify that the N-terminal domain of the Salmonella SipB translocon protein interacts with the SipD tip protein at a surface at the distal region of the tip formed by the mixed α/β domain and a portion of its coiled-coil domain. Likewise, the Shigella IpaB translocon protein and the IpaD tip protein interact with each other using similar surfaces identified for the Salmonella homologs. Furthermore, removal of the extreme N-terminal residues of the translocon protein, previously thought to be important for the interaction, had little change on the binding surface. Finally, mutations at the binding surface of SipD reduced invasion of Salmonella into human intestinal epithelial cells. Together, these results reveal the binding surfaces involved in the tip-translocon protein-protein interaction and advance our understanding of the assembly of the T3SS needle apparatus. Proteins 2016; 84:1097-1107. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Discovery of the type VII ESX-1 secretion needle?

PubMed

Ates, Louis S; Brosch, Roland

2017-01-01

Mycobacterium tuberculosis, the etiological agent of human tuberculosis, harbours five ESAT-6/type VII secretion (ESX/T7S) systems. The first esx gene clusters were identified during the genome-sequencing project of M. tuberculosis H37Rv. Follow-up studies revealed additional genes playing important roles in ESX/T7S systems. Among the latter genes, one can find those that encode Pro-Glu (PE) and Pro-Pro-Glu (PPE) proteins as well as a gene cluster that is encoded >260 kb upstream of the esx-1 locus and encodes ESX-1 secretion-associated proteins EspA (Rv3616c), EspC (Rv3615c) and EspD (Rv3614c). The espACD cluster has been suggested to have an important function in ESX-1 secretion since EspA-EspC and EsxA-EsxB are mutually co-dependent on each other for secretion. However, the molecular mechanism of this co-dependence and interaction between the substrates remained unknown. In this issue of Molecular Microbiology, Lou and colleagues show that EspC forms high-molecular weight polymerization complexes that resemble selected components of type II, III and/or IV secretion systems of Gram-negative bacteria. Indeed, EspC-multimeric complexes form filamentous structures that could well represent a secretion needle of ESX-1 type VII secretion systems. This exciting observation opens new avenues for research to discover and characterize ESX/T7S components and elucidates the co-dependence of EsxA/B secretion with EspA/C. © 2016 John Wiley & Sons Ltd.

Transillumination for needle localization in the larynx.

PubMed

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

2015-10-01

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

DIY guide-needle-assisted conjunctivodacryocystorhinostomy (CDCR).

PubMed

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

2013-01-01

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

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

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

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

Do safety engineered devices reduce needle-stick injuries?

PubMed

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

2018-05-05

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

Social context of needle selling in Baltimore, Maryland.

PubMed

Latkin, Carl A; Davey, Melissa A; Hua, Wei

2006-01-01

Although much of the debate surrounding the distribution of sterile syringes to injection drug users (IDUs) has focused on needle exchange programs (NEPs), IDUs acquire their syringes from three major sources: NEPs, pharmacies, and secondary exchangers or needle sellers. The purpose of the present study is to examine types and frequencies of social interactions among drug injectors who sell needles, most of which come from NEPs, compared with individuals who do not sell needles. Specifically, we compared engagement in drug-related behaviors, roles in the drug economy, and social network membership. Data were collected as part of the SHIELD study, an HIV prevention intervention targeted at drug users and their social networks (n=910) from February 2001 through September 2003 in Baltimore, Maryland (USA). In this sample, 56 participants reported selling needles. Needle sellers had higher levels of engagement in drug-related social interactions, including using drugs with others, giving or receiving drugs from others, and buying drugs with other users. Participants who sold needles had a significantly higher number of roles in the drug economy. Also, they had more social network members who were injectors, with whom they talked about risky drug behaviors, gave needles to, and shared cookers and bleach with. Compared with nonselling injectors, needle sellers engage in HIV risk-related behaviors, such as injecting daily and sharing injection equipment, more frequently. The study's findings may be useful to determine whether secondary exchangers should be targeted for HIV prevention activities both to reduce their own risk and to diffuse risk reduction information throughout the drug using community.

Ultrasound-guided three-dimensional needle steering in biological tissue with curved surfaces

PubMed Central

Abayazid, Momen; Moreira, Pedro; Shahriari, Navid; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2015-01-01

In this paper, we present a system capable of automatically steering a bevel-tipped flexible needle under ultrasound guidance toward a physical target while avoiding a physical obstacle embedded in gelatin phantoms and biological tissue with curved surfaces. An ultrasound pre-operative scan is performed for three-dimensional (3D) target localization and shape reconstruction. A controller based on implicit force control is developed to align the transducer with curved surfaces to assure the maximum contact area, and thus obtain an image of sufficient quality. We experimentally investigate the effect of needle insertion system parameters such as insertion speed, needle diameter and bevel angle on target motion to adjust the parameters that minimize the target motion during insertion. A fast sampling-based path planner is used to compute and periodically update a feasible path to the target that avoids obstacles. We present experimental results for target reconstruction and needle insertion procedures in gelatin-based phantoms and biological tissue. Mean targeting errors of 1.46 ± 0.37 mm, 1.29 ± 0.29 mm and 1.82 ± 0.58 mm are obtained for phantoms with inclined, curved and combined (inclined and curved) surfaces, respectively, for insertion distance of 86–103 mm. The achieved targeting errors suggest that our approach is sufficient for targeting lesions of 3 mm radius that can be detected using clinical ultrasound imaging systems. PMID:25455165

Pneumatically Operated MRI-Compatible Needle Placement Robot for Prostate Interventions

PubMed Central

Fischer, Gregory S.; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; Mewes, Philip W.; Tempany, Clare M.; Hata, Nobuhiko; Fichtinger, Gabor

2011-01-01

Magnetic Resonance Imaging (MRI) has potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. The strong magnetic field prevents the use of conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intra-prostatic needle placement inside closed high-field MRI scanners. The robot performs needle insertion under real-time 3T MR image guidance; workspace requirements, MR compatibility, and workflow have been evaluated on phantoms. The paper explains the robot mechanism and controller design and presents results of preliminary evaluation of the system. PMID:21686038

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

PubMed

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

1992-12-01

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

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

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

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

Effect of vibration frequency on biopsy needle insertion force.

PubMed

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

2017-05-01

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

The biopolitics of needle exchange in the United States

PubMed Central

McLean, Katherine

2012-01-01

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

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

PubMed

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

2010-08-01

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

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

PubMed

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

2013-10-01

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

Investigation of Nonstationary Modes of Atmospheric Pressure Needle-to-Plane Gas Discharge and Streamer Propagation

DTIC Science & Technology

2003-07-20

known, that at atmospheric pressure in oxygen- I" - contained gases a various modes of discharge can be realized in the needle -to-plane electrode geometry... needle -to-plane electrode system was located in the discharge chamber (volume I dmi3) with controlled gas feeding. The gas pressure was an atmospheric...The 3. Experimental results positive DC voltage was applied to the needle electrode . The discharge voltage was varied from 3 to 15kV. The analysis of

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

PubMed

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

1997-06-01

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

[Brief introduction of acupuncture needling and teaching keypoint].

PubMed

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

2014-09-01

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

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

PubMed

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

2010-05-01

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

A biplanar fluoroscopic approach for the measurement, modeling, and simulation of needle and soft-tissue interaction.

PubMed

Hing, James T; Brooks, Ari D; Desai, Jaydev P

2007-02-01

A methodology for modeling the needle and soft-tissue interaction during needle insertion is presented. The approach consists of the measurement of needle and tissue motion using a dual C-arm fluoroscopy system. Our dual C-arm fluoroscopy setup allows real time 3-D extraction of the displacement of implanted fiducials in the soft tissue during needle insertion to obtain the necessary parameters for accurate modeling of needle and soft-tissue interactions. The needle and implanted markers in the tissue are tracked during the insertion and withdrawal of the needle at speeds of 1.016 mm/s, 12.7 mm/s and 25.4 mm/s. Both image and force data are utilized to determine important parameters such as the approximate cutting force, puncture force, the local effective modulus (LEM) during puncture, and the relaxation of tissue. We have also validated the LEM computed from our finite element model with arbitrary needle puncture tasks. Based on these measurements, we developed a model for needle insertion and withdrawal that can be used to generate a 1-DOF force versus position profile that can be experienced by a user operating a haptic device. This profile was implemented on a 7-DOf haptic device designed in our laboratory.

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

PubMed

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

2008-03-01

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

Mixed mode fuel injector with individually moveable needle valve members

DOEpatents

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

2004-08-03

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

Needle placement for piriformis injection using 3-D imaging.

PubMed

Clendenen, Steven R; Candler, Shawn A; Osborne, Michael D; Palmer, Scott C; Duench, Stephanie; Glynn, Laura; Ghazi, Salim M

2013-01-01

Piriformis syndrome is a pain syndrome originating in the buttock and is attributed to 6% - 8% of patients referred for the treatment of back and leg pain. The treatment for piriformis syndrome using fluoroscopy, computed tomography (CT), electromyography (EMG), and ultrasound (US) has become standard practice. The treatment of Piriformis Syndrome has evolved to include fluoroscopy and EMG with CT guidance. We present a case study of 5 successful piriformis injections using 3-D computer-assisted electromagnet needle tracking coupled with ultrasound. A 6-degree of freedom electromagnetic position tracker was attached to the ultrasound probe that allowed the system to detect the position and orientation of the probe in the magnetic field. The tracked ultrasound probe was used to find the posterior superior iliac spine. Subsequently, 3 points were captured to register the ultrasound image with the CT or magnetic resonance image scan. Moreover, after the registration was obtained, the navigation system visualized the tracked needle relative to the CT scan in real-time using 2 orthogonal multi-planar reconstructions centered at the tracked needle tip. Conversely, a recent study revealed that fluoroscopically guided injections had 30% accuracy compared to ultrasound guided injections, which tripled the accuracy percentage. This novel technique exhibited an accurate needle guidance injection precision of 98% while advancing to the piriformis muscle and avoiding the sciatic nerve. The mean (± SD) procedure time was 19.08 (± 4.9) minutes. This technique allows for electromagnetic instrument tip tracking with real-time 3-D guidance to the selected target. As with any new technique, a learning curve is expected; however, this technique could offer an alternative, minimizing radiation exposure.

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS – PART ONE

PubMed Central

Halle, Rob J.

2016-01-01

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

Source strength verification and quality assurance of preloaded brachytherapy needles using a CMOS flat panel detector

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

Golshan, Maryam, E-mail: maryam.golshan@bccancer.bc.ca; Spadinger, Ingrid; Chng, Nick

2016-06-15

Purpose: Current methods of low dose rate brachytherapy source strength verification for sources preloaded into needles consist of either assaying a small number of seeds from a separate sample belonging to the same lot used to load the needles or performing batch assays of a subset of the preloaded seed trains. Both of these methods are cumbersome and have the limitations inherent to sampling. The purpose of this work was to investigate an alternative approach that uses an image-based, autoradiographic system capable of the rapid and complete assay of all sources without compromising sterility. Methods: The system consists of amore » flat panel image detector, an autoclavable needle holder, and software to analyze the detected signals. The needle holder was designed to maintain a fixed vertical spacing between the needles and the image detector, and to collimate the emissions from each seed. It also provides a sterile barrier between the needles and the imager. The image detector has a sufficiently large image capture area to allow several needles to be analyzed simultaneously.Several tests were performed to assess the accuracy and reproducibility of source strengths obtained using this system. Three different seed models (Oncura 6711 and 9011 {sup 125}I seeds, and IsoAid Advantage {sup 103}Pd seeds) were used in the evaluations. Seeds were loaded into trains with at least 1 cm spacing. Results: Using our system, it was possible to obtain linear calibration curves with coverage factor k = 1 prediction intervals of less than ±2% near the centre of their range for the three source models. The uncertainty budget calculated from a combination of type A and type B estimates of potential sources of error was somewhat larger, yielding (k = 1) combined uncertainties for individual seed readings of 6.2% for {sup 125}I 6711 seeds, 4.7% for {sup 125}I 9011 seeds, and 11.0% for Advantage {sup 103}Pd seeds. Conclusions: This study showed that a flat panel detector dosimetry

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

PubMed Central

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

2018-01-01

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

21 CFR 882.1350 - Needle electrode.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

21 CFR 882.1350 - Needle electrode.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

MedlinePlus

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

The evaluation of xenotransplantation of feline ovarian tissue vitrified by needle immersed vitrification technique into male immunodeficient mice.

PubMed

Demirel, Mürşide Ayşe; Acar, Duygu Baki; Ekim, Burcu; Çelikkan, Ferda Topal; Alkan, Kübra Karakaş; Salar, Seçkin; Erdemli, Esra Atabenli; Özkavukçu, Sinan; Yar, Seda Sağlam; Kanca, Halit; Baştan, Ayhan

2018-03-01

In this study, the efficiency of the "Needle Immersed Vitrification" technique was tested on cryopreserved feline ovarian tissue. For vitrification, ovarian fragments (0.5-1.5 mm 2 ) from each ovary were collected; the grafts were exposed to 7.5-15% ethylene glycol and 7.5-15% dimethyl sulfoxide at room temperature and stored in liquid nitrogen at least 1 week. Morphologic examinations, expression of genes such as B cell lymphoma 2, B-cell lymphoma-2-associated X protein, Bone morphogenetic protein 15, zone of polarizing activity, zona pellucida C protein and DNA (cytosine-5)-methyltransferase 1, ultrastructural analysis and viability tests were carried out from collected grafts. Light microscopy examinations revealed the percentage of morphologically normal primordial follicles in a fresh group which was significantly higher than the treatment groups (p < 0.001). Terminal deoxynucleotidyl transferase dUTP nick end labeling and anti-caspase-3 staining observed in oocytes, follicle cells, interstitial tissue showed higher rates of apoptosis for post-vitrification and -transplantation groups than freshly grafted ovarian tissues. Furthermore, we observed significant downregulation of zone of polarizing activity and zona pellucida C protein gene expression in vitrified ovarian tissue grafts than in the fresh grafts (p < 0.05). In conclusion, we suggest that the needle immersed vitrification method is a convenient, cheap, and feasible vitrification method for cat ovarian tissues. However, further studies need to be performed to determine more optimal vitrification solutions and equilibration times for the needle immersed vitrification method in order to adapt it for cat ovaries.

High-pressure needle interface for thermoplastic microfluidics.

PubMed

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

2009-01-07

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

A clinical guide to needle desensitization for the paediatric patient.

PubMed

Taylor, Greig D; Campbell, Caroline

2015-05-01

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

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

PubMed

Leu, S; Ruiz, B; Podder, T

2012-06-01

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

Sugar export limits size of conifer needles

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

A GIS-based methodology for improving needle exchange service delivery

PubMed Central

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

2010-01-01

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

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

PubMed

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

2016-01-01

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

Introduction of a New Diagnostic Method for Breast Cancer Based on Fine Needle Aspiration (FNA) Test Data and Combining Intelligent Systems.

PubMed

Fiuzy, Mohammad; Haddadnia, Javad; Mollania, Nasrin; Hashemian, Maryam; Hassanpour, Kazem

2012-01-01

Accurate Diagnosis of Breast Cancer is of prime importance. Fine Needle Aspiration test or "FNA", which has been used for several years in Europe, is a simple, inexpensive, noninvasive and accurate technique for detecting breast cancer. Expending the suitable features of the Fine Needle Aspiration results is the most important diagnostic problem in early stages of breast cancer. In this study, we introduced a new algorithm that can detect breast cancer based on combining artificial intelligent system and Fine Needle Aspiration (FNA). We studied the Features of Wisconsin Data Base Cancer which contained about 569 FNA test samples (212 patient samples (malignant) and 357 healthy samples (benign)). In this research, we combined Artificial Intelligence Approaches, such as Evolutionary Algorithm (EA) with Genetic Algorithm (GA), and also used Exact Classifier Systems (here by Fuzzy C-Means (FCM)) to separate malignant from benign samples. Furthermore, we examined artificial Neural Networks (NN) to identify the model and structure. This research proposed a new algorithm for an accurate diagnosis of breast cancer. According to Wisconsin Data Base Cancer (WDBC) data base, 62.75% of samples were benign, and 37.25% were malignant. After applying the proposed algorithm, we achieved high detection accuracy of about "96.579%" on 205 patients who were diagnosed as having breast cancer. It was found that the method had 93% sensitivity, 73% specialty, 65% positive predictive value, and 95% negative predictive value, respectively. If done by experts, Fine Needle Aspiration (FNA) can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples. FNA can be the first line of diagnosis in women with breast masses, at least in deprived regions, and may increase health standards and clinical supervision of patients. Such a smart, economical, non-invasive, rapid and accurate system can be introduced as a

Introduction of a New Diagnostic Method for Breast Cancer Based on Fine Needle Aspiration (FNA) Test Data and Combining Intelligent Systems

PubMed Central

Fiuzy, Mohammad; Haddadnia, Javad; Mollania, Nasrin; Hashemian, Maryam; Hassanpour, Kazem

2012-01-01

Background Accurate Diagnosis of Breast Cancer is of prime importance. Fine Needle Aspiration test or "FNA”, which has been used for several years in Europe, is a simple, inexpensive, noninvasive and accurate technique for detecting breast cancer. Expending the suitable features of the Fine Needle Aspiration results is the most important diagnostic problem in early stages of breast cancer. In this study, we introduced a new algorithm that can detect breast cancer based on combining artificial intelligent system and Fine Needle Aspiration (FNA). Methods We studied the Features of Wisconsin Data Base Cancer which contained about 569 FNA test samples (212 patient samples (malignant) and 357 healthy samples (benign)). In this research, we combined Artificial Intelligence Approaches, such as Evolutionary Algorithm (EA) with Genetic Algorithm (GA), and also used Exact Classifier Systems (here by Fuzzy C-Means (FCM)) to separate malignant from benign samples. Furthermore, we examined artificial Neural Networks (NN) to identify the model and structure. This research proposed a new algorithm for an accurate diagnosis of breast cancer. Results According to Wisconsin Data Base Cancer (WDBC) data base, 62.75% of samples were benign, and 37.25% were malignant. After applying the proposed algorithm, we achieved high detection accuracy of about "96.579%” on 205 patients who were diagnosed as having breast cancer. It was found that the method had 93% sensitivity, 73% specialty, 65% positive predictive value, and 95% negative predictive value, respectively. If done by experts, Fine Needle Aspiration (FNA) can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples. FNA can be the first line of diagnosis in women with breast masses, at least in deprived regions, and may increase health standards and clinical supervision of patients. Conclusion Such a smart, economical, non-invasive, rapid

Fine-needle aspiration by vacuum tubes.

PubMed

Holmquist, N D

1989-07-01

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

21 CFR 880.5580 - Acupuncture needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

Image-based tracking of the suturing needle during laparoscopic interventions

NASA Astrophysics Data System (ADS)

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

2015-03-01

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

Spectral signatures of viewing a needle approaching one's body when anticipating pain.

PubMed

Höfle, Marion; Pomper, Ulrich; Hauck, Michael; Engel, Andreas K; Senkowski, Daniel

2013-10-01

When viewing the needle of a syringe approaching your skin, anticipation of a painful prick may lead to increased arousal. How this anticipation is reflected in neural oscillatory activity and how it relates to activity within the autonomic nervous system is thus far unknown. Recently, we found that viewing needle pricks compared with Q-tip touches increases the pupil dilation response (PDR) and perceived unpleasantness of electrical stimuli. Here, we used high-density electroencephalography to investigate whether anticipatory oscillatory activity predicts the unpleasantness of electrical stimuli and PDR while viewing a needle approaching a hand that is perceived as one's own. We presented video clips of needle pricks and Q-tip touches, and delivered spatiotemporally aligned painful and nonpainful intracutaneous electrical stimuli. The perceived unpleasantness of electrical stimuli and the PDR were enhanced when participants viewed needle pricks compared with Q-tip touches. Source reconstruction using linear beamforming revealed reduced alpha-band activity in the posterior cingulate cortex (PCC) and fusiform gyrus before the onset of electrical stimuli when participants viewed needle pricks compared with Q-tip touches. Moreover, alpha-band activity in the PCC predicted PDR on a single trial level. The anticipatory reduction of alpha-band activity in the PCC may reflect a neural mechanism that serves to protect the body from forthcoming harm by facilitating the preparation of adequate defense responses. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Microneedle Arrays Allow Lower Microbial Penetration Than Hypodermic Needles In Vitro

PubMed Central

Donnelly, Ryan F.; Singh, Thakur Raghu Raj; Tunney, Michael M.; Morrow, Desmond I. J.; McCarron, Paul A.; O’Mahony, Conor; Woolfson, A. David

2010-01-01

Methods In this study we determined, for the first time, the ability of microorganisms to traverse microneedle-induced holes using two different in vitro models. Results When employing Silescol® membranes, the numbers of Candida albicans, Pseudomonas aeruginosa and Staphylococcus epidermidis crossing the membranes were an order of magnitude lower when the membranes were punctured by microneedles rather than a 21G hypodermic needle. Apart from the movement of C. albicans across hypodermic needle-punctured membranes, where 40.2% of the microbial load on control membranes permeated the barrier over 24 h, the numbers of permeating microorganisms was less than 5% of the original microbial load on control membranes. Experiments employing excised porcine skin and radiolabelled microorganisms showed that the numbers of microorganisms penetrating skin beyond the stratum corneum were approximately an order of magnitude greater than the numbers crossing Silescol® membranes in the corresponding experiments. Approximately 103cfu of each microorganism adhered to hypodermic needles during insertion. The numbers of microorganisms adhering to MN arrays were an order of magnitude higher in each case. Conclusion We have shown here that microneedle puncture resulted in significantly less microbial penetration than did hypodermic needle puncture and that no microorganisms crossed the viable epidermis in microneedle—punctured skin, in contrast to needle-punctured skin. Given the antimicrobial properties of skin, it is, therefore, likely that application of microneedle arrays to skin in an appropriate manner would not cause either local or systemic infection in normal circumstances in immune-competent patients. In supporting widespread clinical use of microneedle-based delivery systems, appropriate animal studies are now needed to conclusively demonstrate this in vivo. Safety in patients will be enhanced by aseptic or sterile manufacture and by fabricating microneedles from self

Microneedle arrays allow lower microbial penetration than hypodermic needles in vitro.

PubMed

Donnelly, Ryan F; Singh, Thakur Raghu Raj; Tunney, Michael M; Morrow, Desmond I J; McCarron, Paul A; O'Mahony, Conor; Woolfson, A David

2009-11-01

In this study we determined, for the first time, the ability of microorganisms to traverse microneedle-induced holes using two different in vitro models. When employing Silescol membranes, the numbers of Candida albicans, Pseudomonas aeruginosa and Staphylococcus epidermidis crossing the membranes were an order of magnitude lower when the membranes were punctured by microneedles rather than a 21G hypodermic needle. Apart from the movement of C. albicans across hypodermic needle-punctured membranes, where 40.2% of the microbial load on control membranes permeated the barrier over 24 h, the numbers of permeating microorganisms was less than 5% of the original microbial load on control membranes. Experiments employing excised porcine skin and radiolabelled microorganisms showed that the numbers of microorganisms penetrating skin beyond the stratum corneum were approximately an order of magnitude greater than the numbers crossing Silescol membranes in the corresponding experiments. Approximately 10(3) cfu of each microorganism adhered to hypodermic needles during insertion. The numbers of microorganisms adhering to MN arrays were an order of magnitude higher in each case. We have shown here that microneedle puncture resulted in significantly less microbial penetration than did hypodermic needle puncture and that no microorganisms crossed the viable epidermis in microneedle-punctured skin, in contrast to needle-punctured skin. Given the antimicrobial properties of skin, it is, therefore, likely that application of microneedle arrays to skin in an appropriate manner would not cause either local or systemic infection in normal circumstances in immune-competent patients. In supporting widespread clinical use of microneedle-based delivery systems, appropriate animal studies are now needed to conclusively demonstrate this in vivo. Safety in patients will be enhanced by aseptic or sterile manufacture and by fabricating microneedles from self-disabling materials (e

Safer trocar insertion for closed laparoscopic access: ex vivo assessment of an improved Veress needle.

PubMed

Nevler, Avinoam; Har-Zahav, Gil; Rosin, Danny; Gutman, Mordechai

2016-02-01

Laparoscopic surgery is widely practiced surgical technique in the modern surgical toolbox. The Veress needle insertion technique, while faster and easier, is associated with higher rates of iatrogenic complications (injury to internal organs, major blood vessels, etc.), morbidity and even mortality with a reported overall risk of 0.32% during surgical interventions. In order to increase the safety and ease of closed insertion technique, we designed and tested an improved prototype of the Veress needle. The new Veress needle includes a distal expandable portion that allows elevation of the abdominal wall and safe insertion of the first trocar over it. The needle was assessed by measurement of ease of insertion, ease of trocar advancement, associated tissue damage, device integrity and weight-bearing capacity on an ex vivo Gallus domesticus animal model: The prototype was tested over 20 times using different traction forces. The experiment was qualitatively repeated on an ex vivo porcine model. In the G. domesticus model, the improved needle supported forces of up to 5.75 kg F. No damage or mechanical malfunction was seen at any stage of the experiment. Needle penetration, ease of trocar insertion, system anchoring and weight-bearing capacity were rated (1-5) by four raters--mean 4.9 ± 0.31. Inter-rater agreement was high (free marginal κ 0.75). The porcine experiment revealed similar ease of use with neither complication nor damage to the abdominal wall. We believe that the new Veress system is easy to use, requires no additional training, non-inferior in its capabilities compared to the traditional Veress needle, with the advantage of improving the safety of the first trocar insertion phase of the operation.

Portable Optical Epidural Needle-A CMOS-Based System Solution and Its Circuit Design

PubMed Central

Gong, Cihun-Siyong Alex; Lin, Shih-Pin; Mandell, M. Susan; Tsou, Mei-Yung; Chang, Yin; Ting, Chien-Kun

2014-01-01

Epidural anesthesia is a common anesthesia method yet up to 10% of procedures fail to provide adequate analgesia. This is usually due to misinterpreting the tactile information derived from the advancing needle through the complex tissue planes. Incorrect placement also can cause dural puncture and neural injury. We developed an optic system capable of reliably identifying tissue planes surrounding the epidural space. However the new technology was too large and cumbersome for practical clinical use. We present a miniaturized version of our optic system using chip technology (first generation CMOS-based system) for logic functions. The new system was connected to an alarm that was triggered once the optic properties of the epidural were identified. The aims of this study were to test our miniaturized system in a porcine model and describe the technology to build this new clinical tool. Our system was tested in a porcine model and identified the epidural space in the lumbar, low and high thoracic regions of the spine. The new technology identified the epidural space in all but 1 of 46 attempts. Experimental results from our fabricated integrated circuit and animal study show the new tool has future clinical potential. PMID:25162150

The effect of SO2 pollution on pine needle structure

Treesearch

E. A. Zhitkova; L. L. Novitskaya

2000-01-01

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

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

PubMed

Dean, David A

2006-12-01

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

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

PubMed Central

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

2012-01-01

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

Vector optimization and needle-free intradermal application of a broadly protective polyvalent influenza A DNA vaccine for pigs and humans

PubMed Central

Borggren, Marie; Nielsen, Jens; Bragstad, Karoline; Karlsson, Ingrid; Krog, Jesper S; Williams, James A; Fomsgaard, Anders

2015-01-01

The threat posed by the 2009 pandemic H1N1 virus emphasized the need for new influenza A virus vaccines inducing a broad cross-protective immune response for use in both humans and pigs. An effective and broad influenza vaccine for pigs would greatly benefit the pork industry and contribute to public health by diminishing the risk of emerging highly pathogenic reassortants. Current inactivated protein vaccines against swine influenza produce only short-lived immunity and have no efficacy against heterologous strains. DNA vaccines are a potential alternative with advantages such as the induction of cellular and humoral immunity, inherent safety and rapid production time. We have previously developed a DNA vaccine encoding selected influenza proteins of pandemic origin and demonstrated broad protective immune responses in ferrets and pigs. In this study, we evaluated our DNA vaccine expressed by next-generation vectors. These new vectors can improve gene expression, but they are also efficiently produced on large scales and comply with regulatory guidelines by avoiding antibiotic resistance genes. In addition, a new needle-free delivery of the vaccine, convenient for mass vaccinations, was compared with intradermal needle injection followed by electroporation. We report that when our DNA vaccine is expressed by the new vectors and delivered to the skin with the needle-free device in the rabbit model, it can elicit an antibody response with the same titers as a conventional vector with intradermal electroporation. The needle-free delivery is already in use for traditional protein vaccines in pigs but should be considered as a practical alternative for the mass administration of broadly protective influenza DNA vaccines. PMID:25746201

The effect of augmented reality training on percutaneous needle placement in spinal facet joint injections.

PubMed

Yeo, Caitlin T; Ungi, Tamas; U-Thainual, Paweena; Lasso, Andras; McGraw, Robert C; Fichtinger, Gabor

2011-07-01

The purpose of this study was to determine if augmented reality image overlay and laser guidance systems can assist medical trainees in learning the correct placement of a needle for percutaneous facet joint injection. The Perk Station training suite was used to conduct and record the needle insertion procedures. A total of 40 volunteers were randomized into two groups of 20. 1) The Overlay group received a training session that consisted of four insertions with image and laser guidance, followed by two insertions with laser overlay only. 2) The Control group received a training session of six classical freehand insertions. Both groups then conducted two freehand insertions. The movement of the needle was tracked during the series of insertions. The final insertion procedure was assessed to determine if there was a benefit to the overlay method compared to the freehand insertions. The Overlay group had a better success rate (83.3% versus 68.4%, p=0.002), and potential for less tissue damage as measured by the amount of needle movement inside the phantom (3077.6 mm(2) versus 5607.9 mm(2) , p =0.01). These results suggest that an augmented reality overlay guidance system can assist medical trainees in acquiring technical competence in a percutaneous needle insertion procedure. © 2011 IEEE

Benchmarking of state-of-the-art needle detection algorithms in 3D ultrasound data volumes

NASA Astrophysics Data System (ADS)

Pourtaherian, Arash; Zinger, Svitlana; de With, Peter H. N.; Korsten, Hendrikus H. M.; Mihajlovic, Nenad

2015-03-01

Ultrasound-guided needle interventions are widely practiced in medical diagnostics and therapy, i.e. for biopsy guidance, regional anesthesia or for brachytherapy. Needle guidance using 2D ultrasound can be very challenging due to the poor needle visibility and the limited field of view. Since 3D ultrasound transducers are becoming more widely used, needle guidance can be improved and simplified with appropriate computer-aided analyses. In this paper, we compare two state-of-the-art 3D needle detection techniques: a technique based on line filtering from literature and a system employing Gabor transformation. Both algorithms utilize supervised classification to pre-select candidate needle voxels in the volume and then fit a model of the needle on the selected voxels. The major differences between the two approaches are in extracting the feature vectors for classification and selecting the criterion for fitting. We evaluate the performance of the two techniques using manually-annotated ground truth in several ex-vivo situations of different complexities, containing three different needle types with various insertion angles. This extensive evaluation provides better understanding on the limitations and advantages of each technique under different acquisition conditions, which is leading to the development of improved techniques for more reliable and accurate localization. Benchmarking results that the Gabor features are better capable of distinguishing the needle voxels in all datasets. Moreover, it is shown that the complete processing chain of the Gabor-based method outperforms the line filtering in accuracy and stability of the detection results.

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

PubMed

Yang, Jun-xiong; Zhu, Xiao-yi

2008-03-01

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

Torsional Dynamics of Steerable Needles: Modeling and Fluoroscopic Guidance

PubMed Central

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

2017-01-01

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

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

PubMed

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

2007-09-01

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

Time effect and aliquot concentration in Streptococcus mutans elimination by plasma needle

NASA Astrophysics Data System (ADS)

García-Alcantara, E.; López-Callejas, R.; Peña-Eguiluz, R.; Lagunas-Bernabé, S.; Valencia-Alvarado, R.; Mercado-Cabrera, A.; Barocio, S. R.; Muñoz-Castro, A. E.; Rodríguez-Méndez, B. G.; de la Piedad-Beneitez, A.

2012-06-01

Atmospheric plasma needle systems are being intensively studied with a view to potential applications in medicine. The aim of this in vitro study is the improved elimination of Streptococcus Mutants (S. mutans) bacteria. A 5 ml volume of Luria-Bertani culture medium has been inoculated with a test bacterial population and incubated during 24 hours, followed by ten dilutions producing aliquots at 20, 50 and 100 micro l per dilution. Each aliquot is deposited on a paper filter and then exposed to a 2 W RF room pressure helium plasma needle discharge at a 1.5 l.p.m. rate for 1, 3, 5 or 7 minutes. Each sample paper is placed in a test tube, again containing Luria-Bertani fluid, in order to develop a new bacterium colony after a 24h incubation period. The plasma needle lethality has been evaluated from absorbance studies by means of a 6305 Jeway spectrophotometer at a 600 nm wavelength, indicating a clear correlation with exposure time. These studies validate the high disinfection efficacy of the plasma needle.

Dual mode fuel injector with one piece needle valve member

DOEpatents

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

2005-01-18

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

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

PubMed

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

2018-05-11

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

Needle Decompression of Tension Pneumothorax with Colorimetric Capnography.

PubMed

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

2017-11-01

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

Segmentation of prostate biopsy needles in transrectal ultrasound images

NASA Astrophysics Data System (ADS)

Krefting, Dagmar; Haupt, Barbara; Tolxdorff, Thomas; Kempkensteffen, Carsten; Miller, Kurt

2007-03-01

Prostate cancer is the most common cancer in men. Tissue extraction at different locations (biopsy) is the gold-standard for diagnosis of prostate cancer. These biopsies are commonly guided by transrectal ultrasound imaging (TRUS). Exact location of the extracted tissue within the gland is desired for more specific diagnosis and provides better therapy planning. While the orientation and the position of the needle within clinical TRUS image are limited, the appearing length and visibility of the needle varies strongly. Marker lines are present and tissue inhomogeneities and deflection artefacts may appear. Simple intensity, gradient oder edge-detecting based segmentation methods fail. Therefore a multivariate statistical classificator is implemented. The independent feature model is built by supervised learning using a set of manually segmented needles. The feature space is spanned by common binary object features as size and eccentricity as well as imaging-system dependent features like distance and orientation relative to the marker line. The object extraction is done by multi-step binarization of the region of interest. The ROI is automatically determined at the beginning of the segmentation and marker lines are removed from the images. The segmentation itself is realized by scale-invariant classification using maximum likelihood estimation and Mahalanobis distance as discriminator. The technique presented here could be successfully applied in 94% of 1835 TRUS images from 30 tissue extractions. It provides a robust method for biopsy needle localization in clinical prostate biopsy TRUS images.

Study of geographical trends of polycyclic aromatic hydrocarbons using pine needles

NASA Astrophysics Data System (ADS)

Amigo, José Manuel; Ratola, Nuno; Alves, Arminda

2011-10-01

In this work, pine needles were used as polycyclic aromatic hydrocarbons (PAHs) markers to study the PAHs distribution over several geographical locations in Portugal and over time. Four pine needle sampling campaigns (winter, spring, summer and autumn 2007) were carried out in 29 sites, covering the major urban centres, some industrial points, smaller cities, rural areas and remote locations. Needles from Pinus pinaster Ait. and Pinus pinea L. trees were collected from 2005 and 2006 shoots, corresponding to one up to three years of exposure. Spatial trends of the incidence of PAHs indicate an increase from the remote to the urban and industrial sites. The mean values for the sum of 16 PAHs ranged from 96 ± 30 ng g -1 (dry weight) for remote sites to 866 ± 304 ng g -1 (dw) for industrial sites for P. pinaster needles and from 188 ± 117 ng g -1 (dw) for rural sites to 337 ± 153 ng g -1 (dw) for urban sites for P. pinea. Geographic information system tools and principal component analysis revealed that the contamination patterns of PAHs are somehow related to several socio-geographic parameters of the sampling sites. The geographical trend for the PAHs is similar between seasons in terms of PAH levels, but some diverse behaviour is found on the separation of lighter and heavier PAHs. Differences between P. pinaster and P. pinea needles are stronger in terms of PAH uptake loads than in the site type fingerprints.

Diagenesis of conifer needles in a coastal marine environment

NASA Astrophysics Data System (ADS)

Hedges, John I.; Weliky, K.

1989-10-01

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

The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection.

PubMed

Taghavi Zenouz, Ali; Ebrahimi, Hooman; Mahdipour, Masoumeh; Pourshahidi, Sara; Amini, Parisa; Vatankhah, Mahdi

2008-01-01

Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections. Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test. 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques (P = 0.127) and between right and left injection sites (P = 0.778). According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance.

A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures.

PubMed

Oliveira-Santos, Thiago; Klaeser, Bernd; Weitzel, Thilo; Krause, Thomas; Nolte, Lutz-Peter; Peterhans, Matthias; Weber, Stefan

2011-01-01

Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well

Rooting of needle fascicles from western white pine seedlings

Treesearch

Ramond J. Hoff; Geral I. McDonald

1968-01-01

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

Endpoint Accuracy in Manual Control of a Steerable Needle.

PubMed

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

2017-02-01

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

[The future of bedside chest radiography: Comparative study of mobile flat-panels and needle-image plate storage phosphor systems].

PubMed

Bremicker, K; Gosch, D; Kahn, T; Borte, G

2015-11-01

Chest radiography is the most common diagnostic modality in intensive care units with new mobile flat-panels gaining more attention and availability in addition to the already used storage phosphor plates. Comparison of the image quality of mobile flat-panels and needle-image plate storage phosphor system in terms of bedside chest radiography. Retrospective analysis of 84 bedside chest radiographs of 42 intensive care patients (20 women, 22 men, average age: 65 years). All images were acquired during daily routine. For each patient, two images were analyzed, one from each system mentioned above. Two blinded radiologists evaluated the image quality based on ten criteria (e.g., diaphragm, heart contour, tracheal bifurcation, thoracic spine, lung structure, consolidations, foreign material, and overall impression) using a 5-point visibility scale (1 = excellent, 5 = not usable). There was no significant difference between the image quality of the two systems (p < 0.05). Overall some anatomical structures such as the diaphragm, heart, pulmonary consolidations and foreign material were considered of higher diagnostic quality compared to others, e.g., tracheal bifurcation and thoracic spine. Mobile flat-panels achieve an image quality which is as good as those of needle-image plate storage phosphor systems. In addition, they allow immediate evaluation of the image quality but in return are much more expensive in terms of purchase and maintenance.

Research on needle exchange: redefining the agenda.

PubMed Central

Hantman, J. A.

1995-01-01

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

Design and evaluation of an intraocular B-scan OCT-guided 36-gauge needle

NASA Astrophysics Data System (ADS)

Shen, Jin H.; Joos, Karen M.

2015-03-01

Optical coherence tomography imaging is widely used in ophthalmology and optometry clinics for diagnosing retinal disorders. External microscope-mounted OCT operating room systems have imaged retinal changes immediately following surgical manipulations. However, the goal is to image critical surgical maneuvers in real time. External microscope-mounted OCT systems have some limitations with problems tracking constantly moving intraocular surgical instruments, and formation of absolute shadows by the metallic surgical instruments upon the underlying tissues of interest. An intraocular OCT-imaging probe was developed to resolve these problems. A disposable 25-gauge probe tip extended beyond the handpiece, with a 36-gauge needle welded to a disposable tip with its end extending an additional 3.5 mm. A sealed 0.35 mm diameter GRIN lens protected the fiber scanner and focused the scanning beam at a 3 to 4 mm distance. The OCT engine was a very high-resolution spectral-domain optical coherence tomography (SDOCT) system (870 nm, Bioptigen, Inc. Durham, NC) which produced 2000 A-scan lines per B-scan image at a frequency of 5 Hz with the fiber optic oscillations matched to this frequency. Real-time imaging of the needle tip as it touched infrared paper was performed. The B-scan OCT-needle was capable of real-time performance and imaging of the phantom material. In the future, the B-scan OCT-guided needle will be used to perform sub-retinal injections.

[Comparison of port needle with safety device between Huber Plus (HP) and Poly PERF Safe (PPS)].

PubMed

Shimono, Chigusa; Tanaka, Atsuko; Fujita, Ai; Ishimoto, Miki; Oura, Shoji; Yamaue, Hiroki; Sato, Morio

2010-05-01

An embedded port is frequently used for outpatients with advanced cancer in central venous chemotherapy or hepatic arterial chemoinfusion. The port needle with a safety device in an ambulatory treatment center is indispensable for medical employees and patient plus family to reduce the risk of a needle puncture accident and to prevent iatrogenic infection. The port needle with safety system has been already introduced in our chemotherapy center. There are two types of port needle with safety device; Huber Plus (HP, Medicon Co., Ltd.) and POLY PERF Safe (PPS, Pyolax Device, Co., Ltd.). The comparison of the feasibility between HP and PPS was conducted by both medical employees and patients plus family using an inquiry score method. HP was highly regarded for its stability plus fixation and PPS for its usefulness in puncture and extraction of the needle. PPS was found to be preferable to HP based on the overall evaluation.

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

PubMed

Aamodt, A; Vedeler, C

2001-06-01

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

Deactivation of Escherichia coli by the plasma needle

NASA Astrophysics Data System (ADS)

Sladek, R. E. J.; Stoffels, E.

2005-06-01

In this paper we present a parameter study on deactivation of Escherichia coli (E. coli) by means of a non-thermal plasma (plasma needle). The plasma needle is a small-sized (1 mm) atmospheric glow sustained by radio-frequency excitation. This plasma will be used to disinfect heat-sensitive objects; one of the intended applications is in vivo deactivation of dental bacteria: destruction of plaque and treatment of caries. We use E. coli films plated on agar dishes as a model system to optimize the conditions for bacterial destruction. Plasma power, treatment time and needle-to-sample distance are varied. Plasma treatment of E. coli films results in formation of a bacteria-free void with a size up to 12 mm. 104-105 colony forming units are already destroyed after 10 s of treatment. Prolongation of treatment time and usage of high powers do not significantly improve the destruction efficiency: short exposure at low plasma power is sufficient. Furthermore, we study the effects of temperature increase on the survival of E. coli and compare it with thermal effects of the plasma. The population of E. coli heated in a warm water bath starts to decrease at temperatures above 40°C. Sample temperature during plasma treatment has been monitored. The temperature can reach up to 60°C at high plasma powers and short needle-to-sample distances. However, thermal effects cannot account for bacterial destruction at low power conditions. For safe and efficient in vivo disinfection, the sample temperature should be kept low. Thus, plasma power and treatment time should not exceed 150 mW and 60 s, respectively.

Nitrogen fertilizer factory effects on the amino acid and nitrogen content in the needles of Scots pine.

PubMed

Kupsinskiene, E

2001-12-04

The aim of the research was to evaluate the content of amino acids in the needles of Pinus sylvestris growing in the area affected by a nitrogen fertilizer factory and to compare them with other parameters of needles, trees, and sites. Three young-age stands of Scots pine were selected at a distance of 0.5 km, 5 km, and 17 km from the factory. Examination of the current-year needles in winter of the year 2000 revealed significant (p < 0.05) differences between the site at a 0.5-km distance from the factory and the site at a 17-km distance from the factory--with the site closest to the factory showing the highest concentrations of protein (119%), total arginine (166%), total other amino acids (depending on amino acid, the effect ranged between 119 and 149%), free arginine (771%), other free amino acids (glutamic acid, threonine, serine, lysine--depending on amino acid, the effect ranged between 162 and 234%), also the longest needles, widest diameter, largest surface area, and heaviest dry weight (respectively, 133, 110, 136, and 169%). The gradient of nitrogen concentration in the needles was assessed on the selected plots over the period of 1995-2000, with the highest concentration (depending on year, 119 to 153%) documented in the site located 0.5 km from the factory. Significant correlations were determined between the total amino acid contents (r = 0.448 -0.939, p < 0.05), some free amino acid (arginine, aspartic acid, glutamic acid, lysine, threonine, and serine) contents (r = 0.418 - 0.975, p < 0.05), and air pollutant concentration at the sites, the distance between the sites and the factory, and characteristics of the needles. No correlation was found between free or total arginine content and defoliation or retention of the needles. In conclusion, it was revealed that elevated mean monthly concentration of ammonia (26 microg m(-3)) near the nitrogen fertilizer factory caused changes in nitrogen metabolism, especially increasing (nearly eight times

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

PubMed

Abdala, Nadia; Patel, Amisha; Heimer, Robert

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

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

PubMed

Rose, B I; Laky, D

2013-06-01

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

Needle Exchange and the Geography of Survival in the South Bronx

PubMed Central

McLean, Katherine

2012-01-01

This paper explores the position of needle exchange programs (NEPs) in the “geography of survival” in the South Bronx neighborhood of New York City. Stemming the spread of HIV through the provision of sterile injecting equipment, needle exchange promotes the survival of injection drug users (IDUs) in the starkest sense; yet NEPs also attract a diverse population of service users whose attendance is not necessarily related to drugs. This paper locates NEPs among a larger constellation of social services accessed by residents of poor neighborhoods, including injection drug users, the homeless, the hungry, and those in need of medical services or just safe space. Drawing on ethnographic and interview data from a needle exchange in the South Bronx, I describe how both IDUs and others employed the organization to make ends meet, elaborating four “off-label” usages of needle exchange: as a place to obtain basic necessities, as a source of income, as a safe space, and as a site of social contact. As harm reduction in the United States moves towards an increasingly clinical model of care, this paper considers these latent functions of needle exchange within the context of a larger struggle over the content and meaning of harm reduction services. By themselves, NEPs are clearly an unsatisfactory solution to the economic and political circumstances that drive a variety of individuals through their doors; yet, in a country that lacks a comprehensive welfare system, needle exchange arguably represents an important thread within a social safety net that is being woven from the ground up. This study may be used argue for a (re)expanded mission for harm reduction in the United States, in the face of constant moves to narrow its mandate and reduce its budget. PMID:22417824

A novel curvature-controllable steerable needle for percutaneous intervention.

PubMed

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

2016-08-01

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

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

PubMed

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

2015-02-01

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

Molecular dynamics simulation of a needle-sphere binary mixture

NASA Astrophysics Data System (ADS)

Raghavan, Karthik

This paper investigates the dynamic behaviour of a hard needle-sphere binary system using a novel numerical technique called the Newton homotopy continuation (NHC) method. This mixture is representative of a polymer melt where both long chain molecules and monomers coexist. Since the intermolecular forces are generated from hard body interactions, the consequence of missed collisions or incorrect collision sequences have a significant bearing on the dynamic properties of the fluid. To overcome this problem, in earlier work NHC was chosen over traditional Newton-Raphson methods to solve the hard body dynamics of a needle fluid in random media composed of overlapping spheres. Furthermore, the simplicity of interactions and dynamics allows us to focus our research directly on the effects of particle shape and density on the transport behaviour of the mixture. These studies are also compared with earlier works that examined molecular chains in porous media primarily to understand the differences in molecular transport in the bulk versus porous systems.

MRI-Compatible Pneumatic Robot for Transperineal Prostate Needle Placement.

PubMed

Fischer, Gregory S; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; Dimaio, Simon P; Tempany, Clare M; Hata, Nobuhiko; Fichtinger, Gabor

2008-06-01

Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of prostate and surrounding tissue, thus granting potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. However, the benefits cannot be readily harnessed for interventional procedures due to difficulties that surround the use of high-field (1.5T or greater) MRI. The inability to use conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intraprostatic needle placement inside closed high-field MRI scanners. MRI compatibility of the robot has been evaluated under 3T MRI using standard prostate imaging sequences and average SNR loss is limited to 5%. Needle alignment accuracy of the robot under servo pneumatic control is better than 0.94 mm rms per axis. The complete system workflow has been evaluated in phantom studies with accurate visualization and targeting of five out of five 1 cm targets. The paper explains the robot mechanism and controller design, the system integration, and presents results of preliminary evaluation of the system.

MRI-Compatible Pneumatic Robot for Transperineal Prostate Needle Placement

PubMed Central

Fischer, Gregory S.; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; DiMaio, Simon P.; Tempany, Clare M.; Hata, Nobuhiko; Fichtinger, Gabor

2010-01-01

Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of prostate and surrounding tissue, thus granting potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. However, the benefits cannot be readily harnessed for interventional procedures due to difficulties that surround the use of high-field (1.5T or greater) MRI. The inability to use conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intraprostatic needle placement inside closed high-field MRI scanners. MRI compatibility of the robot has been evaluated under 3T MRI using standard prostate imaging sequences and average SNR loss is limited to 5%. Needle alignment accuracy of the robot under servo pneumatic control is better than 0.94 mm rms per axis. The complete system workflow has been evaluated in phantom studies with accurate visualization and targeting of five out of five 1 cm targets. The paper explains the robot mechanism and controller design, the system integration, and presents results of preliminary evaluation of the system. PMID:21057608

21 CFR 882.4650 - Neurosurgical suture needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

21 CFR 882.4650 - Neurosurgical suture needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

21 CFR 868.5150 - Anesthesia conduction needle.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

21 CFR 868.5090 - Emergency airway needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

PubMed

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

2015-04-01

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

Etiological study of the short needle disease of pine

Treesearch

Francis A. Wood; Stanley P. Pennypacker

1976-01-01

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

In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle

NASA Astrophysics Data System (ADS)

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

2016-06-01

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

Transjugular liver biopsy with use of the shark jaw needle: diagnostic yield, complications, and cost-effectiveness.

PubMed

Psooy, B J; Clark, T W; Beecroft, J R; Malatjalian, D

2001-01-01

Obtaining transjugular liver biopsy specimens with use of single-use needle systems is expensive, whereas biopsy specimens obtained with use of reusable needle systems are frequently associated with inadequate core specimens. The authors report their experience with the reusable Cook Shark Jaw biopsy needle, including diagnostic yield, complications, and cost-effectiveness. A retrospective audit was performed of a cohort of 134 patients who underwent 136 transjugular liver biopsies with use of a reusable 16-gauge Shark Jaw needle during a 30-month period. Specimen adequacy and complication rates were assessed and direct costs of expendable components calculated. Cost-effectiveness was expressed as cost-per-successful biopsy. Biopsies were technically successful in 126 of 136 (93%) patients, with diagnostic histologic core specimens obtained in 124 of 126 (98%) patients, for an overall success rate of 91%. Complications included capsular penetration in six (4.4%) patients, cardiac arrhythmia in two (1.5%) patients, and puncture site hematoma or bleeding in 10 (7.4%) patients. Three tract embolizations were performed for capsular penetration. No instances of subcapsular hematoma, hemoperitoneum, or sepsis occurred, and no deaths were attributed to the procedure. The cost of expendable components totaled $103 per biopsy, corresponding to a cost-effectiveness of $113/successful biopsy. Transjugular liver biopsy specimens obtained with use of the Shark Jaw needle have a diagnostic yield comparable to those obtained with use of single-use biopsy systems, at a substantially lower cost with no increase in serious complications.

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

21 CFR 878.5350 - Needle-type epilator.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

A serious game for learning ultrasound-guided needle placement skills.

PubMed

Chan, Wing-Yin; Qin, Jing; Chui, Yim-Pan; Heng, Pheng-Ann

2012-11-01

Ultrasound-guided needle placement is a key step in a lot of radiological intervention procedures such as biopsy, local anesthesia and fluid drainage. To help training future intervention radiologists, we develop a serious game to teach the skills involved. We introduce novel techniques for realistic simulation and integrate game elements for active and effective learning. This game is designed in the context of needle placement training based on the some essential characteristics of serious games. Training scenarios are interactively generated via a block-based construction scheme. A novel example-based texture synthesis technique is proposed to simulate corresponding ultrasound images. Game levels are defined based on the difficulties of the generated scenarios. Interactive recommendation of desirable insertion paths is provided during the training as an adaptation mechanism. We also develop a fast physics-based approach to reproduce the shadowing effect of needles in ultrasound images. Game elements such as time-attack tasks, hints and performance evaluation tools are also integrated in our system. Extensive experiments are performed to validate its feasibility for training.

Precision grid and hand motion for accurate needle insertion in brachytherapy

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

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

2011-08-15

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

Needle-free delivery of macromolecules through the skin using controllable jet injectors.

PubMed

Hogan, Nora C; Taberner, Andrew J; Jones, Lynette A; Hunter, Ian W

2015-01-01

Transdermal delivery of drugs has a number of advantages in comparison to other routes of administration. The mechanical properties of skin, however, impose a barrier to administration and so most compounds are administered using hypodermic needles and syringes. In order to overcome some of the issues associated with the use of needles, a variety of non-needle devices based on jet injection technology has been developed. Jet injection has been used primarily for vaccine administration but has also been used to deliver macromolecules such as hormones, monoclonal antibodies and nucleic acids. A critical component in the more recent success of jet injection technology has been the active control of pressure applied to the drug during the time course of injection. Jet injection systems that are electronically controllable and reversible offer significant advantages over conventional injection systems. These devices can consistently create the high pressures and jet speeds necessary to penetrate tissue and then transition smoothly to a lower jet speed for delivery of the remainder of the desired dose. It seems likely that in the future this work will result in smart drug delivery systems incorporated into personal medical devices and medical robots for in-home disease management and healthcare.

Real-time needle guidance with photoacoustic and laser-generated ultrasound probes

NASA Astrophysics Data System (ADS)

Colchester, Richard J.; Mosse, Charles A.; Nikitichev, Daniil I.; Zhang, Edward Z.; West, Simeon; Beard, Paul C.; Papakonstantinou, Ioannis; Desjardins, Adrien E.

2015-03-01

Detection of tissue structures such as nerves and blood vessels is of critical importance during many needle-based minimally invasive procedures. For instance, unintentional injections into arteries can lead to strokes or cardiotoxicity during interventional pain management procedures that involve injections in the vicinity of nerves. Reliable detection with current external imaging systems remains elusive. Optical generation and reception of ultrasound allow for depth-resolved sensing and they can be performed with optical fibers that are positioned within needles used in clinical practice. The needle probe developed in this study comprised separate optical fibers for generating and receiving ultrasound. Photoacoustic generation of ultrasound was performed on the distal end face of an optical fiber by coating it with an optically absorbing material. Ultrasound reception was performed using a high-finesse Fabry-Pérot cavity. The sensor data was displayed as an M-mode image with a real-time interface. Imaging was performed on a biological tissue phantom.

The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection

PubMed Central

Taghavi Zenouz, Ali; Ebrahimi, Hooman; Mahdipour, Masoumeh; Pourshahidi, Sara; Amini, Parisa; Vatankhah, Mahdi

2008-01-01

Background and aims Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections. Materials and methods Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test. Results 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques (P = 0.127) and between right and left injection sites (P = 0.778). Conclusion According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance. PMID:23285329

An automated optimization tool for high-dose-rate (HDR) prostate brachytherapy with divergent needle pattern

NASA Astrophysics Data System (ADS)

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

2015-10-01

Focal high-dose-rate (HDR) for prostate cancer has gained increasing interest as an alternative to whole gland therapy as it may contribute to the reduction of treatment related toxicity. For focal treatment, optimal needle guidance and placement is warranted. This can be achieved under MR guidance. However, MR-guided needle placement is currently not possible due to space restrictions in the closed MR bore. To overcome this problem, a MR-compatible, single-divergent needle-implant robotic device is under development at the University Medical Centre, Utrecht: placed between the legs of the patient inside the MR bore, this robot will tap the needle in a divergent pattern from a single rotation point into the tissue. This rotation point is just beneath the perineal skin to have access to the focal prostate tumor lesion. Currently, there is no treatment planning system commercially available which allows optimization of the dose distribution with such needle arrangement. The aim of this work is to develop an automatic inverse dose planning optimization tool for focal HDR prostate brachytherapy with needle insertions in a divergent configuration. A complete optimizer workflow is proposed which includes the determination of (1) the position of the center of rotation, (2) the needle angulations and (3) the dwell times. Unlike most currently used optimizers, no prior selection or adjustment of input parameters such as minimum or maximum dose or weight coefficients for treatment region and organs at risk is required. To test this optimizer, a planning study was performed on ten patients (treatment volumes ranged from 8.5 cm3to 23.3 cm3) by using 2-14 needle insertions. The total computation time of the optimizer workflow was below 20 min and a clinically acceptable plan was reached on average using only four needle insertions.

High resolution microphotonic needle for endoscopic imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Tadayon, Mohammad Amin; Mohanty, Aseema; Roberts, Samantha P.; Barbosa, Felippe; Lipson, Michal

2017-02-01

GRIN (Graded index) lens have revolutionized micro endoscopy enabling deep tissue imaging with high resolution. The challenges of traditional GRIN lenses are their large size (when compared with the field of view) and their limited resolution. This is because of the relatively weak NA in standard graded index lenses. Here we introduce a novel micro-needle platform for endoscopy with much higher resolution than traditional GRIN lenses and a FOV that corresponds to the whole cross section of the needle. The platform is based on polymeric (SU-8) waveguide integrated with a microlens micro fabricated on a silicon substrate using a unique molding process. Due to the high index of refraction of the material the NA of the needle is much higher than traditional GRIN lenses. We tested the probe in a fluorescent dye solution (19.6 µM Alexa Flour 647 solution) and measured a numerical aperture of 0.25, focal length of about 175 µm and minimal spot size of about 1.6 µm. We show that the platform can image a sample with the field of view corresponding to the cross sectional area of the waveguide (80x100 µm2). The waveguide size can in principle be modified to vary size of the imaging field of view. This demonstration, combined with our previous work demonstrating our ability to implant the high NA needle in a live animal, shows that the proposed system can be used for deep tissue imaging with very high resolution and high field of view.

Virtobot 2.0: the future of automated surface documentation and CT-guided needle placement in forensic medicine.

PubMed

Ebert, Lars Christian; Ptacek, Wolfgang; Breitbeck, Robert; Fürst, Martin; Kronreif, Gernot; Martinez, Rosa Maria; Thali, Michael; Flach, Patricia M

2014-06-01

In this paper we present the second prototype of a robotic system to be used in forensic medicine. The system is capable of performing automated surface documentation using photogrammetry, optical surface scanning and image-guided, post-mortem needle placement for tissue sampling, liquid sampling, or the placement of guide wires. The upgraded system includes workflow optimizations, an automatic tool-change mechanism, a new software module for trajectory planning and a fully automatic computed tomography-data-set registration algorithm. We tested the placement accuracy of the system by using a needle phantom with radiopaque markers as targets. The system is routinely used for surface documentation and resulted in 24 surface documentations over the course of 11 months. We performed accuracy tests for needle placement using a biopsy phantom, and the Virtobot placed introducer needles with an accuracy of 1.4 mm (±0.9 mm). The second prototype of the Virtobot system is an upgrade of the first prototype but mainly focuses on streamlining the workflow and increasing the level of automation and also has an easier user interface. These upgrades make the Virtobot a potentially valuable tool for case documentation in a scalpel-free setting that uses purely imaging techniques and minimally invasive procedures and is the next step toward the future of virtual autopsy.

Computed tomography (CT)-compatible remote center of motion needle steering robot: Fusing CT images and electromagnetic sensor data.

PubMed

Shahriari, Navid; Heerink, Wout; van Katwijk, Tim; Hekman, Edsko; Oudkerk, Matthijs; Misra, Sarthak

2017-07-01

Lung cancer is the most common cause of cancer-related death, and early detection can reduce the mortality rate. Patients with lung nodules greater than 10 mm usually undergo a computed tomography (CT)-guided biopsy. However, aligning the needle with the target is difficult and the needle tends to deflect from a straight path. In this work, we present a CT-compatible robotic system, which can both position the needle at the puncture point and also insert and rotate the needle. The robot has a remote-center-of-motion arm which is achieved through a parallel mechanism. A new needle steering scheme is also developed where CT images are fused with electromagnetic (EM) sensor data using an unscented Kalman filter. The data fusion allows us to steer the needle using the real-time EM tracker data. The robot design and the steering scheme are validated using three experimental cases. Experimental Case I and II evaluate the accuracy and CT-compatibility of the robot arm, respectively. In experimental Case III, the needle is steered towards 5 real targets embedded in an anthropomorphic gelatin phantom of the thorax. The mean targeting error for the 5 experiments is 1.78 ± 0.70 mm. The proposed robotic system is shown to be CT-compatible with low targeting error. Small nodule size and large needle diameter are two risk factors that can lead to complications in lung biopsy. Our results suggest that nodules larger than 5 mm in diameter can be targeted using our method which may result in lower complication rate. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

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

PubMed

Tan, Lingqiong; Zhao, Yanling

2015-04-01

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

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

PubMed

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

2017-03-08

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

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

PubMed

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

2015-08-01

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

Drug-related deaths and the sales of needles through pharmacies

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-10-01

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

Design of an Optically Controlled MR-Compatible Active Needle

PubMed Central

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

2015-01-01

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

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

PubMed

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

2010-01-01

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

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

PubMed

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

2017-05-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-10-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

Belavy, David

2010-09-01

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

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

PubMed

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

2018-01-01

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

[Special penetration needling for refractory peripheral facial paralysis].

PubMed

Cao, Rongjuan; Qiu, Xiaohu; Xie, Xiaokun

2018-03-12

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

Needle and syringe sharing among Iranian drug injectors

PubMed Central

Rafiey, Hassan; Narenjiha, Hooman; Shirinbayan, Peymaneh; Noori, Roya; Javadipour, Morteza; Roshanpajouh, Mohsen; Samiei, Mercedeh; Assari, Shervin

2009-01-01

Objective The role of needle and syringe sharing behavior of injection drug users (IDUs) in spreading of blood-borne infections – specially HIV/AIDS – is well known. However, very little is known in this regard from Iran. The aim of our study was to determine the prevalence and associates of needle and syringe sharing among Iranian IDUs. Methods In a secondary analysis of a sample of drug dependents who were sampled from medical centers, prisons and streets of the capitals of 29 provinces in the Iran in 2007, 2091 male IDUs entered. Socio-demographic data, drug use data and high risk behaviors entered to a logistic regression to determine independent predictors of lifetime needle and syringe sharing. Results 749(35.8%) reported lifetime experience of needle and syringe sharing. The likelihood of lifetime needle and syringe sharing was increased by female gender, being jobless, having illegal income, drug use by family members, pleasure/enjoyment as causes of first injection, first injection in roofless and roofed public places, usual injection at groin, usual injection at scrotum, lifetime experience of nonfatal overdose, and history of arrest in past year and was decreased by being alone at most injections. Conclusion However this data has been extracted from cross-sectional design and we can not conclude causation, some of the introduced variables with association with needle and syringe sharing may be used in HIV prevention programs which target reducing syringe sharing among IDUs. PMID:19643014

Pine needle abortion biomarker detected in bovine fetal fluids.

PubMed

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

2015-01-01

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

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

PubMed

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

2013-11-01

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

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

PubMed

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

2018-03-19

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

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

PubMed

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

2015-02-01

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

Guided percutaneous fine-needle aspiration biopsy of the liver

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

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

1981-04-01

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

Needle Exchange Programs and Drug Injection Behavior

ERIC Educational Resources Information Center

DeSimone, Jeff

2005-01-01

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

Imaging and Spectroscopy of Natural Fluorophores in Pine Needles

PubMed Central

Williams, Nari

2018-01-01

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

The Multi-Needle Langmuir Probe System on Board NorSat-1

NASA Astrophysics Data System (ADS)

Hoang, H.; Clausen, L. B. N.; Røed, K.; Bekkeng, T. A.; Trondsen, E.; Lybekk, B.; Strøm, H.; Bang-Hauge, D. M.; Pedersen, A.; Spicher, A.; Moen, J. I.

2018-06-01

On July 14th, 2017, the first Norwegian scientific satellite NorSat-1 was launched into a high-inclination (98∘), low-Earth orbit (600 km altitude) from Baikonur, Kazakhstan. As part of the payload package, NorSat-1 carries the multi-needle Langmuir probe (m-NLP) instrument which is capable of sampling the electron density at a rate up to 1 kHz, thus offering an unprecedented opportunity to continuously resolve ionospheric plasma density structures down to a few meters. Over the coming years, NorSat-1 will cross the equatorial and polar regions twice every 90 minutes, providing a wealth of data that will help to better understand the mechanisms that dissipate energy input from larger spatial scales by creating small-scale plasma density structures within the ionosphere. In this paper we describe the m-NLP system on board NorSat-1 and present some first results from the instrument commissioning phase. We show that the m-NLP instrument performs as expected and highlight its unique capabilities at resolving small-scale ionospheric plasma density structures.

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

PubMed

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

2017-10-01

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

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

PubMed Central

Nelson, Russell; Beamer, Lisa

2017-01-01

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

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

PubMed

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

2014-04-01

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

Whitacre or Quincke needles--does it really matter.

PubMed

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

1998-01-01

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

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

PubMed

Peterman, S B

1996-09-01

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

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

PubMed

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

1996-01-01

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

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

PubMed

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

2017-07-01

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

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

PubMed

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

2017-06-01

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

Protein-protein interactions: an application of Tus-Ter mediated protein microarray system.

PubMed

Sitaraman, Kalavathy; Chatterjee, Deb K

2011-01-01

In this chapter, we present a novel, cost-effective microarray strategy that utilizes expression-ready plasmid DNAs to generate protein arrays on-demand and its use to validate protein-protein interactions. These expression plasmids were constructed in such a way so as to serve a dual purpose of synthesizing the protein of interest as well as capturing the synthesized protein. The microarray system is based on the high affinity binding of Escherichia coli "Tus" protein to "Ter," a 20 bp DNA sequence involved in the regulation of DNA replication. The protein expression is carried out in a cell-free protein synthesis system, with rabbit reticulocyte lysates, and the target proteins are detected either by labeled incorporated tag specific or by gene-specific antibodies. This microarray system has been successfully used for the detection of protein-protein interaction because both the target protein and the query protein can be transcribed and translated simultaneously in the microarray slides. The utility of this system for detecting protein-protein interaction is demonstrated by a few well-known examples: Jun/Fos, FRB/FKBP12, p53/MDM2, and CDK4/p16. In all these cases, the presence of protein complexes resulted in the localization of fluorophores at the specific sites of the immobilized target plasmids. Interestingly, during our interactions studies we also detected a previously unknown interaction between CDK2 and p16. Thus, this Tus-Ter based system of protein microarray can be used for the validation of known protein interactions as well as for identifying new protein-protein interactions. In addition, it can be used to examine and identify targets of nucleic acid-protein, ligand-receptor, enzyme-substrate, and drug-protein interactions.

The Hydrodynamics of Needle-Free Intradermal Jet Injection

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

Single Crystal Diamond Needle as Point Electron Source.

PubMed

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

2016-10-12

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

Single Crystal Diamond Needle as Point Electron Source

PubMed Central

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

2016-01-01

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

Single Crystal Diamond Needle as Point Electron Source

NASA Astrophysics Data System (ADS)

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

2016-10-01

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

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

PubMed

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

2017-02-01

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

Single-incision laparoscopic cholecystectomy with needle graspers.

PubMed

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

2012-01-01

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

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

PubMed

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

2013-01-01

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

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

PubMed

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

1997-10-01

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

Needle oils of three pine species and species hybrids

Treesearch

Robert Z. Callaham

1956-01-01

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

Thermoelectric needle probe for temperature measurements in biological materials.

PubMed

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

1980-04-01

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

Ultrasonic-assisted conversion of limestone into needle-like hydroxyapatite nanoparticles.

PubMed

Klinkaewnarong, Jutharatana; Utara, Songkot

2018-09-01

Needle-like hydroxyapatite nanoparticles were successfully synthesized via a reaction between calcium oxide (CaO) that was obtained from calcined limestone and orthophosphoric acid (H 3 PO 4 ) under ultrasonic irradiation at 25 °C. The reaction systems were exposed to ultrasonic waves of 20 kHz for various times ranging from 0 to 4 h. The initial and final pH values of the mixtures of CaO and H 3 PO 4 solution were continuously observed (pH < 4.0) after ultrasonic irradiation. The powder was then dried at 60 °C and calcined at 300 °C for 3 h (3 °C/min). The products were characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and transmission electron microscopy (TEM). The results showed that the formation of needle-like hydroxyapatite (HAp) nanoparticles was substantially accelerated compared with the reaction without ultrasonic irradiation. The HAp phase was increasingly visible with longer ultrasonic irradiation time compared with the monetite phase (CaHPO 4 ). This suggests that ultrasonic waved induced a phase transition from the monetite to HAp phase. A smaller needle-like structure of HAp (diameter ∼ 7.4 nm) with a lower contamination of monetite phase was obtained following sonication for 3 h. This study shows that Thai limestone can used as a starting material for synthesizing needle-like HAp nanoparticles with the aid of ultrasonic methods. Copyright © 2018 Elsevier B.V. All rights reserved.

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

PubMed

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

2016-01-01

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

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

PubMed

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

2018-04-01

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

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

PubMed

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

2017-07-15

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

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

PubMed

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

2006-07-01

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

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

PubMed

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

2018-05-16

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

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

PubMed

Feng, Mu-Lan

2009-04-01

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

Rice-based mucosal vaccine as a global strategy for cold-chain- and needle-free vaccination

PubMed Central

Nochi, Tomonori; Takagi, Hidenori; Yuki, Yoshikazu; Yang, Lijun; Masumura, Takehiro; Mejima, Mio; Nakanishi, Ushio; Matsumura, Akiko; Uozumi, Akihiro; Hiroi, Takachika; Morita, Shigeto; Tanaka, Kunisuke; Takaiwa, Fumio; Kiyono, Hiroshi

2007-01-01

Capable of inducing antigen-specific immune responses in both systemic and mucosal compartments without the use of syringe and needle, mucosal vaccination is considered ideal for the global control of infectious diseases. In this study, we developed a rice-based oral vaccine expressing cholera toxin B subunit (CTB) under the control of the endosperm-specific expression promoter 2.3-kb glutelin GluB-1 with codon usage optimization for expression in rice seed. An average of 30 μg of CTB per seed was stored in the protein bodies, which are storage organelles in rice. When mucosally fed, rice seeds expressing CTB were taken up by the M cells covering the Peyer's patches and induced CTB-specific serum IgG and mucosal IgA antibodies with neutralizing activity. When expressed in rice, CTB was protected from pepsin digestion in vitro. Rice-expressed CTB also remained stable and thus maintained immunogenicity at room temperature for >1.5 years, meaning that antigen-specific mucosal immune responses were induced at much lower doses than were necessary with purified recombinant CTB. Because they require neither refrigeration (cold-chain management) nor a needle, these rice-based mucosal vaccines offer a highly practical and cost-effective strategy for orally vaccinating large populations against mucosal infections, including those that may result from an act of bioterrorism. PMID:17573530

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

PubMed

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

2005-08-01

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

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

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

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

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

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

PubMed

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

1996-11-01

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

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

PubMed

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

2018-06-04

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

The 3DBiopsy Prostate Biopsy System: Preclinical Investigation of a Needle, Actuator, and Specimen Collection Device Allowing Sampling of Individualized Prostate Lengths Between 20 and 60 mm.

PubMed

Stone, Nelson N; Mouraviev, Vladimir; Schechter, David; Lucia, M Scott; Smith, Elizabeth E; Arangua, Paul; Hoenemeyer, John; Rosa, Jim; Bawa, Rajan; Crawford, E David

2017-09-01

To increase the likelihood of detecting anterior cancers within the prostate and provide a specimen that spans the length of the gland. Newly designed 17- and 15-gauge (G) biopsy needles, a variable actuator, and an integrated pathology system intended for the longer cores were developed and tested for this purpose. Testing was performed comparing 2 common cannula tip grinds, a Vet-point (sharp tip) and a Menghini-point (atraumatic tip), and were tested against 18-G Bard Monopty in porcine kidney. A variable actuator was developed to fire the needle 20-60 mm and tested in cadaver prostates. The aggregate firings for 3 different shot lengths comparing the Vet- with the Menghini-tip cannulas demonstrated 91% vs 85.2% fill (length of specimen/length of core bed, P = .007). A 15-G trocar needle with the Vet-tip cannula also had the best performance, with an aggregate standard deviation of 6.4% across 3 firing ranges and a minimum to maximum specimen length of 81%-105% of potential fill. Cadaver testing with the Vet-tip needles in the actuator for the transrectal (17-G) and transperineal (15-G) biopsies demonstrated mean fills of 93.3% and 76.5%, respectively. The new transrectal ultrasound needle obtained a 2-fold increase in specimen length over the standard Bard device (P <.001). Longer and consistent cores were obtained using the new biopsy needles. Combined with an adjustable actuator, the physician can obtain specimens that include peripheral and anterior zone tissue in 1 core. Determination of cancer location on the longer specimens could enhance focal therapy planning. Copyright © 2017 Elsevier Inc. All rights reserved.

Molecular imaging needles: dual-modality optical coherence tomography and fluorescence imaging of labeled antibodies deep in tissue

PubMed Central

Scolaro, Loretta; Lorenser, Dirk; Madore, Wendy-Julie; Kirk, Rodney W.; Kramer, Anne S.; Yeoh, George C.; Godbout, Nicolas; Sampson, David D.; Boudoux, Caroline; McLaughlin, Robert A.

2015-01-01

Molecular imaging using optical techniques provides insight into disease at the cellular level. In this paper, we report on a novel dual-modality probe capable of performing molecular imaging by combining simultaneous three-dimensional optical coherence tomography (OCT) and two-dimensional fluorescence imaging in a hypodermic needle. The probe, referred to as a molecular imaging (MI) needle, may be inserted tens of millimeters into tissue. The MI needle utilizes double-clad fiber to carry both imaging modalities, and is interfaced to a 1310-nm OCT system and a fluorescence imaging subsystem using an asymmetrical double-clad fiber coupler customized to achieve high fluorescence collection efficiency. We present, to the best of our knowledge, the first dual-modality OCT and fluorescence needle probe with sufficient sensitivity to image fluorescently labeled antibodies. Such probes enable high-resolution molecular imaging deep within tissue. PMID:26137379

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

PubMed

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

2012-06-01

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

Comparison of the antimicrobial efficacy of irrigation using the EndoVac to endodontic needle delivery.

PubMed

Miller, Todd A; Baumgartner, J Craig

2010-03-01

The purpose of this investigation was to compare the antimicrobial efficacy of root canal irrigation with the EndoVac (Discus Dental, Culver City, CA) to endodontic needle irrigation in the apical 5 mm of root canals infected with Enterococcus faecalis. Bilaterally matched, extracted human teeth were sterilized and inoculated with E. faecalis. Specimens in the EndoVac group were irrigated using the EndoVac system, whereas those in the needle group were irrigated with a 30-G side-vented needle. After chemomechanical preparation, the apical 5 mm of the roots were removed, frozen in liquid nitrogen, and pulverized to expose E. faecalis in dentinal tubules or other morphologic irregularities. The number of colony forming units (cfus) of E. faecalis per mg dentin was determined. The EndoVac Group had a mean of 31.6 cfu/mg, whereas the needle group had a mean of 157 cfu/mg. This represents a bacterial reduction of 99.7% in group A and 98.8% in group B when compared with positive controls. Although there were fewer cfu/mg when using the EndoVac, there was not a statistically significant difference between the EndoVac and needle groups. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2018-01-01

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

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

PubMed

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

2016-11-01

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