Scraping technique of stuck needle at Anmian point in the treatment of insomnia: a randomized controlled trial

Institute of Scientific and Technical Information of China (English)

张全爱

2013-01-01

Objective To compare the efficacy difference in the treatment of insomnia between scraping technique of stuck needle and conventional acupuncture at Anmian (Extra) .Methods One hundred and thirty one cases

[Impact on the gait time cycle of ischemic stroke in the treatment with yin-yang respiratory reinforcing and reducing needling technique].

Science.gov (United States)

Li, Qi; Tian, Fu-Ling; Liu, Guo-Rong; Zheng, De-Song; Chen, Jin-Ming; Ma, Shu-Riang; Cui, Jian-Mei; Wang, Hong-Bin; Li, Xue-Qing

2014-03-01

To compare the difference in the efficacy on gait time cycle of ischemic stroke between yin-yang respiratory reinforcing and reducing needling technique (yin-yang needling) and the conventional acupuncture. Sixty cases of ischemic stroke were randomized into a conventional acupuncture group and a yin-yang needling group, 30 cases in each one. The basic treatment (the control of blood pressure, blood sugar and blood lipid, the intravenous drops of ginkgo leaf extract and dipyridamole injection and vinpocetine injection) were applied in the two groups. Additionally, in the conventional acupuncture group, the acupoints of the Stomach Meridian of Foot-Yangming [Biguan (ST 31), Liangqiu (ST 34), Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), etc.] were selected and stimulated with the even needling technique. In the yin-yang needling group, the acupoints of yin meridians such as Zuwuli (LR 10), Xuehai (SP 10), Yinlingquan (SP 9) and Sanyinjiao (SP 6), etc. and the acupoints of yang meridians such as Biguan (ST 31), Liangqiu (ST 34) and Yanglingquan (GB 34), etc. were selected. The reducing manipulation of respiratory reinforcing and reducing technique was applied to the acupoints of yin meridians and the reinforcing manipulation was applied to the acupoints of yang meridians. The kinematics time parameters were determined and compared before and 4 weeks after treatment. After treatment, the differences in the gait cycle, the phase time of standing (%), the phase time of single support (%), the phase time of unilateral sway (%) on the affected (healthy) foot and phase time of double support (%) were significant as compared with those before treatment in the patients of the two groups (all P yin-yang needling group were improved much obviously after treatment as compared with those in the conventional acupuncture group. The differences in support phase time (%), single support phase time (%) and sway phase time (%) were significant between the affected limb and

Retrospective Study of Vitreous Tap Technique Using Needle Aspiration for Management of Shallow Anterior Chamber during Phacoemulsification

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Ashraf Ahmed Nossair

2017-01-01

Full Text Available Purpose. To evaluate the technique of vitreous tap using needle aspiration for management of anterior chamber shallowness during phacoemulsification. Methods. A retrospective study included 26 eyes of 17 patients who underwent phacoemulsification in which vitreous tap was performed using a 27-gauge needle attached to a 5 ml syringe, inserted 3.5 mm from the limbus to aspirate 0.2 ml of liquefied vitreous if a cohesive (OVD failed to sufficiently deepen the anterior chamber. Results. Preoperative anterior chamber depth was 2.31 ± 0.26 mm, axial length was 21.7 ± 0.67 mm, lens thickness was 4.5 ± .19 mm, and cataract grade was 3.77 ± 1.4. Preoperative CDVA in LogMAR units was 0.98 ± 0.75. Coexisting angle closure glaucoma was present in 7 patients (26.92% preoperatively. Vitreous needle tap was successful in vitreous removal on the first attempt in 26 eyes (100%. Postoperative follow-up period was 22.88 ± 10.24 (4–39 months. The final postoperative CDVA in LogMAR units was 0.07 ± 0.1, while the final postoperative IOP was 16.54 ± 1.45 mmHg. No complications related to vitreous tap were noted. Conclusion. Vitreous needle tap is a simple, cost-effective, and safe technique for management of shallow anterior chamber in phacoemulsification.

Freehand biopsy guided by electromagnetic needle tracking

DEFF Research Database (Denmark)

Ewertsen, C; Nielsen, Marie Kristina Rue; Nielsen, M Bachmann

2011-01-01

To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking....

CT-guided spinal injection: initial experience with Sprotte tip needles

Energy Technology Data Exchange (ETDEWEB)

Pua, Uei [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

2010-09-15

The purpose of this paper is to describe our initial experience and to illustrate the potential benefits of using small caliber (25 and 27 G), noncutting pencil point needles (Sprotte) with single puncture coaxial technique in CT-guided spinal intervention (CTSI). From January 2009 to June 2009, Sprotte needles with single puncture coaxial technique were used in a total of ten patients for selective nerve root block (SNRB), facet joint block, and pars block under CT fluoroscopy (total of 16 target structures). All procedures were performed without conscious sedation, and visual analog scale (VAS) scores were recorded to determine pain related to needle placement. Total CT fluoroscopy time and out-of-plane needle deviation were obtained. Final needle position was documented by contrast injection for SNRBs and image capture for joint space cannulation. Sixteen out of the 16 structures were successfully targeted. No increase in VAS scores associated with needle placement was recorded, after infiltration of local anesthesia. Optimal peri-neurograms were obtained in all cases of SNRB, despite the side-hole opening in the Sprotte needles. Mean CT fluoroscopy time was 2 s (range 2-8 s per structure), and there was no case of out-of-plane needle deviation that required adjustment of the CT gantry. The use of small caliber Sprotte needles in CTSI is technically feasible and represents a potential refinement to current techniques in the management of chronic spinal pain. (orig.)

Evaluating the advances and use of hypodermic needles in dentistry.

Science.gov (United States)

Boynes, Sean G

2014-10-01

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

Capillary Versus Aspiration Biopsy: Effect of Needle Size and Length on the Cytopathological Specimen Quality

International Nuclear Information System (INIS)

Hopper, Kenneth D.; Grenko, Ronald T.; Fisher, Alicia I.; TenHave, Thomas R.

1996-01-01

Purpose: To test the value of the nonaspiration, or capillary, biopsy technique by experimental comparison with the conventional fine-needle aspiration technique using various needle gauges and lengths. Methods: On fresh hepatic and renal tissue from five autopsies, multiple biopsy specimens were taken with 20, 22, and 23-gauge Chiba needles of 5, 10, 15, and 20-cm length, using the aspiration technique and the capillary technique. The resultant specimens were graded on the basis of a grading scheme by a cytopathologist who was blinded to the biopsy technique. Results: The capillary technique obtained less background blood or clot which could obscure diagnostic tissue, although not significantly different from the aspiration technique (p= 0.2). However, for the amount of cellular material obtained, retention of appropriate architecture, and mean score, the capillary technique performed statistically worse than aspiration biopsy (p < 0.01). In addition, with decreasing needle caliber (increasing needle gauge) and increasing length, the capillary biopsy was inferior to the aspiration biopsy. Conclusion: The capillary biopsy technique is inferior to the aspiration technique according to our study. When the capillary technique is to be applied, preference should be given to larger caliber, shorter needles

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

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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.

Peribulbar block in equine isolated heads. Development of a single needle technique and tomographic evaluation

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vanessa rabbogliatti

2017-05-01

Full Text Available Peribulbar block (PPB has been used in humans as a safer alternative to retrobulbar block (RBB. PBB, depends on the diffusion of anaesthetic solution into the muscle across the connective tissue and it is performed introducing the needle within the extraconal space. The advantages are fewer complications and palpebral akinesia. In Veterinary Medicine few studies describe this technique in dogs (Ahn J 2013 and cats (Shilo-Benjamini et al. 2013. Based on literature the aim of the study is to determinate, in equine specimens, feasibility of inferior PBB with single needle injection, by using contrast medium (CM, and to evaluate thought Computed Tomography (CT the distribution around the optic nerve (degrees. PBB was performed in 6 orbits. The mixture injected consisted of 20 ml of physiological solution and iodinated CM at 25%. Each periorbital area underwent three CT scans. A basal acquisition to assess the needle position before the injection, a second and third scan were performed immediately after injection, and after application of pressure on the periorbital surface area to promote CM diffusion. The needle position was measured from the tip to the optic nerve with a mean distance of 2,27 mm ± 0,28. The mean volume distribution before pressure application was 23,56 cm3 ± 2,58 and after pressure application was 27,56 cm3 ± 4,8.  The CM distribution, was defined (Nouvellon et al. 2010 “successful” in 4 orbits (>270° and “inadequate” in 2 orbits (<180°. The present study demonstrates feasibility of inferior PBB by single injection in horses for its simple and practical execution. Inferior PPB is a potential alternative to systemic administration of neuromuscular blocking agents for ophthalmic surgery. However, this approach needs to be evaluate in clinical trials to assess its feasibility and effectiveness in clinical practice for standing procedures.

High-Quality Large-Magnification Polymer Lens from Needle Moving Technique and Thermal Assisted Moldless Fabrication Process.

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Ratthasart Amarit

Full Text Available The need of mobile microscope is escalating as well as the demand of high quality optical components in low price. We report here a novel needle moving technique to fabricate milli-size lens together with thermal assist moldless method. Our proposed protocol is able to create a high tensile strength structure of the lens and its base which is beneficial for exploiting in convertinga smart phone to be a digital microscope. We observe that no bubble trapped in a lens when this technique is performed which can overcome a challenge problem found in a typical dropping technique. We demonstrate the symmetry, smoothness and micron-scale resolution of the fabricated structure. This proposed technique is promising to serve as high quality control mass production without any expensive equipment required.

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

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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.

Comparison of needles size in pediatric renal biopsy with sono-guided percutaneous-automated gun technique

International Nuclear Information System (INIS)

Kim, Jong Chul; Park, Jin Yong

1997-01-01

To compare the efficacy of a 20-gauge and an 18-gauge needle in sono-guided percutaneous automated gun biopsy for establishing the specific diagnosis of renal parenchymal disease in pediatric kidneys. In 60 pediatric patients with renal parenchymal diseases, percutaneous sono-guided gun biopsy was performed by an experienced radiologist. In two groups of 30 patients, regardless of their age, two needle passes were performed, using alternately an 18-gauge or a 20-gauge biopsy needle. The core of renal tissue thus obtained was examined with light, immunofluorescent or electron microscopy by the renal pathologist. The mean number of intact glomeruli of whole tissue core per biopsy, as seen on the light microscopy, and post-bioptic complications were compared between the two different needle size groups. The number (mean±1 standard deviation) of glomeruli obtained per biopsy was 17±8 in the 18-gauge needle group, and 14±5 in the 20-gauge group. Between two groups, there was no major post-bioptic complication requiring specific treatment, nor a statistically significant difference in the frequency of minor complications. Even though more glomeruli were obtained with an 18-gauge needle, the number obtained with a 20-gauge needle also permitted adequate pathologic examination. Both an 18-gauge and a 20-gauge needle may thus be suitable for renal biopsy in pediatric patients

Structure and photoluminescence properties of Ag-coated ZnO nano-needles

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Li Xiaozhu, E-mail: Lixiaozhu1019@21cn.com [Department of Physics, Shaoguan University, Shaoguan, Guangdong 512005 (China) and Department of Physics and Key Laboratory of Acoustic and Photonic Materials and Devices of Ministry of Education, Wuhan University, Wuhan, Hubei 430072 (China); Wang Yongqian [Engineering Research Center of Nano-Geomaterials of Ministry of Education (China University of Geosciences), Wuhan, Hubei 430074 (China)

2011-05-12

Highlights: > ZnO nano-needles were synthesized by thermal oxidation. > Their surfaces were coated with Ag by pulse electro-deposition technique. > The uncoated and coated ZnO nano-needles were characterized. > The results showed that the prepared ZnO nano-needles have been coated with Ag successfully. > The photoluminescence spectrums of ZnO nano-needles with Ag-coated and uncoated were analyzed, finding that the Ag-coated ZnO nano-needles can increase the absorption of UV light. - Abstract: A large number of zinc oxide (ZnO) nano-needles were synthesized by thermal oxidation of pure zinc. The surfaces of ZnO nano-needles were coated with a layer of Ag by pulse electro-deposition technique. The uncoated and coated ZnO nano-needles were characterized by using the X-ray diffraction and the scanning electron microscope (SEM). The results showed that the uncoated samples were close-packed hexagonal structure, which showed needle-like morphology. Their average diameter is about 40 nm, lengths up to 5 {mu}m. At the same time we observed that the prepared ZnO nano-needles have been coated with Ag successfully. The photoluminescence spectrums of ZnO nano-needles with Ag-coated and uncoated were analyzed, finding that the uncoated ZnO nano-needles have two fluorescence peaks at 388 nm and 470.8 nm, respectively, the relative intensity of 143.4 and 93.61; and the Ag-coated ZnO nano-needles showed a pair of strong peaks at 387.4 nm and 405.2 nm, the relative intensity of 1366 and 1305, respectively, indicating that the Ag-coated ZnO nano-needles can increase the absorption of UV light.

Fine Needle Aspiration Cytology In Tumour Diagnosis | Obaseki ...

African Journals Online (AJOL)

Fine needle aspiration cytology (FNAC), a technique for obtaining cellular material for cytological examination and diagnosis using a 21- gauge or smaller needle, is performed using a 5, 10, or 20ml syringe either freehand or using special syringe holders. It allows a minimally invasive, rapid diagnosis of tissue samples but

[Novel echogenic needle for ultrasound-guided peripheral nerve block "Hakko type CCR"].

Science.gov (United States)

Takayama, Wataru; Yasumura, Rie; Kaneko, Takehiko; Kobayashi, Yoshiro; Kamada, Takaaki; Yoshikawa, Tamotsu; Aoyama, Yasuhiko

2009-04-01

A novel echogenic insulated nerve block needle (CCR-needle: Echogenic Needle Type CCR; Hakko, Japan) is commercially available since 2006 in Japan. This needle has three echogenic dimples, namely corner cube reflectors (CCR) on its tip. The CCR-needle will potentially provide a significant advantage for detecting the needle tip. In this report, we firstly evaluated this new disposable echogenic needle in simulation phantom, and demonstrated improved visibility of the needle tip. Afterwards, an interscalene brachial plexus block was performed on a male patient undergoing shoulder surgery. The needle insertion procedure was the "out of plane" ultrasound-guided technique using simultaneous electrical nerve stimulation. The surgery was successfully conducted without any complications.

Structure and photoluminescence properties of Ag-coated ZnO nano-needles

International Nuclear Information System (INIS)

Li Xiaozhu; Wang Yongqian

2011-01-01

Highlights: → ZnO nano-needles were synthesized by thermal oxidation. → Their surfaces were coated with Ag by pulse electro-deposition technique. → The uncoated and coated ZnO nano-needles were characterized. → The results showed that the prepared ZnO nano-needles have been coated with Ag successfully. → The photoluminescence spectrums of ZnO nano-needles with Ag-coated and uncoated were analyzed, finding that the Ag-coated ZnO nano-needles can increase the absorption of UV light. - Abstract: A large number of zinc oxide (ZnO) nano-needles were synthesized by thermal oxidation of pure zinc. The surfaces of ZnO nano-needles were coated with a layer of Ag by pulse electro-deposition technique. The uncoated and coated ZnO nano-needles were characterized by using the X-ray diffraction and the scanning electron microscope (SEM). The results showed that the uncoated samples were close-packed hexagonal structure, which showed needle-like morphology. Their average diameter is about 40 nm, lengths up to 5 μm. At the same time we observed that the prepared ZnO nano-needles have been coated with Ag successfully. The photoluminescence spectrums of ZnO nano-needles with Ag-coated and uncoated were analyzed, finding that the uncoated ZnO nano-needles have two fluorescence peaks at 388 nm and 470.8 nm, respectively, the relative intensity of 143.4 and 93.61; and the Ag-coated ZnO nano-needles showed a pair of strong peaks at 387.4 nm and 405.2 nm, the relative intensity of 1366 and 1305, respectively, indicating that the Ag-coated ZnO nano-needles can increase the absorption of UV light.

Conserved Epigenetic Mechanisms Could Play a Key Role in Regulation of Photosynthesis and Development-Related Genes during Needle Development of Pinus radiata.

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Valledor, Luis; Pascual, Jesús; Meijón, Mónica; Escandón, Mónica; Cañal, María Jesús

2015-01-01

Needle maturation is a complex process that involves cell growth, differentiation and tissue remodelling towards the acquisition of full physiological competence. Leaf induction mechanisms are well known; however, those underlying the acquisition of physiological competence are still poorly understood, especially in conifers. We studied the specific epigenetic regulation of genes defining organ function (PrRBCS and PrRBCA) and competence and stress response (PrCSDP2 and PrSHMT4) during three stages of needle development and one de-differentiated control. Gene-specific changes in DNA methylation and histone were analysed by bisulfite sequencing and chromatin immunoprecipitation (ChIP). The expression of PrRBCA and PrRBCS increased during needle maturation and was associated with the progressive loss of H3K9me3, H3K27me3 and the increase in AcH4. The maturation-related silencing of PrSHMT4 was correlated with increased H3K9me3 levels, and the repression of PrCSDP2, to the interplay between AcH4, H3K27me3, H3K9me3 and specific DNA methylation. The employ of HAT and HDAC inhibitors led to a further determination of the role of histone acetylation in the regulation of our target genes. The integration of these results with high-throughput analyses in Arabidopsis thaliana and Populus trichocarpa suggests that the specific epigenetic mechanisms that regulate photosynthetic genes are conserved between the analysed species.

Conserved Epigenetic Mechanisms Could Play a Key Role in Regulation of Photosynthesis and Development-Related Genes during Needle Development of Pinus radiata.

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Luis Valledor

Full Text Available Needle maturation is a complex process that involves cell growth, differentiation and tissue remodelling towards the acquisition of full physiological competence. Leaf induction mechanisms are well known; however, those underlying the acquisition of physiological competence are still poorly understood, especially in conifers. We studied the specific epigenetic regulation of genes defining organ function (PrRBCS and PrRBCA and competence and stress response (PrCSDP2 and PrSHMT4 during three stages of needle development and one de-differentiated control. Gene-specific changes in DNA methylation and histone were analysed by bisulfite sequencing and chromatin immunoprecipitation (ChIP. The expression of PrRBCA and PrRBCS increased during needle maturation and was associated with the progressive loss of H3K9me3, H3K27me3 and the increase in AcH4. The maturation-related silencing of PrSHMT4 was correlated with increased H3K9me3 levels, and the repression of PrCSDP2, to the interplay between AcH4, H3K27me3, H3K9me3 and specific DNA methylation. The employ of HAT and HDAC inhibitors led to a further determination of the role of histone acetylation in the regulation of our target genes. The integration of these results with high-throughput analyses in Arabidopsis thaliana and Populus trichocarpa suggests that the specific epigenetic mechanisms that regulate photosynthetic genes are conserved between the analysed species.

Transrectal ultrasound: Diagnosis of prostate cancer by a new biplane US-guided biopsy technique. Comparison of thin-needle cytology and histology with large-core biopsy

International Nuclear Information System (INIS)

Lee, F.; Littrup, P.; McLeary, R.; Kumasaka, G.; Borlaza, G.; McHugh, T.; Soiderer, M.; Roi, L.

1986-01-01

A new transperineal biopsy technique was developed that uses biplane transrectal US guidance for needle placement into anechoic-hypoechoic lesions thought to indicate prostate cancer (n = 83). The results of histologic studies on biopsy material obtained with a 22-gauge needle and of aspiration histologic studies on biopsy material obtained with a 19-gauge needle were compared with results of histologic studies on material obtained with a 14-gauge needle. When sufficient tissue was obtained, the positive biopsy yield was 61% by cytology and 58% by histology; the combined yield was 61%. A limited study ( n = 21) of histologic findings in biopsy material obtained with 19-gauge and 14-gauge needles showed equivalent diagnostic results. Sixty-seven percent of the biopsies were of lesions less than 1.5 cm in diameter, and 57% (13 of 23) of the biopsy-proved cancers in this group were either nonpalpable or only mildly suspicious on digital rectal examination

[Transabdominal chorionic villus sampling using biopsy forceps or needle: pregnancy outcomes by technique used].

Science.gov (United States)

Spallina, J; Anselem, O; Haddad, B; Touboul, C; Tsatsaris, V; Le Ray, C

2014-11-01

To compare pregnancy outcomes after transabdominal chorionic villus sampling using biopsy forceps or needle. Retrospective bicentric study including all women who had a transabdominal chorionic villus sampling between 2005 and 2009 (172 using biopsy forceps and 160 using needle). The primary endpoint was the rate of fetal loss, after excluding medical abortion due to the result of the biopsy. The secondary endpoint was the rate of premature rupture of the membrane. All cases were reviewed to try to determine the responsibility of the biopsy. The pregnancy outcomes were not different between the two groups: 4 (4.4%) fetal losses in the biopsy forceps group and 6 (7.4%) in the needle group (P=0.52). Only one case (1.2%) of fetal loss can be attributed to the biopsy, using a needle, and none (0%) following a forceps biospy (P=0.29). The rate of premature rupture of the membrane was comparable in the two groups. The pregnancy outcomes following chorionic villus sampling using a biopsy forceps or a needle seem comparable. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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

Science.gov (United States)

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 (pcore (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.

An ultrasound-driven needle-insertion robot for percutaneous cholecystostomy

International Nuclear Information System (INIS)

Hong, J; Dohi, T; Hashizume, M; Konishi, K; Hata, N

2004-01-01

A real-time ultrasound-guided needle-insertion medical robot for percutaneous cholecystostomy has been developed. Image-guided interventions have become widely accepted because they are consistent with minimal invasiveness. However, organ or abnormality displacement due to involuntary patient motion may undesirably affect the intervention. The proposed instrument uses intraoperative images and modifies the needle path in real time by using a novel ultrasonic image segmentation technique. In phantom and volunteer experiments, the needle path updating time was 130 and 301 ms per cycle, respectively. In animal experiments, the needle could be placed accurately in the target

Bone biopsy needles. Mechanical properties, needle design and specimen quality

International Nuclear Information System (INIS)

Keulers, Annika; Penzkofer, T.; Cunha-Cruz, V.C.; Bruners, P.; Helmholtz Inst. fuer biomedizinische Technik, Aachen; Braunschweig, T.; Schmitz-Rode, T.; Mahnken, A.; Helmholtz Inst. fuer biomedizinische Technik, Aachen

2011-01-01

To quantitatively analyze differences in mechanical properties, needle design including signs of wear, subjective handling and specimen quality of bone biopsy needles. Materials and Methods: In this study 19 different bone biopsy systems (total 38; 2 /type) were examined. With each biopsy needle five consecutive samples were obtained from vertebral bodies of swine. During puncture a force-torques sensor measured the mechanical properties and subjective handling was assessed. Before and after each biopsy the needles were investigated using a profile projector and signs of wear were recorded. Afterwards, a pathologist semi-quantitatively examined the specimen regarding sample quality. The overall evaluation considered mechanical properties, needle wear, subjective handling and sample quality. Differences were assessed for statistical significance using ANOVA and t-test. Results: Needle diameter (p = 0.003) as well as needle design (p = 0.008) affect the mechanical properties significantly. Franseen design is significantly superior to other needle designs. Besides, length reduction recorded by the profile projector, as a quality criterion showed notable distinctions in between the needle designs. Conclusion: Bone biopsy needles vary significantly in performance. Needle design has an important influence on mechanical properties, handling and specimen quality. Detailed knowledge of those parameters would improve selecting the appropriate bone biopsy needle. (orig.)

A Novel Fenestration Technique for Abdominal Aortic Dissection Membranes Using a Combination of a Needle Re-entry Catheter and the “Cheese-wire” Technique

International Nuclear Information System (INIS)

Kos, Sebastian; Gürke, Lorenz; Jacob, Augustinus L.

2011-01-01

Purpose: This study was designed to demonstrate the applicability of a combined needle-based re-entry catheter and “cheese-wire” technique for fenestration of abdominal aortic dissection membranes. Methods: Four male patients (mean age: 65 years) with acute complicated aortic type B dissections were treated at our institution by fenestrating the abdominal aortic dissection membrane using a hybrid technique. This technique combined an initial membrane puncture with a needle-based re-entry catheter using a transfemoral approach. A guidewire was passed through the re-entry catheter and across the membrane. Using a contralateral transfemoral access, this guidewire was then snared, creating a through-and-through wire access. The membrane was then fenestrated using the cheese-wire maneuver. Results: We successfully performed: (a) membrane puncture; (b) guidewire passage; (c) guidewire snaring; and (d) cheese-wire maneuver in all four cases. After this maneuver, decompression of the false lumen and acceptable arterial inflow into the true lumen was observed in all cases. The dependent visceral arteries were reperfused. In one case, portions of the fenestrated membrane occluded the common iliac artery, which was immediately and successfully stented. In another case, long-standing intestinal hypoperfusion before the fenestration resulted in reperfusion-related shock and intraoperative death of the patient. Conclusions: The described hybrid approach for fenestration of dissection membranes is technically feasible and may be established as a therapeutic method in cases with a complicated type B dissection.

Use of a Puncture Needle for Recanalization of an Occluded Right Subclavian Vein

International Nuclear Information System (INIS)

Gupta, Himanshu; Murphy, Timothy P.; Soares, Gregory M.

1998-01-01

We report a patient in whom we used a puncture needle to initiate percutaneous recanalization of a chronic occlusion of the junction between the right subclavian vein and the right brachiocephalic vein. Under fluoroscopic guidance, an 18-gauge needle was used to puncture the right subclavian vein. When contrast material injected through the needle confirmed intravascular location, the needle was advanced until it deflected and perforated an occlusion balloon target positioned within the right brachiocephalic vein. This technique may be useful in patients with central venous occlusions that are refractory to traversal using traditional catheter and guidewire techniques

Cannula Versus Sharp Needle for Placement of Soft Tissue Fillers: An Observational Cadaver Study.

Science.gov (United States)

van Loghem, Jani A J; Humzah, Dalvi; Kerscher, Martina

2017-12-13

Soft-tissue fillers have become important products for facial rejuvenation. Deep fat compartments and facial bones lose volume during the natural aging process. For the most natural-looking results, deep volumetric injections at strategic sites are therefore preferred. Supraperiosteal placement is performed with a sharp needle or a non-traumatic cannula. The primary objective was to determine whether there is a difference in precision between supraperiosteal placement with a sharp needle compared with a non-traumatic cannula in cadaver specimens. A secondary objective was to analyze the safety profiles of both injection techniques. Cadaver heads were injected with dye material and soft-tissue fillers at multiple aesthetic facial sites on the supraperiosteum and subsequently dissected for observation of dye and filler placement. The non-traumatic cannula technique resulted in product being confined to the deep anatomic layers. In contrast, with the sharp needle technique, material was placed in multiple anatomic layers, from the periosteum to more superficial skin layers. For both techniques results were consistent for all facial sites. Although direct extrapolation from cadavers to the in vivo situation cannot be made, cannulae showed more precision in placement of product. With the sharp needle, the material was injected on the periosteum, and then migrated in a retrograde direction along the trajectory of the needle path, ending up in multiple anatomic layers. The sharp needle technique also showed a higher complication risk with intra-arterial injection occurring, even though the needle tip was positioned on the periosteum and the product was injected with the needle in constant contact with the periosteum. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

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

Science.gov (United States)

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 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 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.

Needle Decompression in Appalachia Do Obese Patients Need Longer Needles?

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Carter, Thomas Edward

2013-11-01

Full Text Available Introduction: Needle decompression of a tension pneumothorax can be a lifesaving procedure. It requires an adequate needle length to reach the chest wall to rapidly remove air. With adult obesity exceeding one third of the United States population in 2010, we sought to evaluate the proper catheter length that may result in a successful needle decompression procedure. Advance Trauma Life Support (ATLS currently recommends a 51 millimeter (mm needle, while the needles stocked in our emergency department are 46 mm. Given the obesity rates of our patient population, we hypothesize these needles would not have a tolerable success rate of 90%. Methods: We retrospectively reviewed 91 patient records that had computed tomography of the chest and measured the chest wall depth at the second intercostal space bilaterally. Results: We found that 46 mm needles would only be successful in 52.7% of our patient population, yet the ATLS recommended length of 51 mm has a success rate of 64.8%. Therefore, using a 64 mm needle would be successful in 79% percent of our patient population. Conclusion: Use of longer length needles for needle thoracostomy is essential given the extent of the nation’s adult obesity population. [West J Emerg Med. 2013;14(6:650-652.

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

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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.

A RANDOMIZED TRIAL TO STUDY THE COMPARISON OF TRIGGER POINT DRY NEEDLING VERSUS KINESIO TAPING TECHNIQUE IN MYOFASCIAL PAIN SYNDROME DURING A 3-MONTH FOLLOW UP

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Emrullah Hayta

2016-10-01

Full Text Available Background: Managemen of myofascial pain syndrome (MPS is a current research subject since there is a small number of randomized studies comparing different management techniques. Multiple studies attempted to assess various treatment options including trigger point dry needling and kinesiotaping. We compared the effects of trigger point dry needling and kinesiotaping in the management of myofascial pain syndome during a 3-month follow-up period. Methods: In this prospective randomized studyin MPS patients with upper trapezius muscle trigger points, the effects of dry needling (n=28 and kinesiotaping (n=27 was compared with regard to the visual analog scale (VAS, neck disability index (NDI, and Nottingham health profile (NHP scores measured at the weeks 0, 4, and 12. Results: Both dry needling and kinesiotaping comparably reduced VAS scores measured at the weeks 4 and 12 and their efficacies were more remarkable at the week 12 (p<0.05. These interventions significantly reduced the NDI and NHP score and their effects were also more remarkable at the week 12; however, dry needling was found more effective (p<0.05. Conclusion: Overall, in current clinical settings, during the management of MPS, pain can be reduced comparably by both dry needling and kinesiotaping; however, restriction in the range of motionin neck region and quality of life are more remarkably reduced by dry needling. Both dry needling and kinesiotaping can provide an increasing effectiveness up to 12 weeks.

Development of a virtual reality haptic Veress needle insertion simulator for surgical skills training.

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Okrainec, A; Farcas, M; Henao, O; Choy, I; Green, J; Fotoohi, M; Leslie, R; Wight, D; Karam, P; Gonzalez, N; Apkarian, J

2009-01-01

The Veress needle is the most commonly used technique for creating the pneumoperitoneum at the start of a laparoscopic surgical procedure. Inserting the Veress needle correctly is crucial since errors can cause significant harm to patients. Unfortunately, this technique can be difficult to teach since surgeons rely heavily on tactile feedback while advancing the needle through the various layers of the abdominal wall. This critical step in laparoscopy, therefore, can be challenging for novice trainees to learn without adequate opportunities to practice in a safe environment with no risk of injury to patients. To address this issue, we have successfully developed a prototype of a virtual reality haptic needle insertion simulator using the tactile feedback of 22 surgeons to set realistic haptic parameters. A survey of these surgeons concluded that our device appeared and felt realistic, and could potentially be a useful tool for teaching the proper technique of Veress needle insertion.

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

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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.

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

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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.

Fine needle aspiration cytology of cervicofacial actinomycosis

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Venkatesh Kusuma

2008-01-01

Full Text Available Actinomycosis is a chronic infection caused by Actinomyces israelii, usually seen in immunocompromised patients or in the background of tissue injury. Cervicofacial actinomycosis presenting as a fixed jaw swelling in an elderly individual can mimic malignancy and pose a diagnostic dilemma. We report here a case of cervicofacial actinomycosis diagnosed by fine needle aspiration, along with a review of the relevant literature. A 60 year-old man presented with a gradually increasing 6 x 5 cm swelling in the left side of his jaw. The swelling was fixed, without any apparent sinus or abscess. Fine needle aspiration was diagnostic as it revealed colonies of actinomyces surrounded by polymorphs and chronic inflammatory cells. The histopathological study of the excised specimen confirmed the cytological findings. Fine needle aspiration is an effective tool in the diagnosis of actinomycosis although its documentation is rare. Difficulties in the management can be avoided by early diagnosis using the fine needle aspiration technique.

Analysis of a Steerable Needle for Fine Needle Aspiration and Biopsy: Efficiency and Radiation Dose Compared With a Conventional Straight Needle.

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Rutigliano, Sandra; Abraham, John A; Kenneally, Barry E; Zoga, Adam C; Nevalainen, Mika; Roedl, Johannes B

Percutaneous computed tomography (CT)-guided needle biopsy has proven to be an efficacious method for sampling of many soft tissue lesions, especially deep-seated masses in the abdomen and pelvis. This study sought to test the potential for a novel steerable needle to improve localization and to reduce procedure duration and radiation dose compared with a conventional straight needle. A fresh, raw meat sample (lean bovine flank) was imbedded with cylindrical radiopaque and radiolucent obstacles designed to simulate vessels (radiolucent objects) and bones (radiopaque objects) on CT. A pit-containing olive (partially radiopaque) was imbedded beyond the obstacles to represent the target. Two sites on the surface of the meat were selected and marked to determine initial needle placement. Two radiologists with different levels of experience proceeded to position a straight needle and the steerable needle from each skin site to the target using CT guidance as efficiently as possible, avoiding the obstacles. The total positioning time, the number of CT scans required for positioning, and the number of repositioning events (partial withdrawal followed by advancement) were tracked for the straight and steerable needles. For the straight needle, total time to reach the target was 499 to 667 seconds (mean, 592 seconds); for the steerable needle, total time to reach the target was 281 to 343 seconds (mean, 309 seconds), on average, 48% lower. The number of CT scans needed for needle positioning averaged 6.25 for the straight needle and 3.5 for the steerable needle, which is 44% lower. Repositioning events (withdrawing and readvancing the needle) ranged from 3 to 10 for the straight needle (mean, 6.5) and 0 for the steerable needle. Using an in vitro model embedded with obstacles, the steerable needle performed better than a straight needle with regard to procedure time, needle repositioning events, and CT scans required for placement.

Comparison of Fine Needle Aspiration and Fine Needle Nonaspiration Cytology of Thyroid Nodules: A Meta-Analysis

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Hongming Song

2015-01-01

Full Text Available Background. Fine needle aspiration cytology (FNAC and fine needle nonaspiration cytology (FNNAC are useful cost-effective techniques for preoperatively assessing thyroid lesions. Both techniques have advantages and disadvantages, and there is controversy over which method is superior. This meta-analysis was performed to evaluate the differences between FNAC and FNNAC for diagnosis of thyroid nodules. Methods. Primary publications were independently collected by two reviewers from PubMed, Web of Science, Google Scholar, EBSCO, OALib, and the Cochrane Library databases. The following search terms were used: fine needle, aspiration, capillary, nonaspiration, sampling without aspiration, thyroid, and cytology. The last search was performed on February 1, 2015. Results. Sixteen studies comprising 1,842 patients and 2,221 samples were included in this study. No statistically significant difference was observed between FNAC and FNNAC groups with respect to diagnostically inadequate smears, diagnostically superior smears, diagnostic performance (accuracy, sensitivity, specificity, negative predictive value, and positive predictive value, area under the summary receiver operating characteristic curve, average score of each parameter (background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and retention of appropriate architecture, and total score of five parameters. Conclusion. FNAC and FNNAC are equally useful in assessing thyroid nodules.

TU-H-CAMPUS-JeP3-05: Adaptive Determination of Needle Sequence HDR Prostate Brachytherapy with Divergent Needle-By-Needle Delivery

International Nuclear Information System (INIS)

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

2016-01-01

Purpose: To develop a new method which adaptively determines the optimal needle insertion sequence for HDR prostate brachytherapy involving divergent needle-by-needle dose delivery by e.g. a robotic device. A needle insertion sequence is calculated at the beginning of the intervention and updated after each needle insertion with feedback on needle positioning errors. Methods: Needle positioning errors and anatomy changes may occur during HDR brachytherapy which can lead to errors in the delivered dose. A novel strategy was developed to calculate and update the needle sequence and the dose plan after each needle insertion with feedback on needle positioning errors. The dose plan optimization was performed by numerical simulations. The proposed needle sequence determination optimizes the final dose distribution based on the dose coverage impact of each needle. This impact is predicted stochastically by needle insertion simulations. HDR procedures were simulated with varying number of needle insertions (4 to 12) using 11 patient MR data-sets with PTV, prostate, urethra, bladder and rectum delineated. Needle positioning errors were modeled by random normally distributed angulation errors (standard deviation of 3 mm at the needle’s tip). The final dose parameters were compared in the situations where the needle with the largest vs. the smallest dose coverage impact was selected at each insertion. Results: Over all scenarios, the percentage of clinically acceptable final dose distribution improved when the needle selected had the largest dose coverage impact (91%) compared to the smallest (88%). The differences were larger for few (4 to 6) needle insertions (maximum difference scenario: 79% vs. 60%). The computation time of the needle sequence optimization was below 60s. Conclusion: A new adaptive needle sequence determination for HDR prostate brachytherapy was developed. Coupled to adaptive planning, the selection of the needle with the largest dose coverage impact

[Standardizing the manipulation procedure of acupuncture-moxibustion, reinforcing the training of' clinical skill: learning experience of Acupuncture-moxibustion Clinical Skills Training: Chapter of Commonly Used Needling and Moxibustion Techniques].

Science.gov (United States)

Tian, Hongfang; Yang, Chao; Tang, Jie; Qin, Qiuguo; Zhao, Mingwen; Zhao, Jiping

2015-07-01

The book Acupuncture-moxibustion Clinical Skills Training is one of "Twelfth Five-Year Plan" in novative teaching materials, which is published by People's Medical Publishing House. Through learning the first half of the book commonly used needling and moxibustion techniques, it is realized that the selection of book content is reasonable and much attention is paid to needling and moxibustion techniques; the chapter arrangement is well-organized, and the form is novel, which is concise and intuitive; for every technique, great attention is paid to standardize the manipulation procedure and clarify the technique key, simultaneously the safety of acupuncture and moxibustion is also emphasized. The characteristics of the book, including innovativeness, practicability, are highlighted, and it greatly helps to improve students' clinical skills and examination ability.

The Gothic arch (needle point) tracing and condylar inclination.

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el-Gheriani, A S; Winstanley, R B

1987-11-01

The records of 11 patients referred for treatment of TMJ disorders were used to compare condylar inclination found by drawing a tangent and by using a mathematic technique. Needle point tracing angles were also measured for the same patients and were compared with the condylar inclination. It can be concluded that (1) the mathematic technique outlined records a more accurate condylar angulation, and (2) there is a great variation in condylar inclination values between patients and between left and right sides of the same patient, and (3) there is no direct relationship between condylar inclination and the needle point tracing angle.

Computed tomography guided needle biopsy: experience from 1,300 procedures

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Chojniak, Rubens; Isberner, Rony Klaus; Viana, Luciana Marinho; Yu, Liao Shin; Aita, Alessandro Amorim; Soares, Fernando Augusto [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Radiologia e Patologia

2006-01-15

Context and objective: computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center. Design and setting: retrospective study at Hospital do Cancer A. C. Camargo, Sao Paulo.Methods: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy. Results: adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis. Conclusion: both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications. (author)

Endoscopic vocal fold injection using a 25-gauge butterfly needle.

Science.gov (United States)

Buchanan, M A; Riffat, F; Palme, C E

2016-04-01

To describe a useful technique for infiltrating a bulking agent using a butterfly needle, as part of a transoral endoscopic vocal fold medialisation procedure. This paper describes the procedure of grasping the needle with phonosurgery forceps and administering the injectate to the vocal fold through careful application of the syringe plunger via a length of rubber tubing from outside the mouth. This procedure is performed routinely in our institution without complication. The advantages of this technique are discussed. This is a safe and easy method of injecting into a vocal fold.

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

Science.gov (United States)

Zhang, Fang; Wang, Hong-Du

2012-12-01

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

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

Science.gov (United States)

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

An in vitro comparison of irrigation using photon-initiated photoacoustic streaming, ultrasonic, sonic and needle techniques in removing calcium hydroxide.

Science.gov (United States)

Arslan, H; Akcay, M; Capar, I D; Saygili, G; Gok, T; Ertas, H

2015-03-01

To evaluate the effect of various techniques including photon-initiated photoacoustic streaming (PIPS), ultrasonic, sonic and needle irrigation on the removal of calcium hydroxide [Ca(OH)2 ] from artificial grooves created in root canals. The root canals of 48 extracted single-rooted teeth with straight canals were prepared using ProTaper rotary instruments up to size 40. After the specimens had been split longitudinally, a standardized groove was prepared in the apical part of one segment that was filled with Ca(OH)2 powder mixed with distilled water. Each tooth was reassembled and the apices closed with wax. The specimens were irrigated for 60 s with one of the following techniques: needle irrigation using 17% EDTA, PIPS with 17% EDTA, ultrasonic irrigation using 17% EDTA and sonic irrigation (EndoActivator) using 17% EDTA. The root segments were then disassembled, and the amount of remaining Ca(OH)2 evaluated under a stereomicroscope at 25× magnification. A pixel count of Ca(OH)2 remaining on the artificially created grooves was recorded as a percentage of the overall groove surface. The data were evaluated statistically using one-way analysis of variance and the least significant difference post hoc tests at 95% confidence level (P = 0.05). Photon-initiated photoacoustic streaming was superior in removing Ca(OH)2 as compared to needle irrigation (P streaming provided complete removal of Ca(OH)2 from artificial grooves in straight root canals. Ultrasonic irrigation enhanced the Ca(OH)2 removal capacity of irrigating solution but did not provide complete removal from artificial grooves. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

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Sara Pourshahidi

2008-04-01

Full Text Available

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.

Relations between Scots pine needle element concentrations and decreased needle longevity along pollution gradients

International Nuclear Information System (INIS)

Lamppu, Jukka; Huttunen, Satu

2003-01-01

Deceased needle longevity was related to increased heavy metal concentrations. - Scots pine (Pinus sylvestris L.) shoots were sampled along transects near one urban pollution source and two smelters. Needle Mg, P and K concentrations decreased from the second to the fourth age class linearly with needle survival along the urban pollution gradient. Still, over 80% of the average concentration of these nutrients remained in the fourth needle age class. Decreased needle longevity was closely related to the increased heavy metal concentrations near the smelters. Near the urban pollution source, it was related to the increased annual needle mass and the increased needle nutrient concentrations. Decreased Mn accumulation along with needle age was detected near all pollution sources. Leaching of Mn from needles and especially from soil as a cause of decreased needle concentrations is discussed

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

Science.gov (United States)

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

2015-03-01

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

Transbronchial needle aspiration with a new electromagnetically-tracked TBNA needle

Science.gov (United States)

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.

Needle Decompression of Tension Pneumothorax with Colorimetric Capnography.

Science.gov (United States)

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 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. Published by Elsevier Inc. All rights reserved.

Mechanics of needle-tissue interaction

NARCIS (Netherlands)

Roesthuis, Roy; van Veen, Youri; Jahya, Alex; Misra, Sarthak

2011-01-01

When a needle is inserted into soft tissue, interac- tion forces are developed at the needle tip and along the needle shaft. The needle tip force is due to cutting of the tissue, and the force along the needle shaft is due to friction between needle and tissue. In this study, the friction force is

Platelet-Rich Plasma Injection With Percutaneous Needling for Recalcitrant Lateral Epicondylitis: Comparison of Tenotomy and Fenestration Techniques.

Science.gov (United States)

Gaspar, Michael P; Motto, Michael A; Lewis, Sarah; Jacoby, Sidney M; Culp, Randall W; Lee Osterman, A; Kane, Patrick M

2017-12-01

Recalcitrant lateral epicondylitis (LE) is a common debilitating condition, with numerous treatment options of varying success. An injection of platelet-rich plasma (PRP) has been shown to improve LE, although it is unclear whether the method of needling used in conjunction with a PRP injection is of clinical importance. To determine whether percutaneous needle tenotomy is superior to percutaneous needle fenestration when each is combined with a PRP injection for the treatment of recalcitrant LE. Cohort study; Level of evidence, 3. A total of 93 patients with recalcitrant LE were treated with a PRP injection and percutaneous needle fenestration (n = 45) or percutaneous needle tenotomy (n = 48) over a 5-year study interval. Preoperative patient data, including visual analog scale for pain (VAS-P), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Patient-Rated Tennis Elbow Evaluation (PRTEE) scores and grip strength, were obtained from a chart review and compared with postoperative values obtained prospectively. Secondary outcomes included the incidence of complications, need for additional interventions, return to work, and patient satisfaction. At a mean follow-up of 40 months, significant improvements in VAS-P (mean, -6.1; 95% CI, -6.8 to -5.5; P < .0001), QuickDASH (mean, -46; 95% CI, -52 to -40; P < .0001), and PRTEE (mean, -57; 95% CI, -64 to -50; P < .0001) scores and grip strength (mean, +6.1 kg; 95% CI, 4.9 to 7.3; P < .0001) were observed across the entire study cohort, with no significant differences noted between the fenestration and tenotomy groups. Nine of 45 patients (22%) underwent additional procedures to treat recurrent symptoms in the fenestration group compared with 5 of 48 patients (10%) in the tenotomy group ( P = .05). No complications occurred in any patients, and no patients expressed dissatisfaction with their treatment course. A PRP injection with concomitant percutaneous needling is an effective treatment for recalcitrant

Single-incision laparoscopic cholecystectomy with needle graspers.

Science.gov (United States)

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.

The Hydrodynamics of Needle-Free Intradermal Jet Injection

Science.gov (United States)

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.

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Efficacy of Tuohy Needle in Oocytes Collection from Excised Mare Ovaries

Directory of Open Access Journals (Sweden)

F. Cremonesi

2010-01-01

Full Text Available Two methods have been described to recover oocytes from equine follicles in excised ovaries: aspiration and scraping. Aim of this work was to develop an effective method for collecting equine oocytes using Tuohy needle and comparing this technique to aspiration and scraping, with or without tunica albuginea removal. This hollow hypodermic needle, usually employed for inserting epidural catheters, is designed with a slightly curved tip, shaped similar to a small curette. In unpeeled ovaries, the recovery rates of Tuohy needle group was higher (<.05 than in the 16 g needle aspiration and in the scraped ovaries (57% versus 36% and 47% while the rate of cumulus-intact oocytes was higher than aspiration (46.9% versus 39.36% but lower than scraping (46.97% (<.001. In unpeeled ovaries there was significant difference in maturation rate of oocytes recovered by Tuohy needle in respect to peeled ovaries (58.54% versus 50.17%, resp.. Combination of aspiration and scraping by Tuohy needle allows a faster and reliable collection of oocytes suitable for horse IVM.

MLESAC Based Localization of Needle Insertion Using 2D Ultrasound Images

Science.gov (United States)

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

2018-04-01

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

Investigating the Effects of Three Needling Parameters (Manipulation, Retention Time, and Insertion Site) on Needling Sensation and Pain Profiles: A Study of Eight Deep Needling Interventions

Science.gov (United States)

Loyeung, Bertrand Y. K.; Cobbin, Deirdre M.

2013-01-01

Introduction. In traditional Chinese acupuncture, needle sensation (deqi) is purported to contribute to a therapeutic outcome. While researchers have attempted to define deqi qualitatively, few have examined the effects of needling parameters on its intensity. Methods. 24 healthy subjects completed eight interventions scheduled at least one week apart, which involved manual acupuncture to LI4 or a designated nonacupoint (NAP) on the hand, with real or simulated manipulation each three minutes and needle retentions of one or 21 minutes. Intensities of needling sensation and pain were reported every three minutes and sensation qualities were reported post-intervention. Results. Immediately after needle insertion, similar levels of mean needle sensation and of pain were reported independent of intervention. At subsequent measurement times, only two interventions (one at LI4 and one at NAP) maintained statistically significantly elevated needle sensation and pain scores and reported higher numbers of needle sensation descriptors. For both, the needle was retained for 21 minutes and manipulated every three minutes. Neither intervention differed significantly in terms of levels of pain, and needle sensation or numbers and qualities of needle sensation described. Conclusion. In this group of healthy subjects, the initial needling for all eight interventions elicited similar levels of needle sensation and pain. These levels were only maintained if there was ongoing of needle manipulation and retention of the needle. By contrast, the strength of needle sensation or pain experienced was independent of insertion site. PMID:24159337

Platelet-Rich Plasma Injection With Percutaneous Needling for Recalcitrant Lateral Epicondylitis: Comparison of Tenotomy and Fenestration Techniques

Science.gov (United States)

Gaspar, Michael P.; Motto, Michael A.; Lewis, Sarah; Jacoby, Sidney M.; Culp, Randall W.; Lee Osterman, A.; Kane, Patrick M.

2017-01-01

Background: Recalcitrant lateral epicondylitis (LE) is a common debilitating condition, with numerous treatment options of varying success. An injection of platelet-rich plasma (PRP) has been shown to improve LE, although it is unclear whether the method of needling used in conjunction with a PRP injection is of clinical importance. Purpose: To determine whether percutaneous needle tenotomy is superior to percutaneous needle fenestration when each is combined with a PRP injection for the treatment of recalcitrant LE. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 93 patients with recalcitrant LE were treated with a PRP injection and percutaneous needle fenestration (n = 45) or percutaneous needle tenotomy (n = 48) over a 5-year study interval. Preoperative patient data, including visual analog scale for pain (VAS-P), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Patient-Rated Tennis Elbow Evaluation (PRTEE) scores and grip strength, were obtained from a chart review and compared with postoperative values obtained prospectively. Secondary outcomes included the incidence of complications, need for additional interventions, return to work, and patient satisfaction. Results: At a mean follow-up of 40 months, significant improvements in VAS-P (mean, –6.1; 95% CI, –6.8 to –5.5; P < .0001), QuickDASH (mean, –46; 95% CI, –52 to –40; P < .0001), and PRTEE (mean, –57; 95% CI, –64 to –50; P < .0001) scores and grip strength (mean, +6.1 kg; 95% CI, 4.9 to 7.3; P < .0001) were observed across the entire study cohort, with no significant differences noted between the fenestration and tenotomy groups. Nine of 45 patients (22%) underwent additional procedures to treat recurrent symptoms in the fenestration group compared with 5 of 48 patients (10%) in the tenotomy group (P = .05). No complications occurred in any patients, and no patients expressed dissatisfaction with their treatment course. Conclusion: A PRP injection

Effect of needle tract bleeding on occurrence of pneumothorax after transthoracic needle biopsy

International Nuclear Information System (INIS)

Topal, U.; Berkman, Yahya M.

2005-01-01

Purpose: Occasionally bleeding along the needle trajectory is observed at post-biopsy computed tomographic sections. This study was designed to evaluate the possible effect of needle tract bleeding on the occurrence of pneumothorax and on requirement of chest tube insertion. Materials and methods: Two hundred eighty-four needle biopsies performed in 275 patients in whom the needle traversed the aerated lung parenchyma were retrospectively reviewed. Bleeding along the needle tract, occurrence of pneumothorax and need for chest tube insertion, type and size of the needle, size of the lesion, length of the lung traversed by the needle, presence or absence of emphysema were noted. Effect of these factors on the rate of pneumothorax and needle-tract bleeding was evaluated. The data were analyzed by χ 2 test. Results: Pneumothorax developed in 100 (35%) out of 284 procedures requiring chest tube placement in 16 (16%). Variables that were significantly associated with an increased risk of pneumothorax were depth of the lesion (P 0.05). However, analysis of the relation between length of lung traversed by the needle, tract-bleeding and pneumothorax rate indicated that tract-bleeding had a preventive effect on development of pneumothorax (P 0.05). Conclusion: Bleeding in the needle tract has a preventive effect on the occurrence of the pneumothorax in deep-seated lesions and in the presence of emphysema, although it does not affect the overall rate of pneumothorax

[Establishment of data warehouse of needling and moxibustion literature based on data mining].

Science.gov (United States)

Wang, Jian-Ling; Li, Ren-Ling; Jia, Chun-Sheng

2012-02-01

In order to explore the efficacy specificity and valuable rules of clinical application of needling and moxibustion methods in a large quantity of information from literature, a data warehouse needs being established. On the basis of the original databases of red-hot needle therapy and hydro-acupuncture therapy, and the newly-established databases of acupoint catgut embedding therapy, acupoint application therapy, etc., and in accordance with the characteristics of different types of needling-moxibustion literature information, databases on different subjects were established first. These subject databases constitute a general "literature data warehouse on needling moxibustion methods" composing of multi-subjects and multiple dimensions so as to discover useful regularities about clinical treatment and trials collected in the literature by using data mining techniques. In the present paper, the authors introduce the design of the data warehouse, determination of subjects, establishment of subject relations, application of the administration platform, and application of data. This data warehouse will provide a standard data representation mode, enlarge data attributes and create extensive data links among literature information in the network, and may bring us with considerable convenience and profits in clinical application decision making and scientific research about needling-moxibustion techniques.

Thin-needle aspiration biopsy of the prostate.

Science.gov (United States)

Koss, L G; Woyke, S; Schreiber, K; Kohlberg, W; Freed, S Z

1984-05-01

The authors summarize the current status of thin-needle aspiration biopsy of the prostate and evaluate the accomplishments and limitations of this method of diagnosis. Historical developments, indications, technique, contraindications, complications, cytology of aspirates, diagnostic efficacy of aspirates, and grading of prostatic carcinomas are discussed.

Improved transvenous liver biopsy needle

DEFF Research Database (Denmark)

Henriksen, Jens Henrik Sahl; Matzen, P; Christoffersen, P

1979-01-01

A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle...... should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver....

[Clinical study of post-stroke upper limb spasmodic hemiplegia treated with jingou diaoyu needling technique and Bobath therapy].

Science.gov (United States)

Sun, Runjie; Tian, Liang; Fang, Xiaoli; Du, Xiaozheng; Zhu, Bowen; Song, Zhongyang; Xu, Xuan; Qin, Xiaoguang

2017-04-12

To compare the difference in the clinical efficacy on post-stroke upper limb spasmodic hemiplegia between the combined therapy of jingou diaoyu needling technique and Bobath technology and simple Bobath technology. Sixty patients were randomized into an observation group and a control group, 30 cases in each one. The usual medication of neurological internal medicine was used in the two groups. In the control group, Bobath facilitation technology was applied to the rehabilitation training. In the observation group, on the basis of the treatment as the control group, jingou diaoyu needling technique was used to stimulate Zhongfu (LU 1), Tianfu (LU 3), Chize (LU 5), Quchi (LI 11), Jianshi (PC 5) and Daling (PC 7). The treatment was given once a day; 5 treatments made one session and totally 4-week treatment was required in the two groups. The modified Ashworth scale, the modified Fugle-Meyer assessment (FMA) and the Barthel index (BI) were adopted to evaluate the muscular tension, the upper limb motor function and the activities of daily living (ADL) before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared with those before treatment, the modified Ashworth scale, Fugl-Meyer score and BI score were all improved after treatment in the two groups (all P Bobath therapy achieve the superior efficacy on post-stroke upper limb spasmodic hemiplegia as compared with the simple application Bobath therapy. This combined treatment effectively relieve spasmodic state and improve the upper limb motor function and the activities of daily living.

The Matador Technique: A technique to improve prostatic ...

African Journals Online (AJOL)

A. Pai

Abstract. The accuracy of brachytherapy seed implantation is reduced by the movement of the prostate when needles are introduced transperineally. This report describes a simple method of introducing the first two needles, which reduces prostate deflection. This technique is analogous to the way a matador uses two ...

[Professor WU Zhongchao's experience in the treatment of bi syndrome with fire needling therapy at lower he-sea points].

Science.gov (United States)

Zhou, Yu; Chen, Zhongjie; Liu, Chun; Wang, Bing; Zhang, Ning; Li, Caifen; Xie, Qian

2016-07-12

Bi syndrome is classified into five categories. Based on the syndrome differentiation of meridians and collaterals and zangfu theories, Professor WU Zhongchao proposed the fire needling therapy at the lower he -sea points for five types of bi syndromes. Professor WU stresses on the flexible application of fire needling therapy for bi syndrome at the lower he -sea points and innovated the unique five techniques of fire needling therapy, named lifting and threating needle of small amplitude at the lower he -sea points, the stimulation along the relevant meri-dians before fire needling, detecting the sensitive sites by gentle pressing the relevant lower he -sea points, combining the movement of affected upper limb or joint during fire needling, or combining with contralateral needling technique, and controlling the depth of fire needling based on the duration of sickness and depth of affected site. He pointed out that Shangjuxu (ST 37) is for skin bi syndrome, Zusanli (ST 36) for muscle bi syndrome, Yanglingquan (GB 34) for tendon bi syndrome, Weizhong (BL 40) for bone bi syndrome and Xiajuxu (ST 39) for vessel bi syndrome.

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

Science.gov (United States)

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  .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 Elsevier Inc. All rights reserved.

Sensorimotor Learning of Acupuncture Needle Manipulation Using Visual Feedback.

Directory of Open Access Journals (Sweden)

Won-Mo Jung

Full Text Available Humans can acquire a wide variety of motor skills using sensory feedback pertaining to discrepancies between intended and actual movements. Acupuncture needle manipulation involves sophisticated hand movements and represents a fundamental skill for acupuncturists. We investigated whether untrained students could improve their motor performance during acupuncture needle manipulation using visual feedback (VF.Twenty-one untrained medical students were included, randomly divided into concurrent (n = 10 and post-trial (n = 11 VF groups. Both groups were trained in simple lift/thrusting techniques during session 1, and in complicated lift/thrusting techniques in session 2 (eight training trials per session. We compared the motion patterns and error magnitudes of pre- and post-training tests.During motion pattern analysis, both the concurrent and post-trial VF groups exhibited greater improvements in motion patterns during the complicated lifting/thrusting session. In the magnitude error analysis, both groups also exhibited reduced error magnitudes during the simple lifting/thrusting session. For the training period, the concurrent VF group exhibited reduced error magnitudes across all training trials, whereas the post-trial VF group was characterized by greater error magnitudes during initial trials, which gradually reduced during later trials.Our findings suggest that novices can improve the sophisticated hand movements required for acupuncture needle manipulation using sensorimotor learning with VF. Use of two types of VF can be beneficial for untrained students in terms of learning how to manipulate acupuncture needles, using either automatic or cognitive processes.

The intravenous injection of illicit drugs and needle sharing: an historical perspective.

Science.gov (United States)

Zule, W A; Vogtsberger, K N; Desmond, D P

1997-01-01

This study reviewed the literature on the history of needle sharing and intravenous drug abuse. Reports suggest that needle sharing was practiced by drug abusers as early as 1902 in China and 1914 in the United States. Intravenous drug abuse was first mentioned in the literature in 1925. However other references suggest that some opioid users were injecting intravenously prior to 1920. Outbreaks of malaria in Egypt, the United States, and China between 1929 and 1937 were attributed to needle sharing and intravenous injection of opioids. These reports suggest that both needle sharing and intravenous drug use were common by 1937. Factors such as medical use of intravenous injections, enactment and zealous enforcement of antinarcotic laws, and interactions among drug users in institutional settings such as regional hospitals and prisons may have contributed to the spread of both needle sharing and the intravenous technique among drug abusers.

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

Science.gov (United States)

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.

Immunolocalization of IAA and ABA in roots and needles of radiata pine (Pinus radiata) during drought and rewatering.

Science.gov (United States)

De Diego, N; Rodríguez, J L; Dodd, I C; Pérez-Alfocea, F; Moncaleán, P; Lacuesta, M

2013-05-01

Anatomical, physiological and phytohormonal changes involved in drought tolerance were examined in different Pinus radiata D. Don breeds subjected to soil drying and rewatering. Breeds with the smallest stomatal chamber size had the lowest transpiration rate and the highest intrinsic water-use efficiency. Xylem cell size was positively correlated with leaf hydraulic conductance and needle indole-3-acetic acid (IAA) concentrations, whereas transpiration rate was negatively correlated with needle abscisic acid (ABA) levels. Since these two phytohormones seem important in regulating the P. radiata drought response, they were simultaneously immunolocalized in roots and needles of the most tolerant breed (P. radiata var. radiata × var. cedrosensis) during two sequential drought cycles and after rewatering. During drought, IAA was unequally distributed into the pointed area of the needle cross-section and mainly located in mesophyll and vascular tissue cells of needles, possibly inducing needle epinasty, whereas ABA was principally located in guard cells, presumably to elicit stomata closure. In the roots, at the end of the first drought cycle, while strong IAA accumulation was observed in the cortex, ABA levels decreased probably due to translocation to the leaves. Rewatering modified the distribution of both IAA and ABA in the needles, causing an accumulation principally in vascular tissue, with residual concentrations in mesophyll, likely favouring the acclimatization of the plants for further drought cycles. Contrarily, in the roots IAA and ABA were located in the exodermis, a natural barrier that regulates the phytohormone translocation to other plant tissues and hormone losses to the soil solution after rewatering. These results confirm that immunolocalization is an efficient tool to understand the translocation of IAA and ABA in plants subjected to different water stress situations, and clarify their role in regulating physiological responses such as stomata

Effectiveness and Complications of Percutaneous Needle Tenotomy with a Large Needle for Muscle Contractures: A Cadaver Study.

Directory of Open Access Journals (Sweden)

Camille Chesnel

Full Text Available Twenty-two percent of institutionalised elderly persons have muscle contractures. Contractures have important functional consequences, rendering hygiene and positioning in bed or in a chair difficult. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning is not very effective and surgery may be required. Surgery is carried out in the operating theatre, under local or general anaesthesia but is often not possible in fragile patients. Mini-invasive tenotomy could be a useful alternative as it can be carried out in ambulatory care, under local anaesthesia.To evaluate the effectiveness of percutaneous needle tenotomy and the risks of damage to adjacent structures in cadavers.Thirty two doctors who had never practiced the technique (physical medicine and rehabilitation specialists, geriatricians and orthopaedic surgeons carried out 401 tenotomies on the upper and lower limbs of 8 fresh cadavers. A 16G needle was used percutaneous following location of the tendons. After each tenotomy, a neuro-orthopaedic surgeon and an anatomist dissected the area in order to evaluate the success of the tenotomy and any adjacent lesions which had occurred.Of the 401 tenotomies, 72% were complete, 24.9% partial and 2.7% failed. Eight adjacent lesions occurred (2%: 4 (1% in tendons or muscles, 3 (0.7% in nerves and 1 (0.2% in a vessel.This percutaneous needle technique effectively ruptured the desired tendons, with few injuries to adjacent structures. Although this study was carried out on cadavers, the results suggest it is safe to carry out on patients.

Effectiveness and Complications of Percutaneous Needle Tenotomy with a Large Needle for Muscle Contractures: A Cadaver Study.

Science.gov (United States)

Chesnel, Camille; Genêt, François; Almangour, Waleed; Denormandie, Philippe; Parratte, Bernard; Schnitzler, Alexis

2015-01-01

Twenty-two percent of institutionalised elderly persons have muscle contractures. Contractures have important functional consequences, rendering hygiene and positioning in bed or in a chair difficult. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not very effective and surgery may be required. Surgery is carried out in the operating theatre, under local or general anaesthesia but is often not possible in fragile patients. Mini-invasive tenotomy could be a useful alternative as it can be carried out in ambulatory care, under local anaesthesia. To evaluate the effectiveness of percutaneous needle tenotomy and the risks of damage to adjacent structures in cadavers. Thirty two doctors who had never practiced the technique (physical medicine and rehabilitation specialists, geriatricians and orthopaedic surgeons) carried out 401 tenotomies on the upper and lower limbs of 8 fresh cadavers. A 16G needle was used percutaneous following location of the tendons. After each tenotomy, a neuro-orthopaedic surgeon and an anatomist dissected the area in order to evaluate the success of the tenotomy and any adjacent lesions which had occurred. Of the 401 tenotomies, 72% were complete, 24.9% partial and 2.7% failed. Eight adjacent lesions occurred (2%): 4 (1%) in tendons or muscles, 3 (0.7%) in nerves and 1 (0.2%) in a vessel. This percutaneous needle technique effectively ruptured the desired tendons, with few injuries to adjacent structures. Although this study was carried out on cadavers, the results suggest it is safe to carry out on patients.

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

Science.gov (United States)

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.

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

Science.gov (United States)

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.

A Randomised Clinical Trial to Compare Coaxial and Noncoaxial Techniques in Percutaneous Core Needle Biopsy of Renal Parenchyma

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Babaei Jandaghi, Ali [Guilan University of Medical Sciences, Department of Radiology, Poursina Hospital (Iran, Islamic Republic of); Lebady, Mohammadkazem; Zamani, Athar-Alsadat [Guilan University of Medical Sciences, Urology Research Center, Razi Hospital (Iran, Islamic Republic of); Heidarzadeh, Abtin [Guilan University of Medical Sciences, Department of Community Medicine (Iran, Islamic Republic of); Monfared, Ali [Guilan University of Medical Sciences, Urology Research Center, Razi Hospital (Iran, Islamic Republic of); Pourghorban, Ramin, E-mail: ramin-p2005@yahoo.com [Tehran University of Medical Sciences, Department of Radiology, Imam Khomeini Hospital Complex (Iran, Islamic Republic of)

2017-01-15

PurposeTo compare the coaxial and noncoaxial techniques of renal parenchymal core needle biopsy.Materials and MethodsThis is an institutional review board-approved randomised controlled trial comparing 83 patients (male, n = 49) who underwent renal parenchymal core biopsy with coaxial method and 83 patients (male, n = 40) with noncoaxial method. The rate of complications, the number of glomerular profiles, and the procedural time were evaluated in a comparison of the two methods. Correlation between the presence of renal parenchymal disease and the rate of complication was also evaluated.ResultsThe procedural time was significantly shorter in the coaxial technique (coaxial group, 5 ± 1 min; noncoaxial group, 14 ± 2 min; p < 0.001). The rates of complications for the coaxial method was significantly lower than the noncoaxial method (coaxial group, 10.8 %; noncoaxial group, 24.1 %; p = 0.025). There was no significant correlation between gender and the rate of complication. The number of glomerular profiles was significantly higher in patents who underwent renal biopsy with the coaxial method (coaxial group, 18.2 ± 9.1; noncoaxial group, 8.6 ± 5.5; p < 0.001). In the whole study population, the rate of complications was significantly higher in patients with a pathologic renal parenchyma compared to those with a normal parenchyma (19/71 vs. 10/95; p = 0.006).ConclusionsRenal parenchymal biopsy using a coaxial needle is a faster and safer method with a lower rate of complications.

A Randomised Clinical Trial to Compare Coaxial and Noncoaxial Techniques in Percutaneous Core Needle Biopsy of Renal Parenchyma

International Nuclear Information System (INIS)

Babaei Jandaghi, Ali; Lebady, Mohammadkazem; Zamani, Athar-Alsadat; Heidarzadeh, Abtin; Monfared, Ali; Pourghorban, Ramin

2017-01-01

PurposeTo compare the coaxial and noncoaxial techniques of renal parenchymal core needle biopsy.Materials and MethodsThis is an institutional review board-approved randomised controlled trial comparing 83 patients (male, n = 49) who underwent renal parenchymal core biopsy with coaxial method and 83 patients (male, n = 40) with noncoaxial method. The rate of complications, the number of glomerular profiles, and the procedural time were evaluated in a comparison of the two methods. Correlation between the presence of renal parenchymal disease and the rate of complication was also evaluated.ResultsThe procedural time was significantly shorter in the coaxial technique (coaxial group, 5 ± 1 min; noncoaxial group, 14 ± 2 min; p < 0.001). The rates of complications for the coaxial method was significantly lower than the noncoaxial method (coaxial group, 10.8 %; noncoaxial group, 24.1 %; p = 0.025). There was no significant correlation between gender and the rate of complication. The number of glomerular profiles was significantly higher in patents who underwent renal biopsy with the coaxial method (coaxial group, 18.2 ± 9.1; noncoaxial group, 8.6 ± 5.5; p < 0.001). In the whole study population, the rate of complications was significantly higher in patients with a pathologic renal parenchyma compared to those with a normal parenchyma (19/71 vs. 10/95; p = 0.006).ConclusionsRenal parenchymal biopsy using a coaxial needle is a faster and safer method with a lower rate of complications.

Needle phobia during pregnancy.

Science.gov (United States)

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-tissue interactive mechanism and steering control in image-guided robot-assisted minimally invasive surgery: a review.

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Li, Pan; Yang, Zhiyong; Jiang, Shan

2018-06-01

Image-guided robot-assisted minimally invasive surgery is an important medicine procedure used for biopsy or local target therapy. In order to reach the target region not accessible using traditional techniques, long and thin flexible needles are inserted into the soft tissue which has large deformation and nonlinear characteristics. However, the detection results and therapeutic effect are directly influenced by the targeting accuracy of needle steering. For this reason, the needle-tissue interactive mechanism, path planning, and steering control are investigated in this review by searching literatures in the last 10 years, which results in a comprehensive overview of the existing techniques with the main accomplishments, limitations, and recommendations. Through comprehensive analyses, surgical simulation for insertion into multi-layer inhomogeneous tissue is verified as a primary and propositional aspect to be explored, which accurately predicts the nonlinear needle deflection and tissue deformation. Investigation of the path planning of flexible needles is recommended to an anatomical or a deformable environment which has characteristics of the tissue deformation. Nonholonomic modeling combined with duty-cycled spinning for needle steering, which tracks the tip position in real time and compensates for the deviation error, is recommended as a future research focus in the steering control in anatomical and deformable environments. Graphical abstract a Insertion force when the needle is inserted into soft tissue. b Needle deflection model when the needle is inserted into soft tissue [68]. c Path planning in anatomical environments [92]. d Duty-cycled spinning incorporated in nonholonomic needle steering [64].

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

Science.gov (United States)

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 deep needling, group, the THI score, tinnitus grade and the VAS score were improved than those before treatment (all P 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 shallow needling at the three acupoints.

Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

Directory of Open Access Journals (Sweden)

Ewa Łukasiewicz

2017-12-01

Full Text Available Aim: The aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle biopsy. Material and methods: Fifty-five articles (original papers and reviews, half of them published within the past 5 years, were included in the analysis. The authors also took their own experience into account. Results: Pre-operative assessment of focal lesions in the breasts is crucial in the planning of further therapeutic management. The role of fine-needle aspiration biopsy has been reduced lately due to its low sensitivity and specificity as well as a high rate of non-diagnostic, suspicious and false negative results. This method does not enable one to differentiate between in situ and invasive disease. Currently, fine-needle biopsy is recommended for cystic lesions, suspected of being recurrences in the chest wall, and lymph node metastases. Core-needle biopsy is the basic diagnostic method of breast lesions. According to the recommendations of the Polish Ultrasound Society and American College of Radiology, BIRADS 4 and 5 lesions should be evaluated histopathologically. Core-needle biopsy makes it possible to establish a final diagnosis more frequently than fine-needle biopsy, both in the case of benign and malignant lesions. It delivers more information about the nature of a tumor (mutation of HER-2, estrogen and progesterone receptors and Ki-67 index. Its limitations include: underestimation of invasion and failure to recognize the components of ductal carcinoma in situ in papillary and atypical lesions. Single fine-needle aspiration biopsy is inexpensive, but when considering the cost of further diagnosis due to non-diagnostic, suspicious and atypical results, this method generates high additional costs. Conclusions: Microscopic verification of focal breast lesions is crucial for further therapeutic decisions. It has been proven that histopathological verification is more

Patients’ Knowledge of and Practices Relating to the Disposal of Used Insulin Needles

Directory of Open Access Journals (Sweden)

Kerri T. Musselman, PharmD

2010-01-01

Full Text Available Objective: To determine (1 how patients currently dispose of used insulin needles, (2 whether patients were educated about disposal of their used insulin needles, and (3 who educated patients about the disposal of their used insulin needles.Methods: A self-administered questionnaire was designed for this study. The survey assessed patient knowledge about disposal of used insulin needles and the patient-reported source and location of education about disposal techniques. The questionnaire was administered to a convenience sample of patients from four locations in Richmond, Virginia. Any patient who used insulin, was at least 18 years old, and was willing to complete the survey was eligible for inclusion.Results: Fifty responses were received with 40% indicating that education had been received on the disposal of used needles. From that 40%, nurses were identified as the source of education 60% of the time and pharmacists 25% of the time. Approximately 50% of the respondents reported disposing of used needles directly in the trash when at home. While away from home, 22% reported placing used needles in the trash, and 38% took them home for disposal.Conclusion: Patients are not consistently educated regarding the proper disposal of used needles. Health care practitioners should play a larger role in educating patients about the potential risks of inappropriate needle disposal and appropriate disposal methods. Future research is still needed to understand fully the magnitude of the problems associated with inappropriate needle disposal by patients.

Needle bar for warp knitting machines

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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.

MDCT-Guided Transthoracic Needle Aspiration Biopsy of the Lung Using the Transscapular Approach

International Nuclear Information System (INIS)

Rossi, Umberto G.; Seitun, Sara; Ferro, Carlo

2011-01-01

The purpose of this study is to report our preliminary experience using MDCT-guided percutaneous transthoracic needle aspiration biopsy using the transscapular approach in the upper posterolateral lung nodules, an area that it is difficult or hazardous to reach with the conventional approach. Five patients underwent CT-guided percutaneous transthoracic needle aspiration biopsy of the lung via the transscapular approach. A coaxial needle technique was used in all patients. Biopsy was successful in all patients. No major complications were encountered. One patient developed a minimal pneumothorax next to the lesion immediately after biopsy, which resolved spontaneously. MDCT-guided percutaneous transthoracic needle aspiration biopsy of the lung via the transscapular approach is an effective and safe procedure that reduces the risk of pneumothorax in selected patients.

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

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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

A technique to improve diagnostic information from fine-needle aspirations: immunohistochemistry on cytoscrape

DEFF Research Database (Denmark)

Skov, Birgit Guldhammer; Kiss, Katalin; Ramsted, Julie

2009-01-01

BACKGROUND: Cytologic examination of fine-needle aspiration (FNA) material is being used increasingly for the diagnosis of pulmonary lesions. Accurate distinction between nonsmall cell lung cancer (NSCLC), including subgroups, and small cell lung cancer and between primary lung cancer and metasta...

Students as effective harm reductionists and needle exchange organizers.

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Barbour, Kyle; McQuade, Miriam; Brown, Brandon

2017-03-17

Needle exchange programs are safe, highly effective programs for promoting health among people who inject drugs. However, they remain poorly funded, and often illegal, in many places worldwide due to fear and stigma surrounding drug use. Continued advocacy, education, and implementation of new needle exchanges are thus essential to improve public health and reduce structural inequality. We argue that students, and especially professional and graduate students, have the potential to play an important role in advancing harm reduction. Students benefit from the respect given to the professions they are training to enter, which gives them leverage to navigate the political hurdles often faced by needle exchange organizers, especially in areas that presently lack services. In addition, due to their relative simplicity, needle exchanges do not require much of the licensing, clinical knowledge, and infrastructure associated with more traditional student programs, such as student-run free medical clinics. Students are capable of learning harm reduction cultural approaches and techniques if they remain humble, open-minded, and seek the help of the harm reduction community. Consequently, students can generate tremendous benefits to their community without performing beyond their appropriate clinical limitations. Students benefit from organizing needle exchanges by gaining applied experience in advocacy, organization-building, and political finesse. Working in a needle exchange significantly helps erode stigma against multiple marginalized populations. Students in health-related professions additionally learn clinically-relevant knowledge that is often lacking from their formal training, such as an understanding of structural violence and inequality, root causes of substance use, client-centered approaches to health services, and interacting with clients as peers, rather than through the standard hierarchical medical interaction. We therefore encourage students to learn about

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

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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.

Brachytherapy needle deflection evaluation and correction

International Nuclear Information System (INIS)

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

2005-01-01

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

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

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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 core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P 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.

Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions.

Science.gov (United States)

Chakrabarti, Sudipta; Datta, Alok Sobhan; Hira, Michael

2012-01-01

Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

Clarification of the characteristics of needle-tip movement during vacuum venipuncture to improve safety.

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Fujii, Chieko

2013-01-01

Complications resulting from venipuncture include vein and nerve damage, hematoma, and neuropathic pain. Although the basic procedures are understood, few analyses of actual data exist. It is important to improve the safety standards of this technique during venipuncture. This study aimed to obtain data on actual needle movement during vacuum venipuncture in order to develop appropriate educational procedures. Six experienced nurses were recruited to collect blood samples from 64 subjects. These procedures were recorded using a digital camera. Software was then used to track and analyze motion without the use of a marker in order to maintain the sterility of the needle. Movement along the X- and Y-axes during blood sampling was examined. Approximately 2.5 cm of the needle was inserted into the body, of which 6 mm resulted from advancing or moving the needle following puncture. The mean calculated puncture angle was 15.2°. Given the hazards posed by attaching and removing the blood collection tube, as well as by manipulating the needle to fix its position, the needle became unstable whether it was fixed or not fixed. This study examined venipuncture procedures and showed that the method was influenced by increased needle movement. Focusing on skills for puncturing the skin, inserting the needle into the vein, and changing hands while being conscious of needle-tip stability may be essential for improving the safety of venipuncture.

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

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

2015-05-21

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

Fabrication of tungsten wire needles

International Nuclear Information System (INIS)

Roder, A.

1983-02-01

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

Needle autopsy

Directory of Open Access Journals (Sweden)

Philip Davis Marsden

1997-04-01

Full Text Available Often in tropical practice there is not time or conditions to do a proper autopsy on a patient who has died. A needle biopsy technique is described for limited closed autopsy examination to clariffy organ histology. In this way the clinician may resolve puzzling fatal disease.Muitas vezes, em clínicas de países tropicais, não há tempo nem condições para se realizar uma necropsia adequada em um paciente que foi a óbito. Um técnica de biópsia por punção é descrita para fins de exame em necropsia limitadamente fechada, para esclarecimento da histologia do órgão. Dessa maneira, o clínico pode resolver enigmas de doenças fatais.

21 CFR 880.5580 - Acupuncture needle.

Science.gov (United States)

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...

Usefulness of sono-guided needle puncture for MR arthrography of the shoulder

International Nuclear Information System (INIS)

Choi, Jae Woong; Hong, Suk Ju; Suh, San Il; Yong, Hwan Suk; Kim, Jung Hyuk; Park, Cheol Min; Suh, Won Hyuck; Kim, Myung Gyu

2000-01-01

To evaluate the usefulness of sono-guided needle puncture for MR arthrography of the shoulder to locate the path of access and to control the correct placement of the needle into the shoulder. Fifteen patients with suspicion of shoulder pathology were included in this study. Patients were laid in supine positions with the arm extended and slightly abducted, the palm of the hand facing upward. A sonographic unit with a high resolution transducer with 7.5 MHz linear array was used. Axial images in the anterior aspect of the shoulder were obtained to localize the coracoid process and the anteromedical portion of the humerus. Using an aseptic technique, a 21-guage needle was advanced into the shoulder joint under ultrasonographic guidance. When the needle made contract with the articular cartilage of the humeral head, the needle was tiled to position is point in the articular cavity. Solution of 0.1 ml gadopentetate dimeglumine in 25 ml of normal saline was prepared and 12-16 ml was injected into the joint cavity. The intra-articular position of the needle and the compete distension of the shoulder joint were again confirmed by sonography. The needle was accurately placed in 14 out of 15 patients without damage to neighboring structures. It took 10 to 15 minutes to complete the procedure in 14 patients. No side effects attributable to gadopentetate dimeglumine were found. Sono-guided needle puncture for the shoulder MR arthrography can be a substitutable method for fluoroscopic guidance, with easy access, advantages of lacking radiation hazard and eliminating the need for iodized contrast agents.

Do Superior or Inferior Interlaminar Approach or Bevel Orientation Predispose to Nonepidural Needle Penetration?

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Koontz, Nicholas A; Wiggins, Richard H; Stoddard, Gregory J; Shah, Lubdha M

2017-10-01

There is a paucity of evidence-based literature regarding the advantages and disadvantages of the interlaminar approach and needle bevel orientation for performing a lumbar interlaminar epidural steroid injection (ESI). The purpose of this study was to determine if superior versus inferior lamina approach, needle bevel tip orientation, or both may predispose to inadvertent nonepidural penetration during lumbar interlaminar ESI. A prospective study was performed of patients with low back pain with or without radicular pain or neurogenic claudication referred for lumbar interlaminar ESI. Two hundred eleven patients were randomized by interlaminar approach (superior vs inferior) and bevel tip orientation (cranial vs caudal). Lumbar interlaminar ESI was performed by six interventionalists of varying levels of experience using fluoroscopic guidance with curved tip epidural needles, using loss-of-resistance technique and confirmation with contrast opacification. Exact Poisson regression was used to model the study outcome. Two hundred twenty-one lumbar interlaminar ESIs were performed on 211 patients, randomized to a superior (n = 121) or inferior lamina approach (n = 100) and to a cranial (n = 103) or caudal (n = 118) orientation of the bevel tip. Epidural needle placement was confirmed in 96.4% (n = 213) of cases. Nonepidural needle placement was most commonly associated with superior lamina approach and caudal bevel tip orientation, which was marginally significant (adjusted risk ratio, 6.88; 95% CI, 0.93-∞; p = 0.059). Inadvertent nonepidural needle penetration during fluoroscopically guided lumbar interlaminar ESI appears to be affected by approach, with superior lamina approach and caudal bevel tip orientation being the least favorable technique.

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

Science.gov (United States)

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 (Pdeep 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 (Pdeep or shallow needling group. Deep and shallow needling at Tianshu (ST25) can improve intestinal function remarkably and safely. Therapeutic effects of deep and shallow needling are not

Closed chamber globe stabilization and needle capsulorhexis using irrigation hand piece of bimanual irrigation and aspiration system

Directory of Open Access Journals (Sweden)

Rai Harminder K

2005-08-01

Full Text Available Abstract Background The prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation. This helps to achieve a capsulorhexis of optimal size, shape and obtain the best possible position for a red glow under retroillumination. We report the use of irrigation handpiece of bimanual irrigation aspiration system to stabilize the globe, maintain a deep anterior chamber and manipulate the globe to a position of optimal red reflex during needle capsulorhexis in phacoemulsification. Methods Two side ports are made with 20 G MVR 'V' lance knife (Alcon, USA. The irrigation handpiece with irrigation on is introduced into the anterior chamber through one side port and the 26-G cystitome (made from 26-G needle is introduced through the other. The capsolurhexis is completed with the needle. Results Needle capsulorhexis with this technique was used in 30 cases of uncomplicated immature senile cataracts. 10 cases were done under peribulbar anaesthesia and 20 under topical anaesthesia. A complete capsulorhexis was achieved in all cases. Conclusion The irrigating handpiece maintains deep anterior chamber, stabilizes the globe, facilitates pupillary dilatation, and helps in maintaining the eye in the position with optimal red reflex during needle capsulorhexis. This technique is a safe and effective way to perform needle capsulorhexis.

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

Science.gov (United States)

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), 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 0.05) after treatment at 1 month. Stiletto needle, needle-knife and voltaren for the treatment of knee

Needle in the external auditory canal: an unusual complication of inferior alveolar nerve block.

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Ribeiro, Leandro; Ramalho, Sara; Gerós, Sandra; Ferreira, Edite Coimbra; Faria e Almeida, António; Condé, Artur

2014-06-01

Inferior alveolar nerve block is used to anesthetize the ipsilateral mandible. The most commonly used technique is one in which the anesthetic is injected directly into the pterygomandibular space, by an intraoral approach. The fracture of the needle, although uncommon, can lead to potentially serious complications. The needle is usually found in the pterygomandibular space, although it can migrate and damage adjacent structures, with variable consequences. The authors report an unusual case of a fractured needle, migrating to the external auditory canal, as a result of an inferior alveolar nerve block. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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). The slow twisting needle insertion is significantly superior to tubing needle insertion on lowering vascular tension and VER, improving EWK and BV.

[Design and application of silver needle-knife].

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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.

Diagnostic accuracy of lymphoma established by fine-needle aspiration cytological biopsy

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Delyuzar; Amir, Z.; Suryadi, D.

2018-03-01

Based on Globocan data in 2012, it is estimated that about 14,495 Indonesians suffer from lymphoma, both Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma. Some areas of specialization still doubt the accuracy of cytology diagnosis of fine needle aspiration biopsy.This study is a diagnostic test with a cross sectional analytic design to see how the cytology diagnostic accuracy of fine needle aspiration aspirate in lymphoma. It was in Department of Anatomical Pathology Faculty of Medicine USU, Haji Adam Malik Hospital, Dr.Pirngadi hospital, or private clinic in Medan. Peripheral cytology technique biopsy of fine needle aspiration on lymph node subsequently stained with Giemsa, when the cytology of lymphoma is obtained and confirmed by histopathologic examination. Cytology and histopathologic examination will be tested by Diagnostic Test and assessed for its sensitivity and specificity. The diagnostic of lymphoma cytology provides 93.33% sensitivity and 92.31% specificity when confirmed by histopathological examination. Positive predictive value and negative predictive value of 96.55% and 85.71% respectively. In conclusion, the cytology of fine needle aspiration biopsy is accurate enough to be used as a diagnostic tool, so it is advisable to establish a lymphoma diagnosis to perform a needle aspiration biopsy examination.

Distribution of elements in needles of Pinus massoniana (Lamb.) was uneven and affected by needle age

International Nuclear Information System (INIS)

Kuang Yuanwen; Wen Dazhi; Zhou Guoyi; Liu Shizhong

2007-01-01

Macronutrients (P, S, K, Na, Mg, Ca), heavy metals (Fe, Zn, Mn, Cu, Pb, Cr, Ni, Cd) and Al concentrations as well as values of Ca/Al in the tip, middle, base sections and sheaths of current year and previous year needles of Pinus massoniana from Xiqiao Mountain were analyzed and the distribution patterns of those elements were compared. The results indicated that many elements were unevenly distributed among the different components of needles. Possible deficiency of P, K, Ca, Mn and Al toxicity occurred in needles under air pollution. Heavy metals may threaten the health of Masson pine. Needle sheaths were good places to look for particulate pollutants, in this case including Fe, Cu, Zn, Pb, Cr, Cd and Al. - Pine needle sections as bioindicator for heavy metals and nutrient deficiency particularly needle sheath for particle pollutants

Distribution of elements in needles of Pinus massoniana (Lamb.) was uneven and affected by needle age

Energy Technology Data Exchange (ETDEWEB)

Kuang Yuanwen [Institute of Ecology, South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: kuangyw@scbg.ac.cn; Wen Dazhi [Institute of Ecology, South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: dzwen@scbg.ac.cn; Zhou Guoyi [Institute of Ecology, South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: gyzhou@scbg.ac.cn; Liu Shizhong [Institute of Ecology, South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: lsz@scbg.ac.cn

2007-01-15

Macronutrients (P, S, K, Na, Mg, Ca), heavy metals (Fe, Zn, Mn, Cu, Pb, Cr, Ni, Cd) and Al concentrations as well as values of Ca/Al in the tip, middle, base sections and sheaths of current year and previous year needles of Pinus massoniana from Xiqiao Mountain were analyzed and the distribution patterns of those elements were compared. The results indicated that many elements were unevenly distributed among the different components of needles. Possible deficiency of P, K, Ca, Mn and Al toxicity occurred in needles under air pollution. Heavy metals may threaten the health of Masson pine. Needle sheaths were good places to look for particulate pollutants, in this case including Fe, Cu, Zn, Pb, Cr, Cd and Al. - Pine needle sections as bioindicator for heavy metals and nutrient deficiency particularly needle sheath for particle pollutants.

Distribution of elements in needles of Pinus massoniana (Lamb.) was uneven and affected by needle age

Energy Technology Data Exchange (ETDEWEB)

Kuang Yuanwen [South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: kuangyw@scbg.ac.cn; Wen Dazhi [South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: dzwen@scbg.ac.cn; Zhou Guoyi [South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: gyzhou@scbg.ac.cn; Liu Shizhong [South China Botanical Garden, Chinese Academy of Sciences, 510650 Guangzhou (China)]. E-mail: lsz@scbg.ac.cn

2007-02-15

Macronutrients (P, S, K, Na, Mg, Ca), heavy metals (Fe, Zn, Mn, Cu, Pb, Cr, Ni, Cd,) and Al concentrations as well as values of Ca/Al in the tip, middle and base sections, and sheaths of current year and previous year needles of Pinus massoniana from Xiqiao Mountain were analyzed and the distribution patterns of those elements were compared. The results indicated that many elements were unevenly distributed among the different components of needles. Possible deficiency of P, K, Ca, Mn and Al toxicity occurred in needles under air pollution. Heavy metals may threaten the health of Masson pine. Needle sheaths were good places to look for particulate pollutants, in this case including Fe, Cu, Zn, Pb, Cr, Cd and Al. - Pine needle sections as bioindicator for heavy metals and nutrient deficiency particularly needle sheath for particle pollutants.

Distribution of elements in needles of Pinus massoniana (Lamb.) was uneven and affected by needle age

International Nuclear Information System (INIS)

Kuang Yuanwen; Wen Dazhi; Zhou Guoyi; Liu Shizhong

2007-01-01

Macronutrients (P, S, K, Na, Mg, Ca), heavy metals (Fe, Zn, Mn, Cu, Pb, Cr, Ni, Cd,) and Al concentrations as well as values of Ca/Al in the tip, middle and base sections, and sheaths of current year and previous year needles of Pinus massoniana from Xiqiao Mountain were analyzed and the distribution patterns of those elements were compared. The results indicated that many elements were unevenly distributed among the different components of needles. Possible deficiency of P, K, Ca, Mn and Al toxicity occurred in needles under air pollution. Heavy metals may threaten the health of Masson pine. Needle sheaths were good places to look for particulate pollutants, in this case including Fe, Cu, Zn, Pb, Cr, Cd and Al. - Pine needle sections as bioindicator for heavy metals and nutrient deficiency particularly needle sheath for particle pollutants

Comparison Effect of Direct Trocar and Veress Needle Entry Techniques on Gut Functions after Laparoscopic Procedures: Randomized Clinical Trial

Directory of Open Access Journals (Sweden)

Taylan Şenol

2016-12-01

CONCLUSION: Direct or Veress needle entry methods were both safe to create pneumoperitoneum with similar postoperative gastrointestinal functions except for earlier first flatulence in Veress needle group while direct trocar entry was found to be associated with favorable postoperative blood count and shorter duration to obtain enough intraperitoneal pressure.

Comparison of specimen adequacy in fine needle aspiration cytology performed with different gauge needles in palpable external swellings

International Nuclear Information System (INIS)

Sarfraz, T.; Bashir, S.; Tariq, H.; Malik, T.M.

2013-01-01

Background: Fine Needle Aspiration Cytology (FNAC) of external swellings may yield different specimen adequacy depending on different gauge needles used for aspiration. Objective: To compare the specimen adequacy aspirated by various gauge (21 and 22) needles in external palpable swellings of lymph nodes, thyroid gland, salivary glands, breast and soft tissue. Study Design: Comparative cross sectional study. Duration: Six months (1st Jan 2012 to 30th June 2012). Setting: Histopathology/Cytology department Combined Military Hospital Peshawar (Pakistan). Methodology: This was a prospective study of 200 cases in which FNAC was performed with either 21 or 22 gauge needles (100 cases with 21 gauge and 100 with 22 gauge needles). Equal number of aspirations were done with 21 and 22 gauge needles from the swellings of thyroid gland, lymph nodes, salivary glands, breast and soft tissue. Results were analyzed for specimen adequacy by using SPSS 17. Results: A total number of 200 cases were recruited in this study, out of which 100 were aspirated with 21 gauge needles and 100 with 22 gauge needles. Specimen adequacy in swellings of thyroid, lymph nodes and salivary glands was better with 22 gauge amounting 90%, 80% and 80% respectively, as compared to yield with 21 gauge needles which was 85%, 70% and 60% respectively. On the other hand in swellings of breast and soft tissue, the specimen adequacy was better with 21 gauge needles giving 98% and 90 % adequate yield respectively as compared to 22 gauge needles which was 70% and 40 % respectively. Conclusion: Needles of smaller gauge (22 gauge) give a better yield in swellings of thyroid, lymph nodes and salivary gland while in swellings of breast and soft tissue sample adequacy is better with larger gauge needle (21 gauge). (author)

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

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Beigi, Parmida; Rohling, Robert

2014-03-01

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

Training and certification in endobronchial ultrasound-guided transbronchial needle aspiration

Science.gov (United States)

Konge, Lars; Nayahangan, Leizl Joy; Clementsen, Paul Frost

2017-01-01

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) plays a key role in the staging of lung cancer, which is crucial for allocation to surgical treatment. EBUS-TBNA is a complicated procedure and simulation-based training is helpful in the first part of the long learning curve prior to performing the procedure on actual patients. New trainees should follow a structured training programme consisting of training on simulators to proficiency as assessed with a validated test followed by supervised practice on patients. The simulation-based training is superior to the traditional apprenticeship model and is recommended in the newest guidelines. EBUS-TBNA and oesophageal ultrasound-guided fine needle aspiration (EUS-FNA or EUS-B-FNA) are complementary to each other and the combined techniques are superior to either technique alone. It is logical to learn and to perform the two techniques in combination, however, for lung cancer staging solely EBUS-TBNA simulators exist, but hopefully in the future simulation-based training in EUS will be possible. PMID:28840013

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

Science.gov (United States)

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 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 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.

Usefulness of normal saline for sealing the needle track after CT-guided lung biopsy

International Nuclear Information System (INIS)

Li, Y.; Du, Y.; Luo, T.Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.; Zheng, H.J.; Li, B.

2015-01-01

Aim: To determine whether the use of normal saline for sealing the needle track can reduce the incidence of pneumothorax and chest tube placement after computed tomography (CT)-guided lung biopsy. Materials and methods: A prospective, randomised, controlled trial enrolling 322 patients was conducted. All patients were randomly assigned to one of two groups: those in whom the needle track was not sealed with normal saline (n=161, Group A) and those who did receive normal saline (n=161, Group B). CT-guided biopsy was performed with coaxial technique. Normal saline, which ranged from 1–3 ml, was injected while the trocar needle was being withdrawn. Patient characteristics, lesion, and procedure variables were analysed as potential risk variables for occurrence of pneumothorax and chest tube placement. Results: The incidence of pneumothorax was 26.1% in Group A and 6.2% in Group B (p<0.001). Nine patients in Group A and one patient in Group B required chest tube placement (p=0.010). Using multiple logistic regression analysis, smaller lesion size, greater needle–pleural angle, longer lesion–pleural distance, presence of emphysema, and no sealing the needle track with normal saline were significantly associated with an increased risk of pneumothorax, and that the latter three factors were also associated with an increased risk of pneumothorax requiring chest tube placement. Conlusion: Normal saline for sealing the needle track significantly reduces the incidence of pneumothorax and prevents subsequent chest tube placement after CT-guided lung biopsy. - Highlights: • Normal saline is an effective sealant for use in lung biopsy. • This technique reduced the incidence of pneumothorax and chest tube placement. • This technique should be recommended for CT-guided lung biopsy.

Linear-motion tattoo machine and prefabricated needle sets for the delivery of plant viruses by vascular puncture inoculation

Science.gov (United States)

Vascular puncture inoculation (VPI) of plant viruses previously has been conducted either manually or by use of a commercial engraving tool and laboratory-fabricated needle arrays. In an effort to improve this technique, a linear-motion tattoo machine driving industry-standard needle arrays was tes...

Needle-less local anesthesia: clinical evaluation of the effectiveness of the jet anesthesia Injex in local anesthesia in dentistry.

Science.gov (United States)

Dabarakis, Nikolaos N; Alexander, Veis; Tsirlis, Anastasios T; Parissis, Nikolaos A; Nikolaos, Maroufidis

2007-01-01

To clinically evaluate the jet injection Injex (Rösch AG Medizintechnik) using 2 different anesthetic solutions, and to compare the jet injection and the standard needle injection techniques. Of the 32 patients in the study, 10 received mepivacaine 3% anesthetic solution by means of the jet injection technique, while the remaining 22 patients received lidocaine 2% with epinephrine 1:80,000 by the same method. The 14 patients in whom pulp anesthesia was achieved were selected for an additional evaluation of the pulp reaction using standard needle injection anesthesia. The differences between the 2 compounds with Injex were statistically evaluated by means of independent-samples t test analysis. The differences between subgroups receiving both jet injection and needle injection anesthesia were evaluated by means of paired t test analysis. The administration of mepivacaine 3% using Injex did not achieve pulp anesthesia in any of the 10 patients, although the soft tissue anesthesia was successful. The administration of lidocaine with epinephrine using Injex resulted in pulp anesthesia in only 14 patients; soft tissue anesthesia was observed in all patients of this group. There was no statistically significant difference between Injex and the needle injection technique in onset of anesthesia. However, the duration of anesthesia was significantly longer for the needle infiltration group than for the Injex injection group. The anesthetic solution should be combined with a vasoconstriction agent when the Injex technique is implemented.

Clarification of the characteristics of needle-tip movement during vacuum venipuncture to improve safety

Directory of Open Access Journals (Sweden)

Fujii C

2013-07-01

Full Text Available Chieko FujiiFaculty of Nursing and Medical Care, Keio University, Kanagawa, JapanBackground: Complications resulting from venipuncture include vein and nerve damage, hematoma, and neuropathic pain. Although the basic procedures are understood, few analyses of actual data exist. It is important to improve the safety standards of this technique during venipuncture. This study aimed to obtain data on actual needle movement during vacuum venipuncture in order to develop appropriate educational procedures.Methods: Six experienced nurses were recruited to collect blood samples from 64 subjects. These procedures were recorded using a digital camera. Software was then used to track and analyze motion without the use of a marker in order to maintain the sterility of the needle. Movement along the X- and Y-axes during blood sampling was examined.Results: Approximately 2.5 cm of the needle was inserted into the body, of which 6 mm resulted from advancing or moving the needle following puncture. The mean calculated puncture angle was 15.2°. Given the hazards posed by attaching and removing the blood collection tube, as well as by manipulating the needle to fix its position, the needle became unstable whether it was fixed or not fixed.Conclusion: This study examined venipuncture procedures and showed that the method was influenced by increased needle movement. Focusing on skills for puncturing the skin, inserting the needle into the vein, and changing hands while being conscious of needle-tip stability may be essential for improving the safety of venipuncture.Keywords: blood collection, nerve damage, motion analysis, patient safety, puncture angle, clinical education

Musculoskeletal ultrasound: how to treat calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique.

Science.gov (United States)

Lee, Kenneth S; Rosas, Humberto G

2010-09-01

The purpose of this video article is to illustrate the ultrasound appearance of calcium deposition in the rotator cuff and provide a detailed step-by-step protocol for performing the ultrasound-guided single-needle lavage technique for the treatment of calcific tendinitis with emphasis on patient positioning, necessary supplies, real-time lavage technique, and steroid injection into the subacromial subdeltoid bursa. Musculoskeletal ultrasound is well established as a safe, cost-effective imaging tool in diagnosing and treating common musculoskeletal disorders. Calcific tendinitis of the rotator cuff is a common disabling cause of shoulder pain. Although most cases are self-limiting, a subset of patients is refractory to conservative therapy and requires treatment intervention. Ultrasound-guided lavage is an effective and safe minimally-invasive treatment not readily offered in the United States as an alternative to surgery, perhaps because of the limited prevalence of musculoskeletal ultrasound programs and limited training. On completion of this video article, the participant should be able to develop an appropriate diagnostic and therapeutic algorithm for the treatment of calcific tendinitis of the rotator cuff using ultrasound.

[Learning experience of acupuncture technique from professor ZHANG Jin].

Science.gov (United States)

Xue, Hongsheng; Zhang, Jin

2017-08-12

As a famous acupuncturist in the world, professor ZHANG Jin believes the key of acupuncture technique is the use of force, and the understanding of the "concentrating the force into needle body" is essential to understand the essence of acupuncture technique. With deep study of Huangdi Neijing ( The Inner Canon of Huangdi ) and Zhenjiu Dacheng ( Compendium of Acupuncture and Moxibustion ), the author further learned professor ZHANG Jin 's theory and operation specification of "concentrating force into needle body, so the force arriving before and together with needle". The whole-body force should be subtly focused on the tip of needle, and gentle force at tip of needle could get significant reinforcing and reducing effect. In addition, proper timing at tip of needle could start reinforcing and reducing effect, lead qi to disease location, and achieve superior clinical efficacy.

History of the Buttonhole Technique.

Science.gov (United States)

Misra, Madhukar

2015-01-01

The constant side method of access cannulation in hemodialysis, popularly known as the 'buttonhole' method, has an interesting history. Dr. Zbylut J. Twardowski, a Polish nephrologist, discovered this technique by pure serendipity in 1972. A patient with a complicated vascular access history and limited options for cannulation was repeatedly 'stuck' at the same sites by a nurse. Soon it was noticed that the cannulation at the same spot became easier with time. Since the needles were being reused, the sharpness of the needles decreased with time and the bluntness of the needle seemed to minimize the damage to the cannulation tract (another serendipity!). This method soon became popular among patients, and many patients started using this technique. This chapter traces the invention of this technique and its subsequent development following Dr. Twardowski's emigration to the USA. © 2015 S. Karger AG, Basel.

Sci-Thur AM: YIS – 03: Combining sagittally-reconstructed 3D and live-2D ultrasound for high-dose-rate prostate brachytherapy needle segmentation

Energy Technology Data Exchange (ETDEWEB)

Hrinivich, Thomas; Hoover, Douglas; Surry, Kathleen; Edirisinghe, Chandima; D’Souza, David; Fenster, Aaron; Wong, Eugene [University of Western Ontario, London Regional Cancer Program/LHSC, London Regional Cancer Program/LHSC, Robarts Research Institute, London Regional Cancer Program/LHSC, Robarts Research Institute, University of Western Ontario (Canada)

2016-08-15

Ultrasound-guided high-dose-rate prostate brachytherapy (HDR-BT) needle segmentation is performed clinically using live-2D sagittal images. Organ segmentation is then performed using axial images, introducing a source of geometric uncertainty. Sagittally-reconstructed 3D (SR3D) ultrasound enables both needle and organ segmentation, but suffers from shadow artifacts. We present a needle segmentation technique augmenting SR3D with live-2D sagittal images using mechanical probe tracking to mitigate image artifacts and compare it to the clinical standard. Seven prostate cancer patients underwent TRUS-guided HDR-BT during which the clinical and proposed segmentation techniques were completed in parallel using dual ultrasound video outputs. Calibrated needle end-length measurements were used to calculate insertion depth errors (IDEs), and the dosimetric impact of IDEs was evaluated by perturbing clinical treatment plan source positions. The proposed technique provided smaller IDEs than the clinical approach, with mean±SD of −0.3±2.2 mm and −0.5±3.7mm respectively. The proposed and clinical techniques resulted in 84% and 43% of needles with IDEs within ±3mm, and IDE ranges across all needles of [−7.7mm, 5.9mm] and [−9.3mm, 7.7mm] respectively. The proposed and clinical IDEs lead to mean±SD changes in the volume of the prostate receiving the prescription dose of −0.6±0.9% and −2.0±5.3% respectively. The proposed technique provides improved HDR-BT needle segmentation accuracy over the clinical technique leading to decreased dosimetric uncertainty by eliminating the axial-to-sagittal registration, and mitigates the effect of shadow artifacts by incorporating mechanically registered live-2D sagittal images.

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

Science.gov (United States)

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.

Dry needling and exercise for chronic whiplash - a randomised controlled trial

Directory of Open Access Journals (Sweden)

Souvlis Tina

2009-12-01

Full Text Available Abstract Background Chronic whiplash is a common and costly problem. Sensory hypersensitivity is a feature of chronic whiplash that is associated with poor responsiveness to physical treatments such as exercise. Modalities such as dry-needling have shown some capacity to modulate sensory hypersensitivity, suggesting that when combined with advice and exercise, such an approach may be more effective in the management of chronic whiplash. The primary aim of this project is to investigate the effectiveness of dry-needling, advice and exercise for chronic whiplash. Method/Design A double-blind randomised controlled trial will be conducted. 120 participants with chronic whiplash, grade II will be randomised to receive either 1 dry-needling, advice and exercise or 2 sham dry-needling, advice and exercise. All participants will receive an educational booklet on whiplash. Participants who are randomised to Group 1 will receive 6 treatments of combined dry-needling and exercise delivered in the first 3 weeks of the 6 week program, and 4 treatments of exercise only in the last 3 weeks of the program. Participants randomised to Group 2 will receive an identical protocol, except that a sham dry-needling technique will be used instead of dry-needling. The primary outcome measures are the Neck Disability Index (NDI and participants' perceived recovery. Outcomes will be measured at 6, 12, 24 and 52 weeks after randomization by an assessor who is blind to the group allocation of the participants. In parallel, an economic analysis will be conducted. Discussion This trial will utilise high quality trial methodologies in accordance with CONSORT guidelines. The successful completion of this trial will provide evidence of the effectiveness and cost-effectiveness of a combined treatment approach for the management of chronic whiplash. Trial registration ACTRN12609000470291

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

Science.gov (United States)

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.

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

Directory of Open Access Journals (Sweden)

Lyubomyr Lytvynchuk

Full Text Available 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.

The use of dry needling in the treatment of cervical and masticatory myofascial pain

OpenAIRE

Carvalho, Andreia Valle de; Grossmann, Eduardo; Ferreira, Flávia Regina; Januzzi, Eduardo; Fonseca, Roberta Maria Drumond Furtado Bossi

2017-01-01

ABSTRACT BACKGROUND AND OBJECTIVES: Dry needling is an interventionist, minimally invasive technique, used in the treatment of myofascial pain. The objective of this study was to describe the use of dry needling and to perform a critical literature analysis about the technical aspects of its use by qualified health care professionals. CONTENTS: A search in the literature was carried out for books in English, review articles, randomized controlled or quasi-randomized clinical trials, blind o...

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

Science.gov (United States)

2016-06-01

Orofacial Pain Graduate...JOURNAL PHYSICAL PROPERTIES OF ACUPUNCTURE NEEDLES: DO DISPOSABLE ACUPUNCTURE NEEDLES BREAK WITH NORMAL USE? James Kyle Vick DDS, Orofacial Pain ...MS CAPT, DC, USN Orofacial Pain Department Head Naval Postgraduate Dental School vi    TABLE OF CONTENTS GUIDELINE I. TITLE

Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

Science.gov (United States)

León-Hernández, Jose V.; Martín-Pintado-Zugasti, Aitor; Frutos, Laura G.; Alguacil-Diego, Isabel M.; de la Llave-Rincón, Ana I.; Fernandez-Carnero, Josue

2016-01-01

ABSTRACT Background Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain. PMID:27410163

Changing the needle for lumbar punctures

DEFF Research Database (Denmark)

Engedal, Thorbjørn Søndergaard; Ording, H.; Vilholm, O. J.

2015-01-01

Objective: Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar punctures. Both a non-cutting needle design and the use of smaller size needles have been shown to greatly reduce the risk of PDPH. Nevertheless, larger cutting needles are still widely used. This study d...

Incidence of tissue coring during transseptal catheterization when using electrocautery and a standard transseptal needle.

Science.gov (United States)

Greenstein, Eugene; Passman, Rod; Lin, Albert C; Knight, Bradley P

2012-04-01

The application of radiofrequency electrocautery to a standard, open-ended transseptal needle has been used to facilitate transseptal puncture (TSP). The purpose of this study was to determine the incidence of cardiac tissue coring when this technique is used. A model using excised swine hearts submerged in a saline-filled basin was developed to simulate TSP with electrocautery and a standard transseptal needle. Punctures were performed without the use of electrocautery and by delivering radiofrequency energy to the transseptal needle using a standard electrocautery pen at 3 target sites (fossa ovalis, non-fossa ovalis septum, and aorta). The tissue of the submerged heart was gently tented, and the needle was advanced on delivery of radiofrequency. The devices were retracted, and the needle was flushed in a collection basin. None of the TSPs without cautery caused tissue coring. For TSPs using electrocautery, the frequency of coring was at least 21% for any puncture permutation used in the study and averaged 37% at septal sites (Pelectrocautery and a standard open-ended Brockenbrough needle resulted in coring of the septal tissue in 35% of cases (33 of 96 punctures).

Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients---a PET-CT cerebral functional imaging study

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Huang Yong

2012-06-01

Full Text Available Abstract Background Acupuncture has been applied to aid in the recovery of post-stroke patients, but its mechanism is unclear. This study aims to analyze the relationship between acupuncture and glucose metabolism in cerebral functional regions in post-stroke patients using 18 FDG PET-CT techniques. Forty-three ischemic stroke patients were randomly divided into 5 groups: the Waiguan (TE5 needling group, the TE5 sham needling group, the sham point needling group, the sham point sham needling group and the non-needling group. Cerebral functional images of all patients were then acquired using PET-CT scans and processed by SPM2 software. Results Compared with the non-needling group, sham needling at TE5 and needling/sham needling at the sham point did not activate cerebral areas. However, needling at TE5 resulted in the activation of Brodmann Area (BA 30. Needling/sham needling at TE5 and needling at the sham point did not deactivate any cerebral areas, whereas sham needling at the sham point led to deactivation in BA6. Compared with sham needling at TE5, needling at TE5 activated BA13, 19 and 47 and did not deactivate any areas. Compared with needling at the sham point, needling at TE5 had no associated activation but a deactivating effect on BA9. Conclusion Needling at TE5 had a regulating effect on cerebral functional areas shown by PET-CT, and this may relate to its impact on the recovery of post-stroke patients.

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

Science.gov (United States)

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.

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

Science.gov (United States)

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

2017-02-01

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

Effect of Blinding With a New Pragmatic Placebo Needle

Science.gov (United States)

Liu, Baoyan; Xu, Huanfang; Ma, Rui; Mo, Qian; Yan, Shiyan; Liu, Zhishun

2014-01-01

Abstract Placebo control is a useful method for determining the efficacy of a therapy. In acupuncture researches, the preferred method for placebo control is acupuncture using a placebo needle that has a blunt tip and achieves no skin penetration. We performed a crossover study to validate the blinding effect of a new type of placebo needle. Sixty volunteers were randomized to receive acupuncture using 2 types of needles with different sequences: sequence AB, involving first the pragmatic placebo needle and then the real needle, and sequence BA, in a reverse order. Placebo acupuncture was performed by administering the placebo needle through an adhesive pad without skin penetration on the acupoints LI4, RN12, BL25, and BL36. Real acupuncture was performed by needling through the pad and penetrating the skin to 15 mm using a real needle on the same acupoints. The acupuncture was administered every other day with 3 sessions for 1 type of needle. The primary outcome was the perception of needle penetration. Besides degree of acupuncture pain, type, and degree of needle sensation, needle acceptability and factors influencing the subject blinding effect were assessed. Needle penetration was felt by 100%, 90% (54/60), 88.3% (53/60), and 95% (57/60) of volunteers receiving placebo acupuncture and 98.3% (59/60), 96.7% (58/60), 95% (57/60), and 95% (57/60) of volunteers receiving real acupuncture on LI4, RN12, BL25, and BL36, respectively. Differences of the volunteers’ perception of needle penetration between the placebo needle and real needle were not significant for the 4 acupoints (all P > 0.05). Volunteers experienced fewer distension sensations (P = 0.01), a lower degree of needle sensation (P = 0.007), and less pain (P = 0.006) during placebo acupuncture than during real acupuncture. The placebo needle was more easily accepted than the real needle (OR = 1.63, 95% CI, 1.01–2.64). The influences of age, sex, educational level, acupuncture

Comparison of complications between pediatric peripherally inserted central catheter placement techniques

International Nuclear Information System (INIS)

Dasgupta, Niloy; Lungren, Matthew P.; Patel, Manish N.; Racadio, John M.; Johnson, Neil D.

2016-01-01

Peripherally inserted central catheter (PICC) is among the most common procedures performed in children in the hospital setting. PICC insertion can be simplified with the use of a sheathed needle as an alternative to the modified Seldinger technique. To retrospectively evaluate PICC placement for the technique used and the incidence of complications at a large pediatric tertiary care center. We retrospectively reviewed all PICC placements at a single institution over a 4-year period. We reviewed patient records for demographic data, PICC placement technique, catheter size and number of lumens, and the incidence of complications (i.e. multiple attempted puncture sites, phlebitis and vessel thrombosis). We analyzed complication rates between two placement techniques using a chi-square test. We identified 8,816 successful PICC placements, 4,749 (53.9%) in males and 4,067 (46.1%) in females. The average age of the patients for which a line was placed was 5.6 years (range 1 day to 45 years). A direct sheathed needle puncture technique was used in 8,362 (94.9%) placements and a modified Seldinger technique was used in 454 (5.1%). Complications occurred in 312 (3.7%) of direct sheathed needle puncture placements versus 17 (3.7%) of modified Seldinger placements (P = 0.99). Multiple puncture sites were required in 175 (2.1%) attempted direct sheathed needle puncture placements compared with 8 (1.7%) attempted modified Seldinger placements (P = 0.63). Phlebitis occurred in 94 (1.1%) direct sheathed needle puncture lines versus 5 (1.1%) modified Seldinger placed lines (P = 0.96). Vessel thrombosis occurred in 43 (0.5%) direct sheathed needle puncture lines versus 4 (0.9%) modified Seldinger placed lines (P = 0.30). The direct peel-away sheathed needle vessel puncture technique and the modified Seldinger technique used to place PICC lines in children have similar complication rates. (orig.)

Comparison of complications between pediatric peripherally inserted central catheter placement techniques

Energy Technology Data Exchange (ETDEWEB)

Dasgupta, Niloy; Lungren, Matthew P. [Lucile Packard Children' s Hospital Stanford, Department of Radiology, Palo Alto, CA (United States); Patel, Manish N.; Racadio, John M.; Johnson, Neil D. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

2016-09-15

Peripherally inserted central catheter (PICC) is among the most common procedures performed in children in the hospital setting. PICC insertion can be simplified with the use of a sheathed needle as an alternative to the modified Seldinger technique. To retrospectively evaluate PICC placement for the technique used and the incidence of complications at a large pediatric tertiary care center. We retrospectively reviewed all PICC placements at a single institution over a 4-year period. We reviewed patient records for demographic data, PICC placement technique, catheter size and number of lumens, and the incidence of complications (i.e. multiple attempted puncture sites, phlebitis and vessel thrombosis). We analyzed complication rates between two placement techniques using a chi-square test. We identified 8,816 successful PICC placements, 4,749 (53.9%) in males and 4,067 (46.1%) in females. The average age of the patients for which a line was placed was 5.6 years (range 1 day to 45 years). A direct sheathed needle puncture technique was used in 8,362 (94.9%) placements and a modified Seldinger technique was used in 454 (5.1%). Complications occurred in 312 (3.7%) of direct sheathed needle puncture placements versus 17 (3.7%) of modified Seldinger placements (P = 0.99). Multiple puncture sites were required in 175 (2.1%) attempted direct sheathed needle puncture placements compared with 8 (1.7%) attempted modified Seldinger placements (P = 0.63). Phlebitis occurred in 94 (1.1%) direct sheathed needle puncture lines versus 5 (1.1%) modified Seldinger placed lines (P = 0.96). Vessel thrombosis occurred in 43 (0.5%) direct sheathed needle puncture lines versus 4 (0.9%) modified Seldinger placed lines (P = 0.30). The direct peel-away sheathed needle vessel puncture technique and the modified Seldinger technique used to place PICC lines in children have similar complication rates. (orig.)

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

Science.gov (United States)

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.

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

Science.gov (United States)

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.

Science.gov (United States)

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.

Invasive and noninvasive dental analgesia techniques.

Science.gov (United States)

Estafan, D J

1998-01-01

Although needle-administered local anesthesia has been an essential tool of modern dentistry, it has also been responsible for many patients' fears of dental visits. Several new techniques have recently evolved that may offer viable alternatives. Two of these operate via electronic mechanisms that interfere with pain signals, two others involve transmucosal modes of administration, and a fifth technique involves an intraosseous pathway for anesthesia administration. Each of these techniques has different indications for dental procedures, but none is intended to replace needle administration in dentistry. This overview highlights the salient features of these alternative dental anesthesia techniques.

Numerical Modelling of Mutual Effect among Nearby Needles in a Multi-Needle Configuration of an Atmospheric Air Dielectric Barrier Discharge

Directory of Open Access Journals (Sweden)

Xiaoxing Zhang

2012-05-01

Full Text Available A numerical study has been conducted to understand the mutual effect among nearby needles in a multi-needle electrode dielectric barrier discharge. In the present paper, a fluid-hydrodynamic model is adopted. In this model, the mutual effect among nearby needles in a multi-needle configuration of an atmospheric air dielectric barrier discharge are investigated using a fluid-hydrodynamic model including the continuity equations for electrons and positive and negative ions coupled with Poisson’s equation. The electric fields at the streamer head of the middle needle (MN and the side needles (SNs in a three-needle model decreased under the influence of the mutual effects of nearby needles compared with that in the single-needle model. In addition, from the same comparison, the average propagation velocities of the streamers from MN and SNs, the electron average energy profile of MN and SNs (including those in the streamer channel, at the streamer head, and in the unbridged gap, and the electron densities at the streamer head of the MN and SNs also decreased. The results obtained in the current paper agreed well with the experimental and simulation results in the literature.

The effects of needle deformation during lumbar puncture

Directory of Open Access Journals (Sweden)

Hasan Hüseyin Özdemir

2015-01-01

Full Text Available 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.

The effects of needle deformation during lumbar puncture

Science.gov (United States)

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

[Use of percutaneous needles in the feasability of single-port laparoscopic cholecystectomy].

Science.gov (United States)

Dávila, Fausto; Tsin, Daniel; González, Gloria; Dávila, M Ruth; Lemus, José; Dávila, Ulises

2014-04-01

The usefulness of percutaneous needles (PN) to replace traditional assistance ports in mini-invasive techniques with a single port is analyzed and their feasibility for conducting a single port laparoscopic cholecystectomy (SPLC) is demonstrated. A retrospective, linear and descriptive study covering 2,431 patients with a diagnosis of acute and non-acute gallbladder disease has been conducted. The patients underwent a single port laparoscopic cholecystectomy using some type of PNs, replacing the assisting ports used in traditional laparoscopic cholecystechtomy (TLC). Based on the progressive use of PNs-reins (R), hooked needles (HN) and passing suture needles (PSN)-to carry out the SPLC technique, 3 groups have been established: A, B and C. The results were compared using a Student T test, odds ratio and CI and were analyzed by means of the SPSS software v. 13.0. The use of PNs showed an increased feasibility for the laparoscopic procedure, as they were included in the surgical technique. The R were useful when carrying out the SPLC in 78% of the cases and when the HK were added, the results increased to 88%. When using the 3 types (R, HN and PSN), the results increased by 96%. Statistical significance was obtained with these values: chi 2=67.13 and P<.001; odds ratio and 95% CI became significant when comparing the B/C, A/C, and A-B/C groups. The PNs, replacing the assisting ports in laparoscopy, make it possible to attain a feasibility of the process in 96% of the cases. This percentage was similar to what is achieved with the TLC, which places the one port laparoscopy surgery technique as an advantageous and economic alternative. This application of the PNs could be made extensive to other single-port techniques, with a multi-valve platform and natural orifice surgery. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

Ultrasound probe and needle-guide calibration for robotic ultrasound scanning and needle targeting.

Science.gov (United States)

Kim, Chunwoo; Chang, Doyoung; Petrisor, Doru; Chirikjian, Gregory; Han, Misop; Stoianovici, Dan

2013-06-01

Image-to-robot registration is a typical step for robotic image-guided interventions. If the imaging device uses a portable imaging probe that is held by a robot, this registration is constant and has been commonly named probe calibration. The same applies to probes tracked by a position measurement device. We report a calibration method for 2-D ultrasound probes using robotic manipulation and a planar calibration rig. Moreover, a needle guide that is attached to the probe is also calibrated for ultrasound-guided needle targeting. The method is applied to a transrectal ultrasound (TRUS) probe for robot-assisted prostate biopsy. Validation experiments include TRUS-guided needle targeting accuracy tests. This paper outlines the entire process from the calibration to image-guided targeting. Freehand TRUS-guided prostate biopsy is the primary method of diagnosing prostate cancer, with over 1.2 million procedures performed annually in the U.S. alone. However, freehand biopsy is a highly challenging procedure with subjective quality control. As such, biopsy devices are emerging to assist the physician. Here, we present a method that uses robotic TRUS manipulation. A 2-D TRUS probe is supported by a 4-degree-of-freedom robot. The robot performs ultrasound scanning, enabling 3-D reconstructions. Based on the images, the robot orients a needle guide on target for biopsy. The biopsy is acquired manually through the guide. In vitro tests showed that the 3-D images were geometrically accurate, and an image-based needle targeting accuracy was 1.55 mm. These validate the probe calibration presented and the overall robotic system for needle targeting. Targeting accuracy is sufficient for targeting small, clinically significant prostatic cancer lesions, but actual in vivo targeting will include additional error components that will have to be determined.

A low-level needle counter

International Nuclear Information System (INIS)

Fujita, Y.; Taguchi, Y.; Imamura, M.; Inoue, T.; Tanaka, S.

1977-01-01

A small end-window type gas-flow counter which has a sharpened needle (anode) against the end-window plane (cathode) was developed for low-level counting of β particles to the amount of less than one count per hour in solid sources of relatively high specific activity. The advantage of the needle counter for low-level work is that being of a conical shape the active volume as against the window area is small. The background count rate of 0.0092+-0.0005 cpm was obtained for a 10 mm dia needle counter operating in GM mode and in anticoincidence with a well-type NaI(Tl) guard crystal with massive shields. The counter design and the counter characteristics are presented in detail. The needle counter is simple in design, low-cost and stable in long time operation. (author)

Processing and Characterization of Needled Carbon Composites

Science.gov (United States)

2015-12-01

needle is used to insert high strength yarns (i.e., threads) through the dry fabric or prepreg laminate , leaving a loose thread loop underneath [9-11...capability which uses commercially-available felting needles to insert z-fibers into composite laminates at different angles (±45/90°) relative to the... laminate plane. Previous work with needled glass/epoxy composites has shown a 270% improvement in Mode I interlaminar fracture toughness when needled

The research of knitting needle status monitoring setup

Science.gov (United States)

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.

Shaping symmetric Airy beam through binary amplitude modulation for ultralong needle focus

Energy Technology Data Exchange (ETDEWEB)

Fang, Zhao-Xiang; Gong, Lei [Department of Optics and Optical Engineering, University of Science and Technology of China, Hefei 230026 (China); Ren, Yu-Xuan, E-mail: yxren@ustc.edu.cn [National Center for Protein Sciences Shanghai, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Shanghai 200031 (China); Vaveliuk, Pablo [Centro de Investigaciones Opticas (CONICET La Plata-CIC), Cno. Centenario y 506, P.O. Box 3, 1897 Gonnet, La Plata, Pcia. de Buenos Aires (Argentina); Chen, Yue; Lu, Rong-De, E-mail: lrd@ustc.edu.cn [Physics Experiment Teaching Center, School of Physical Sciences, University of Science and Technology of China, Hefei 230026 (China)

2015-11-28

Needle-like electromagnetic field has various advantages for the applications in high-resolution imaging, Raman spectroscopy, as well as long-distance optical transportation. The realization of such field often requires high numerical aperture (NA) objective lens and the transmission masks. We demonstrate an ultralong needle-like focus in the optical range produced with an ordinary lens. This is achieved by focusing a symmetric Airy beam (SAB) generated via binary spectral modulation with a digital micromirror device. Such amplitude modulation technique is able to shape traditional Airy beams, SABs, as well as the dynamic transition modes between the one-dimensional and two-dimensional (2D) symmetric Airy modes. The created 2D SAB was characterized through measurement of the propagating fields with one of the four main lobes blocked by an opaque mask. The 2D SAB was verified to exhibit self-healing property against propagation with the obstructed major lobe reconstructed after a certain distance. We further produced an elongated focal line by concentrating the SAB via lenses with different NAs and achieved an ultralong longitudinal needle focus. The produced long needle focus will be applied in optical, chemical, and biological sciences.

An ex vivo comparison of pressures within dental pulp space using conventional anesthetic technique versus needle-mounted obturator.

Science.gov (United States)

Grubbs, S Lee; Alley, Larry W; Eleazer, Paul D

2014-07-01

The intrapulpal (IP) injection technique is 1 of several ways of obtaining profound anesthesia. There is evidence to suggest that pressure is the primary factor in obtaining anesthesia using IP injection. This is an ex vivo comparison of pressures within dental pulp space using the conventional anesthetic technique versus a needle-mounted obturator technique. Twenty extracted anterior and premolar teeth were accessed with a high-speed 169L bur. A saline-filled tube connected to a digital pressure gauge was attached to the apical 10 mm of each tooth in a fixed mount. One operator performed all the injections under moderate pressure. Each tooth was injected twice; first, the tooth was given an IP injection with a normal setup, and then the same tooth was given an IP injection with the modified obturator syringe. The pressure at the apex was recorded for each tooth. A paired sample t test was completed to determine statistical significance. The pressure generated was considerably higher for the obturator group in every tooth when compared with the normal group (P < .001). IP injection with the obturator resulted in increased pressure at the apex of each tooth. This pressure increase may allow for increased anesthesia when IP injections are indicated. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Two-dimensional mapping of needle visibility with linear and curved array for ultrasound-guided interventional procedure

Science.gov (United States)

Susanti, Hesty; Suprijanto, Kurniadi, Deddy

2018-02-01

Needle visibility in ultrasound-guided technique has been a crucial factor for successful interventional procedure. It has been affected by several factors, i.e. puncture depth, insertion angle, needle size and material, and imaging technology. The influences of those factors made the needle not always well visible. 20 G needles of 15 cm length (Nano Line, facet) were inserted into water bath with variation of insertion angles and depths. Ultrasound measurements are performed with BK-Medical Flex Focus 800 using 12 MHz linear array and 5 MHz curved array in Ultrasound Guided Regional Anesthesia mode. We propose 3 criteria to evaluate needle visibility, i.e. maximum intensity, mean intensity, and the ratio between minimum and maximum intensity. Those criteria were then depicted into representative maps for practical purpose. The best criterion candidate for representing the needle visibility was criterion 1. Generally, the appearance pattern of the needle from this criterion was relatively consistent, i.e. for linear array, it was relatively poor visibility in the middle part of the shaft, while for curved array, it is relatively better visible toward the end of the shaft. With further investigations, for example with the use of tissue-mimicking phantom, the representative maps can be built for future practical purpose, i.e. as a tool for clinicians to ensure better needle placement in clinical application. It will help them to avoid the "dead" area where the needle is not well visible, so it can reduce the risks of vital structures traversing and the number of required insertion, resulting in less patient morbidity. Those simple criteria and representative maps can be utilized to evaluate general visibility patterns of the needle in vast range of needle types and sizes in different insertion media. This information is also important as an early investigation for future research of needle visibility improvement, i.e. the development of beamforming strategies and

CT fluoroscopy guided transpleural cutting needle biopsy of small ({<=}2.5 cm) subpleural pulmonary nodules

Energy Technology Data Exchange (ETDEWEB)

Prosch, Helmut; Oschatz, Elisabeth; Eisenhuber, Edith; Wohlschlager, Helmut [Otto Wagner Hospital, Department of Radiology, Sanatoriumsstrasse 2, 1140 Vienna (Austria); Mostbeck, Gerhard H., E-mail: gerhard.mostbeck@wienkav.at [Otto Wagner Hospital, Department of Radiology, Sanatoriumsstrasse 2, 1140 Vienna (Austria)

2011-01-15

Purpose: Small subpleural pulmonary lesions are difficult to biopsy. While the direct, short needle path has been reported to have a lower rate of pneumothorax, the indirect path provides a higher diagnostic yield. Therefore, we tried to optimize the needle pathway and minimize the iatrogenic pneumothorax risk by evaluating a CT fluoroscopy guided direct approach to biopsy subpleural lesions. Material and methods: Between 01/2005 and 01/2007, CT fluoroscopy guided core biopsies were performed in 24 patients. Using our technique, the tip of the guide needle remains outside the visceral pleura (17 G coaxial guide needle, 18 G Biopsy-gun, 15 or 22 mm needle path). The position of the lesion relative to the needle tip can be optimized using CT fluoroscopy by adjusting the breathing position of the patient. The Biopty gun is fired with the needle tip still outside the pleural space. Cytological smears are analyzed by a cytopathologist on-site, and biopsies are repeated as indicated with the coaxial needle still outside the pleura. Results: Median nodule size was 1.6 cm (0.7-2.3 cm). A definitive diagnosis was obtained in 22 patients by histology and/or cytology. In one patient, only necrotic material could be obtained. In another patient, the intervention had to be aborted as the dyspnoic patient could not follow breathing instructions. An asymptomatic pneumothorax was present in seven patients; chest tube placement was not required. Conclusion: The presented biopsy approach has a high diagnostic yield and is especially advantageous for biopsies of small subpleural lesions in the lower lobes.

Experiences with a new breast localisation needle

International Nuclear Information System (INIS)

Hergan, K.; Amann, T.; Doringer, W.; Hollenstein, P.

1990-01-01

In view of the increasing number of biopsies of non-palpable lesions of the female breast we found an ideal localisation system in the Hawkins breast localisation needle. Localisation was successful without technical problems in 31 out of 34 patients. The special advantages of the needle are its stability in position and excellent manoeverability due to the construction of the needle. The very simple handling of the needle is an advantage not only for the radiologist but also for the surgeon. (orig.) [de

21 CFR 868.5150 - Anesthesia conduction needle.

Science.gov (United States)

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...

Evaluation of the incidence on insufficient cytology results comparing different ultrasound-guided aspiration techniques for thyroid nodules

Energy Technology Data Exchange (ETDEWEB)

Kim, Seong Hyng; Park, Jun Hyun; Park, Ji Kang [Dept. of Radiology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

2013-07-15

We compared the incidence of insufficient thyroid cytology due to blood-stained materials or low cellularity in terms of aspiration technique, especially focusing on the degree of suction pressure and needle size. Three experienced radiologists performed ultrasound-guided aspiration for thyroid nodules in 1174 thyroid nodules consecutively. Three different techniques were used; (A) using a 25 gauge needle with mainly capillary technique in 269 nodules; (B) using a 25 gauge needle with 3 cc syringe and minimal suction pressure in 303 nodules; (C) using a 22-23 gauge needle with 10 cc syringe and aspirator in 602 nodules. The differences of the incidence of the insufficient cytology among the three aspiration techniques and relationships of the incidence and needle size/degree of suction pressure was statistically analyzed using the Mann-Whitney U test and the chi-square test with linear-by-linear association. Overall, the difference in insufficient cytology was significant across the three aspiration technique (p = 0.004), and the incidence tended to increase significantly with increase of needle size and degree of suction pressure (p < 0.001). A pairwise comparison of aspiration techniques found significant differences (p = 0.003) between techniques (A) and (C), and no differences between technique (B) and (C) (p 0.07) and between techniques (A) and (B) (p = 0.10). The incidence of insufficient cytology was significantly low in the capillary technique, and it increased significantly with the increase of needle size and degree of suction pressure.

Evaluation of the incidence on insufficient cytology results comparing different ultrasound-guided aspiration techniques for thyroid nodules

International Nuclear Information System (INIS)

Kim, Seong Hyng; Park, Jun Hyun; Park, Ji Kang

2013-01-01

We compared the incidence of insufficient thyroid cytology due to blood-stained materials or low cellularity in terms of aspiration technique, especially focusing on the degree of suction pressure and needle size. Three experienced radiologists performed ultrasound-guided aspiration for thyroid nodules in 1174 thyroid nodules consecutively. Three different techniques were used; (A) using a 25 gauge needle with mainly capillary technique in 269 nodules; (B) using a 25 gauge needle with 3 cc syringe and minimal suction pressure in 303 nodules; (C) using a 22-23 gauge needle with 10 cc syringe and aspirator in 602 nodules. The differences of the incidence of the insufficient cytology among the three aspiration techniques and relationships of the incidence and needle size/degree of suction pressure was statistically analyzed using the Mann-Whitney U test and the chi-square test with linear-by-linear association. Overall, the difference in insufficient cytology was significant across the three aspiration technique (p = 0.004), and the incidence tended to increase significantly with increase of needle size and degree of suction pressure (p < 0.001). A pairwise comparison of aspiration techniques found significant differences (p = 0.003) between techniques (A) and (C), and no differences between technique (B) and (C) (p 0.07) and between techniques (A) and (B) (p = 0.10). The incidence of insufficient cytology was significantly low in the capillary technique, and it increased significantly with the increase of needle size and degree of suction pressure.

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

Science.gov (United States)

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.

EUS needle identification comparison and evaluation (NICE) study (with videos)

Science.gov (United States)

Tang, Shou-jiang; Vilmann, Andreas S.; Saftoiu, Adrian; Wang, Wanmei; Streba, Costin; 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; del Ali, Mohammad A; Campbell, Garth; Chen, Edward; Vilmann, Peter

2017-01-01

Background and Aims Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) or biopsy is widely practiced. Optimal sonographic visualization of the needle is critical for image guided interventions. There are several commercially available needles but no bench-top testing and direct comparison of these needles 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. Methods Descriptive bench-top testing and comparison. Bench-top testing of 8 commonly used EUS-FNA needles (all of 22 gauge in size): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition, (Cook Medical); ClearView (Conmed); EZ Shot2 (Olympus); BNX (Beacon Endoscopic); and 2 new prototype needles that are coated by echogenic polymers by Medi-Globe. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in gastrointestinal ultrasound examination that is unfamiliar with EUS needle devices. Results There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, one prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (p<0.01). 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<0.001). Conclusions All FNA needles have their inherent and different echogenicity, 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. PMID:26873530

Effect of bidirectional rotation of an acupuncture needle at LI10 on acupuncture needle sensation and experimentally-induced contact heat pain in healthy human volunteers.

Science.gov (United States)

Benham, Alex; Johnson, Mark I

2014-06-01

There is insufficient evidence of a relationship between acupuncture needle sensations (de qi) and hypoalgesia. The aim of this study was to investigate the effects of bidirectional needle rotation at LI10 on acupuncture needle sensations and heat pain thresholds. Twenty-two healthy participants received one acupuncture needle at LI10 with bidirectional rotation of the needle in one experimental session and one acupuncture needle at LI10 with mock rotation in a separate session, in a randomised order. Measurements of heat pain thresholds were taken before needle insertion, during needle retention and 15 min after needle removal. At each measurement time point, participants rated needle sensations using the Massachusetts Acupuncture Sensation Scale (MASS) and a visual analogue scale (VAS) of overall intensity of needle sensation. Bidirectional needle rotation produced significantly higher scores for VAS, MASStotal, MASSpain and MASSsensation compared with mock rotation (all psensation and change in pain threshold after needling was only found when data from mock and rotation interventions were combined. Needle rotation increases the magnitude of hypoalgesia. There is tentative evidence that needle sensation may be associated with the amount of change in pain threshold. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Needle counter

International Nuclear Information System (INIS)

Fujita, Yuzo

1977-01-01

Needle counter had been devised by Geiger about 60 years ago before the present GM counter appeared. It is suitable for the detection of weak radiation because it is limited in effective volume, if the background due to mainly cosmic ray is proportional to the effective volume of the counter. Recently the very low β detector having a needle counter as the main detector has been developed. It showed highly excellent performance in the measurements of small area samples, about ten times sensitive as compared with other detectors. The counter is installed in the very low radiation measuring well at Nokogiriyama, Chiba Prefecture, using a NaI scintillator as its guard counter. D. H. Wilkinson first treated a gas amplification counter theoretically and quantitatively. The authors have obtained good results in the comparison with the experiments of the counter using a generalized form of Wilkinson theory. The findings obtained through this study seem to be applicable to the electrode arrangement which is important for the counter design. It was found that the excellent rise time of induced pulses in a gas amplification counter was achieved in larger amplification factor and smaller convolution effect. In the detection of charged particles with small obstructing capability such as γ ray, faster rise time and higher pulses can be obtained with needle counters than wire counters. (Wakatsuki, Y.)

Observations of needle-tissue interactions

NARCIS (Netherlands)

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

2009-01-01

Needles with asymmetric bevel tips naturally bend when they are inserted into soft tissue. In this study, we present an analytical model for the loads developed at the bevel tip during needle-tissue interaction. The model calculates the loads based on the geometry of the bevel edge and gel material

Radio-frequency ablation in patients with malignant hepatic tumor and experimental model: comparison of expandable needle and water-cooled needle

Energy Technology Data Exchange (ETDEWEB)

Moon, Yong Ju; Jeong, Yong Yeon; Kim, Jeong; Yim, Nam yeol; Kang, Heoung Keun [School of Medicine, Chonnam National Univ., Gwangju (Korea, Republic of); Kim, Eun Ha; Yoon, Kwon Ha [School of Medicine, Wonkwang Univ., Iksan (Korea, Republic of); Ko, Seog Wan [School of Medicine, Chonbuk National Univ., Jeonju (Korea, Republic of)

2004-12-01

The purpose of this study was to compare the shape and volume of the radio-frequency induced lesions produced by two commercially available radio-frequency ablation (RFA) systems, the expandable and cooled-tip needles, in clinical patients and an experimental model. A twelve-array anchor expandable needle electrode and a single cooled-tip needle electrode were used to treat hepatic tumors with a single session in 23 patients (20 hepatocellular carcinomas and 3 hepatic metastases) and fourteen patients (10 hepatocellular carcinomas and 4 hepatic metastases), respectively. Twenty RFA induced lesions were created with each system in 10 explanted bovine livers. The shape of the RFA induced lesions were divided into oval lesions along or perpendicular to the axis of the electrode and spherical lesions, and we then calculated the volumes of the RFA induced lesions. Fourteen (61%) lesions of the 23 patients treated with the expandable system were oval perpendicular to the axis of the electrode and nine (39%) of the lesions were spherical. All the lesions (100%) of the 14 patients treated with the cooled-tip needle were ovaI along the axis of the electrode. In the ex vivo bovine livers, the shape of the all RFA induced lesions was oval perpendicular to the axis of the electrode for the expandable needle, and oval along the axis of the electrode for the cooled-tip needle. The mean diameter and volume of the RFA induced lesions in the patients were 3.35{+-}0.56 cm and 19.9{+-}6.53 cm{sup 3}, respectively, for the expandable needle and 3.58{+-}0.78 cm and 23.19{+-}5.27 cm{sup 3}, respectively, for the cooled-tip needle. In the ex vivo model, the mean diameter and volume of RFA induced lesions were 3.41{+-}0.59 cm and 26.59{+-}8.02 cm{sup 3}, respectively, for the expandable needle, and 4.04{+-}0.65 cm and 33.82{+-}6.16 cm{sup 3}, respectively, for the cooled-tip needle (p <0.05). These results indicate that the shape of RFA induced lesions with the expandable needle were oval

Comparison of a novel real-time SonixGPS needle-tracking ultrasound technique with traditional ultrasound for vascular access in a phantom gel model.

Science.gov (United States)

Kopac, Daniel S; Chen, Jerry; Tang, Raymond; Sawka, Andrew; Vaghadia, Himat

2013-09-01

Ultrasound-guided percutaneous vascular access for endovascular procedures is well established in surgical practice. Despite this, rates of complications from venous and arterial access procedures remain a significant cause of morbidity. We hypothesized that the use of a new technique of vascular access using an ultrasound with a novel needle-guidance positioning system (GPS) would lead to improved success rates of vascular puncture for both in-plane and out-of-plane techniques compared with traditional ultrasound. A prospective, randomized crossover study of medical students from all years of medical school was conducted using a phantom gel model. Each medical student performed three ultrasound-guided punctures with each of the four modalities (in-plane no GPS, in-plane with GPS, out-of-plane no GPS, out-of-plane with GPS) for a total of 12 attempts. The success or failure was judged by the ability to aspirate a simulated blood solution from the model. The time to successful puncture was also recorded. A poststudy validated NASA Task Load Index workload questionnaire was conducted to assess the student's perceptions of the two different techniques. A total of 30 students completed the study. There was no significant difference seen in the mean times of vascular access for each of the modalities. Higher success rates for vascular access using the GPS for both the in-plane (94% vs 91%) and the out-of-plane (86% vs 70%) views were observed; however, this was not statistically significant. The students perceived the mental demand (median 12.0 vs 14.00; P = .035) and effort to be lower (mean 11.25 vs 14.00; P = .044) as well as the performance to be higher (mean 15.50 vs 14.00; P = .041) for the GPS vs the traditional ultrasound-guided technique. Students also perceived their ability to access vessels increased with the aid of the GPS (7.00 vs 6.50; P = .007). The majority of students expressed a preference for GPS (26/30, 87%) as opposed to the traditional counterpart

Current status of core needle biopsy of the thyroid

Energy Technology Data Exchange (ETDEWEB)

Baek, Jung Hwan [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2017-04-15

Thyroid nodules are a common clinical problem. Fine-needle aspiration (FNA) and large-needle biopsy have been used to diagnose thyroid nodules. Before the 1980s, large-needle biopsy was the standard procedure for the thyroid, but FNA became the standard diagnostic tool in the 1980s because it is a safe procedure that leads to accurate diagnoses. With advances in core needle biopsy (CNB) devices (i.e., spring-activated core needles) and development of high-resolution ultrasound, it has become possible to make accurate diagnoses while minimizing complications. Although 18- to 21-gauge core needles can be used to biopsy thyroid nodules, 18-gauge needles are most commonly used in Korea. The relationships among the size of the needle, the number of core specimens, and diagnostic accuracy have not yet been conclusively established, but the general tendency is that thinner needles cause less damage to the normal thyroid, but allow a smaller amount of thyroid tissue to be biopsied to be obtained. These relationships may be validated in the future.

Molecular imaging needles: dual-modality optical coherence tomography and fluorescence imaging of labeled antibodies deep in tissue

Science.gov (United States)

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

Are needles of Pinus pinaster more vulnerable to xylem embolism than branches? New insights from X-ray computed tomography.

Science.gov (United States)

Bouche, Pauline S; Delzon, Sylvain; Choat, Brendan; Badel, Eric; Brodribb, Timothy J; Burlett, Regis; Cochard, Hervé; Charra-Vaskou, Katline; Lavigne, Bruno; Li, Shan; Mayr, Stefan; Morris, Hugh; Torres-Ruiz, José M; Zufferey, Vivian; Jansen, Steven

2016-04-01

Plants can be highly segmented organisms with an independently redundant design of organs. In the context of plant hydraulics, leaves may be less embolism resistant than stems, allowing hydraulic failure to be restricted to distal organs that can be readily replaced. We quantified drought-induced embolism in needles and stems of Pinus pinaster using high-resolution computed tomography (HRCT). HRCT observations of needles were compared with the rehydration kinetics method to estimate the contribution of extra-xylary pathways to declining hydraulic conductance. High-resolution computed tomography images indicated that the pressure inducing 50% of embolized tracheids was similar between needle and stem xylem (P50 needle xylem  = -3.62 MPa, P50 stem xylem  = -3.88 MPa). Tracheids in both organs showed no difference in torus overlap of bordered pits. However, estimations of the pressure inducing 50% loss of hydraulic conductance at the whole needle level by the rehydration kinetics method were significantly higher (P50 needle  = -1.71 MPa) than P50 needle xylem derived from HRCT. The vulnerability segmentation hypothesis appears to be valid only when considering hydraulic failure at the entire needle level, including extra-xylary pathways. Our findings suggest that native embolism in needles is limited and highlight the importance of imaging techniques for vulnerability curves. © 2015 John Wiley & Sons Ltd.

Pine needle abortion biomarker detected in bovine fetal fluids

Science.gov (United States)

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...

Moving beyond non-engagement on regulated needle-syringe exchange programs in Australian prisons

Directory of Open Access Journals (Sweden)

Levy Michael

2009-05-01

Full Text Available Abstract Background Australia is at a fork in the road with the possibility of a needle-syringe exchange program (NSP to be introduced at the new prison in the ACT. However, the current situation is characterised by non-engagement from major stakeholders. We explore why informed discussion will not be enough to convince prison officers, policy makers and the wider community of the benefits of prison-based NSPs. Other methods of engagement and communication will be proposed – in that may provide avenues for "breakthrough". Methods A review of the literature on needle-syringe exchanges and harm reduction strategies within the context of prisons and prisoner health was conducted. Literature on strategies to change attitudes and move beyond intractable situations was also consulted. In addition, one author, DM, conducted a two-hour interview with an ex-prison officer. Results No studies were found which investigated the potential efficacy of interventions to modify attitudes or behaviours in the specific context of introducing an NSP into a prison. Nonetheless, several theories were identified which may explain the failure of informed discussion alone to create change in this situation and may therefore lead to suggestions for engagement and communication to move towards a resolution Discussion Cognitive-behavioural therapy highlights the importance of individual cognitions and how they shape behaviours in any change campaign. Social identity theory emphasizes changes to social processes that may open the prison officer workforce to change. Peace studies also suggests socialization strategies such as observing an established and effective prison-based needle-syringe exchange. Social marketing provides suggestions on how to sell an exchange to ensuring the benefits are framed to outweigh the costs. Conclusion Psychology, peace studies and social marketing all agree people's views must be carefully collected and analysed if people are going to be

An investigation of sulfur concentrations in soils and pine needles in Bandelier National Monument, New Mexico

International Nuclear Information System (INIS)

Gladney, E.S.; Ferenbaugh, R.W.; Jones, E.A.; Bell, M.G.; Morgan, J.D.; Stallings, E.A.; Nelson, L.A.; Lundstrom, C.; Bowker, R.G.

1993-03-01

Sulfur measurements in different age groups of pinon pine needles and adjacent soil samples from ten sampling sites at Bandelier National Monument were determined using combustion elemental analysis and chromatographic techniques. The primary goal was to establish base-line levels for elemental sulfur in the Monument. Sulfur levels in foliage and soils were evaluated using analysis of variance techniques. Foliage sulfur concentrations differed significantly among the 10 sampling sites and among trees within sites; however, needles of different ages did not differ significantly in sulfur content. Average soil concentrations were very low, approximately 12% of the average needle concentrations. Soil sulfur concentrations also differed significantly among the 10 sampling sites and at different depths in the soil. No statistical differences were evident in soils sampled at the four compass points (N,S,E,W) around each tree. These differences imply that large numbers of samples are needed to identify small effects from anthropogenic inputs of sulfur into the system or that the effects must be large relative to the differences among sampling sites and individual trees in order to be detected

STUDY & ANALYSIS OF MICRO NEEDLE MATERIAL BY ANSYS

OpenAIRE

Santosh Kumar Singh*, Prabhat Sinha, N.N. Singh, Nagendra Kumar

2017-01-01

In this research the concept of design and analysis, silicon and stainless steel based on hollow micro-needles for transdermal drug delivery(TDD) have been evaluated by Using ANSYS & computational fluid dynamic (CFD), structural. Micro fluidic analysis has performed to ensure the micro-needles design suitability for Drug delivery. The effect of axial and transverse load on single and micro-needle array has investigated with the mechanical properties of micro-needle. The analysis predicte...

The efficacy of an ultrasound-guided core needle biopsy with an 18G cutting needle for the diagnosis of pancreatic diseases

International Nuclear Information System (INIS)

Jung, Sung Hwa; Park, Won Kyu; Chang, Jay Chun; Kim, Jae Woon; Cho, Jae Ho; Jang, Han Won; Lee, Jae Kyo; Choi, Joon Hyuk

2008-01-01

The objective of this study is to evaluate the efficacy and safety of an ultrasound-guided core needle biopsy with an 18G cutting needle in patients suspected of having a pancreatic disease by analyzing the diagnostic performance and complication rate. The study population comprised 35 consecutive patients who underwent an ultrasound-guided core needle biopsy using a high-speed biopsy gun accompanied with an 18G cutting-type needle between May of 2001 and October of 2005. The diagnostic performance (i.e., the acquisition rate and diagnostic accuracy) and complications associated with core needle biopsies were evaluated for its efficacy and safety. Thirty-six sessions of ultrasound-guided core needle biopsies were performed in 35 consecutive patients. All patients, except two (serous cystadenoma and autoimmune pancreatitis) were diagnosed with various subtypes of pancreatic cancer. The acquisition rate and diagnostic accuracy were 97% (35/36) and 94% (34/36), respectively. A complication occurred only in one patient (3%), which further proved to be a delayed complication (i.e., needle tract implantation). According to our findings, the ultrasound-guided core needle biopsy is a viable and safe method for the diagnosis of pancreatic diseases. Moreover, it enables the diagnosis of the pancreatic cancer subtype

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

International Nuclear Information System (INIS)

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

2012-01-01

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

[Flying needling therapy combined with clomiphene for ovulation failure in polycystic ovary syndrome:a randomized controlled trial].

Science.gov (United States)

Ma, Hong; Quan, Xiaohong; Chen, Xiuhua; Dong, Ying

2016-11-12

To compare the efficacy among the combined treatment of flying needling therapy and clomiphene, the simple application of flying needling therapy and simple clomiphene in the treatment of ovulation failure in polycystic ovary syndrome (PCOS). Ninety patients of PCOS were randomized into a flying needling therapy group, a medication group and a combined treatment group, 30 cases in each one. In the flying needling therapy group, the flying needling therapy was simply applied to Ganshu (BL 18), Shenshu (BL 23), Zhongwan (CV 12), Shuifen (CV 9), Guanyuan (CV 4) and Zhongji (CV 3). The unilateral back- shu points were used alternatively in each treatment. The needles were inserted rapidly with rotation technique and even-needling manipulation. The needles were retained for 30 min. The treatment was given once every two days, 3 times a week. In the medication group, clomiphene was taken orally on the 5th day of menstruation, continuously for 5 days. In the combined treatment group, the flying needling therapy and clomiphene were used in combination. All of the patients were treated for 3 months and followed up for 1 month. The ovulation rates were compared among the three groups. The levels of androgen testosterone were compared before and after treatment. In the combined treatment group, the ovulation rate was 86.2% (100/116), better than 66.7% (80/120) in the flying needling therapy group and 69.6% (78/112) in the medication group (both P medication group ( P >0.05). After treatment, the level of testosterone was reduced in the three groups (all P medication group (both P medication group ( P >0.05). The adverse reactions in the combined treatment group and the flying needling therapy group were lower than those in the medication group (both P <0.05). The flying needling therapy effectively improves in the ovulation failure of PCOS and its effect is similar to clomiphene. The allied treatment of them apparently improves the clinical efficacy and alleviates the adverse

Medically relevant ElectroNeedle technology development.

Energy Technology Data Exchange (ETDEWEB)

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

2008-11-01

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

[Inheritance and evolution of acupuncture manipulation techniques of Zhejiang acupuncture masters in modern times].

Science.gov (United States)

Yu, Daxiong; Ma, Ruijie; Fang, Jianqiao

2015-05-01

There are many eminent acupuncture masters in modern times in the regions of Zhejiang province, which has developed the acupuncture schools of numerous characteristics and induces the important impacts at home and abroad. Through the literature collection on the acupuncture schools in Zhejiang and the interviews to the parties involved, it has been discovered that the acupuncture manipulation techniques of acupuncture masters in modern times are specifically featured. Those techniques are developed on the basis of Neijing (Internal Classic), Jinzhenfu (Ode to Gold Needle) and Zhenjiu Dacheng (Great Compendium of Acupuncture and Moxibustion). No matter to obey the old maxim or study by himself, every master lays the emphasis on the research and interpretation of classical theories and integrates the traditional with the modern. In the paper, the acupuncture manipulation techniques of Zhejiang acupuncture masters in modern times are stated from four aspects, named needling techniques in Internal Classic, feijingzouqi needling technique, penetrating needling technique and innovation of acupuncture manipulation.

Developed a needle trap device with PDMS sorbent for microextraction of toluene and methyl ethyl ketone from aquatic samples using dynamic headspace

Directory of Open Access Journals (Sweden)

Sara Karimi Zeverdegani

2016-09-01

Full Text Available Introduction: Due to the widespread use of toxic chemicals in most workplaces that can lead to toxic effects on human, various chemical extraction technique have been defined for analysis these toxic substances in air, water and biological samples. The purpose of this research is extraction of  toluene and methyl ethyl ketone from aquatic samples with needle trap device and  one commercial sorbent. Methods: In this research, needle trap device was used to extraction of  toluene and methyl ethyl ketone in aquatic samples, so needles(size 20 were packed with PDMS and extraction was done with dynamic headspace needle trap device. Gas chromatography with - flame ionization detector was used to analysis and optimized extraction of two substances were obtained. Results: Results show that the optimum temperature and time extraction was similar for toluene and methyl ethyl ketone (30 ° C, 30 min, but the reproducibility of results and calibration curve that obtained for toluene was better than methyl ethyl ketone. Conclusion: Needle trap technique is inexpensive, sensitive and portable also this method has good recovery to extract small amounts of  toluene and methyl ethyketon from aquatic samples with polydimethylsiloxane.

Migration of innumerable chronically retained acupuncture needles

Directory of Open Access Journals (Sweden)

Frances Lazarow, MD

2017-09-01

Full Text Available We present a case of a 50-year-old female with a 2-day history of back and abdominal pain who was discovered to have innumerable chronically retained acupuncture needles, which had migrated throughout her abdomen and pelvis. Although many of these needles were in precarious positions, including the epidural space, renal parenchyma, small bowel, and vasculature, there was no evidence for acute injury. We also briefly discuss evidence for the magnetic resonance imaging compatibility of acupuncture needles. Although a rare complication, given the high frequency of acupuncture therapy in the United States, physicians must be aware of the potential for retained and migrated needles.

Accuracy of biopsy needle navigation using the Medarpa system - computed tomography reality superimposed on the site of intervention

International Nuclear Information System (INIS)

Khan, M. Fawad; Maataoui, Adel; Gurung, Jessen; Schiemann, Mirko; Vogl, Thomas J.; Dogan, Selami; Ackermann, Hanns; Wesarg, Stefan; Sakas, Georgios

2005-01-01

The aim of this work was to determine the accuracy of a new navigational system, Medarpa, with a transparent display superimposing computed tomography (CT) reality on the site of intervention. Medarpa uses an optical and an electromagnetic tracking system which allows tracking of instruments, the radiologist and the transparent display. The display superimposes a CT view of a phantom chest on a phantom chest model, in real time. In group A, needle positioning was performed using the Medarpa system. Three targets (diameter 1.5 mm) located inside the phantom were punctured. In group B, the same targets were used to perform standard CT-guided puncturing using the single-slice technique. The same needles were used in both groups (15 G, 15 cm). A total of 42 punctures were performed in each group. Post puncture, CT scans were made to verify needle tip positions. The mean deviation from the needle tip to the targets was 6.65±1.61 mm for group A (range 3.54-9.51 mm) and 7.05±1.33 mm for group B (range 4.10-9.45 mm). No significant difference was found between group A and group B for any target (p>0.05). No significant difference was found between the targets of the same group (p>0.05). The accuracy in needle puncturing using the augmented reality system, Medarpa, matches the accuracy achieved by CT-guided puncturing technique. (orig.)

Efficacy of repeated 5-fluorouracil needling for failing and failed filtering surgeries based on simple gonioscopic examination

Directory of Open Access Journals (Sweden)

Rashad MA

2012-12-01

Full Text Available Mohammad A RashadOphthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptPurpose: To evaluate the success rate of a modified bleb needling technique in eyes with previous glaucoma surgery that had elevated intraocular pressure.Methods: A retrospective study of 24 eyes of 24 patients that underwent repeated bleb needling performed for failing and failed blebs on slit lamp with 5-fluorouracil (5-FU injections on demand. This was performed after gonioscopic examination to define levels of filtration block.Results: There was significant reduction of mean IOP from 36.91 mmHg to 14.73 mmHg at the final follow-up (P < 0.001. The overall success rate was 92%.Conclusion: Repeated needling with adjunctive 5-FU proved a highly effective, safe alternative to revive filtration surgery rather than another medication or surgery.Keywords: bleb, failure, 5-FU, needling, gonioscopy

An investigation of sulfur concentrations in soils and pine needles in Canyonlands National Park, Utah

International Nuclear Information System (INIS)

Gladney, E.S.; Ferenbaugh, R.W.; Jones, E.A.; Bell, M.G.; Morgan, J.D.; Nelson, L.A.; Lundstrom, C.; Bowker, R.G.

1993-03-01

Sulfur measurements in different age groups of pinon pine needles and adjacent soil samples from ten sampling sites at Canyonlands National Park were determined using combustion elemental analysis and chromatographic techniques. The primary goal was to establish base-line levels for elemental sulfur in the Park. Sulfur levels in foliage and soils were evaluated using analysis of variance techniques. No significant differences were found in foliage sulfur concentrations among the 10 sampling sites; however, trees within sites were significantly different. Needles of different ages did not differ significantly in sulfur content. Average soil concentrations were very low, approximately 4% of the average needle concentrations. Soil sulfur concentrations also differed significantly among the 10 sampling sites and at different depths in the soil. No statistical differences were evident in soils sampled at the four compass points (N,S,E,W) around each tree. These differences imply that large numbers of samples are needed to identify small effects from anthropogenic inputs of sulfur into the system, or that the effects must be large relative to the differences among sampling sites and individual trees in order to be detected

Comparison of 22G reverse-beveled versus standard needle for endoscopic ultrasound-guided sampling of solid pancreatic lesions

Science.gov (United States)

Alatawi, Abdullah; Beuvon, Frédéric; Grabar, Sophie; Leblanc, Sarah; Chaussade, Stanislas; Terris, Benoit; Barret, Maximilien

2015-01-01

Objectives Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) using standard needles has a high diagnostic value in the evaluation of solid pancreatic masses. Fenestrated needles have been developed to improve the quality of EUS-guided tissue sampling by providing core biopsies (FNB). Methods Patients with solid pancreatic masses of >2 cm were prospectively included in our study and randomized to receive EUS sampling, using either a standard 22G FNA or a 22G Procore® FNB needle. The main study endpoint was the number of needle passes required to obtain a diagnosis in more than 90% of cases. Results We included 100 patients (male = 63, female = 37; mean age = 68.4 years) in our study. We found that 88% of the lesions were malignant, with a mean size of 32 mm. A sample adequate for diagnosis was obtained in more than 90% of cases after the second needle pass in the FNB group, versus the third needle pass in the FNA group. Slide cellularity and presence of tissue microfragments were significantly higher in the FNB group. Sensitivity for the diagnosis of malignancy was 88.4% versus 97.8% for the EUS-FNA and EUS-FNB group, respectively, while specificity for both techniques was 100%. No complications were recorded. Conclusions Although the accuracy of both needle types for proving malignancy was similar, a lower number of passes was required with the FNB needles to achieve the same contributive sample rate as with the FNA needles. FNB also improved the histopathological quality of specimens, suggesting an overall superiority of FNB sampling. PMID:26279842

Rapid on-site evaluation of axillary fine-needle aspiration cytology in breast cancer.

LENUS (Irish Health Repository)

O'Leary, D P

2012-06-01

Axillary ultrasonography (AUS) and fine-needle aspiration cytology (FNAC) can establish axillary lymph node status before surgery, although this technique is hampered by poor adequacy rates. To achieve consistently high rates of FNAC adequacy, rapid on-site evaluation (ROSE) of FNAC samples was introduced.

Investigation of environmental pollution with pine needles by NAA

Energy Technology Data Exchange (ETDEWEB)

Lee, Kil Yong; Yoon, Yoon Yeol; Yang, Myung Kwon; Shim, Sang Kwon; Seo, Bum Kyoung [Korea Inst. of Geosience and Mineral Resources, Environmental Geology Division, Daejeon (Korea); Chung, Yong Sam [Korea Atomic Energy Research Inst., HANARO Center, Daejeon (Japan)

2002-04-01

NAA was studied to precision analysis of metallic elements in pine needle. The pine needle was investigated whether it can be feasible or not as a bio-monitor. Only one year old needle was taken from three different regions of urban, suburban and rural area in four seasons. The needle sample was divided with two aliquots, and then one was cleaned and the other was not. Loss and contamination of analytes were cautiously minimized when the needle was sample and transferred from mountain to laboratory and prepared for NAA. Some elements such as As, Br, Ce, W, Zn have shown different characteristics with regions and seasons as well as surface cleaning. It is found that about twenty elements in pine needle could be simply analyzed by NAA and the pine needle could be suitable as a bio-monitor for the monitoring of environmental pollution in Korea. (author)

PVA matches human liver in needle-tissue interaction.

Science.gov (United States)

de Jong, Tonke L; Pluymen, Loes H; van Gerwen, Dennis J; Kleinrensink, Gert-Jan; Dankelman, Jenny; van den Dobbelsteen, John J

2017-05-01

Medical phantoms can be used to study needle-tissue interaction and to train medical residents. The purpose of this research is to study the suitability of polyvinyl alcohol (PVA) as a liver tissue mimicking material in terms of needle-tissue interaction. Insertions into ex-vivo human livers were used for reference. Six PVA samples were created by varying the mass percentage of PVA to water (4m% and 7m%) and the number of freeze-thaw cycles (1, 2 and 3 cycles, 16hours of freezing at -19°C, 8hours of thawing). The inner needle of an 18 Gauge trocar needle with triangular tip was inserted 13 times into each of the samples, using an insertion velocity of 5 mm/s. In addition, 39 insertions were performed in two ex-vivo human livers. Axial forces on the needle were captured during insertion and retraction and characterized by friction along the needle shaft, peak forces, and number of peak forces per unit length. The concentration of PVA and the number of freeze-thaw cycles both influenced the mechanical interaction between needle and specimen. Insertions into 4m% PVA phantoms with 2 freeze-thaw cycles were comparable to human liver in terms of estimated friction along the needle shaft and the number of peak forces. Therefore, these phantoms are considered to be suitable liver mimicking materials for image-guided needle interventions. The mechanical properties of PVA hydrogels can be influenced in a controlled manner by varying the concentration of PVA and the number of freeze-thaw cycles, to mimic liver tissue characteristics. Copyright © 2017 Elsevier Ltd. All rights reserved.

Silica needle template fabrication of metal hollow microneedle arrays

International Nuclear Information System (INIS)

Zhu, M W; Li, H W; Chen, X L; Tang, Y F; Lu, M H; Chen, Y F

2009-01-01

Drug delivery through hollow microneedle (HMN) arrays has now been recognized as one of the most promising techniques because it minimizes the shortcomings of the traditional drug delivery methods and has many exciting advantages—pain free and tunable release rates, for example. However, this drug delivery method has been hindered greatly from mass clinical application because of the high fabrication cost of HMN arrays. Hence, we developed a simple and cost-effective procedure using silica needles as templates to massively fabricate HMN arrays by using popular materials and industrially applicable processes of micro- imprint, hot embossing, electroplating and polishing. Metal HMN arrays with high quality are prepared with great flexibility with tunable parameters of area, length of needle, size of hollow and array dimension. This efficient and cost-effective fabrication method can also be applied to other applications after minor alterations, such as preparation of optic, acoustic and solar harvesting materials and devices

Silica needle template fabrication of metal hollow microneedle arrays

Science.gov (United States)

Zhu, M. W.; Li, H. W.; Chen, X. L.; Tang, Y. F.; Lu, M. H.; Chen, Y. F.

2009-11-01

Drug delivery through hollow microneedle (HMN) arrays has now been recognized as one of the most promising techniques because it minimizes the shortcomings of the traditional drug delivery methods and has many exciting advantages—pain free and tunable release rates, for example. However, this drug delivery method has been hindered greatly from mass clinical application because of the high fabrication cost of HMN arrays. Hence, we developed a simple and cost-effective procedure using silica needles as templates to massively fabricate HMN arrays by using popular materials and industrially applicable processes of micro- imprint, hot embossing, electroplating and polishing. Metal HMN arrays with high quality are prepared with great flexibility with tunable parameters of area, length of needle, size of hollow and array dimension. This efficient and cost-effective fabrication method can also be applied to other applications after minor alterations, such as preparation of optic, acoustic and solar harvesting materials and devices.

Comparison between wire-mesh sensors and conductive needle-probes for measurements of two-phase flow parameters

International Nuclear Information System (INIS)

Manera, A.; Ozar, B.; Paranjape, S.; Ishii, M.; Prasser, H.-M.

2009-01-01

Measurements of two-phase flow parameters such as void-fraction, bubble velocities, and interfacial area density have been performed in an upwards air-water flow at atmospheric pressure by means of a four-tip needle-probe and a wire-mesh sensor. For the first time, a direct comparison between the two measuring techniques has been carried out. Both techniques are based on the measurement of the fluid conductivity. For void-fraction and velocity measurements, similarity exists between the two methodologies for signal analysis. A significantly different approach is followed, instead, for the estimation of the interfacial area concentration: while the evaluation based on the needle-probe signal is carried out by using projections of the gas-liquid interface velocity, the evaluation based on the wire-mesh signals consist in a full reconstruction of the bubbles interfaces. The comparison between the two techniques shows a good agreement.

Comparison between wire-mesh sensors and conductive needle-probes for measurements of two-phase flow parameters

Energy Technology Data Exchange (ETDEWEB)

Manera, A. [Paul Scherrer Institute, 5232 Villigen (Switzerland); Research Center Dresden Rossendorf, Dresden (Germany)], E-mail: annalisa.manera@psi.ch; Ozar, B.; Paranjape, S.; Ishii, M. [Purdue University, West Lafayette (United States); Prasser, H.-M. [Research Center Dresden Rossendorf, Dresden (Germany); ETH Zuerich, Sonneggstrasse 3, 8092 Zuerich (Switzerland)

2009-09-15

Measurements of two-phase flow parameters such as void-fraction, bubble velocities, and interfacial area density have been performed in an upwards air-water flow at atmospheric pressure by means of a four-tip needle-probe and a wire-mesh sensor. For the first time, a direct comparison between the two measuring techniques has been carried out. Both techniques are based on the measurement of the fluid conductivity. For void-fraction and velocity measurements, similarity exists between the two methodologies for signal analysis. A significantly different approach is followed, instead, for the estimation of the interfacial area concentration: while the evaluation based on the needle-probe signal is carried out by using projections of the gas-liquid interface velocity, the evaluation based on the wire-mesh signals consist in a full reconstruction of the bubbles interfaces. The comparison between the two techniques shows a good agreement.

Exploring needle anxiety among students attending a Nigerian ...

African Journals Online (AJOL)

Needle anxiety, a form of specific phobia refers to an intense fear of needles used for various medical procedures. It may result in the avoidance of such needle-involving procedures like intramuscular injections or vaccinations. About 4-8% of children and adolescents are said to generally suffer some form of anxiety.

Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman's Knot.

Science.gov (United States)

Shin, Yong Un; Seong, Mincheol; Cho, Hee Yoon; Kang, Min Ho

2017-01-01

To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman's knot (SFK). First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

Observations on rotating needle insertions using a brachytherapy robot

International Nuclear Information System (INIS)

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

2007-01-01

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

Insertion mechanics of bioinspired needles into soft tissues.

Science.gov (United States)

Sahlabadi, Mohammad; Khodaei, Seyedvahid; Jezler, Kyle; Hutapea, Parsaoran

2017-12-22

Most studies to date confirm that any increase in the needle insertion force increases the damage to the tissue. When it comes to brain tissue, even minor damage can cause a long-lasting traumatic brain injury. Thus there is a great demand for innovative minimally invasive needles among the medical community. In our previous studies a novel bioinspired needle design with specially designed barbs was used to perform insertion tests into Polyvinyl chloride (PVC) tissue-mimicking gels, in which it decreased the insertion force by as much as 25%. In this work, bioinspired needles were designed using a CAD software, and were then manufactured using a 3 D printer. The insertion tests into bovine brain and liver were then performed to further investigate the performance of our bioinspired needles in real tissues. Our results show that there was a 10-25% decrease in the insertion force for insertions into bovine brain, and a 35-45% reduction in the insertion force for insertions into bovine liver using the proposed bioinspired needles. The reduction in the insertion force is due to the decrease in the friction force of the bioinspired needle with the bovine tissues, and its results are consistent with our previous results.

High-pressure needle interface for thermoplastic microfluidics.

Science.gov (United States)

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.

Pinus roxburghii plant needles as a three-season biomonitor for elemental air pollution monitoring along roadside

Energy Technology Data Exchange (ETDEWEB)

Daud, Muhammad; Wasim, Mohammad; Khalid, Nasir; Waheed, Shahida [Pakistan Institute of Nuclear Science and Technology, Islamabad (Pakistan). Chemistry Div.

2015-07-01

The present study deals with the determination of 36 elements in Pinus roxburghii plant needles to assess their potential as biomonitor for elemental air pollution monitoring. The elemental quantification was made by employing Instrumental Neutron Activation Analysis (INAA) and Atomic Absorption Spectrometric (AAS) techniques. The needles of Pinus roxburghii were collected in spring, summer and winter seasons from various sites in Islamabad. The method validation was performed by analyzing two certified reference materials i.e., Citrus leaves - NIST-SRM-1572 and IAEA-Soil-7. Pollution level was assessed by using three indicators: enrichment factor, pollution load index and average toxic element concentration. The results indicated that the needles of Pinus roxburghii plant had potential to monitor the extent of air pollution in the vicinity of high traffic areas.

Treating malfunction filtering bleb with repeated needling combined with adjunctive 5-FU after glaucoma filtration surgery

Directory of Open Access Journals (Sweden)

Yi Liu

2013-07-01

Full Text Available AIM: To evaluate the therapeutic efficacy of a repeated bleb needling technique combined with subconjunctival injection of 5-FU in eyes with previous glaucoma surgery that had malfunctional filtering blebs. METHODS: A retrospective review of 34 consecutive patients(34 eyesof repeated bleb needling combined with subconjunctival injection of 5-FU in eyes, which had malfunctional filtering blebs after previous glaucoma surgery in our hospital from March 2009 to February 2013 was performed. The intraocular pressures(IOP, shapes of filtering blebs and complications after surgery were analyzed. RESULTS: There was significant reduction of mean IOP from 35.51mmHg to 14.43mmHg(PCONCLUSION: Repeated needling with adjunctive 5-FU proved a highly effective, safe alternative to treat malfunctional filtering blebs after previous glaucoma surgery.

Bowel lesions: percutaneous US-guided 18-gauge needle biopsy--preliminary experience.

Science.gov (United States)

Tudor, G R; Rodgers, P M; West, K P

1999-08-01

Ultrasonography-guided percutaneous biopsy was performed with local anesthesia and an 18-gauge needle in 10 patients with bowel-wall lesions. All patients underwent clinical review within 1 month. Biopsy was diagnostic in all patients. There were no complications, and all patients tolerated the procedure well. The technique appears to be safe and had an excellent diagnostic yield in our series.

Autoaspiration versus manual aspiration in transbronchial needle aspiration in diagnosis of intrathoracic lymphadenopathy.

Science.gov (United States)

Boonsarngsuk, Viboon; Pongtippan, Atcharaporn; Juthakarn, Sabaitip; Boonsarngsuk, Wison; Kurimoto, Noriaki

2009-10-01

Traditionally, aspiration with high negative pressure is recommended to obtain a specimen in transbronchial needle aspiration (TBNA). Undeniably, however, the assistant experiences difficulty in the generation of the negative pressure and precise control of the syringe while performing the procedure. To evaluate the effectiveness of the autoaspiration method created by our plunger lock in comparison with the conventional manual aspiration in the diagnosis of intrathoracic lymphadenopathy by TBNA. A prospective study was conducted on all patients referred for diagnostic TBNA of enlarged intrathoracic lymph nodes. Both automatic and manual aspiration techniques were performed after the needle had been completely inserted into the nodes. The diagnostic yield and the numbers of diagnostic cells or benign lymphoid cells obtained by each technique were compared in the same node. A total of 31 intrathoracic lymph nodes in 24 patients were prospectively studied. Twenty-four nodes (77.4%) were malignancies whereas 7 nodes (22.6%) were benign disease. Adequate lymph node samples were obtained in 30 targets (96.8%), and TBNA revealed definite diagnosis for 25 nodes (80.6%). Both aspiration techniques showed exactly the same diagnostic yield. However, the autoaspiration technique provided significantly more adequate samples than manual aspiration techniques did (P=0.003). The autoaspiration method using our plunger lock was superior to the manual method in obtaining the numbers of adequate samples in TBNA procedures.

The Problem of Metal Needles in Acupuncture-fMRI Studies

Directory of Open Access Journals (Sweden)

Florian Beissner

2011-01-01

Full Text Available Acupuncture is a therapy based on sensory stimulation of the human body by means of metal needles. The exact underlying mechanisms of acupuncture have not been clarified so far. Functional magnetic resonance imaging (fMRI has become an important tool in acupuncture research. Standard acupuncture needles, which are made of ferromagnetic steel, however, are problematic in acupuncture-fMRI studies for several reasons, such as attraction by the scanner's magnetic field, significant image distortions and signal-dropouts, when positioned close to the head or even heating due to absorption of radio frequency (RF. The aim of this study was to compare two novel types of acupuncture needles with a standard needle for their effect on MRI image quality. The standard needle severely reduced image quality, when located inside the RF coil. The nonferromagnetic metal needle may pose a risk due to RF heating, while the plastic needle has a significantly larger diameter. In conclusion, our recommendations are: (1 standard needles should not be used in MRI; (2 Nonferromagnetic metal needles seem to be the best choice for acupoints outside of the transmitter coil; and (3 only plastic needles are suited for points inside the coil. Laser acupuncture may be a safe alternative, too.

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

International Nuclear Information System (INIS)

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

2004-01-01

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

High-Field MRI-Compatible Needle Placement Robot for Prostate Interventions

OpenAIRE

SU, Hao; CAMILO, Alex; COLE, Gregory A.; HATA, Nobuhiko; TEMPANY, Clare M.; FISCHER, Gregory S.

2011-01-01

This paper presents the design of a magnetic resonance imaging (MRI) compatible needle placement system actuated by piezoelectric actuators for prostate brachytherapy and biopsy. An MRI-compatible modular 3 degree-of-freedom (DOF) needle driver module coupled with a 3-DOF x-y-z stage is proposed as a slave robot to precisely deliver radioactive brachytherapy seeds under interactive MRI guidance. The needle driver module provides for needle cannula rotation, needle insertion and cannula retrac...

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

Science.gov (United States)

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.

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

Directory of Open Access Journals (Sweden)

Jaung-Geng Lin

2013-01-01

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

Canopy position affects photosynthetic adjustments to long-term elevated CO{sub 2} concentration (FACE) in aging needles in a mature Pinus taeda forest

Energy Technology Data Exchange (ETDEWEB)

Crous, K. Y.; Ellsworth, D. S. [University of Michigan, School of Natural Resources and Environment, Ann Arbor, MI (United States)

2004-09-01

Results of an assessment of the long-term effects of exposure to elevated carbon dioxide in free-air enrichment (FACE) on two age classes of pine needles in the upper and lower canopy of a pine forest in North Carolina are discussed. The observations were made during the second through sixth year of exposure. A significant response was observed in 60 per cent of all age classes and canopy locations. Evidence of concurrent down-regulation of Rubisco and electron transport capacity in upper canopy sunlit leaves was noted beyond the sixth year. No such effect was seen in the lower canopy. Carboxylation capacity and electron transport capacity in the upper canopy was down-regulated by 17-20 per cent in one year-old needles, but this was significant across sampling years only for electron transport capacity. It is suggested that a reduction in photosynthetic capacity in aging conifer needles at the canopy top may have significant consequences for canopy carbon balance and global carbon sinks because a major proportion of the annual carbon balance of these conifers is contributed by one-year old sunlit needles. 45 refs., 3 tabs., 4 figs.

Ultrasound guided percutaneous fine needle aspiration biopsy ...

African Journals Online (AJOL)

)-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

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

DEFF Research Database (Denmark)

Ronellenfitsch, Henrik; Liesche, Johannes; Jensen, Kaare Hartvig

2015-01-01

The phloem vascular system facilitates transport of energy-rich sugar and signalling molecules in plants, thus permitting long-range communication within the organism and growth of non-photosynthesizing organs such as roots and fruits. The flow is driven by osmotic pressure, generated...... by differences in sugar concentration between distal parts of the plant. The phloem is an intricate distribution system, and many questions about its regulation and structural diversity remain unanswered. Here, we investigate the phloem structure in the simplest possible geometry: a linear leaf, found......, for example, in the needles of conifer trees. We measure the phloem structure in four tree species representing a diverse set of habitats and needle sizes, from 1 (Picea omorika) to 35 cm (Pinus palustris). We show that the phloem shares common traits across these four species and find that the size of its...

[Effect of Small Knife Needle on β-enorpin and Enkehalin Contents of Tansverse Process Syndrome of the Third Vertebra].

Science.gov (United States)

Liu, Nai-gang; Guo, Chang-qing; Sun, Hong-mei; Li, Xiao-hong; Wu, Hai-xia; Xu, Hong

2016-04-01

To explore the analgesic mechanism of small knife needle for treating transverse process syndrome of the third vertebra (TPSTV) by observing peripheral and central changesof β-endorphin (β-EP) and enkephalin (ENK) contents. Totally 30 Japanese white big-ear rabbits of clean grade were divided into 5 groups according to random digit table, i.e., the normal control group, the model group, the small knife needle group, the electroacupunture (EA) group, and the small knife needle plus EA group, 6 in each group. The TPSTV model was established by inserting a piece of gelatin sponge into the left transverse process of 3rd lumbar vertebrae. Rabbits in the small knife needlegroup were intervened by small knife needle. Those in the EA group were intervened by EA at bilateralWeizhong (BL40). Those in the small knife needle plus EA group were intervened by small knife needleand EA at bilateral Weizhong (BL40). Contents of β-EP and ENK in plasma, muscle, spinal cord, and hypothalamus were determined after sample collection at day 28 after modeling. Compared with the normal control group, contents of β-EP and ENK in plasma and muscle increased significantly, and contents of β-EP and ENK in spinal cord and hypothalamus decreased significantly in the model group (P 0.05). Small knife needle treatment and EA had benign regulation on peripheral and central β-EP and ENK in TPSTV rabbits. Small knife needle treatment showed better effect than that of EA.

A retrospective analysis of ultrasound-guided large core needle ...

African Journals Online (AJOL)

2016-07-27

Jul 27, 2016 ... The different types of non-surgical breast biopsy procedures include: fine needle aspiration biopsy. (FNAB), core needle ... needle biopsies of breast lesions at a regional public hospital in ..... NCR_2009_FINAL.pdf. 2. Parikh J ...

Microbiopsies versus Bergström needle for skeletal muscle sampling: impact on maximal mitochondrial respiration rate.

Science.gov (United States)

Isner-Horobeti, M E; Charton, A; Daussin, F; Geny, B; Dufour, S P; Richard, R

2014-05-01

Microbiopsies are increasingly used as an alternative to the standard Bergström technique for skeletal muscle sampling. The potential impact of these two different procedures on mitochondrial respiration rate is unknown. The objective of this work was to compare microbiopsies versus Bergström procedure on mitochondrial respiration in skeletal muscle. 52 vastus lateralis muscle samples were obtained from 13 anesthetized pigs, either with a Bergström [6 gauges (G)] needle or with microbiopsy needles (12, 14, 18G). Maximal mitochondrial respiration (V GM-ADP) was assessed using an oxygraphic method on permeabilized fibers. The weight of the muscle samples and V GM-ADP decreased with the increasing gauge of the needles. A positive nonlinear relationship was observed between the weight of the muscle sample and the level of maximal mitochondrial respiration (r = 0.99, p respiration (r = 0.99, p respiration compared to the standard Bergström needle.Therefore, the higher the gauge (i.e. the smaller the size) of the microbiopsy needle, the lower is the maximal rate of respiration. Microbiopsies of skeletal muscle underestimate the maximal mitochondrial respiration rate, and this finding needs to be highlighted for adequate interpretation and comparison with literature data.

Laser-Controlled Growth of Needle-Shaped Organic Nanoaggregates

DEFF Research Database (Denmark)

Balzer, Frank; Rubahn, Horst-Günter

2002-01-01

Arrays of mutually parallel oriented, single-crystalline, needle-like structures of light-emitting p-hexaphenyl molecules are generated in the focus of an argon ion laser. The cross sectional dimensions of the needles are of the order of 100 to 200 nm with lengths up to several hundred micrometer....... While the orientation of the individual molecules in the needles is defined by the direction of surface dipoles, the localization on the surface, the length distribution as well as mutual distances can be adjusted via size and position of the laser focus spot.......Arrays of mutually parallel oriented, single-crystalline, needle-like structures of light-emitting p-hexaphenyl molecules are generated in the focus of an argon ion laser. The cross sectional dimensions of the needles are of the order of 100 to 200 nm with lengths up to several hundred micrometers...

Interactions of Cells with Magnetic Nanowires and Micro Needles

KAUST Repository

Perez, Jose E.

2017-12-01

through lithography and electrodeposition, characterized using the previously mentioned techniques and then evaluated as a vector for intracellular delivery. Fluorescence and electron microscopy imaging were first performed to assess the biocompatibility, cell spreading and the interface of the cells and the needles. Intracellular delivery of a fluorescent dye was achieved via inductive heating of the needles, with the results showing a dependency of delivery and cell survivability on the exposure time.

A comparison of ultrasound guided fine needle aspiration cytology and core needle biopsy in evaluation of palpable breast lesions

International Nuclear Information System (INIS)

Altaf, H.N.; Farooqui, F.

2015-01-01

Objective: To compare ultrasound guided fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in patients presenting with palpable breast lumps (PBLs), in terms of sensitivity and specificity, taking final histopathology as gold standard. Methodology: This cross-sectional study was conducted at Holy Family Hospital, Rawalpindi, Pakistan. Ultrasound guided FNAC and CNB were taken of all female patients with PBLs. The results were compared with final histopathology as gold standard. Data analysis was performed using SPSS software and chi-square test. Results: A total of 60 patients were included in the study. The mean age was 33.8 yrs. The sensitivity and specificity of ultrasound guided FNAC were 68.7% and 93.1%, respectively. The sensitivity and specificity of ultrasound guided CNB was 93.7% and 100%. The accuracy of FNAC was 86.2% and that of core needle biopsy was 98.3%. Conclusion: The ultrasound guided core needle biopsy can be used as an initial diagnostic test for the evaluation of all PBLs. Because of high negative predictive value core needle biopsy can replace surgical excision biopsy for benign lesions. (author)

Quantification of Tissue Trauma following Insulin Pen Needle Insertions in Skin

DEFF Research Database (Denmark)

Jensen, Casper Bo; Larsen, Rasmus; Vestergaard, Jacob Schack

Objective: Within the field of pen needle development, most research on needle design revolves around mechanical tensile testing and patient statements. Only little has been published on the actual biological skin response to needle insertions. The objective of this study was to develop a computa......Objective: Within the field of pen needle development, most research on needle design revolves around mechanical tensile testing and patient statements. Only little has been published on the actual biological skin response to needle insertions. The objective of this study was to develop...... a computational method to quantify tissue trauma based on skin bleeding and immune response. Method: Two common sized pen needles of 28G (0.36mm) and 32G (0.23mm) were inserted into skin of sedated LYD pigs prior to termination. Four pigs were included and a total of 32 randomized needle insertions were conducted...... diameter. Conclusion: A computational and quantitative method has been developed to assess tissue trauma following insulin pen needle insertions. Application of the method is tested by conduction of a needle diameter study. The obtained quantitative measures of tissue trauma correlate positively to needle...

Vacuum-assisted breast biopsy: A comparison of 11-gauge and 8-gauge needles in benign breast disease

Directory of Open Access Journals (Sweden)

Kraemer Bernhard

2008-05-01

Full Text Available Abstract Background Minimal invasive breast biopsy is standard care for the diagnosis of suspicious breast lesions. There are different vacuum biopsy (VB systems in use. The aim of the study was to determine the differences between the 8-gauge and the 11-gauge needle with respect to a diagnostic reliability, b complication rate and c subjective perception of pain when used for vacuum-assisted breast biopsy. Methods Between 01/2000 and 09/2004, 923 patients at St. Josefs-Hospital Wiesbaden underwent VB using the Mammotome® (Ethicon Endosurgery, Hamburg. Depending on preoperative detection, the procedure was performed under sonographic or mammographic guidance under local anaesthesia. All patients included in the study were followed up both clinically and using imaging techniques one week after the VB and a second time after a median of 41 months. Excisional biopsy on the ipsilateral breast was an exclusion criteria. Subjective pain scores were recorded on a scale of 0 – 10 (0 = no pain, 10 = unbearable pain. The mean age of the patients was 53 years (30 – 88. Results 123 patients were included in the study in total. 48 patients were biopsied with the 8-gauge needle and 75 with the 11-gauge needle. The use of the 8-gauge needle did not show any significant differences to the 11-gauge needle with regard to diagnostic reliability, complication rate and subjective perception of pain. Conclusion Our data show that there are no relevant differences between the 8-gauge and 11-gauge needle when used for VB. Under sonographic guidance, the use of the 8-gauge needle is recommended for firm breast tissue due to its sharp scalpel point and especially for complete removal of benign lesions. We did not find any advantages in the use of the larger 8-gauge needle compared to the 11-gauge needle in the mammography setting. The utilisation costs of the 8-gauge needle are somewhat higher.

Comparison of the pain levels of computer-controlled and conventional anesthesia techniques in prosthodontic treatment

Directory of Open Access Journals (Sweden)

Murat Yenisey

2009-10-01

Full Text Available OBJECTIVE: The objective of this study was to compare the pain levels on opposite sides of the maxilla at needle insertion during delivery of local anesthetic solution and tooth preparation for both conventional and anterior middle superior alveolar (AMSA technique with the Wand computer-controlled local anesthesia application. MATERIAL AND METHODS: Pain scores of 16 patients were evaluated with a 5-point verbal rating scale (VRS and data were analyzed nonparametrically. Pain differences at needle insertion, during delivery of local anesthetic, and at tooth preparation, for conventional versus the Wand technique, were analyzed using the Mann-Whitney U test (p=0.01. RESULTS: The Wand technique had a lower pain level compared to conventional injection for needle insertion (p0.05. CONCLUSIONS: The AMSA technique using the Wand is recommended for prosthodontic treatment because it reduces pain during needle insertion and during delivery of local anaesthetic. However, these two techniques have the same pain levels for tooth preparation.

High-Field MRI-Compatible Needle Placement Robot for Prostate Interventions

Science.gov (United States)

SU, Hao; CAMILO, Alex; COLE, Gregory A.; HATA, Nobuhiko; TEMPANY, Clare M.; FISCHER, Gregory S.

2014-01-01

This paper presents the design of a magnetic resonance imaging (MRI) compatible needle placement system actuated by piezoelectric actuators for prostate brachytherapy and biopsy. An MRI-compatible modular 3 degree-of-freedom (DOF) needle driver module coupled with a 3-DOF x-y-z stage is proposed as a slave robot to precisely deliver radioactive brachytherapy seeds under interactive MRI guidance. The needle driver module provides for needle cannula rotation, needle insertion and cannula retraction to enable the brachytherapy procedure with the preloaded needles. The device mimics the manual physician gesture by two point grasping (hub and base) and provides direct force measurement of needle insertion force by fiber optic force sensors. The fabricated prototype is presented and an experiment with phantom trials in 3T MRI is analyzed to demonstrate the system compatibility. PMID:21335868

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

Science.gov (United States)

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

Master-slave robotic system for needle indentation and insertion.

Science.gov (United States)

Shin, Jaehyun; Zhong, Yongmin; Gu, Chengfan

2017-12-01

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

Possibilities of the chemical analysis of Scots pine (Pinus sylvestris) needles

International Nuclear Information System (INIS)

Viksna, A.

1999-01-01

Scots pine (Pinus sylvestris L.) is a good bio indicator. This species is widely distributed in Europe, including Latvia, is easily identified, and is used in bio indication studies. It is known that the concentrations of most elements in needles change with time. These changes are connected to the processes involved in the uptake, transportation, storage and retranslocation of the elements. Scots pine keeps their needles for several years (3 to 4 years) and are suitable for the study of time related processes. The chemical composition of pine needles is used for the study the deposition and impact of air pollutants. Coniferous needles are covered with epicuticular wax, which act as a trap for airborne deposits. A comparison of chemical composition of pine needles that were unwashed and washed with chloroform made it possible to distinguish which elements were on the needles and to evaluate the character of pollution. The most important stage of the analysis of pine needles is sampling. Nutrient concentrations in the needles of coniferous trees have been shown to vary with the needle age and tree age, the phase of the annual physiological cycle, availability of nutrients in the soil and needle position within the crown. It is very important to take representative sample for the analysis. In the current work the trace element concentrations of the single needle were analysed by electrothermal atomic absorption spectrometry (ETAAS) and total reflection X-ray spectrometry (TXRF). The results of analysis showed that concentration of some elements depends from the position of needle within branch for the same needle age class. The concentrations of trace elements in the single needles within main shoot were more or less constant compare with other order shoots at given needle age class. Some higher variations in the elemental concentrations between single needles were observed in the tip part of main shoot. The actual distribution of the elements within a needle has

Robotic needle steering: design, modeling, planning, and image guidance

NARCIS (Netherlands)

Cowan, Noah J.; Goldberg, Ken; Chirikjian, Gregory S.; Fichtinger, Gabor; Alterovitz, Ron; Reed, Kyle B.; Kallem, Vinutha; Misra, Sarthak; Park, Wooram; Okamura, Allison M.; Rosen, Jacob; Hannaford, Blake; Satava, Richard M.

2010-01-01

This chapter describes how advances in needle design, modeling, planning, and image guidance make it possible to steer flexible needles from outside the body to reach specified anatomical targets not accessible using traditional needle insertion methods. Steering can be achieved using a variety of

Use of gadolinium chelate to confirm epidural needle placement in patients with an iodinated contrast reaction

International Nuclear Information System (INIS)

Shetty, Sanjay K.; Nelson, Erik N.; Lawrimore, Tara M.; Palmer, William E.

2007-01-01

administration. During the same time period, there were 11/2,067 (0.5%) instances of intrathecal needle placement discovered during attempted epidurography despite the use of fluoroscopy for needle guidance and reliance on loss-of-resistance technique. Gadolinium chelate represents a safe and useful alternative contrast agent for confirmation of epidural needle placement in patients with an iodinated contrast allergy. (orig.)

Use of gadolinium chelate to confirm epidural needle placement in patients with an iodinated contrast reaction

Energy Technology Data Exchange (ETDEWEB)

Shetty, Sanjay K. [Massachusetts General Hospital, Harvard Medical School, Division of Musculoskeletal Radiology, Department of Radiology, Boston, MA (United States); Beth Israel Deaconess Medical Center, Harvard Medical School, Department of Radiology, Boston, MA (United States); Nelson, Erik N.; Lawrimore, Tara M.; Palmer, William E. [Massachusetts General Hospital, Harvard Medical School, Division of Musculoskeletal Radiology, Department of Radiology, Boston, MA (United States)

2007-04-15

administration. During the same time period, there were 11/2,067 (0.5%) instances of intrathecal needle placement discovered during attempted epidurography despite the use of fluoroscopy for needle guidance and reliance on loss-of-resistance technique. Gadolinium chelate represents a safe and useful alternative contrast agent for confirmation of epidural needle placement in patients with an iodinated contrast allergy. (orig.)

Ultrasonography-guided fine-needle aspiration biopsy for thyroid nodules: effective technique and a peculiar smear method

International Nuclear Information System (INIS)

Park, Kyeong Rok; Rho, Myung Ho; Kim, Dong Wook; Koo, Yong Woon; Lee, Kyeong Hee; Kang, Tae Woo

2006-01-01

We wanted to evaluate the effective methods that are appropriate for an endemic area of thyroid disease and to compare the differences of cytologic diagnostic rates with and without using a peculiar smear technique. We analyzed the incidence rate of insufficient results, complications and the total procedure times of 1,126 thyroid nodules in 776 patients who underwent US-FNAB (ultrasonography-guided fine-needle aspiration biopsy) from January to December 2005. We compared the diagnostic rate between the two groups; the groups' tests were performed with a peculiar smear technique (Group A, n 313) or with a ventional smear technique (Group B, n = 250). According to the size of the thyroid nodule, the incidence rate of an insufficient result on US-FNAB and the mean total procedure time for 1126 thyroid nodules in 776 patients were measured as 16.9% (52/308) and 208 seconds for nodules under 0.5 cm, 9.8% (30/306) and 160 seconds for nodules between 0.5 cm-10 cm, and 6.0% (30/504) and 134 seconds for nodules over 1.0 cm. These 776 patients showed no significant complication, except for mild pain. In Group A, the incidence rate of an insufficient result was calculated as 15.1% (14/93) for the group with nodules under 0.5 cm, 5.3% (5/95) for the group with nodules between 0.5 cm-1.0 cm, 4.8% (6/125) for the group with nodules over 1.0 cm, and 8.0% (25/313) for the total A Group. In Group B, the incidence rate of an insufficient result was measured as 33.3% (15/45) for the group with nodules under 0.5 cm, 28.1% (25/89) for the group with nodules between 0.5 cm-1.0 cm, 21.4% (24/112) for the group with nodules over 1.0 cm, and 25.7% (63/245) for the total B group. There was a statistically significant correlation between the rate of an insufficient result and the peculiar smear technique or the size of the thyroid nodule. We consider that US-FNAB is very simple, safe and accurate diagnostic method for thyroid nodules, and US-FNAB with a peculiar smear technique is able to

Endoscopic Ultrasound Guided Rendezvous Drainage of Biliary Obstruction Using a New Flexible 19-Gauge Fine Needle Aspiration Needle.

Science.gov (United States)

Tang, Zhouwen; Igbinomwanhia, Efehi; Elhanafi, Sherif; Othman, Mohamed O

2016-01-01

Background and Aim. A successful endoscopic ultrasound guided rendezvous (EUS-RV) biliary drainage is dependent on accurate puncture of the bile duct and precise guide wire manipulation across the ampulla of Vater. We aim to study the feasibility of using a flexible 19-gauge fine aspiration needle in the performance of EUS-RV biliary drainage. Method. This is a retrospective case series of EUS-RV biliary drainage procedures at a single center. Patients who failed ERCP during the same session for benign or malignant biliary obstruction underwent EUS-RV using a flexible, nitinol covered, 19-gauge needle for biliary access and guide wire manipulation. Result. 24 patients underwent EUS-RV biliary drainage via extrahepatic access while 1 attempt was via intrahepatic access. The technical success rate was 80%, including 83.3% of cases via extrahepatic access. There was no significant difference in success rate of inpatient and outpatient procedures, benign or malignant indications, or type of guide wire used. Adverse events included mild pancreatitis (3 patients) and cholangitis (1 patient). Conclusion. A flexible 19-gauge needle for biliary access can be safe and effective when used to perform EUS-RV biliary drainage. Direct comparison between the nitinol needle and conventional metal needles in the performance of EUS guided biliary drainage is needed.

NUTRIENTS CONCENTRATION AND RETRANSLOCATION IN THE Pinus taeda L. NEEDLES

Directory of Open Access Journals (Sweden)

Márcio Viera

2010-03-01

Full Text Available Aiming at evaluating nutrients concentration and retranslocation in the Pinus taeda L. needles, this study was developed in two stands, in native grass area and in second rotation area, with same species and same age (7.5 years old in Cambará do Sul, RS. The needles were collected in plants in four orthogonal points (South, North, East and West, sampled new needles, mature needles and old needles. The material was dried in a stove, milled and chemically analyzed (macro and micronutrients. The concentrations of N, P, K, B, Cu and Zn had decreased, of Ca, Fe and Mn increased, and the Mg and S have remained constant with the age of the needles. The retranslocation rate (old-new needles was more than 50% for most nutrients, except for Mn and Fe, showed that cumulative effect and the Ca reference element.

Optimisation of steam extraction of oil from maritime pine needles

OpenAIRE

Rezzoug , Sid-Ahmed

2009-01-01

International audience; Essential oil from pine maritime needles is generally extracted by steam distillation process at atmospheric pressure for more than one hour, or by solvent extraction process. In the last decade, there has been an increasing demand for new extraction techniques enabling automation, shorter extraction time and reduced consumption of organic solvent. In this study, Response Surface Methodology (RSM) was used to evaluate the effects of two processing parameters of an alte...

The present-day level of long-living artificial radionuclides content in mosses, lichens and needles of Siberia areas

International Nuclear Information System (INIS)

Strakhovenko, V.D.; Sukhorukov, F.V.; Shcherbov, B.L.

2005-01-01

The purpose of the paper is to estimate the present-day level of long-living artificial radionuclides activity in lichen-moss cover and needles in the Siberia region. During the expeditionary activities (1995-2004) the Lichen cover mosses and needles were sampled in the Ust'-Ordinsky and Aginsky Buryatsky autonomous regions, Altai area, Republic of Altai, Novosibirsk Region, the Yamal-Nenets Autonomous region. The identical species of lichen, mosses. needles were collected from Siberia (lichens - Cladonia, Evernia, Usnea, Parmeli; mosses - Polytrichum, Hylocomium, Pleurozium, Sphagnum; needles - Pinaceae). It was collected 6 and more lichen species from each of 18 sample sites, more than 3 Moss species from 7 sample sites, and in place of coniferous trees joint growth (a pine, a cedar, a fir, a fur-tree and a larch). The needles were selected from all trees and thus were divided into one-year-old and many-year old. The samples were analyzed in the Laboratory of Trace Elements Geochemistry and Ecogeochemistry of the UIGGM, Novosibirsk, using special sample preparation and analysis techniques. The content of 137 Cs were determined by gamma-spectrometry (analyst Stepin A.S.), 90 Sr by beta-radiometry with a radiochemical sample preparation (analyst Makeover I.V.). The data reported are evidence that a present-day level of radioactive contamination in moss-lichen cover and needles of Siberia areas corresponds to this of global background, expect for northern area of Siberia (YNAD) for which hyperactivity are determined for the each of three components. Radiocesium concentration in one-year old needles reflects a level of atmospheric intake only for accidents, for other cases the condition of current needles reflects basically radionuclide level established as the result of dynamic balance between root intake and annual biogenic abscission of needles. (author)

Novel Double-Needle System That Can Prevent Intravascular Injection of Any Filler

Directory of Open Access Journals (Sweden)

Hsiang Huang, MD

2017-09-01

Full Text Available Summary:. A new type of needle system combines 2 parts, an inner needle and an outer needle. The inner needle is used for filler injection and the outer needle acts as a guiding needle that can observe blood reflow when inserting into the vessel lumen during injection process. This new needle system can be used for all kinds of filler, providing real time monitoring for physician and preventing intravascular injection of any filler.

Torsional Dynamics of Steerable Needles: Modeling and Fluoroscopic Guidance

Science.gov (United States)

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

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

Science.gov (United States)

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.

Effective self-regulation change techniques to promote mental wellbeing among adolescents: a meta-analysis

NARCIS (Netherlands)

Genugten, L. van; Dusseldorp, E.; Massey, E.K.; Empelen, P. van

2017-01-01

Mental wellbeing is influenced by self-regulation processes. However, little is known on the efficacy of change techniques based on self-regulation to promote mental wellbeing. The aim of this meta-analysis is to identify effective self-regulation techniques (SRTs) in primary and secondary

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

Science.gov (United States)

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

2013-08-01

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

Diagenesis of conifer needles in a coastal marine environment

Science.gov (United States)

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

Radioactive needle implants in the treatment of anorectal cancer

International Nuclear Information System (INIS)

Price, A.; Kerr, G.R.; Arnott, S.J.

1988-01-01

Radioactive needle implants (Ra 226 , Cs 137 ) were used to treat 44 patients with inoperable anorectal cancer. An implant dose of 60 Gy or higher was administered to 27 patients at a mean dose rate of 0.493 Gy/h (SE ± 0.167 Gy/h). In five patients this was preceded by external beam irradiation. A further 17 patients received an implant dose of less than 60 Gy; this followed external irradiation in 10 patients. A complete response was achieved in 52% (16 out of 31) of patients assessed. Three of these patients later relapsed locally. The median duration of response was 23 months. A partial response of median duration 3 months was achieved by a further 13 patients. Five year actuarial survival was 23.9%. Serious morbidity occurred in six patients; three developed strictures and three necrosis. Features of the tumour and the treatment technique contributing to successful management are discussed. It is suggested that radioactive needle implants have an important part to play in the management of low-lying inoperable anorectal cancers. (author)

Rooting of needle fascicles from western white pine seedlings

Science.gov (United States)

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.

Smart surgical needle actuated by shape memory alloys for percutaneous procedures

Science.gov (United States)

Konh, Bardia

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

Development of a comprehensive analytical method for the determination of chlorinated paraffins in spruce needles applied in passive air sampling

International Nuclear Information System (INIS)

Iozza, Saverio; Schmid, Peter; Oehme, Michael

2009-01-01

Conifer needles are used for the monitoring of atmospheric persistent organic pollutants. The objective of the present study was to develop a method for the detection of airborne chlorinated paraffins (CPs) using spruce needles as a passive sampler. The method is based on liquid extraction of the cuticular wax layer followed by chromatographic fractionation and detection of CPs using two different GCMS techniques. Total CP concentrations (sum of short (SCCP), medium (MCCP) and long chain CPs (LCCP)) were determined by EI-MS/MS. SCCP and MCCP levels as well as congener group patterns (n-alkane chain length, chlorine content) could be evaluated using ECNI-LRMS. For the first time, data on environmental airborne CPs on spruce needles taken within the Monitoring Network in the Alpine Region for Persistent and other Organic Pollutants (MONARPOP) are presented providing evidence that spruce needles are a suitable passive sampling system for the monitoring of atmospheric CPs. - A developed method for chlorinated paraffins (CPs) provided evidence that spruce needles are a suitable passive sampling system for the monitoring of atmospheric CPs.

The longitudinal distribution of elements in developing and aging scots pine needles

International Nuclear Information System (INIS)

Viksna, A.; Helmisaari, H.S.; Standzenieks, P.; Lindgren, E.S.

2001-01-01

Needle or leaf nutrient concentrations are commonly used for analysing tree nutritional status for e.g. estimating possible nutrient deficiencies or unbalances. The practise used e.g. in northern Europe is to sample needles during the dormant period from either the current or in some cases several needle age classes from a fixed position of a number of trees in a stand. The sampled needles are then dried and ground for nutrient analysis. The sampling aims to minimise the spatial and temporal variation in needle nutrient concentrations for estimating the availability of nutrients in soil through needle analysis. It is well known that the concentrations of different nutrients vary in needles with the phase of the annual physiological cycle (Fife and Nambiar 1982, 1984), needle age (Florence and Chuoung 1974, Madgwick et al. 1983) and sampling position (Helmisaari 1992). The samples analysed are usually bulk samples of a large number of needles, and the results are mean concentrations representing an age class in a stand. There is little information on how different needles vary in nutrient concentrations, and even less on how nutrient concentrations vary within individual needles. The import and export of elements to and from needles varies according to the developmental phase of needles, and is likely to affect the element concentrations in different parts of the needles. Accordingly, the elemental concentrations measured in different parts of the needles may give an insight into the transport pattern of an element and its potential mobility. Up to now, very few studies report needle element concentrations in different parts of the needles, e.g. tip, base and middle (Giertych et al. 1997), or in different parts of the leaf phloem (Eschrich et al. 1988). The aim of this study was to determine the distribution of different elements along the length of single Scots pine needles of different age and during different stages of needle physiological cycle. The scanning

Sugar export limits size of conifer needles

DEFF Research Database (Denmark)

Rademaker, Hanna; Zwieniecki, Maciej A.; Bohr, Tomas

2017-01-01

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...... 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...

CUDA accelerated simulation of needle insertions in deformable tissue

International Nuclear Information System (INIS)

Patriciu, Alexandru

2012-01-01

This paper presents a stiff needle-deformable tissue interaction model. The model uses a mesh-less discretization of continuum; avoiding thus the expensive remeshing required by the finite element models. The proposed model can accommodate both linear and nonlinear material characteristics. The needle-deformable tissue interaction is modeled through fundamental boundaries. The forces applied by the needle on the tissue are divided in tangent forces and constraint forces. The constraint forces are adaptively computed such that the material is properly constrained by the needle. The implementation is accelerated using NVidia CUDA. We present detailed analysis of the execution timing in both serial and parallel case. The proposed needle insertion model was integrated in a custom software that loads DICOM images, generate the deformable model, and can simulate different insertion strategies.

Single-needle temporomandibular joint arthrocentesis with hyaluronic acid injections. Preliminary data after a five-injection protocol.

Science.gov (United States)

Manfredini, D; Guarda-Nardini, L; Ferronato, G

2009-10-01

The classical technique for temporomandibular joint (TMJ) arthrocentesis provides a double access to the joint space, which may lead to patient's postoperatory discomfort. For this reason, a less invasive, single-needle approach has been recently described, and the present investigation reports findings on a case series of patients with TMJ osteoarthritis treated with hyaluronic acid injections following a single needle arthrocentesis. METHODS. Fourteen consecutive patients with a diagnosis of TMJ osteoarthritis according to the Research Diagnostic Criteria for Temporo-mandibular Disorders were treated with a cycle of five weekly injections of hyaluronic acid after arthrocentesis. A number of subjective (pain at rest and mastication, masticatory efficiency, functional limitation, subjective efficacy of treatment, tolerability of treatment) and objective (maximum assisted and unassited mouth opening, protrusive and laterotrusive movements) outcome variables were assessed before and after the treatment period. At the end of the five-injection protocol, significant improvements were showed in almost all the subjective outcome variables. Tolerability of the treatment was good on a four-point ordinal scale since the time of the first injection. The present investigation suggested that the single needle technique for TMJ hyaluronic injection following arthrocentesis in osteoarthritic joints may have promising applications in the clinical setting, which have to be confirmed with future studies.

Precision grid and hand motion for accurate needle insertion in brachytherapy

International Nuclear Information System (INIS)

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

2011-01-01

Purpose: In prostate brachytherapy, a grid is used to guide a needle tip toward a preplanned location within the tissue. During insertion, the needle deflects en route resulting in target misplacement. In this paper, 18-gauge needle insertion experiments into phantom were performed to test effects of three parameters, which include the clearance between the grid hole and needle, the thickness of the grid, and the needle insertion speed. Measurement apparatus that consisted of two datum surfaces and digital depth gauge was developed to quantify needle deflections. Methods: The gauge repeatability and reproducibility (GR and R) test was performed on the measurement apparatus, and it proved to be capable of measuring a 2 mm tolerance from the target. Replicated experiments were performed on a 2 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.

Inserting needles into the body: a meta-analysis of brain activity associated with acupuncture needle stimulation.

Science.gov (United States)

Chae, Younbyoung; Chang, Dong-Seon; Lee, Soon-Ho; Jung, Won-Mo; Lee, In-Seon; Jackson, Stephen; Kong, Jian; Lee, Hyangsook; Park, Hi-Joon; Lee, Hyejung; Wallraven, Christian

2013-03-01

Acupuncture is a therapeutic treatment that is defined as the insertion of needles into the body at specific points (ie, acupoints). Advances in functional neuroimaging have made it possible to study brain responses to acupuncture; however, previous studies have mainly concentrated on acupoint specificity. We wanted to focus on the functional brain responses that occur because of needle insertion into the body. An activation likelihood estimation meta-analysis was carried out to investigate common characteristics of brain responses to acupuncture needle stimulation compared to tactile stimulation. A total of 28 functional magnetic resonance imaging studies, which consisted of 51 acupuncture and 10 tactile stimulation experiments, were selected for the meta-analysis. Following acupuncture needle stimulation, activation in the sensorimotor cortical network, including the insula, thalamus, anterior cingulate cortex, and primary and secondary somatosensory cortices, and deactivation in the limbic-paralimbic neocortical network, including the medial prefrontal cortex, caudate, amygdala, posterior cingulate cortex, and parahippocampus, were detected and assessed. Following control tactile stimulation, weaker patterns of brain responses were detected in areas similar to those stated above. The activation and deactivation patterns following acupuncture stimulation suggest that the hemodynamic responses in the brain simultaneously reflect the sensory, cognitive, and affective dimensions of pain. This article facilitates a better understanding of acupuncture needle stimulation and its effects on specific activity changes in different brain regions as well as its relationship to the multiple dimensions of pain. Future studies can build on this meta-analysis and will help to elucidate the clinically relevant therapeutic effects of acupuncture. Copyright © 2013 American Pain Society. All rights reserved.

Does the effect of acupuncture depend on needling sensation and manipulation?

Science.gov (United States)

Choi, Yu-Jin; Lee, Jae-Eun; Moon, Won-Kyung; Cho, Seung-Hun

2013-06-01

Acupuncture sensation and manipulation have been considered to be an important component of acupuncture in traditional Asian medicine. However, there has been limited research as to whether acupuncture sensation is associated with therapeutic benefit. This study investigated the relationship between acupuncture sensation and analgesic effect according to acupuncture manipulation. Fifty-three healthy volunteers received three different forms of acupuncture in a single-blinded crossover design: superficial needling (0.3 cm), deep needling (2 cm) and needling with bi-directional rotation. The effects of acupuncture were evaluated by using the pressure pain threshold. Acupuncture sensation measurement was done in two ways. Both total acupuncture sensation and increase of the pressure pain threshold were maximum in needling with rotation, followed by deep needling and superficial needling. Repeated-measure analysis of variance (ANOVA) analysis was carried out to assess whether there was a significant difference; both showed significant difference (p = 0.000, 0.003). A paired sample t-test was carried out, which revealed that needling with rotation showed significant difference from both superficial needling and deep needling. Further, the correlation between the total acupuncture sensation and changes in pressure pain threshold were calculated using Pearson correlation; there was a significant correlation (p = 0.002, p = 0.013). Acupuncture sensation and pressure pain threshold increase according to the depth and rotation of acupuncture. Especially, both display significant increase with needle rotation. Further, there is a significant correlation between acupuncture needling sensation and increase in pressure pain threshold. It seems that needle rotation and acupuncture sensation play an important role in verifying the effect of acupuncture. Copyright © 2013 Elsevier Ltd. All rights reserved.

Return Rates for Needle Exchange Programs: A Common Criticism Answered

Directory of Open Access Journals (Sweden)

Ksobiech Kate

2004-04-01

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

In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle

Science.gov (United States)

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.

Spruce needles used as radioecological biotracers

International Nuclear Information System (INIS)

Seidel, C.; Gruber, V.; Baumgartner, A.

2009-01-01

In a two years project spruce needle samples of the Austrian Bioindicator Grid were analysed by gamma-ray spectrometry to investigate the spatial and temporal distribution of radionuclides in spruce needles of the last 25 years with the main focus on the radioactive contamination before and after the Chernobyl fallout 1986. More than 600 spruce needle samples at selected locations of the Bioindicator Grid were analysed for different natural and anthropogenic radionuclides: 137 Cs, 40 K, 210 Pb, 226 Ra, 228 Ra, 238 U. Additionally, soil samples were taken at selected sites to study the soil-to-plant transfer. This radioecological evaluation is an important part of an existing environmental surveillance programme in Upper Austria in order to gain basic information on the impact of environmental changes on the radioecological behaviour of spruce trees. (orig.)

A new robotic needle insertion method to minimise attendant prostate motion

International Nuclear Information System (INIS)

Lagerburg, Vera; Moerland, Marinus A.; Vulpen, Marco van; Lagendijk, Jan J.W.

2006-01-01

Background and purpose: The purpose of this study is to investigate the efficacy of a new needle insertion method (tapping instead of pushing) in reducing attendant tissue motion. This can be useful in applications where tissue motion due to needle insertion is problematic such as e.g. MRI-guided prostate brachytherapy and breast biopsies. In this study we will focus on prostate motion due to needle insertion. Material and methods: Prostate motion due to needle insertion was measured in 30 patients, who were transperineally implanted with fiducial gold markers for position verification in prostate intensity modulated radiotherapy. In total 32 needles were manually pushed into the prostate and 29 were tapped with a prototype robotic system. The prostate motion in the cranio-caudal direction was measured on the video record of the ultrasound images. Differences in prostate motion between the two needle insertion methods were analysed making use of SPSS. Results: The mean prostate motion was 5.6 mm (range 0.3-21.6) when the needle was pushed and 0.9 mm (range 0-2.0) when the needle was tapped into the prostate (p < 0.001). Conclusion: Prostate motion was significantly less when the needle was tapped into the prostate compared to when the needle was pushed. This result is important for the development of a tapping, MRI-guided, prostate implant robotic system

The optical "Veress-needle"--initial puncture with a minioptic.

Science.gov (United States)

Schaller, G; Kuenkel, M; Manegold, B C

1995-02-01

Laparoscopic access is a necessary part of minimally invasive surgery. The double blind puncture with Veress-needle and trocar can cause lethal complications such as bowel injury, bleeding and gas-embolisation. Some authors have reported alternative techniques for laparoscopic abdominal access. Because no blind procedure can absolutely prevent injury, permanent visual control of perforated tissue layers as in open surgery should be achieved to prevent possible injury at an early stage. Previously described procedures could not fulfil all requirements to comply with this ideal, i.e. permanent visual control of abdominal wall penetration prior to establishment of pneumoperitoneum and trocar insertion without further possible damage. We designed a 2 mm fibreglass optic 250 mm in length that is inserted into a suitable cannula. Special construction allows rinsing through the cannula to clear the vision and to open spaces in the puncture track by water dissection. After incision of the skin, all layers of the abdominal wall can be visualised, including blood vessels and internal surfaces. Once the abdominal cavity is reached, the needle tip is retracted and a two-step dilation allows the trocar to be introduced via the puncture track. Only then does insufflation begin. The fibreglass optic-equipped safety needle was used for visually controlled access in 184 laparoscopic surgical procedures. After a period of training, all layers of the abdominal wall could be recognised exactly. In two patients with dense adhesions, perforation of the small bowel was diagnosed immediately by endoscopic viewing. The small injury needed no treatment, and the intended procedure was completed laparoscopically.(ABSTRACT TRUNCATED AT 250 WORDS)

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

Energy Technology Data Exchange (ETDEWEB)

Xia, Wenfeng, E-mail: wenfeng.xia@ucl.ac.uk; Desjardins, Adrien E. [Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT (United Kingdom); Mari, Jean Martial [Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom and GePaSud, University of French Polynesia, Faa’a 98702, French Polynesia (France); West, Simeon J. [Department of Anaesthesia, University College Hospital, Main Theatres, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1 2BU (United Kingdom); Ginsberg, Yuval; David, Anna L. [Institute for Women’s Health, University College London, 86-96 Chenies Mews, London WC1E 6HX (United Kingdom); Ourselin, Sebastien [Center for Medical Imaging Computing, University College London, Gower Street, London WC1E 6BT (United Kingdom)

2015-10-15

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 with 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. With

[Effect of twirling-reinforcing-reducing needling manipulations on contents of serum acetylcholine and arterial NOS and cGMP in stress-induced hypertension rats].

Science.gov (United States)

Liu, Wei; Zhu, Ling-Qun; Chen, Si-Si; Lu, Shu-Chao; Tang, Jie; Liu, Qing-Guo

2015-04-01

To observe the effect of twirling-reinforcing or reducing needling manipulations on plasma acetylcholine (Ach) content and expression of nitric oxide synthetase (NOS) and cyclic guanosine monophosphate (cGMP) in thoracic artery tissue in stress-induced hypertension rats. A total of 60 male rats were randomly divided into blank control, model, acupuncture (no-needle-manipulation) , twirling-reinforcing needling and twirling-reducing needling groups (n = 12 in each group). The stress hypertension model was established by giving the animals with noise and electric shock stimulation (paw), twice a day for 15 days. Acupuncture stimulation was applied to bilateral "Taichong" (LR 3) for 1 min, followed by retaining the needles for 20 min. The treatment was conducted once daily for 7 days. Systolic blood pressure of the rat's tail was detected with non-invasive method and plasma Ach, and NOS and cGMP contents in the thoracic artery tissue were measured using ELISA method. Compared with the control group, the systolic blood pressure was significantly higher in the model group after 15 days' stress stimulation (P arterial NOS and cGMP were markedly down-regulated (P arterial cGMP content was found in the no-needle-manipulation group (P > 0.05). The effect of the twirling-reducing needling was superior to that of no-needle-manipulation and twirling-reinforcing needling in lowering blood pressure and raising plasma Ach content (P hypertensive effect in stress hypertension rats, which may be associated with its effects in raising blood Ach, and arterial NOS and cGMP levels.

Composition and Chemical Variability of the Needle Oil from Pinus halepensis growing in Corsica.

Science.gov (United States)

Nam, Anne-Marie; Tomi, Félix; Gibernau, Marc; Casanova, Joseph; Bighelli, Ange

2016-04-01

The composition of oil samples isolated from needles of Pinus halepensis growing in three locations in Corsica (Saleccia, Capo di Feno, and Tre Padule) has been investigated by combination of chromatographic (GC with retention indices) and spectroscopic (MS and (13)C-NMR) techniques. In total, 35 compounds that accounted for 77 - 100% of the whole composition have been identified. α-Pinene, myrcene, and (E)-β-caryophyllene were the major component followed by α-humulene and 2-phenylethyl isovalerate. Various diterpenes have been identified as minor components. 47 Oil samples isolated from pine needles have been analyzed and were differentiated in two groups. Oil samples of the first group (15 samples) contained myrcene (M = 28.1 g/100 g; SD = 10.6) and (E)-β-caryophyllene (M = 19.0 g/100 g; SD = 2.2) as major components and diterpenes were absent. All these oil samples were isolated from pine needles harvested in Saleccia. Oil samples of the second group (32 samples) contained mostly (E)-β-caryophyllene (M = 28.7 g/100 g; SD = 7.9), α-pinene (M = 12.3 g/100 g; SD = 3.6), and myrcene (M = 11.7 g/100 g; SD = 7.3). All these oil samples were isolated from pine needles harvested in Capo di Feno and Tre Padule. © 2016 Verlag Helvetica Chimica Acta AG, Zürich.

Shoulder, hip, and knee arthrography needle placement using fluoroscopic guidance: practice patterns of musculoskeletal radiologists in North America

International Nuclear Information System (INIS)

Shortt, Conor P.; Morrison, William B.; Deely, Diane M.; Gopez, Angela G.; Zoga, Adam C.; Roberts, Catherine C.

2009-01-01

The aim of this study was to evaluate the range of techniques used by radiologists performing shoulder, hip, and knee arthrography using fluoroscopic guidance. Questionnaires on shoulder, hip, and knee arthrography were distributed to radiologists at a national radiology meeting. We enquired regarding years of experience, preferred approaches, needle gauge, gadolinium dilution, and volume injected. For each approach, the radiologist was asked their starting and end needle position based on a numbered and lettered grid superimposed on a radiograph. Sixty-eight questionnaires were returned. Sixty-eight radiologists performed shoulder and hip arthrography, and 65 performed knee arthrograms. Mean experience was 13.5 and 12.8 years, respectively. For magnetic resonance arthrography, a gadolinium dilution of 1/200 was used by 69-71%. For shoulder arthrography, an anterior approach was preferred by 65/68 (96%). The most common site of needle end position, for anterior and posterior approaches, was immediately lateral to the humeral cortex. A 22-gauge needle was used by 46/66 (70%). Mean injected volume was 12.7 ml (5-30). For hip arthrography, an anterior approach was preferred by 51/68 (75%). The most common site of needle end position, for anterior and lateral approaches, was along the lateral femoral head/neck junction. A 22-gauge needle was used by 53/68 (78%). Mean injected volume was 11.5 ml (5-20). For knee arthrography, a lateral approach was preferred by 41/64 (64%). The most common site of needle end position, for lateral and medial approaches, was mid-patellofemoral joint level. A 22-gauge needle was used by 36/65 (56%). Mean injected volume was 28.2 ml (5-60). Arthrographic approaches for the shoulder, hip, and knee vary among radiologists over a wide range of experience levels. (orig.)

Shoulder, hip, and knee arthrography needle placement using fluoroscopic guidance: practice patterns of musculoskeletal radiologists in North America

Energy Technology Data Exchange (ETDEWEB)

Shortt, Conor P. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Morrison, William B.; Deely, Diane M.; Gopez, Angela G.; Zoga, Adam C. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Roberts, Catherine C. [Mayo Clinic College of Medicine, Department of Radiology, Phoenix, AZ (United States)

2009-04-15

The aim of this study was to evaluate the range of techniques used by radiologists performing shoulder, hip, and knee arthrography using fluoroscopic guidance. Questionnaires on shoulder, hip, and knee arthrography were distributed to radiologists at a national radiology meeting. We enquired regarding years of experience, preferred approaches, needle gauge, gadolinium dilution, and volume injected. For each approach, the radiologist was asked their starting and end needle position based on a numbered and lettered grid superimposed on a radiograph. Sixty-eight questionnaires were returned. Sixty-eight radiologists performed shoulder and hip arthrography, and 65 performed knee arthrograms. Mean experience was 13.5 and 12.8 years, respectively. For magnetic resonance arthrography, a gadolinium dilution of 1/200 was used by 69-71%. For shoulder arthrography, an anterior approach was preferred by 65/68 (96%). The most common site of needle end position, for anterior and posterior approaches, was immediately lateral to the humeral cortex. A 22-gauge needle was used by 46/66 (70%). Mean injected volume was 12.7 ml (5-30). For hip arthrography, an anterior approach was preferred by 51/68 (75%). The most common site of needle end position, for anterior and lateral approaches, was along the lateral femoral head/neck junction. A 22-gauge needle was used by 53/68 (78%). Mean injected volume was 11.5 ml (5-20). For knee arthrography, a lateral approach was preferred by 41/64 (64%). The most common site of needle end position, for lateral and medial approaches, was mid-patellofemoral joint level. A 22-gauge needle was used by 36/65 (56%). Mean injected volume was 28.2 ml (5-60). Arthrographic approaches for the shoulder, hip, and knee vary among radiologists over a wide range of experience levels. (orig.)

Bronchoscopic techniques in the management of patients with tuberculosis

Directory of Open Access Journals (Sweden)

Michele Mondoni

2017-11-01

Full Text Available Tuberculosis (TB is one of the leading causes of morbidity and mortality worldwide. Early diagnosis and treatment are key to prevent Mycobacterium tuberculosis transmission. Bronchoscopy can play a primary role in pulmonary TB diagnosis, particularly for suspected patients with scarce sputum or sputum smear negativity, and with endobronchial disease. Bronchoscopic needle aspiration techniques are accurate and safe means adopted to investigate hilar and mediastinal lymph nodes in cases of suspected TB lymphadenopathy. Tracheobronchial stenosis represents the worst complication of endobronchial tuberculosis. Bronchoscopic procedures are less invasive therapeutic strategies than conventional surgery to be adopted in the management of TB-related stenosis.We conducted a non-systematic review aimed at describing the scientific literature on the role of bronchoscopic techniques in the diagnosis and therapy of patients with TB.We focused on three main areas of interventions: bronchoscopic diagnosis of smear negative/sputum scarce TB patients, endobronchial TB diagnosis and treatment and needle aspiration techniques for intrathoracic TB lymphadenopathy. We described experiences on bronchoalveolar lavage, bronchial washing, and biopsy techniques for the diagnosis of patients with tracheobronchial and pulmonary TB; furthermore, we described the role played by conventional and ultrasound-guided transbronchial needle aspiration in the diagnosis of suspected hilar and mediastinal TB adenopathy. Finally, we assessed the role of the bronchoscopic therapy in the treatment of endobronchial TB and its complications, focusing on dilation techniques (such as balloon dilation and airway stenting and ablative procedures (both heat and cold therapies. Keywords: Bronchoscopy, Tuberculosis, Endoscopic ultrasound-guided fine needle aspiration, Tracheobronchial stenosis

Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman’s Knot

Directory of Open Access Journals (Sweden)

Yong Un Shin

2017-01-01

Full Text Available Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL using a single fisherman’s knot (SFK. Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

APPLICABILITY OF CONSOLIDATED TECHNIQUES IN THE VIEW OF ROMANIAN ACCOUNTING REGULATIONS

Directory of Open Access Journals (Sweden)

Cristina Rosu

2016-06-01

Full Text Available The accounting regulations are more and more interested in groups of companies. In some cases, these regulations require for preparing the consolidated financial statements. This is the task of the parent company who keeps the consolidated accounts. To accomplish its goals, the consolidated accounting uses a couple of, so-called, consolidation techniques. These are applied in the case of groups of companies with a complex structure. Their goal is to elaborate the consolidated financial statements using a set of methods and empirical skills. In this article we synthetize and apply the consolidation techniques in the view of Romanian accounting regulations. The Romanian practice has revealed, especially, two techniques: one based on direct consolidation and another one based on multiple levels (phased consolidation. Therefore, this work regards only the technical side of consolidated accounting, accounting records being evaded. Furthermore, we focus only on the preparation of the consolidated balance sheet in the case of some hypothetical groups of companies.

Guide for the realization of core needle biopsy through stereotaxy in the diagnosis of suspicious breast lesions of malignity

International Nuclear Information System (INIS)

Jimenez Zuniga, Jorge Luis

2012-01-01

demonstrated to be more precise and to make more accurate the diagnostic evaluation. While, the systems of vacuum-assisted biopsy have allowed the obtention of higher quality cylinders, clearly improving results, especially in cases of microcalcifications. The main indications for the use of stereotaxy in the intervention of the breast are analyzed, among which can be mentioned: fine-needle aspiration biopsy, core needle biopsy and preoperative localization. The technique of fine-needle aspiration biopsy has gained acceptation in the diagnosis of palpable lesions of the breast, the function of this technique in the management of nonpalpable lesions not is completely defined, due to the high percentage of insufficient samples. The systems of core needle biopsy have allowed the obtention of multiple cylinders with great diagnostic reliability, especially in the case of breast nodules. However, its use in microcalcifications has showed false negative results. The preoperative localization through needle in the nonpalpable lesions of the breast, has allowed to the radiologist to provide a guide to the surgeon that has realized the open biopsy, ensuring thus, that surgical procedure can be carried out quickly and with the best possible cosmetic result. The radiological assessment of the breast lesions in mammography are defined, in order to standardize the terminology applied at the time to report studies of the breast, to categorize the lesions according to the level of suspicion and to assign a recommendation to follow in injury determined. Before all nonpalpable breast lesion that has required a biopsy, should be considered first which will be the guidance system most adequate, and second, which is the technique with best diagnostic performing and better relationship cost/effectiveness. The core needle biopsy (CNB) has been a little aggressive technique and highly reliable in the diagnosis of the palpable and nonpalpable lesions. The sensitivity of the CNB has been different

[King Injo's disease and burnt needle therapy].

Science.gov (United States)

Kim, In-Sook

2004-12-01

This paper investigates an interrelationship between burnt needle therapy and King Injo's disease. From 1633 (Year 11 in King Injo's reign) to May 5, 1649 (Year 27 in King Injo's reign), right before his death, King Injo was treated with burnt needles by Yi Hyeongik, an acupuncturist when the king had health problems. This study arises from two questions: why was King Injo often treated with burnt needles? and what effect did burnt needles have?Burnt needle therapy is a combined form of acupuncture and moxibustion. Yi Hyeongik was famous for eradicating pathogenic factors. He was appointed as a doctor in the Royal Hospital. The medical definition for pathogenic factors is that they are disease-causing factors. Understanding the pathogenic factor for King Injo's disease could make it possible to find the interrelationship between burnt needles and the king's disease. In the Joseon ear, the prevalent belief about diseases was that diseases could be caused by homeopathic magic. Some people thought homeopathic magic caused King Injo's disease. The actual reasons for King Injo's disease were the participation in the excessive rites of Queen Mother Inmok's funeral and the constant oppression from the Ching Dynasty after disgraceful defeat in the war. When King Injo started to be sick, homeopathic magic cases were found in the royal palace. The king's incurable disease was believed to have happened as a result of homeopathic magic. King Injo's suspicion toward Princess Jeongmyeong derived from her mother, Queen Mother Inmok. Moral justification for King Injo's coup was Gwanghaegun or Prince Gwanghae's immoral conduct toward Queen Mothe Inmok. After he was installed, King Injo obeyed the Queen Mother and showed her every attention. Meanwhile, he treated Princess Jeongmyeong with respect, maximized the moral justification for the coup, and solidified the royal authority. However, constant rebellions and treasons threatened King Injo. The king suspected that Queen Mother

Fine Needle Aspiration Biopsy in a Rural Family Practice

African Journals Online (AJOL)

ultrasound scan. A 21-gauge 1½-inch or 23-gauge 1¼-inch needle, attached to a 10-mL disposable plastic syringe, was used for FNAB of superficial masses. For percutaneous FNAB of deep-seated organs and masses, a 23 gauge 1¼-inch needle or 3½-inch spinal needle was used. The aspirate was spread on slides and ...

Compressed sensing electron tomography of needle-shaped biological specimens – Potential for improved reconstruction fidelity with reduced dose

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Saghi, Zineb, E-mail: saghizineb@gmail.com [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Divitini, Giorgio [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Winter, Benjamin [Center for Nanoanalysis and Electron Microscopy (CENEM), Friedrich-Alexander-Universität Erlangen-Nürnberg, Cauerstraße 6, 91058 Erlangen (Germany); Leary, Rowan [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Spiecker, Erdmann [Center for Nanoanalysis and Electron Microscopy (CENEM), Friedrich-Alexander-Universität Erlangen-Nürnberg, Cauerstraße 6, 91058 Erlangen (Germany); Ducati, Caterina [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Midgley, Paul A., E-mail: pam33@cam.ac.uk [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom)

2016-01-15

Electron tomography is an invaluable method for 3D cellular imaging. The technique is, however, limited by the specimen geometry, with a loss of resolution due to a restricted tilt range, an increase in specimen thickness with tilt, and a resultant need for subjective and time-consuming manual segmentation. Here we show that 3D reconstructions of needle-shaped biological samples exhibit isotropic resolution, facilitating improved automated segmentation and feature detection. By using scanning transmission electron tomography, with small probe convergence angles, high spatial resolution is maintained over large depths of field and across the tilt range. Moreover, the application of compressed sensing methods to the needle data demonstrates how high fidelity reconstructions may be achieved with far fewer images (and thus greatly reduced dose) than needed by conventional methods. These findings open the door to high fidelity electron tomography over critically relevant length-scales, filling an important gap between existing 3D cellular imaging techniques. - Highlights: • On-axis electron tomography of a needle-shaped biological sample is presented. • A reconstruction with isotropic resolution is achieved. • Compressed sensing methods are compared to conventional reconstruction algorithms. • High fidelity reconstructions are achieved with greatly undersampled datasets.

Compressed sensing electron tomography of needle-shaped biological specimens – Potential for improved reconstruction fidelity with reduced dose

International Nuclear Information System (INIS)

Saghi, Zineb; Divitini, Giorgio; Winter, Benjamin; Leary, Rowan; Spiecker, Erdmann; Ducati, Caterina; Midgley, Paul A.

2016-01-01

Electron tomography is an invaluable method for 3D cellular imaging. The technique is, however, limited by the specimen geometry, with a loss of resolution due to a restricted tilt range, an increase in specimen thickness with tilt, and a resultant need for subjective and time-consuming manual segmentation. Here we show that 3D reconstructions of needle-shaped biological samples exhibit isotropic resolution, facilitating improved automated segmentation and feature detection. By using scanning transmission electron tomography, with small probe convergence angles, high spatial resolution is maintained over large depths of field and across the tilt range. Moreover, the application of compressed sensing methods to the needle data demonstrates how high fidelity reconstructions may be achieved with far fewer images (and thus greatly reduced dose) than needed by conventional methods. These findings open the door to high fidelity electron tomography over critically relevant length-scales, filling an important gap between existing 3D cellular imaging techniques. - Highlights: • On-axis electron tomography of a needle-shaped biological sample is presented. • A reconstruction with isotropic resolution is achieved. • Compressed sensing methods are compared to conventional reconstruction algorithms. • High fidelity reconstructions are achieved with greatly undersampled datasets.

An investigation of sulfur concentrations in soils and pine needles in Chaco Culture National Historical Park, New Mexico

International Nuclear Information System (INIS)

Gladney, E.S.; Ferenbaugh, R.W.; Jones, E.A.; Bell, M.G.; Morgan, J.D.; Nelson, L.A.; Bowker, R.G.

1993-03-01

Sulfur measurements in different age groups of pinon pine needles and adjacent soil samples from ten sampling sites at Chaco Culture National Historical Park were determined using combustion elemental analysis and chromatographic techniques. The primary goal was to establish base-line levels for elemental sulfur in the Park. Sulfur levels in foliage and soils were evaluated using analysis of variance techniques. No significant differences were found in foliage sulfur concentrations among the 10 sampling sites; however, trees within sites were significantly different. Needles of different ages did not differ significantly in sulfur content. Average soil concentrations were low, approximately 30% of the average needle concentrations. Soil sulfur concentrations did not differ significantly among the 10 sampling sites; however, different depths in the soil had statistically different concentrations of sulfur. No statistical differences were evident in soils sampled at the four compass points (N,S,E,W) around each tree. These differences imply that large numbers of samples are needed to identify small effects from anthropogenic inputs of sulfur into the system or that the effects must be large relative to the differences among sampling sites and individual trees in order to be detected

A convenient tool for gas derivatization using fine-needle capillary mounting for protein crystals

International Nuclear Information System (INIS)

Mizuno, Nobuhiro; Makino, Masatomo; Kumasaka, Takashi

2013-01-01

A convenient gas-derivatization tool for protein crystals is presented in combination with a fine-needle capillary and a gas-pressure regulator. Gas derivatization of protein crystals is useful not only to analyse gas-binding proteins but also to solve the phase problem of X-ray crystallography by using noble gases. However, the gas pressurization tools for these experiments are often elaborate and need to release the gas before flash-cooling. To simplify this step, a procedure using a fine-needle capillary to mount and flash-cool protein crystals under the pressurization of gases has been developed. After the crystals are picked up with the capillary, the capillary is sealed with an adhesive and then connected directly to a gas regulator. The quality of the diffraction data using this method is comparable with that of data from conventional pressurization procedures. The preparation of xenon-derivatives of hen egg-white lysozyme using this method was a success. In the derivatives, two new xenon binding sites were found and one of their sites vanished by releasing the gas. This observation shows the availability of flash-cooling under gas pressurization. This procedure is simple and useful for preparing gas-derivative crystals

Usefulness of the coaxial technique in US-guided breast core biopsy

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Kim, Dong Hyun; Lee, Jeong Hwa; Ha, Jeon Ju; Lee, Keon; Kim, Won Ho; Kwon, Jung Hyeok [Dongkang general hospital, Seoul (Korea, Republic of); Ham, Soo Youn [Ulsan Univ. Hospital, Ulsan (Korea, Republic of)

1999-05-01

To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40 patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion. Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We used an 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens were obtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and their rate were evaluated. For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, and the findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 of fibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12 lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. The procedure time was about 15 minutes and no significant complications were noted. In breast core biopsy, the coaxial technique is simple and time-saving, and compared with standard breast core biopsy, may also be less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells.

Usefulness of the coaxial technique in US-guided breast core biopsy

International Nuclear Information System (INIS)

Kim, Dong Hyun; Lee, Jeong Hwa; Ha, Jeon Ju; Lee, Keon; Kim, Won Ho; Kwon, Jung Hyeok; Ham, Soo Youn

1999-01-01

To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40 patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion. Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We used an 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens were obtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and their rate were evaluated. For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, and the findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 of fibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12 lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. The procedure time was about 15 minutes and no significant complications were noted. In breast core biopsy, the coaxial technique is simple and time-saving, and compared with standard breast core biopsy, may also be less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells

The reliability of ultrasound-guided core needle biopsy in the evaluation of non-palpable solid breast lesions using 18-gauge needles

Energy Technology Data Exchange (ETDEWEB)

Lim, Sung Chul; Kim, Young Sook [Chosun University College of Medicine, Gwangju (Korea, Republic of); Sneige, Nour [The University of Texas M.D. Andreson Carcer Canter, Houston (United States)

2003-04-01

Ultrasound-guided core needle biopsy (US CNB) is increasingly used in the histologic evaluation of non-palpable solid breast lesions. We retrospectively investigated the diagnostic accuracy of this technique, using an 18-gauge needle in 422 non-palpable breast lesions. 583 female patients with an average age 56 (range, 22-90) years underwent 590 US CNBs. Between January 1994 and December 1999, using 18-gauge needles, an average of four cores per lesion was obtained. Three hundred and eighty-five lesions were subsequently surgically excised; for 14 of these, the pathologic diagnosis was breast carcinoma metastasis, while 23 with benign diagnoses were clinically followed up for {>=}2.5 years and were considered for analysis. Of the 422 lesions, 340 (80.6%) were malignant [308 invasive, 24 ductal carcinoma in situ (DCIS), 7 DCIS with undetermined invasion and 1 DCIS vs. lobular carcinoma in situ], 67 (15.9%) were benign [30 fibroadenoma (FA) and 37 other diagnoses], and five (1.2%) were fibroepithelial lesions. The remaining ten samples (2,4%) included six cases of atypical ductal hyperplasia (ADH), two of atypical hyperplasia (AH), and two of lobular neoplasia. The sensitivity, specificity, positive predictive value, and negative predictive value of CNBs were 99%, 100%, 100%, and 96%, respectively. Two cases of invasive carcinoma were missed at CNB; there was no false-positive diagnosis. Five of six ADHs and one of two AHs were found to be carcinomas (3 DCIS and 3 infiltrating duct carcinomas). Sixteen of 24 (66.7%) cases of DCIS were found at excision to be invasion carcinomas. Of 31 FAs, two (6.5%) were found to be low-grade phyllodes tumor (PT). The five fibroepithelial lesions were shown at excision to be either PT (n=4) or FA (n=1). US CNB using an 18-gauge needle is a safe and reliable means of diagnosing breast carcinoma. Because of the high prevalence of ductal carcinoma is these lesions; findings of ADH/AH at US CNB indicate that surgical excision is needed

Trabeculectomy bleb needling and antimetabolite administration practices in the UK: a glaucoma specialist national survey.

Science.gov (United States)

Mercieca, Karl; Drury, Brett; Bhargava, Archana; Fenerty, Cecilia

2017-12-06

To evaluate, describe and quantify the diversity in postoperative antimetabolite administration and bleb needling practices among glaucoma specialists performing trabeculectomy surgery within the UK and Ireland. A cross-sectional online survey was distributed to all consultant glaucoma specialists who are on the United Kingdom and Eire Glaucoma Society (UKEGS) contact list. Participants were asked specific questions about their current practices for post-trabeculectomy antimetabolite administration followed by questions directly related to bleb needling procedures. 60 (83%) of UKEGS glaucoma subspecialty consultants completed the survey. 70% of respondents administered 5-fluorouracil (5-FU) in their clinic room while 30% used a separate treatment room. Doses of 5-FU varied considerably but 70% used 5 mg as standard. Techniques used to reduce corneal toxicity included precipitation with amethocaine (44%) or benoxinate (14%), saline wash (14%) and modified injection technique (8%). Topical antibiotics and/or betadine were used to prevent infection following 5-FU injection in just over 50%. Bleb needling was exclusively performed in operating theatre by 56% of respondents and solely at the slit lamp in the clinic room by 12%. A further 30% used a combination of both theatre and outpatient clinic rooms. Anti-metabolites used were 5-FU (72%) and mitomycin C (22%) with 12% using either of the two substances. There is a significantly wide variety of current practices for antimetabolite administration and bleb needling within the UK and Ireland. This may be influenced by a glaucoma surgeon's specific experience and audit results as well as particular clinical set-up, availability of antimetabolite and clinic room space. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

Science.gov (United States)

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.

Cavernous sinus lesions biopsy with neuronavigation and tip-cut needle

Science.gov (United States)

Lorenzetti, Martin; Carvalho, Herculano; Cattoni, Maria; Gonçalves-Ferreira, Antonio; Pimentel, José; Antuñes, Joao

2014-01-01

Background: Transoval biopsy of cavernous sinus (CS) lesions is the last non-invasive diagnostic option in those 15% of patients in whom etiology remains unclear in spite of extensive neuroradiological imaging, clinical assessment, and laboratory evaluation. However, there are no guidelines defining indications and the most appropriate technique for this procedure. Case Description: We present four patients in whom we performed X-ray and neuronavigation-assisted transoval CS biopsies using tip-cut needles. Conclusion: The technique described allows the operator to determine the optimal angle for entering the CS, avoiding the complications due to distorted anatomy, and facilitating orientation once inside the CS. It reduces both radiation exposure as well as general anesthesia duration. PMID:25593783

[Special penetration needling for refractory peripheral facial paralysis].

Science.gov (United States)

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

Investigation into the effects of using two or four acupuncture needles with bidirectional rotation on experimentally-induced contact heat pain in healthy subjects.

Science.gov (United States)

Paley, Carole A; Johnson, Mark I

2015-02-01

There is growing evidence from experimental studies that the acupuncture dose or technique influences the speed of onset of hypoalgesia. The aim of this study was to investigate the effects of acupuncture using two or four needles on experimental contact thermal pain in healthy volunteers. Forty two participants were randomised into three groups: four-needle group (LI4, LI11, LI10, TE5), two-needle group (verum at LI4, LI11 and mock at LI10, TE5) and mock acupuncture group (LI4, LI11, LI10, TE5). Each participant rated pain intensity (visual analogue scale, VAS) to a series of noxious stimuli administered to the forearm 2°C above the heat pain threshold during needling and immediately after removal of the needles. Experimentally-induced heat pain intensity (VAS) during and after the intervention was lower than pre-intervention but there were no statistically significant differences in this change between groups. There were no statistically significant differences between groups in the time taken for pain intensity to decrease by 33% from pre-intervention. However, a 33% decrease in pain intensity within 3 min of needle insertion was observed for 13 participants (92.9%) in the four-needle group compared with 66.7% of participants in the two-needle group and 57.1% in the mock acupuncture group. There was less variance in VAS in the four-needle group, suggesting more consistency in hypoalgesic response when using more needles. There is tentative evidence that four needles may be superior to two needles in generating rapid onset hypoalgesia. The findings suggest that further investigation is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Raman Spectroscopy Differentiates Each Tissue From the Skin to the Spinal Cord: A Novel Method for Epidural Needle Placement?

Science.gov (United States)

Anderson, T. Anthony; Kang, Jeon Woong; Gubin, Tatyana; Dasari, Ramachandra R.; So, Peter T. C.

2016-01-01

BACKGROUND Neuraxial anesthesia and epidural steroid injection techniques require precise anatomical targeting to ensure successful and safe analgesia. Previous studies suggest that only some of the tissues encountered during these procedures can be identified by spectroscopic methods, and no previous study has investigated the use of Raman, diffuse reflectance, and fluorescence spectroscopies. The authors hypothesized that real-time needle-tip spectroscopy may aid epidural needle placement and tested the ability of spectroscopy to distinguish each of the tissues in the path of neuraxial needles. METHODS For comparison of detection methods, the spectra of individual, dissected ex vivo paravertebral and neuraxial porcine tissues were collected using Raman spectroscopy (RS), diffuse reflectance spectroscopy (DRS), and fluorescence spectroscopy (FS). Real-time spectral guidance was tested using a 2 mm inner diameter fiber optic probe-in-needle device. Raman spectra were collected during the needle’s passage through intact paravertebral and neuraxial porcine tissue and analyzed afterward. The RS tissue signatures were verified as mapping to individual tissue layers using histochemical staining and widefield microscopy. RESULTS Raman spectroscopy revealed a unique spectrum for all ex vivo paravertebral and neuraxial tissue layers; DRS and FS spectra were not distinct for all tissues. Moreover, when accounting for the expected order of tissues, real-time Raman spectra recorded during needle insertion also permitted identification of each paravertebral and neuraxial porcine tissue. CONCLUSIONS This study demonstrates Raman spectroscopy can distinguish the tissues encountered during epidural needle insertion. This technology may prove useful during needle placement by providing evidence of its anatomical localization. PMID:27466032

25-gauge fibered-needle for label-free fluorescence analysis of breast masses: a first in vivo study

Science.gov (United States)

Toullec, Alexis; Mathieu, Marie-Christine; Benoit, Charlotte; Farcy, René; Tourasse, Christophe; Boisserie-Lacroix, Martine; Fontaine-Aupart, Marie-Pierre; Delaloge, Suzette; Balleyguier, Corinne

2018-02-01

Breast lesions diagnosis and characterization need additional cost-effective techniques to avoid unnecessary invasive procedures, such as core needle biopsies, in the case of benign tumors. Endogenous fluorescence is an effective method to highlight in situ metabolic and/or structural changes between cancerous and non-cancerous lesions. In this context, we developed an original set-up, consisting of a 405 nm laser diode transmitting light through a 25 Gauge (0.45 mm x 50mm) 14° sharp fibered needle to excite intranodular fluorophores around the needle tip and providing real-time labelfree fluorescence spectral analysis of lesions from 450 nm to 650 nm. The objective was to help radiologists to classify suspicious masses in vivo and in real-time within the lesion. We reported the results of spectral differences between 14 invasive lobular carcinomas and 6 intraductal papilloma enrolled in a clinical study.

Comparative Studies on the Phytochemistry of Essential Oil from Needles and Berries of Juniperus excelsa M. Bieb

International Nuclear Information System (INIS)

Nadir, M.

2013-01-01

The study provides a comparison on the essential oil composition of Juniperus excelsa M. Bieb. Essential oil extracted separately from berries (yield 0.11%) and needles (yield 0.13%) were subjected to GC-MS and GC-FID techniques for the identification and quantification of the constituents. A total of 26 compounds; 21 from berries and 20 from needles were identified. Of these major constituents in berries were beta-pinene (43.4%), beta-pinene (32.3%), limonene (9.6%), and sabinene (2.7%) while in needles were beta-pinene (36.0%), beta-pinene (30.2%), limonene (12.6%), and beta-phellandrene (3.9%). 3 identified compounds (guaiol, beta-elemene and epi-bicyclosesquiphellandrene) were not reported yet from any essential oil of J. excelsa, beta-guaiene is also reported for the first time from needles. A comparative discussion on the chemical composition of the essential oil from two different parts of plants in the current study with those available in literature is also included. The findings confirmed that the Pakistan origin plant belongs to alpha-pinene chemotype, alpha-pinene rich oils are used as local antiseptic. (author)

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

Science.gov (United States)

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.

Are percutaneous transgastric biopsies using 14-,16- and 18-G Tru-Cut needles safe? An experimental study in the rabbit

International Nuclear Information System (INIS)

Akan, H.; Incesu, L.; Gunes, M.; Ozen, N.; Gumus, S.

1998-01-01

We evaluated perforation, peritonitis and bleeding after 14-, 16-, 18-G Tru-Cut needles were passed through the stomach in an animal model. Insertions were performed on seven anesthetized rabbits with 18-,16-and 14-G needles simulating the clinical technique. Diluted contrast medium with methylene blue (60mL) was administered through a nasogastric tube after the biopsy. Computed tomography (CT) scanning of the upper abdomen was performed 10 minutes after the insertion for leakage. The abdominal contents were inspected by laparotomy. There was no contrast medium leakage outside the gastrointestinal tract on CT images. Neither methylene blue nor other stomach content leakage was identified by laparotomy, even with manual squeezing. A tiny spot of blood was observed on the serosal surface of the stomach with the 18-G needle passes (five cases), whereas a relatively large haematoma was present with 14-G needle (four cases). Six of the rabbits survived and one died due to an inadvertant aortic injury. The results of the study show that transgastric route with an 1 8-G cutting needle can be used without fear of peritonitis and bleeding. Copyright (1998) Blackwell Science Pty Ltd

Are percutaneous transgastric biopsies using 14-,16- and 18-G Tru-Cut needles safe? An experimental study in the rabbit

Energy Technology Data Exchange (ETDEWEB)

Akan, H.; Incesu, L.; Gunes, M. [Ondokuz Mayis University Medical School, Samsun (Turkey). Department of Radiology; Ozen, N.; Gumus, S. [Ondokuz Mayis University Medical School, Samsun (Turkey). Department of Surgery

1998-05-01

We evaluated perforation, peritonitis and bleeding after 14-, 16-, 18-G Tru-Cut needles were passed through the stomach in an animal model. Insertions were performed on seven anesthetized rabbits with 18-,16-and 14-G needles simulating the clinical technique. Diluted contrast medium with methylene blue (60mL) was administered through a nasogastric tube after the biopsy. Computed tomography (CT) scanning of the upper abdomen was performed 10 minutes after the insertion for leakage. The abdominal contents were inspected by laparotomy. There was no contrast medium leakage outside the gastrointestinal tract on CT images. Neither methylene blue nor other stomach content leakage was identified by laparotomy, even with manual squeezing. A tiny spot of blood was observed on the serosal surface of the stomach with the 18-G needle passes (five cases), whereas a relatively large haematoma was present with 14-G needle (four cases). Six of the rabbits survived and one died due to an inadvertant aortic injury. The results of the study show that transgastric route with an 1 8-G cutting needle can be used without fear of peritonitis and bleeding. Copyright (1998) Blackwell Science Pty Ltd 19 refs., 1 tab., 1 fig.

Root canal debris removal using different irrigating needles: An SEM study

Directory of Open Access Journals (Sweden)

Sheetal Ghivari

2011-01-01

Full Text Available Aim: This study was carried out to compare the efficacy of three irrigating needle designs in removal of debris from different parts of the root canal. Materials and Methods: Thirty human maxillary canines were prepared using HERO Shaper rotary system and irrigated with 1 ml of 5.25% sodium hypochlorite (NaOCl after each instrument change. Three 25-gauge irrigation needle designs - brush-covered Navi Tip FX (Group I, side-vented needle RC Twents (Group II and single-beveled (Group III irrigating needles - were tested for their efficiency in debris removal in three different parts of the root canal (n=10 canals per group. Following instrumentation, the roots were vertically sectioned and divided into coronal, middle and apical thirds for observation under scanning electron microscope (×200 magnification. Debris on the canal wall was evaluated by using a four-scale scoring system described by Paque and his co-workers. Results: The canals irrigated with brush-covered needle Navi Tip FX (Group I showed lower average debris score, indicating greater removal of debris in coronal third as compared to middle and apical thirds, whereas the canals irrigated with side-vented needle (Group II and single-beveled needle (Group III exhibited lower average score in the middle third than coronal and apical thirds. All the three needle designs exhibited higher debris score in apical third of the root canal. Tukey multiple comparisons test was applied at a significance level of P>0.05. A statistically significant difference (P<0.05 was observed in the debris removal in the coronal and middle thirds of root canals irrigated with brush-covered Navi Tip FX (Group I and side-vented (Group II needles, respectively, when compared with other needle design groups. Conclusion: Within the limitations of this study, it can be concluded that all the needle designs tested were effective in certain regions of the root canal with apical third uncleaned. Side-vented needle by

A climate response function explaining most of the variation in the forest floor needle mass and the needle decomposition in pine forests across Europe

DEFF Research Database (Denmark)

Kurz-Besson, C.; Coûteaux, M.M.; Berg, Bjørn

2006-01-01

The forest floor needle mass and the decomposition rates of pine needle litter in a European climate transect were studied in order to estimate the impact of climate change on forest soil carbon sequestration. Eight pine forests preserved from fire were selected along a climatic latitudinal...... gradient from 40° to 60° N, from Spain and Portugal to Sweden. The forest floor (Oi and Oe layers) was sorted into five categories of increasing decomposition level according to morphological criteria. The needle mass loss in each category was determined using a linear mass density method. The needle...... and a recalcitrant one. NF was correlated with actual evapotranspiration (AET) whereas the decomposition parameters (decomposition rate of the decomposable fraction, first year mass loss, forest floor needle mass, age of the most-decomposed category) were related to a combined response function to climate (CRF...

Histopathologic Review of Previously Negative Prostatic Core Needle Biopsies following a New Diagnosis of Adenocarcinoma of the Prostate by Core Needle Biopsies: Implications for Quality Assurance Programs

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Jay Patel

2008-01-01

Full Text Available Programs for quality assurance are increasingly important in surgical pathology. Many quality assurance (QA techniques for surgical pathology were adopted from procedures introduced in cytopathology. Surgical pathology specimens have diminished in size such that the majority of diagnostic biopsies of prostatic lesions are now core needle biopsies. These specimens raise issues similar to those of cytology specimens, including concerns regarding adequacy and the representative nature of the biopsy. Due to sample size, some neoplasms may not be diagnosed on initial biopsy, raising concerns regarding false negative results. Cytopathologists have instituted QA procedures including review of all previously negative slides received within five years prior to the new diagnosis of high grade squamous intraepithelial lesion or gynecologic malignancy. No such requirement exists in surgical pathology for review of core biopsies. The Department of Pathology at the University of Utah instituted a QA policy requiring review of prior negative prostatic needle biopsies following a new diagnosis of prostatic adenocarcinoma. We reviewed five years of QA records of prostate needle biopsy review. During this time, nine hundred and fifty-eight core biopsy sets were performed. Two hundred and ninety-five of these contained at least one biopsy with a diagnosis of adenocarcinoma. Two hundred and eight patients had a prior set of prostatic needle biopsies with a diagnosis of adenocarcinoma. The remaining 87 had prior biopsies with either a diagnosis of prostatic intraepithelial neoplasia (23, small atypical acinar proliferation (21 or no evidence of malignancy (43. QA review of these 87 cases revealed two biopsies which revealed foci of adenocarcinoma. Both had been initially diagnosed as no evidence of malignancy. The false negative rate for core biopsy was 0.68%. In an additional twenty-one cases, microscopic foci of atypical small acinar proliferations were found in

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

Science.gov (United States)

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 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.

Dry needling in lateral epicondylitis: a prospective controlled study.

Science.gov (United States)

Uygur, Esat; Aktaş, Birol; Özkut, Afşar; Erinç, Samet; Yilmazoglu, Emime Gül

2017-11-01

Lateral epicondylitis (LE), a common disease, especially in middle age, causes decreased productivity and economic losses. The first-line treatment for LE is conservative and consists of topical and oral anti-inflammatory drugs, ice application, and brace use. If the first-line treatment fails, second-line treatment modalities, which are generally invasive, are offered. Second-line therapeutic regimens include saline, corticosteroid, or platelet-rich plasma injections. Dry needling is relatively new. We hypothesized that dry needling would be at least as effective as first-line treatment for LE. We compared the outcomes of first-line treatment and dry needling. The study allocated 110 patients into groups using online randomization software. After completing the Patient-rated Tennis Elbow Evaluation (PRTEE), patients in group I received dry needling, whereas those in group II received first-line treatment, consisting of ibuprofen 100 mg twice a day and a proximal forearm brace. The patients were evaluated after three weeks and six months. The study ultimately analyzed 92 patients. Although both treatment methods were effective at three weeks, dry needling was significantly more effective than the first-line treatment at six months. Because of the low complication rate, dry needling is a safe method, and it might be an effective treatment option for LE.

King Injo's Disease and Burnt Needle Therapy

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KIM In-Sook

2004-12-01

Full Text Available This paper investigates an interrelationship between burnt needle therapy(번침 and King Injo'sdisease. From 1633 (Year 11 in King Injo's reign to May 5, 1649 (Year 27 King in Injo's reign, right before his death, King Injo(인조 was treated with burnt needles by Yi Hyeongik(이형익, an acupuncturist when the king had health problems. This study arises from two questions: why was King Injo often treated with burnt needles? and what effect did burnt needles have? Burnt needle therapy is a combined form of acupuncture and moxibustion. Yi Hyeongik was famous for eradicating pathogenic factors. He was appointed as a doctor in the Royal Hospital. The medical definition for pathogenic factors is that they are disease-causing factors. Understanding the pathogenic factor for King Injo's disease could make it possible to find the interrelationship between burnt needles and the king's disease. In the Joseon era, the prevalent belief about diseases was that diseases could be caused by homeopathic magic. Some people thought homeopathic magic caused King Injo's disease.　 The actual reasons for King Injo's disease were the participation in the excessive rites of Queen Mother Inmok's funeral and the constant oppression from the Ching Dynasty after disgraceful defeat in the war. When King Injo started to be sick, homeopathic magic cases were found in the royal palace. The king's incurable disease was believed to have happened as a result of homeopathic magic. King Injo's suspicion toward Princess Jeongmyeong(정명공주 derived from her mother, Queen Mother Inmok(인목대비. Moral justification for King Injo's coup was Gwanghaegun(광해군 or Prince Gwanghae's immoral conduct toward Queen Mother Inmok. After he was installed, King Injo obeyed the Queen Mother and showed her every attention. Meanwhile, he treated Princess Jeongmyeong with respect, maximized the moral justification for the coup, and solidified the royal authority. However, constant

Are needle-free injections a useful alternative for growth hormone therapy in children? Safety and pharmacokinetics of growth hormone delivered by a new needle-free injection device compared to a fine gauge needle.

NARCIS (Netherlands)

Dorr, H.G.; Zabransky, S.; Keller, E.; Otten, B.J.; Partsch, C.J.; Nyman, L.; Gillespie, B.K.; Lester, N.R.; Wilson, A.M.; Hyren, C.; Kuijck, M.A. van; Schuld, P.; Schoenfeld, S.L.

2003-01-01

The clinical safety, use and pharmacokinetics of a new needle-free device for delivery of growth hormone (GH) were compared with those of conventional needle injection devices. In an open-label, randomized, 4-period crossover study, 18 healthy adults received single subcutaneous injections of

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

OpenAIRE

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...

Shikimate dehydrogenase from Pinu sylvestris L. needles

International Nuclear Information System (INIS)

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

1986-01-01

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

Modified microdissection electrocautery needle

OpenAIRE

Singh, Virendra; Kumar, Pramod

2014-01-01

Electrocautery is routinely used in surgical procedures. The commercially available microdissection electrocautery needles are costly. To overcome this disadvantage, we have modified monopolar electrocautery tip to function as well as commercially available systems.

Measurement of tritium in tissue free water of pine needles

International Nuclear Information System (INIS)

Zheng Xiaomin; Wu Zongmei

1993-01-01

Tissue Free Water (TFW) of pine needles is separated out through azeotropic distillation of pine needles and toluene. Recovery ratio of TFW is 90%. Tritium activity in the needles is 1.8 Bq/L(H 2 O), which is of the same level with tritiated water vapour (HTO) in atmosphere during the corresponding period

Confocal Microscopy of Unfixed Breast Needle Core Biopsies: A Comparison to Fixed and Stained Sections

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Zavislan James M

2009-08-01

Full Text Available Abstract Background Needle core biopsy, often in conjunction with ultrasonic or stereotactic guided techniques, is frequently used to diagnose breast carcinoma in women. Confocal scanning laser microscopy (CSLM is a technology that provides real-time digital images of tissues with cellular resolution. This paper reports the progress in developing techniques to rapidly screen needle core breast biopsy and surgical specimens at the point of care. CSLM requires minimal tissue processing and has the potential to reduce the time from excision to diagnosis. Following imaging, specimens can still be submitted for standard histopathological preparation. Methods Needle core breast specimens from 49 patients were imaged at the time of biopsy. These lesions had been characterized under the Breast Imaging Reporting And Data System (BI-RADS as category 3, 4 or 5. The core biopsies were imaged with the CSLM before fixation. Samples were treated with 5% citric acid and glycerin USP to enhance nuclear visibility in the reflectance confocal images. Immediately following imaging, the specimens were fixed in buffered formalin and submitted for histological processing and pathological diagnosis. CSLM images were then compared to the standard histology. Results The pathologic diagnoses by standard histology were 7 invasive ductal carcinomas, 2 invasive lobular carcinomas, 3 ductal carcinomas in-situ (CIS, 21 fibrocystic changes/proliferative conditions, 9 fibroadenomas, and 5 other/benign; two were excluded due to imaging difficulties. Morphologic and cellular features of benign and cancerous lesions were identified in the confocal images and were comparable to standard histologic sections of the same tissue. Conclusion CSLM is a technique with the potential to screen needle core biopsy specimens in real-time. The confocal images contained sufficient information to identify stromal reactions such as fibrosis and cellular proliferations such as intra-ductal and

Confocal Microscopy of Unfixed Breast Needle Core Biopsies: A Comparison to Fixed and Stained Sections

Science.gov (United States)

2009-01-01

Background Needle core biopsy, often in conjunction with ultrasonic or stereotactic guided techniques, is frequently used to diagnose breast carcinoma in women. Confocal scanning laser microscopy (CSLM) is a technology that provides real-time digital images of tissues with cellular resolution. This paper reports the progress in developing techniques to rapidly screen needle core breast biopsy and surgical specimens at the point of care. CSLM requires minimal tissue processing and has the potential to reduce the time from excision to diagnosis. Following imaging, specimens can still be submitted for standard histopathological preparation. Methods Needle core breast specimens from 49 patients were imaged at the time of biopsy. These lesions had been characterized under the Breast Imaging Reporting And Data System (BI-RADS) as category 3, 4 or 5. The core biopsies were imaged with the CSLM before fixation. Samples were treated with 5% citric acid and glycerin USP to enhance nuclear visibility in the reflectance confocal images. Immediately following imaging, the specimens were fixed in buffered formalin and submitted for histological processing and pathological diagnosis. CSLM images were then compared to the standard histology. Results The pathologic diagnoses by standard histology were 7 invasive ductal carcinomas, 2 invasive lobular carcinomas, 3 ductal carcinomas in-situ (CIS), 21 fibrocystic changes/proliferative conditions, 9 fibroadenomas, and 5 other/benign; two were excluded due to imaging difficulties. Morphologic and cellular features of benign and cancerous lesions were identified in the confocal images and were comparable to standard histologic sections of the same tissue. Conclusion CSLM is a technique with the potential to screen needle core biopsy specimens in real-time. The confocal images contained sufficient information to identify stromal reactions such as fibrosis and cellular proliferations such as intra-ductal and infiltrating carcinoma, and

An explosive-emitter cathode produced using the heavy ion track technique

International Nuclear Information System (INIS)

Akap'ev, G.N.; Korenev, S.A.

1988-01-01

A cathode based on thin metallic foils with a homogeneous needle surface is described. The cathode was manufactured using the heavy ion track technique which permits the production of cathodes with an unlimited area and a needle density ranging from about 10 3 to 10 9 needles per cm 2 . An electron gun using this type of cathode has a current of 200-900 A and an energy of 100-300 keV. The cross section of the electron beam is fairly uniform. It is shown that needle emitters of similar shape and size play the principal role in forming a homogeneous cathode plasma

Platelet-rich plasma versus dry needling of myofascial meridian trigger points in the treatment of plantar fasciitis

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Reem El Mallah

2017-01-01

Conclusion PRP injection is a promising line of treatment for chronic PF with documented ultrasonographic healing effect. Dry needling is a simple and safe technique for treating pain associated with PF, yet it is more invasive and less effective compared with PRP injection.

Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

International Nuclear Information System (INIS)

Thompson, S.A.; Fung, A.Y.C.; Zaider, M.

2002-01-01

One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results. (author)

Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

Energy Technology Data Exchange (ETDEWEB)

Thompson, S.A. [Department of Medical Physics, North Shore-Long Island Jewish Health System, Manhassett, NY (United States); Fung, A.Y.C.; Zaider, M. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

2002-08-21

One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results. (author)

Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours

Energy Technology Data Exchange (ETDEWEB)

Pianta, Marcus; Chock, Eric; Schlicht, Stephen [St Vincent' s Hospital, Fitzroy, VIC (Australia); McCombe, David [St Vincent' s Hospital and Victorian Hand Surgery Associates, Victoria (Australia)

2015-09-15

This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics. 41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed. 41 biopsies were performed in 38 patients. 68 % schwannomas, 24 % neurofibromas and 7 % malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71 % of lesions were surgically excised. 60 % of patients reported pain related to their lesion. Following the biopsy, 12 % reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain. Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy. (orig.)

Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours

International Nuclear Information System (INIS)

Pianta, Marcus; Chock, Eric; Schlicht, Stephen; McCombe, David

2015-01-01

This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics. 41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed. 41 biopsies were performed in 38 patients. 68 % schwannomas, 24 % neurofibromas and 7 % malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71 % of lesions were surgically excised. 60 % of patients reported pain related to their lesion. Following the biopsy, 12 % reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain. Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy. (orig.)

Relationship between the light environment and carbohydrates in needles of Scots pine (Pinus sylvestris) on a dune

International Nuclear Information System (INIS)

Klõšeiko, J.

2003-01-01

The fraction of photosynthetically active radiation transmitted through the canopy (FPAR) on a forested dune was measured at different locations with a ceptometer, and the correlations of carbohydrates in Scots pine needles with FPAR were studied. The hypothesis was that the sucrose content is relatively stable in different light environments and the main effect of the location on the dune is expressed on the glucose content in needles assuming that glucose regulates the balance between the light environment and nutritional conditions influencing the carbohydrate production and demand processes in trees. The contents of the investigated carbohydrates did not correlate with the FPAR, which was significantly elevated at the higher locations on the dune (500 per cent on top) relative to the locations on the foot. The concentrations of hexoses varied substantially between the individual branches or trees from the same plots and between plots, while sucrose levels on single plots were relatively constant. Analysis of variance indicated the effect of the location on the concentrations of sucrose and excess bound fructose, and on the total content of carbohydrates in current-year needles in which the investigated parameters were positively correlated with the respective parameters in one-year-old needles. The results indicate that the content of carbohydrates does not directly depend on the light environment on the dune, though the large variance in the content of hexoses possibly requires increasing the number of samples on each plot to reveal the differences in needles between the locations on the dune

The diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions

International Nuclear Information System (INIS)

Wang Hui; Zhang Fuchen; Ji Hongjian; Chen Liping

2009-01-01

Objective: To evaluate the diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions. Methods: The clinical data of CT-guided transthoracic cutting needle biopsy in 436 patients performed in past 10 years were retrospectively analyzed. Of 436 cases with pulmonary lesions, primary lung cancer was confirmed in 341, pulmonary metastasis in 62, non-malignant lesions in 33. The diagnostic accuracy and sensitivity were statistically analyzed. The occurrence of complications was discussed. Results: The diagnostic accuracy rate and sensitivity rate in primary lung cancer group were 94.7% and 94.1% respectively, in pulmonary metastasis group were 58.2% and 51.6% respectively and in non-malignant lesions group were 57.6% and 57.6% respectively. The successful rate of biopsy was 97.9%. The occurrence of complications was 15.6%. Conclusion: CT-guided percutaneous transthoracic cutting needle biopsy is a safe and valuable diagnostic technique with high diagnostic accuracy and less complications. It is very helpful in confirming the diagnosis in the patients with suspected primary pulmonary cancer, although the technical procedures need to be further improved for metastatic and non-malignant lung lesions. (authors)

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

NARCIS (Netherlands)

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

2017-01-01

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

Needle-shaped and platelet growth of borax crystals

International Nuclear Information System (INIS)

Takoo, R.K.; Patel, B.R.; Joshi, M.S.

1983-01-01

Needle-shaped and platelet growth of borax crystals from solutions is reported. Results of microtopographical studies on both the varieties are discussed. It is suggested that a slow rate of evaporation favours needle growth and a faster rate is conducive to the growth of platelets. (author)

Discordance Rate between Thyroid Fine Needle Aspiration Cytology ...

African Journals Online (AJOL)

Discordance Rate between Thyroid Fine Needle Aspiration Cytology and Histopathologic Diagnosis. Wondwossen Ergete, Daniel Abebe. Abstract. Fine Needle Aspiration (FNA) of the thyroid is a low cost procedure, which can give an accurate diagnosis promptly. The objective of this study was to assess the diagnostic ...

Biopsy Needle Localization and Tracking Using ROI-RK Method

Directory of Open Access Journals (Sweden)

Yue Zhao

2014-01-01

Full Text Available ROI-RK method is a biopsy needle localization and tracking method. Previous research work has proved that it has a robust performance on different series of simulated 3D US volumes. Unfortunately, in real situations, because of the strong speckle noise of the ultrasound image and the different echogenic properties of the tissues, the real 3D US volumes have more complex background than the simulated images used previously. In this paper, to adapt the ROI-RK method in real 3D US volumes, a line-filter enhancement calculation only in the ROI is added to increase the contrast between the needle and background tissue, decreasing the phenomenon of expansion of the biopsy needle due to reverberation of ultrasound in the needle. To make the ROI-RK method more stable, a self-correction system is also implemented. Real data have been acquired on an ex vivo heart of lamb. The result of the ROI-RK method shows that it is capable to localize and track the biopsy needle in real situations, and it satisfies the demand of real-time application.

Determination of rare earth elements in the biological reference materials Pine Needles and Spruce Needles by neutron activation analysis

International Nuclear Information System (INIS)

Machado, C.N.; Maria, S.P.; Saiki, M.; Figueiredo, A.M.G.

1998-01-01

Instrumental neutron activation analysis was applied to determine La, Ce, Nd, Sm, Eu, Tb, Yb, Lu and Sc in two biological reference materials: NIST 1575 Pine Needles and BCR-CRM 101 Spruce Needles. The purpose was to contribute to the reference data for these two reference materials. The results were obtained with a good precision (relative standard deviations less than 15%). For the Pine Needles reference material there are already some proposed values and our results showed, in general, a good agreement with the data published. The contribution of uranium fission products to La, Ce, Nd and Sm was evaluated and considered in the determination of these elements. Interferences in the determination of rare earth elements in biological materials are also discussed. (author)

Sol-gel titania-coated needles for solid phase dynamic extraction-GC/MS analysis of desomorphine and desocodeine.

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Su, Chi-Ju; Srimurugan, Sankarewaran; Chen, Chinpiao; Shu, Hun-Chi

2011-01-01

Novel sol-gel titania film coated needles for solid-phase dynamic extraction (SPDE)-GC/MS analysis of desomorphine and desocodeine are described. The high thermal stability of titania film permits efficient extraction and analysis of poorly volatile opiate drugs. The influences of sol-gel reaction time, coating layer, extraction and desorption time and temperature on the SPDE needle performance were investigated. The deuterium labeled internal standard was introduced either during the extraction of analyte or directly injected to GC after the extraction process. The latter method was shown to be more sensitive for the analysis of water and urine samples containing opiate drugs. The proposed conditions provided a wide linear range (from 5-5000 ppb), and satisfactory linearity, with R(2) values from 0.9958 to 0.9999, and prominent sensitivity, LOQs (1.0-5.0 ng/g). The sol-gel titania film coated needle with SPDE-GC/MS will be a promising technique for desomorphine and desocodeine analysis in urine.

Group Guidance Services with Self-Regulation Technique to Improve Student Learning Motivation in Junior High School (JHS)

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Pranoto, Hadi; Atieka, Nurul; Wihardjo, Sihadi Darmo; Wibowo, Agus; Nurlaila, Siti; Sudarmaji

2016-01-01

This study aims at: determining students motivation before being given a group guidance with self-regulation technique, determining students' motivation after being given a group counseling with self-regulation technique, generating a model of group counseling with self-regulation technique to improve motivation of learning, determining the…

Novel design of honeybee-inspired needles for percutaneous procedure.

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Sahlabadi, Mohammad; Hutapea, Parsaoran

2018-04-18

The focus of this paper is to present new designs of innovative bioinspired needles to be used during percutaneous procedures. Insect stingers have been known to easily penetrate soft tissues. Bioinspired needles mimicking the barbs in a honeybee stinger were developed for a smaller insertion force, which can provide a less invasive procedure. Decreasing the insertion force will decrease the tissue deformation, which is essential for more accurate targeting. In this study, some design parameters, in particular, barb shape and geometry (i.e. front angle, back angle, and height) were defined, and their effects on the insertion force were investigated. Three-dimensional printing technology was used to manufacture bioinspired needles. A specially-designed insertion test setup using tissue mimicking polyvinyl chloride (PVC) gels was developed to measure the insertion and extraction forces. The barb design parameters were then experimentally modified through detailed experimental procedures to further reduce the insertion force. Different scales of the barbed needles were designed and used to explore the size-scale effect on the insertion force. To further investigate the efficacy of the proposed needle design in real surgeries, preliminary ex vivo insertion tests into bovine liver tissue were performed. Our results show that the insertion force of the needles in different scales decreased by 21-35% in PVC gel insertion tests, and by 46% in bovine liver tissue insertion tests.

Skin Blood Perfusion and Cellular Response to Insertion of Insulin Pen Needles With Different Diameters

DEFF Research Database (Denmark)

Præstmark, Kezia Ann; Stallknecht, Bente Merete; Bo Jensen, Casper

2014-01-01

skin blood perfusion response around needle insertion sites. Three common sized pen needles of 28G, 30G, and 32G as well as hooked 32G needles, were inserted into the neck skin of pigs and then removed. Laser Speckle Contrast Analysis was used to measure skin blood perfusion for 20 minutes after...... blood perfusion recording and grouped according to needle type, skin blood perfusion response relates to needle diameter. The response was significantly higher after insertions with 28G and hooked 32G needles than with 30G (P ..., but there was a trend of an increased response with increasing needle diameter. Skin blood perfusion response to pen needle insertions rank according to needle diameter, and the tissue response caused by hooked 32G needles corresponds to that of 28G needles. The relation between needle diameter and trauma when...

Endobronchial Ultrasound-guided Transbronchial Needle Injection of Liposomal Amphotericin B for the Treatment of Symptomatic Aspergilloma.

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Parikh, Mihir S; Seeley, Eric; Nguyen-Tran, Evelyn; Krishna, Ganesh

2017-10-01

Surgical treatment with lung resection has traditionally been the treatment of choice for pulmonary cavities containing aspergillomas that cause hemoptysis. Endobronchial ultrasound (EBUS) is a minimally invasive bronchoscopic technique that is commonly used for transbronchial needle aspiration of hilar and mediastinal lymph nodes as well as centrally located parenchymal lesions. Here, we describe a case of a 71-year-old woman who was found to have a cavitary lesion in the lung containing aspergillomas. Under direct ultrasound visualization with EBUS, liposomal amphotericin B was injected into the aspergillomas. These aspergillomas regressed after treatment. To our knowledge, this is the first reported treatment of aspergilloma with EBUS-guided transbronchial needle injection of liposomal amphotericin B.

Fine needle diagnosis in lumbar osteomyelitis

International Nuclear Information System (INIS)

Joshi, K.B.; Brinker, R.A.

1983-01-01

Lumbar vertebral body and disk infection, presenting as low back pain, is a relatively uncommon disease but is seen more often in drug addicts. Radiographs show typical changes of infection of the lumbar vertebrae and adjacent disc. Under local anesthesia a fine needle is placed, saline injected, and aspirated. The entire needle-syringe unit is submitted to the bacteriology department. Pseudomonas infection is usually found. This method of diagnosis is simple, cost effective, well accepted by the patients, and can be done on outpatients. (orig.)

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

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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.

Percutaneous needle-biopsy of the adrenal glands

International Nuclear Information System (INIS)

Wernecke, K.; Galanski, M.

1986-01-01

This account of techniques, range of indications and results of percutaneous adrenal biopsy refers to communications in the literature and to the authors' own experience. Lateral, transhepatic aspiration of adrenal material guided by sonographic control is more easy in the right adrenal gland. Punctation of the left adrenal gland ought to be done from the back and guided by computerized tomography, also in order to leave spleen, kidney, pancreas and stomach as unaffected as possible. The most frequent problem indicating adrenal biopsy still is differentiation between metastases or encretorily non-active adenomas in tumor patients. Experienced examiners will achieve an 80 to 90% sensitivity of adrenal biopsy. Clinically established, suspected phaeochromocytoma is an absolute contra-indication to fine-needle biopsy. (orig./MG) [de

Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

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

Oblique needle segmentation and tracking for 3D TRUS guided prostate brachytherapy

International Nuclear Information System (INIS)

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

2005-01-01

An algorithm was developed in order to segment and track brachytherapy needles inserted along oblique trajectories. Three-dimensional (3D) transrectal ultrasound (TRUS) images of the rigid rod simulating the needle inserted into the tissue-mimicking agar and chicken breast phantoms were obtained to test the accuracy of the algorithm under ideal conditions. Because the robot possesses high positioning and angulation accuracies, we used the robot as a ''gold standard,'' and compared the results of algorithm segmentation to the values measured by the robot. Our testing results showed that the accuracy of the needle segmentation algorithm depends on the needle insertion distance into the 3D TRUS image and the angulations with respect to the TRUS transducer, e.g., at a 10 deg. insertion anglulation in agar phantoms, the error of the algorithm in determining the needle tip position was less than 1 mm when the insertion distance was greater than 15 mm. Near real-time needle tracking was achieved by scanning a small volume containing the needle. Our tests also showed that, the segmentation time was less than 60 ms, and the scanning time was less than 1.2 s, when the insertion distance into the 3D TRUS image was less than 55 mm. In our needle tracking tests in chicken breast phantoms, the errors in determining the needle orientation were less than 2 deg. in robot yaw and 0.7 deg. in robot pitch orientations, for up to 20 deg. needle insertion angles with the TRUS transducer in the horizontal plane when the needle insertion distance was greater than 15 mm

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

OpenAIRE

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

2017-01-01

Background Perennial growth in plants is the product of interdependent cycles of daily and annual stimuli that induce cycles of growth and dormancy. In conifers, needles are the key perennial organ that integrates daily and seasonal signals from light, temperature, and water availability. To understand the relationship between seasonal cycles and seasonal gene expression responses in conifers, we examined diurnal and circannual needle mRNA accumulation in Douglas-fir (Pseudotsuga menziesii) n...

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

Science.gov (United States)

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 (Pgaming 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.

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

Science.gov (United States)

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.

Improved radionuclide bone imaging agent injection needle withdrawal method can improve image quality

International Nuclear Information System (INIS)

Qin Yongmei; Wang Laihao; Zhao Lihua; Guo Xiaogang; Kong Qingfeng

2009-01-01

Objective: To investigate the improvement of radionuclide bone imaging agent injection needle withdrawal method on whole body bone scan image quality. Methods: Elbow vein injection syringe needle directly into the bone imaging agent in the routine group of 117 cases, with a cotton swab needle injection method for the rapid pull out the needle puncture point pressing, pressing moment. Improvement of 117 cases of needle injection method to put two needles into the skin swabs and blood vessels, pull out the needle while pressing two or more entry point 5min. After 2 hours underwent whole body bone SPECT imaging plane. Results: The conventional group at the injection site imaging agents uptake rate was 16.24%, improved group was 2.56%. Conclusion: The modified bone imaging agent injection needle withdrawal method, injection-site imaging agent uptake were significantly decreased whole body bone imaging can improve image quality. (authors)

Needle-free influenza vaccination

NARCIS (Netherlands)

Amorij, Jean-Pierre; Hinrichs, Wouter L.J.; Frijlink, Henderik W.; Wilschut, Jan C.; Huckriede, Anke

2010-01-01

Vaccination is the cornerstone of influenza control in epidemic and pandemic situations. Influenza vaccines are typically given by intramuscular injection. However, needle-free vaccinations could offer several distinct advantages over intramuscular injections: they are pain-free, easier to

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

Energy Technology Data Exchange (ETDEWEB)

Veltri, Andrea, E-mail: andrea.veltri@unito.it; Busso, Marco; Sardo, Diego; Angelino, Valeria; Priola, Adriano M. [University of Torino, Department of Radiology, San Luigi Gonzaga Hospital (Italy); Novello, Silvia [University of Torino, Department of Oncology, San Luigi Gonzaga Hospital (Italy); Barba, Matteo [University of Torino, Department of Radiology, San Luigi Gonzaga Hospital (Italy); Gatti, Gaia; Righi, Luisella [University of Torino, Department of Pathology, San Luigi Gonzaga Hospital (Italy)

2017-06-15

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 TTNB 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.

Diagnostic Ability of Percutaneous Needle Biopsy Immediately After Radiofrequency Ablation for Malignant Lung Tumors: An Initial Experience

Energy Technology Data Exchange (ETDEWEB)

Hasegawa, Takaaki, E-mail: t-hasegawa@aichi-cc.jp [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan); Kondo, Chiaki [Aichi Cancer Center Hospital, Department of Pathology and Molecular Diagnosis (Japan); Sato, Yozo; Inaba, Yoshitaka; Yamaura, Hidekazu; Kato, Mina; Murata, Shinichi; Onoda, Yui [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan); Kuroda, Hiroaki; Sakao, Yukinori [Aichi Cancer Center Hospital, Department of Thoracic Surgery (Japan); Yatabe, Yasushi [Aichi Cancer Center Hospital, Department of Pathology and Molecular Diagnosis (Japan)

2016-08-15

PurposeTo evaluate the safety and diagnostic ability of percutaneous needle biopsy performed immediately after lung radiofrequency ablation (RFA).Materials and MethodsFrom May 2013 to April 2014, percutaneous needle biopsy was performed immediately after RFA for 3 patients (2 men and 1 woman, aged 57–76 years) who had lung tumors measuring 1.3–2.6 cm in diameter. All patients had prior history of malignancy, and all tumors were radiologically diagnosed as malignant. Obtained specimens were pathologically classified using standard hematoxylin and eosin staining.ResultsWe completed three planned sessions of RFA followed by percutaneous needle biopsy, all of which obtained tumor tissue that could be pathologically diagnosed. Two tumors were metastatic from renal clear cell carcinoma and rectal adenocarcinoma, respectively; one tumor was primary lung adenocarcinoma. There was no death or major complication related to the procedures. Although pneumothorax occurred in two patients, these resolved without the need for aspiration or chest tube placement. Tumor seeding was not observed, but 21 months after the procedure, one case developed local tumor progression that was treated by additional RFA.ConclusionPathologic diagnosis was possible by needle biopsy immediately after RFA for lung tumors. This technique may reduce the risks and efforts of performing biopsy and RFA on separate occasions.

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

Science.gov (United States)

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.

‘Fast cast’ and ‘needle Tenotomy’ protocols with the Ponseti method to improve clubfoot management in Bangladesh

Directory of Open Access Journals (Sweden)

Angela Evans

2017-11-01

Full Text Available Abstract Background The management of congenital talipes equino varus (clubfoot deformity has been transformed in the last 20 years as surgical correction has been replaced by the non-surgical Ponseti method. The Ponseti method, consists of corrective serial casting followed by maintenance bracing, and has been repeatedly demonstrated to give best results - regarded as the ‘gold standard’ treatment for paediatric clubfoot. Methods To develop the study protocol Level 2 evidence was used to modify the corrective casting phase of the Ponseti method in children aged up to 12 months. Using Level 4 evidence, the percutaneous Achilles tenotomy (PAT was performed using a 19-gauge needle instead of a scalpel blade, a technique found to reduce bleeding and scarring. Results A total of 123 children participated in this study; 88 male, 35 female. Both feet were affected in 67 cases, left only in 22 cases, right only in 34 cases. Typical clubfeet were found in 112/123 cases, six atypical, five syndromic. The average age at first cast was 51 days (13–240 days. The average number of casts applied was five (2–10 casts. The average number of days between the first cast and brace was 37.8 days (10–122 days, including 21 days in a post-PAT cast. Hence, average time of corrective casts was 17 days. Parents preferred the reduced casting time, and were less concerned about unseen skin wounds. PAT was performed in 103/123 cases, using the needle technique. All post tenotomy casts were in situ for three weeks. Minor complications occurred in seven cases - four cases had skin lesions, three cases disrupted casting phase. At another site, 452 PAT were performed using the needle technique. Conclusions The ‘fast cast’ protocol Ponseti casting was successfully used in infants aged less than 8 months. Extended manual manipulation of two minutes was the essential modification. Parents preferred the faster treatment phase, and ability to closer observe

A study on applying Ra needle interstitial brachytherapy for oral cancer

International Nuclear Information System (INIS)

Yoshida, Shunichi; Komiya, Yoshiaki; Uchida, Ikuhiro; Tashiro, Kazuyoshi

1999-01-01

To investigate applicability of Ra needle interstitial brachytherapy, 93 cases of oral squamous carcinoma were examined. The patients underwent Ra needle interstitial brachytherapy as thorough therapy in our hospital. The criteria of applying Ra needle interstitial brachytherapy was diameter of within 5 cm and depth within 2 cm of tumor size. Ra needle interstitial brachytherapy was applied to 82 cases of tongue, 10 cases of oral floor and one case of lower lip carcinomas. The local control rate was 92.5%, and secondary neck metastasis was 32.3% in all cases applied Ra needle interstitial brachytherapy. The results were not bad compared with surgical treatment. However, the 5-year cumulative survival rate was 64.9%, which was not good enough at the result to obtain a good local control rate and secondary neck metastasis rate. The result was relative to low treatment result of local recurrence cases with Ra needle interstitial brachytherapy. To improve the result, it is important to distinguish local recurrence from radioinduced ulcer, and to start early secondary treatment. The cases in which cervical lymph node metastasis was found as the first examination underwent neck dessection after Ra needle interstitial brachytherapy. The 5-year cumulative survival rate was 83.3% in N1 cases and 40.6% in N2 cases, and the result of N2 cases was poorer than N1 cases with a significant difference. The results indicate that a needle having a diameter of within 5 cm, depth of within 2 cm and less than N1 can be applied during Ra needle interstitial brachytherapy for complete cure of cancer. (author)

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

Science.gov (United States)

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.

Combination of water-jet dissection and needle-knife as a hybrid knife simplifies endoscopic submucosal dissection.

Science.gov (United States)

Lingenfelder, Tobias; Fischer, Klaus; Sold, Moritz G; Post, Stefan; Enderle, Markus D; Kaehler, Georg F B A

2009-07-01

The safety and efficacy of endoscopic submucosal dissection (ESD) is very dependent on an effective injection beneath the submucosal lamina and on a controlled cutting technique. After our study group demonstrated the efficacy of the HydroJet in needleless submucosal injections under various physical conditions to create a submucosal fluid cushion (Selective tissue elevation by pressure = STEP technique), the next step was to develop a new instrument to combine the capabilities of an IT-Knife with a high-pressure water-jet in a single instrument. In this experimental study, we compared this new instrument with a standard ESD technique. Twelve gastric ESD were performed in six pigs under endotracheal anesthesia. Square areas measuring 4-cm x 4-cm were marked out on the anterior and posterior wall in the corpus-antrum transition region. The HybridKnife was used as an standard needle knife with insulated tip (i.e., the submucosal injection was performed with an injection needle and only the radiofrequency (RF) part of the HybridKnife was used for cutting (conventional technique)) or the HybridKnife was used in all the individual stages of the ESD, making use of the HybridKnife's combined functions (HybridKnife technique). The size of the resected specimens, the operating time, the frequency with which instruments were changed, the number of bleeding episodes, and the number of injuries to the gastric wall together with the subjective overall assessment of the intervention by the operating physician were recorded. The resected specimens were the same size, with average sizes of 16.96 cm(2) and 15.85 cm(2) resp (p = 0.8125). Bleeding episodes have been less frequent in the HybridKnife group (2.83 vs. 3.5; p = 0.5625). The standard knife caused more injuries to the lamina muscularis propria (0.17 vs. 1.33; p = 0.0313). The operating times had a tendency to be shorter with the HybridKnife technique (47.18 vs. 58.32 minute; p = 0.0313). The combination of a needle

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

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).

In vivo motion and force measurement of surgical needle intervention during prostate brachytherapy

International Nuclear Information System (INIS)

Podder, Tarun; Clark, Douglas; Sherman, Jason; Fuller, Dave; Messing, Edward; Rubens, Deborah; Strang, John; Brasacchio, Ralph; Liao, Lydia; Ng, W.-S.; Yu Yan

2006-01-01

In this paper, we present needle insertion forces and motion trajectories measured during actual brachytherapy needle insertion while implanting radioactive seeds in the prostate glands of 20 different patients. The needle motion was captured using ultrasound images and a 6 degree-of-freedom electromagnetic-based position sensor. Needle velocity was computed from the position information and the corresponding time stamps. From in vivo data we found the maximum needle insertion forces to be about 15.6 and 8.9 N for 17 gauge (1.47 mm) and 18 gauge (1.27 mm) needles, respectively. Part of this difference in insertion forces is due to the needle size difference (17G and 18G) and the other part is due to the difference in tissue properties that are specific to the individual patient. Some transverse forces were observed, which are attributed to several factors such as tissue heterogeneity, organ movement, human factors in surgery, and the interaction between the template and the needle. However, theses insertion forces are significantly responsible for needle deviation from the desired trajectory and target movement. Therefore, a proper selection of needle and modulated velocity (translational and rotational) may reduce the tissue deformation and target movement by reducing insertion forces and thereby improve the seed delivery accuracy. The knowledge gleaned from this study promises to be useful for not only designing mechanical/robotic systems but also developing a predictive deformation model of the prostate and real-time adaptive controlling of the needle

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

Science.gov (United States)

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

2016-02-01

To evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD). Totally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study. (1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P floating needle treatment group (P floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P floating needle treatment group (χ² = 14.9, P floating needle treatment group and 17

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

Science.gov (United States)

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

2017-06-01

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

Acupuncture sensation during ultrasound guided acupuncture needling

Science.gov (United States)

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

2014-01-01

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

Breeding soundness evaluation of bulls by semen analysis, testicular fine needle aspiration cytology and trans-scrotal ultrasonography

Directory of Open Access Journals (Sweden)

Chapwanya A

2008-05-01

Full Text Available Abstract The aim of this study was to evaluate the usefulness of trans-scrotal ultrasonography and testicular fine needle aspiration cytology in assessing bulls for breeding suitability. These two techniques were also compared with semen analysis. Bulls presented for breeding soundness evaluation were assessed using all three techniques. The findings of each technique were compared. There was agreement in classification of fertile bulls using all three techniques, suggesting that the combined use of these techniques enhances routine breeding soundness examination. Use of the three techniques also enhances detailed investigation of suspected sub-fertile bulls while accurately identifying testicular cause(s of sire sub-fertility.

Transcription Through The Eye Of A Needle: Daily And Annual Cycles Of Gene Expression Variation In Douglas-Fir Needles

OpenAIRE

Dolan, Peter; Cronn, Richard; Denver, Dee; Clair, J.; Neale, David; Wegrzyn, Jill; Jogdeo, Sanjuro

2017-01-01

Background: Perennial growth in plants is the product of interdependent cycles of daily and annual stimuli that induce cycles of growth and dormancy. In conifers, needles are the key perennial organ that integrates daily and seasonal signals from light, temperature, and water availability. To understand the relationship between seasonal rhythms and seasonal gene expression responses in conifers, we examined diurnal and circannual needle mRNA accumulation in Douglas-fir (Pseudotsuga menziesii)...

Biocompatible 3D printed magnetic micro needles

KAUST Repository

Kavaldzhiev, Mincho

2017-01-30

Biocompatible functional materials play a significant role in drug delivery, tissue engineering and single cell analysis. We utilized 3D printing to produce high aspect ratio polymer resist microneedles on a silicon substrate and functionalized them by iron coating. Two-photon polymerization lithography has been used for printing cylindrical, pyramidal, and conical needles from a drop cast IP-DIP resist. Experiments with cells were conducted with cylindrical microneedles with 630 ± 15 nm in diameter with an aspect ratio of 1:10 and pitch of 12 μm. The needles have been arranged in square shaped arrays with various dimensions. The iron coating of the needles was 120 ± 15 nm thick and has isotropic magnetic behavior. The chemical composition and oxidation state were determined using energy electron loss spectroscopy, revealing a mixture of iron and Fe3O4 clusters. A biocompatibility assessment was performed through fluorescence microscopy using calcein/EthD-1 live/dead assay. The results show a very high biocompatibility of the iron coated needle arrays. This study provides a strategy to obtain electromagnetically functional microneedles that benefit from the flexibility in terms of geometry and shape of 3D printing. Potential applications are in areas like tissue engineering, single cell analysis or drug delivery.

Biocompatible 3D printed magnetic micro needles

KAUST Repository

Kavaldzhiev, Mincho; Perez, Jose E.; Ivanov, Yurii; Bertoncini, Andrea; Liberale, Carlo; Kosel, Jü rgen

2017-01-01

Biocompatible functional materials play a significant role in drug delivery, tissue engineering and single cell analysis. We utilized 3D printing to produce high aspect ratio polymer resist microneedles on a silicon substrate and functionalized them by iron coating. Two-photon polymerization lithography has been used for printing cylindrical, pyramidal, and conical needles from a drop cast IP-DIP resist. Experiments with cells were conducted with cylindrical microneedles with 630 ± 15 nm in diameter with an aspect ratio of 1:10 and pitch of 12 μm. The needles have been arranged in square shaped arrays with various dimensions. The iron coating of the needles was 120 ± 15 nm thick and has isotropic magnetic behavior. The chemical composition and oxidation state were determined using energy electron loss spectroscopy, revealing a mixture of iron and Fe3O4 clusters. A biocompatibility assessment was performed through fluorescence microscopy using calcein/EthD-1 live/dead assay. The results show a very high biocompatibility of the iron coated needle arrays. This study provides a strategy to obtain electromagnetically functional microneedles that benefit from the flexibility in terms of geometry and shape of 3D printing. Potential applications are in areas like tissue engineering, single cell analysis or drug delivery.

CT-guided procedures: evaluation of a phantom system to teach accurate needle placement

International Nuclear Information System (INIS)

Dimmick, S.; Jones, M.; Challen, J.; Iedema, J.; Wattuhewa, U.; Coucher, J.

2007-01-01

Aim: To evaluate the use of a phantom system to help teach the basic techniques of accurate CT-guided needle placement, thereby avoiding the risks associated with teaching on patients. Materials and Methods: Gelatine phantoms with five, 1.9 cm embedded spherical wooden targets were constructed. Four trainee operators performed 15 simulated biopsy procedures on the targets (series one) and repeated identical procedures 2 weeks later (series two). Statistical analysis of accuracy of needle placement and subject confidence were performed. Results: Significant sequential improvement in axial plane angular error was noted with the average error decreasing by 0.33 degrees after every five procedures performed (95% CI: -0.58 to -0.08, p = 0.01). Operator confidence indicated significant improvement both within each series and from series one to series two (95% CI: 0.08 to 1.17, p = 0.025 and 95% CI: 0.00 to 0.58, p = 0.05) respectively. However, variability in operator performance made statistically significant improvement in other variables unproven. Conclusion: Despite the study comprising a relatively small number of participants and procedures, it clearly demonstrated the effectiveness of teaching operators to perform CT-guided procedures using a phantom system. Needle placement accuracy significantly improved, with a reduction in axial angular error, and improved operator confidence without the risks associated with training on patients. Three of the operators in this study had never performed a CT-guided procedure previously, and their proficiency, after a relatively short but intense period of training, was impressive. The use of phantoms should be considered routinely for basic training of CT-guided needle placement

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

Science.gov (United States)

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

1979-04-01

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

Options for reducing HIV transmission related to the dead space in needles and syringes.

Science.gov (United States)

Zule, William A; Pande, Poonam G; Otiashvili, David; Bobashev, Georgiy V; Friedman, Samuel R; Gyarmathy, V Anna; Des Jarlais, Don C

2018-01-15

When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

NOTE: Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

Science.gov (United States)

Thompson, S. A.; Fung, A. Y. C.; Zaider, M.

2002-08-01

One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results.

Ultrasonography-Guided Fine Needle Aspiration Cytology of Cervical Lymphadenopathy: Comparative Study of the Cytological Adequacy Using of 21- and 23- Gauge Needles

International Nuclear Information System (INIS)

Beak, Jin Wook; KIm, Dong Wook; Kim, Bo Mi

2011-01-01

To assess the difference in the cytological adequacy of ultrasonography (US)-guided fine needle aspiration cytology (US-FNAC) for cervical lymphadenopathy using 21 and 23 gauge needles. US-FNACs were separately performed on two cervical lymph nodes and in each patient using 21 gauge (group A) and 23 gauge (group B) needles, respectively. We used 4 grade classifications for the cytological analysis of each slide and compared the cytological adequacy of US-FNAC for cervical lymphadenopathy in the two groups. We performed US-FNACs on 58 cervical lymph nodes from 29 patients, with a cytological adequacy of 69.0%. The number of adequate cytological results was 19 (65.5%) in group A and 21 (72.4%) in group B, and the diagnostic adequacy did not differ significantly between the two groups (Mann-Whitney test, p = 0.574). There was no statistically significant difference in the cytological adequacy of US-FNAC for cervical lymphadenopathy according using of 21 and 23 gauge needles.

Textiles: Some technocal information and data IV: sewability, sewing needles, threads and seams.

CSIR Research Space (South Africa)

Hunter, L

1979-09-01

Full Text Available half in about four c~ro"dd5 - - - - . . - - . Reducing the needle \\docity during its contact with the fabric can reduce needle temocratures bv about 50°C although other workers found the differences ;o be only 5 to IPC14. ~adiation plays a minor..., may have led to the confusion concerning the relative merits of different needle point30. Needle point shape does not appear to significantly affect maximum penetration force or energy~ expended while bulged-eye needles reduce heat build...

Initial experience with new dedicated needles for laparoscopic ultrasound-guided fine-needle aspiration and histological biopsies

DEFF Research Database (Denmark)

Mortensen, M B; Durup, J; Pless, T

2001-01-01

BACKGROUND AND STUDY AIMS: Laparoscopic ultrasonography (LUS) is an important imaging modality during laparoscopic staging of intra-abdominal malignancies, but LUS-assisted biopsy is often difficult or impossible. We report a newly developed inbuilt biopsy system for direct LUS-guided fine......-needle aspiration (FNA) and Tru-cut biopsies. PATIENTS AND METHODS: LUS-guided biopsy was performed in 20 patients with upper gastrointestinal tract tumors. The biopsied lesions had either not been previously detected by other imaging modalities or had been inaccessible, or the biopsy sample had been inadequate...... were good or acceptable in 18 patients (90%). Slight needle deviation (material was obtained, but pathological examination was impossible owing...

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

Science.gov (United States)

Huang, Yanxi; Zheng, Ying

2015-09-01

To compare the clinical effective differences between shallow needling and medication for the sleep disorder of schizophrenia. Ninety-six patients with the sleep disorder of schizophrenia were randomly divided into a shallow needling group and a medication group, 48 cases in each one (one case dropping in the shallow needling group and two cases dropping in the medication group). The same dose paliperidone tablets were adopted in the two groups. In the shallow needling group, the main acupoints were Baihui (GV 20), Shangenxue (Extra) and Ezhongxian (MS 1), and the acupoints based on syndrome differentiation were selected. The shallow needling manipulation was used once a day, 5 times a week. In the medication group, 3 mg eszopiclone tablets were prescribed orally before sleep once every night. The patients were treated for 6 weeks in the two groups. Sleep condition was evaluated by Pittsburgh sleep quality index (PSQI) before and after treatment, and the clinical efficacy and the adverse reaction were assessed by positive and negative symptoms scale (PANSS) and treatment emergent symptom scale (TESS) before and after 2-week, 4-week and 6-week treatment. The clinical effects between the two groups were compared. After treatment in the two groups, both the total scores and the each factor score of the PSQI and the PANSS were apparently decreased (Pshallow needling group was reduced more obviously than that of the medication group (Pshallow needling group (Pshallow needling group was better than that in the medication group after treatment (Pshallow needling group after treatment (P0. 05). At the end of the 6th week, the curative and effective rate was 63. 9% (30/47) and the total effective rate was 95. 8% (45/47) in the shallow needling group;the curative and effective rate was 58. 7% (27/46) and the total effective rate was 91. 3% (42/46) in the medication group. The difference of the effect was not statistically significant between the two groups (P>0. 05). The

A comparison of epicuticular wax of Pinus sylvestris needles from three sites in Ireland

International Nuclear Information System (INIS)

Donnelly, A.; Dowding, P.

1994-01-01

Three forest stands of Pinus sylvestris were chosen for comparison in Ireland. Needles from three year classes were collected. Cuticular transpiration curves showed that the rate of water loss from 1-year-old needles was faster than either 2-year-old or current-year needles at all sites. The amount of epicuticular wax extracted was similar to that reported in the literature. Needle wettability increased with needle age. Amorphous wax coverage was estimated using scanning electron microscopy (SEM) and was found to increase with needle age. Algal cells were noted on needles of all ages at one site and appeared to affect transpiration and microroughness. The presence of fungal hyphae was also noted. (orig.)

EUS-Guided Needle-Based Confocal Laser Endomicroscopy

DEFF Research Database (Denmark)

Bhutani, Manoop S; Koduru, Pramoda; Joshi, Virendra

2015-01-01

Endoscopic ultrasound (EUS) has emerged as an excellent tool for imaging the gastrointestinal tract, as well as surrounding structures. EUS-guided fine-needle aspiration (EUS-FNA) has become the standard of care for the tissue sampling of a variety of masses and lymph nodes within and around...... the gut, providing further diagnostic and staging information. Confocal laser endomicroscopy (CLE) is a novel endoscopic method that enables imaging at a subcellular level of resolution during endoscopy, allowing up to 1000-fold magnification of tissue and providing an optical biopsy. A new procedure...... that has been developed in the past few years is needle-based confocal laser endomicroscopy (nCLE), which involves a mini-CLE probe that can be passed through a 1 9-gauge needle during EUS-FNA. This enables the real-time visualization of tissue at a microscopic level, with the potential to further improve...

Testicular fine-needle aspiration for the assessment of intratesticular hormone concentrations

Directory of Open Access Journals (Sweden)

Ada P Lee

2016-01-01

Full Text Available Measurement of intratesticular sex steroid concentrations in men informs both the development of male hormonal contraceptives and the understanding of male infertility. Given the challenges of using invasive techniques to measure testicular hormone physiology, our group has used a minimally-invasive fine-needle aspiration technique to measure intratesticular hormones in normal healthy men. Herein, we present a post-hoc analysis of the safety and efficacy of testicular fine-needle aspiration (FNA completed as part of six clinical trials. From 2001 through 2011, a total of 404 procedures were conducted among 163 research volunteers, 85.9% of which were successful in obtaining sufficient fluid for the measurement of intratesticular steroid concentrations. Pain was the most common side effect, with 36.8% of procedures associated with moderate procedural pain and 4.7% with severe procedural pain. Postprocedural pain was uncommon and abated within a few days. Mild local bruising occurred with 14.9% of procedures. Two serious adverse events (0.5% required surgical intervention. The risk of an adverse event was not associated with age, body mass index, testicular size, or the volume of fluid aspirated. Testicular FNA to obtain fluid for measurement of intratesticular steroid concentrations frequently causes mild to moderate procedural pain, but serious adverse events occur rarely. Testicular FNA has been instrumental for defining human intratesticular hormone physiology and is a minimally-invasive, safe, effective method for obtaining fluid for research on testicular physiology and pathology.

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

Science.gov (United States)

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

2013-12-16

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

Knowledge, attitude and practices about needle stick injuries in health care workers

International Nuclear Information System (INIS)

Waqar, S.H.; Siraj, M.U.; Razzaq, Z.; Malik, Z.I.; Zahid, M.A.

2011-01-01

Objectives: To assess knowledge, attitude and practices about needle stick Injuries in health care workers. Study type, settings and duration: Hospital based study carried out at Pakistan Institute of Medical Sciences, Islamabad, from August 2010 to November 2010. Subjects and Methods: A self administered 19 items questionnaire was prepared which contained information about needle stick injuries, its awareness, frequency of injury and the protocols that were followed after an injury had occurred. These questionnaires were given to 500 health care workers working in different wards and theaters of the hospital after obtaining their informed written consent. The health care workers included doctors, nurses and paramedical staff of Pakistan Institute of Medical Sciences, Islamabad. The data was entered and analyzed using SPSS version 15. Results: A total of 500 health care workers filled the questionnaire and returned it. Out of these 416(83.2%) reported ever experiencing needle stick injuries in their professional life. Health care workers working in Emergency department were most frequently affected (65%) followed by those working in different wards (27%) and operation theatre (8%). Most (93.6%) workers had knowledge about needle stick injuries and only 6.4% were not aware of it. Needle stick injury occurred from a brand new (unused) syringe in 51.2% cases, while in 32.8% cases, the needle caused an injury after it had been used for an injection. In 5% cases, injury occurred with blood stained needles. The commonest reasons for needle injury in stick injuries were heavy work load (36.8%) followed by hasty work (33.6%) and needle recapping (18.6%). About 66% health care workers were already vaccinated against hepatitis B. Only 13% workers followed universal guidelines of needle stick injuries and no case was reported to hospital authorities. Conclusions: Health care workers had inadequate knowledge about the risk associated with needle stick injuries and do not

Development of Needle Insertion Manipulator for Central Venous Catheterization

Science.gov (United States)

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.

Broad support for regulating the clinical implementation of future reproductive techniques.

Science.gov (United States)

Hendriks, S; Vliegenthart, R; Repping, S; Dancet, E A F

2018-01-01

Do gynaecologists, infertile patients and the general public, consider that regulation of the clinical implementation of stem cell-based fertility treatments is required? There is broad support from gynaecologists, patients and the general public for regulating the clinical implementation of future stem cell-based fertility treatments. There is debate on the need to regulate the clinical implementation of novel techniques. Regulation may hinder their swift adoption and delay benefits for patients, but may prevent the implementation of ineffective or harmful techniques. Stem cell-based fertility treatments, which involve creating oocytes or spermatozoa by manipulating stem cells, are likely to be implemented in clinical practice in the near future and will probably impact future generations as well as the current one. A cross-sectional survey was conducted among gynaecologists working in fertility clinics (n = 179), patients with severe infertility (n = 348) and a representative sample of the general public (n = 1250). The questionnaire was disseminated in the Netherlands in the winter of 2015-2016. The newly developed questionnaire was reviewed by experts and tested among the general public. The questionnaire assessed whether participants wanted each of nine potential negative consequences of the clinical implementation of stem cell-based fertility treatments to be regulated. In addition, the importance of all negative and positive potential consequences, the appropriate regulatory body and its need to consult with advisors from various backgrounds was questioned. In total, 958 respondents completed the questionnaire (response rate: 54%). A large majority of each participant group (>85%) wanted regulation, for at least one potential negative consequence of the clinical implementation of stem cell-based fertility treatments. The majority of all participant groups wanted regulation for serious health risks for intended parents, serious health risks for children and

Use of CT-guided fine needle aspiration biopsy in epidermal growth factor receptor mutation analysis in patients with advanced lung cancer

Energy Technology Data Exchange (ETDEWEB)

Zhuang, Yi-Ping; Wang, Hai-Yan; Zhang, Jin; Feng, Yong (Dept. of Radiology, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China)), email: yipingzhuang2010@sina.com; Shi, Mei-Qi (Dept. of Chemotherapy, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China))

2011-12-15

Background. The safety of using a cutting needle when performing a core-needle biopsy is of major concern, in particular for small lung tumors or tumors near the hilum. Purpose. To investigate the usefulness of CT-guided fine needle aspiration biopsy (FNAB) of the lung in obtaining tumor tissue for epidermal growth factor receptor (EGFR) mutation analysis in advanced lung cancer patients. Material and Methods. Forty-three patients with stage IIIB-IV lung cancer were enrolled. In all patients, CT-guided FNAB was performed using an 18-gauge or 20-gauge Chiba aspiration needle for histology diagnosis and EGFR mutation analysis. Complications associated with CT-guided FNAB were observed, and the specimen mutational assessments were recorded. Results. The obtained tumor samples ranged from 0.5-1.5 cm in length and were adequate for histological and DNA analyses in all patients. No patient had a pneumothorax or hemoptysis. Minor needle tract bleeding appeared in eight patients. Mutation analysis was satisfactorily demonstrated in 23 mutations and 20 non-mutations. Ten and 13 mutations were identified by 18-gauge and 20-gauge needle biopsies, respectively. EFGR mutations, including 12 cases of EGFR exon 19 deletion and 11 cases of exon 21 point mutation, were present in 21 patients with adenocarcinomas, one with squamous cell carcinoma, and one with undifferentiated carcinoma. Conclusion. CT-guided FNAB is a feasible and safe technique for obtaining lung tumor tissues for EGFR gene mutation analysis

Image-guided automated needle biopsy of 106 thoracic lesions: a retrospective review of diagnostic accuracy and complication rates

International Nuclear Information System (INIS)

Connor, S.; Dyer, J.; Guest, P.

2000-01-01

We reviewed the diagnostic accuracy and complication rates of transthoracic needle biopsy (TNB) with an automated 18-gauge core biopsy needle and gun, using either fluoroscopic or CT guidance. One hundred six lesions were biopsied in 103 patients between 1992 and 1998. Hard-copy images, imaging reports, pathology reports and clinical notes were reviewed. In 3 patients it was not possible to establish the lesion as either malignant or benign from the available follow-up, so these were removed from the analysis of diagnostic accuracy. Adequate samples for histological diagnosis were obtained in 104 of 106 (98 %) biopsies. There were 75 of 85 (88 %) true-positive core biopsies for malignant lesions and a specific cell type was identified in 70 of 85 (82 %) cases. A specific histological diagnosis was obtained in 12 of 18 (66 %) biopsies. There was a 19 % rate of pneumothorax with only 2.4 % requiring drainage. Minor haemoptysis occurred in 3.8 % of procedures. The TNB technique with an automated core biopsy needle provides a high level of diagnostic accuracy, effectively distinguishes cell type in malignancy and provides a definite diagnosis in benign disease more frequently than fine needle aspiration (FNA). There is no increased complication rate compared with FNA. (orig.)

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

Science.gov (United States)

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

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

Science.gov (United States)

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

2018-06-15

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

Effects of different needles and substrates on CuInS{sub 2} deposited by electrostatic spray deposition

Energy Technology Data Exchange (ETDEWEB)

Roncallo, S. [Centre for Materials Science and Engineering, Cranfield University, Shrivenham, Swindon, SN6 8LA (United Kingdom); Painter, J.D., E-mail: j.d.painter@cranfield.ac.u [Centre for Materials Science and Engineering, Cranfield University, Shrivenham, Swindon, SN6 8LA (United Kingdom); Healy, M.J.F. [Centre for Materials Science and Engineering, Cranfield University, Shrivenham, Swindon, SN6 8LA (United Kingdom); Ritchie, S.A.; Finnis, M.V. [Department of Engineering Systems and Management, Cranfield University, Shrivenham, Swindon SN6 8LA (United Kingdom); Rogers, K.D. [Cranfield Health, Cranfield University, Cranfield, Bedfordshire, MK43 0AL (United Kingdom); Scragg, J.J. [University of Bath, Claverton Down, Bath, BA2 7AY (United Kingdom); Dale, P.J. [Laboratoire Photovoltaique, University of Luxembourg, 41 Rue du Brill, L-4422, Belvaux (Luxembourg); Zoppi, G. [Northumbria Photovoltaics Applications Centre, Northumbria, University, Newcastle upon Tyne NE1 8ST (United Kingdom)

2011-03-31

Copper indium disulphide (CuInS{sub 2}) thin films were deposited using the electrostatic spray deposition method. The effects of applied voltage and solution flow rate on the aerosol cone shape, film composition, surface morphology and current conversion were investigated. The effect of aluminium substrates and transparent fluorine doped tin oxide (SnO{sub 2}:F) coated glass substrates on the properties of as-deposited CuInS{sub 2} films were analysed. An oxidation process occurs during the deposition onto the metallic substrates which forms an insulating layer between the photoactive film and substrate. The effects of two different spray needles on the properties of the as-deposited films were also studied. The results reveal that the use of a stainless steel needle results in contamination of the film due to the transfer of metal impurities through the spray whilst this is not seen for the glass needle. The films were characterised using a number of different analytical techniques such as X-ray diffraction, scanning electron microscopy, Rutherford back-scattering and secondary ion mass spectroscopy and opto-electronic measurements.

Spinal anaesthesia in young patients: evaluation of needle gauge ...

African Journals Online (AJOL)

Background:The well-known complication of spinal anaesthesia, postdural puncture headache (PDPH), is especially troublesome in young patients. The needle gauge and configuration of needle tip appear to be the important factors in reducing the incidence of PDPH; however it may increase the incidence of technical ...

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

Energy Technology Data Exchange (ETDEWEB)

McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.; McLaughlin, Patrick W.; Shih, Albert J. [Biomedical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 (United States); Department of Mechanical and Nuclear Engineering, The Pennsylvania State University, State College, Pennsylvania 16802 (United States); Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109 (United States); Biomedical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 and Mechanical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 (United States)

2012-04-15

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

Ear acupuncture in the control of migraine pain: selecting the right acupoints by the "needle-contact test".

Science.gov (United States)

Romoli, M; Allais, G; Airola, G; Benedetto, C

2005-05-01

There is increasing evidence that somatic acupuncture can be helpful in migraine treatment, but substantial data on ear acupuncture (EAP) are still lacking. EAP can be useful both in the diagnosis and in the treatment of many medical conditions. As regards the control of migrainous pain, we present a case report in which a procedure called the "needle-contact test" is described in detail. During a migraine attack, the patient undergoes an accurate search for tender points of the outer ear by means of a specific pressure algometer. Once the most sensitive point has been identified, an acupuncture needle is placed in contact with it for about 10 s, without skin penetration. The expected effect is a quick and evident reduction of acute pain. If no appreciable variation in pain intensity occurs within the following 60 s, a second or third attempt is made on other previously identified tender points, until the point at which the patient notices a clear remission of pain is found. In this positive case, the same testing needle can be immediately used for therapy, completely penetrating the skin, and then extracted after about 30 min. Alternatively, a temporary needle can be implanted and left in situ for a variable period of time (1-15 days). This innovative technique allows the identification, with maximum accuracy, of the most effective ear acupoints on migraine pain during acute attacks.

Lumbar punction: comparison between an atraumatic and a traumatic punction needle

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Tina Bregant

2017-03-01

Full Text Available Background: Lumbar puncture is a standardized, routine diagnostic procedure in the diagnosis of neurological diseases. Post-duarl puncture headache (PDPH is a common complication which occurs in 10 to 30 % of patients. Although the incidence of PDPH is much lower with the use of small, non-cutting needles, neurologists in Slovenia routinely use the classical traumatic spinal needles.Methods: In the article we provide an overview of a research concerned with the use of traumatic and atraumatic needles in the procedure with the emphasis on complications of the lumbar puncture. We present American and European recommendations for lumbar puncture procedure.Conclusions: International recommendations for neurologists advise the use of atraumatic spinal needles for lumbar puncture. We recommend to Slovenian neurologists to start using the atraumatic needles for elective lumbar punctures and hence provide neurological patients with better quality and cheaper long-term care.

Prevalence of Needle Stick Injuries among Healthcare Workers in ...

African Journals Online (AJOL)

Background: Needle stick injuries represent one of the most important occupational hazards to which health workers are exposed. These injuries result from accidental piercing of the skin and or mucous membranes by sharp objects. Needle stick injuries carry the risk of exposure to blood-borne pathogens, especially ...

Diagnosis Of Thyroid Enlargement: Use Of Fine Needle Aspiration ...

African Journals Online (AJOL)

One hundred and ten Fine Needle Aspiration Biopsies (FNAC) obtained from 87 patients with thyroid enlargement or nodules were retrospectively reviewed. Aspiration biopsy was accomplished using 21-gauge needle attached with 20-ml plastic syringe. There were 14 males and 73 females involved in the study. Sixty- four ...

Preoperative US-guided hook-needle insertion in recurrent lymph nodes of papillary thyroid cancer: A help for the surgeon

International Nuclear Information System (INIS)

Duprez, Raphaelle; Lebas, Patrick; Marc, Olivier Saint; Mongeois, Elise; Emy, Philippe; Michenet, Patrick

2010-01-01

Objective: The objective of this study is to investigate whether preoperative ultrasound guided insertion of a hook-needle is useful in reoperations for cervical recurrent lymph node metastases of papillary thyroid cancer. Patients and methods: 8 patients with operated papillary thyroid cancer were included in this study. They all had suspicious nonpalpable cervical lymph nodes discovered during follow-up. These lymph nodes were identified by ultrasound imaging and their metastatic nature was confirmed by fine needle aspiration cytology and measurement of in situ thyroglobulin. In all cases, surgical excision of these lymph nodes was decided. All 8 patients had a hook-needle inserted in the suspicious lymph node(s) preoperatively and under ultrasound guidance. Results and conclusion: In all 8 patients, the suspicious lymph nodes were removed and their metastatic nature was confirmed by the final pathological examination. This localization technique is very helpful for the surgeon during the excision of small and nonpalpable lymph nodes, especially in previously operated area.

Performance Evaluation of Throatless Gasifier Using Pine Needles as a Feedstock for Power Generation

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Dhaundiyal Alok

2016-03-01

Full Text Available This paper deals with the performance evaluation of a throatless gasifier TG-SI-10E. Evaluation of the throatless gasifier was done in three streams, which were the thermal, design and economic aspects. It was tested with pine needles, derived from the Himalayan chir pine (Pinus roxburghii. A non-isokinetic sampling technique was used for measuring the tar and dust contents. The carbon dioxide and carbon monoxide emission at the exhaust of engine was in the range of 12.8% and 0.1-0.5% respectively. The maximum temperature of producer gas measured at the outlet of the gasifier was 505 °C. The specific biomass consumption rate of pine needles was calculated to be 1.595 kg/kWh (electrical. Specific gasification rate for the given design was found to be 107 kg/m2h. Economic evaluation was based on direct tax incidence.

Combined Treatment of Large Hepatocellular Carcinoma with Transcatheter Arterial Chemoembolization and Percutaneous Ethanol Injection with a Multipronged Needle: Experimental and Clinical Investigation

International Nuclear Information System (INIS)

Kawamura, Rinako; Seki, Toshihito; Umehara, Hideto; Ikeda, Kozo; Inokuchi, Ryosuke; Asayama, Toshiki; Yamaguchi, Takashi; Takahashi, Yu; Sakao, Masayuki; Lencioni, Riccardo; Okazaki, Kazuichi

2012-01-01

Purpose: This study was designed to evaluate the usefulness of percutaneous ethanol injection (PEI) with a multipronged needle for the treatment of large hepatocellular carcinoma (HCC). An experimental animal study and a clinical investigation were performed. Methods: In the experimental study, 20 ml of 99.5% ethanol was injected into porcine liver in vivo with a multipronged needle (n = 5) or a straight needle (n = 5), and the volumes of coagulation necrosis were compared. In the clinical investigation, PEI was performed in 17 patients (10 men, 7 women; mean age 73.4 ± 6.7 years) with single, large HCC (mean tumor diameter, 47.2 ± 11.5 mm; range, 32–70 mm) by using a multipronged needle. Fifteen of 17 patients received transarterial chemoembolization (TACE) before PEI. Results: The volume of coagulation in porcine liver in vivo was significantly increased with the multipronged needle compared with the straight needle (longest perpendicular diameters, 34.2 ± 3.6 mm × 30.2 ± 3.6 mm vs. 22.6 ± 2.5 mm × 19 ± 2.2 mm, respectively; P < 0.05). In the clinical trial, initial complete response (CR) of the tumor was achieved in 17 of 17 patients, 7 of whom required two PEI sessions. During the follow-up, local recurrence was detected in 4 of 17 patients at 3–19 months after the procedure, for a rate of sustained local CR of 76%. No major complication occurred. Conclusions: Use of a multipronged needle substantially increases the volume of coagulation in vivo with respect to the conventional PEI technique. Combined TACE and PEI with multipronged needles is a safe and effective option for percutaneous treatment of single, large HCC.

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

Directory of Open Access Journals (Sweden)

Shaoli Liu

Full Text Available 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

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

Science.gov (United States)

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 therapy

Needle Biopsy of the Lung

Science.gov (United States)

... clip. The needle is hollow so it can capture the tissue specimen. There are several types of ... breath, difficulty in catching your breath, rapid pulse (heart rate), sharp chest or shoulder pain with breathing, ...

Reliability of pressure waveform analysis to determine correct epidural needle placement in labouring women.

Science.gov (United States)

Al-Aamri, I; Derzi, S H; Moore, A; Elgueta, M F; Moustafa, M; Schricker, T; Tran, D Q

2017-07-01

Pressure waveform analysis provides a reliable confirmatory adjunct to the loss-of-resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss-of-resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss-of-resistance). Sterile extension tubing, connected to a pressure transducer, was attached to the needle. An investigator determined the presence or absence of a pulsatile waveform, synchronised with the heart rate, on a monitor screen that was not in the view of the anaesthetist or the parturient. A bolus of 4 ml lidocaine 2% with adrenaline 5 μg.ml -1 was administered, and the epidural block was assessed after 15 min. Three women displayed no sensory block at 15 min. The results showed: epidural block present, epidural waveform present 93; epidural block absent, epidural waveform absent 2; epidural block present, epidural waveform absent 4; epidural block absent, epidural waveform present 1. Compared with the use of a local anaesthetic bolus to ascertain the epidural space, the sensitivity, specificity, positive and negative predictive values of waveform analysis were 95.9%, 66.7%, 98.9% and 33.3%, respectively. Epidural waveform analysis provides a simple adjunct to loss-of-resistance for confirming needle placement during performance of obstetric epidurals, however, further studies are required before its routine implementation in clinical practice. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Assessment of bone biopsy needles for sample size, specimen quality and ease of use

International Nuclear Information System (INIS)

Roberts, C.C.; Liu, P.T.; Morrison, W.B.; Leslie, K.O.; Carrino, J.A.; Lozevski, J.L.

2005-01-01

To assess whether there are significant differences in ease of use and quality of samples among several bone biopsy needles currently available. Eight commonly used, commercially available bone biopsy needles of different gauges were evaluated. Each needle was used to obtain five consecutive samples from a lamb lumbar pedicle. Subjective assessment of ease of needle use, ease of sample removal from the needle and sample quality, before and after fixation, was graded on a 5-point scale. The number of attempts necessary to reach a 1 cm depth was recorded. Each biopsy specimen was measured in the gross state and after fixation. The RADI Bonopty 15 g and Kendall Monoject J-type 11 g needles were rated the easiest to use, while the Parallax Core-Assure 11 g and the Bard Ostycut 16 g were rated the most difficult. Parallax Core-Assure and Kendall Monoject needles had the highest quality specimen in the gross state; Cook Elson/Ackerman 14 g and Bard Ostycut 16 g needles yielded the lowest. The MD Tech without Trap-Lok 11 g needle had the highest quality core after fixation, while the Bard Ostycut 16 g had the lowest. There was a significant difference in pre-fixation sample length between needles (P<0.0001), despite acquiring all cores to a standard 1 cm depth. Core length and width decrease in size by an average of 28% and 42% after fixation. Bone biopsy needles vary significantly in performance. Detailed knowledge of the strengths and weaknesses of different needles is important to make an appropriate selection for each individual's practice. (orig.)

Percutaneous image-guided needle biopsy in children - summary of our experience with 57 children

International Nuclear Information System (INIS)

Sklair-Levy, M.; Lebensart, P.D.; Applbaum, Y.H.; Bar-Ziv, J.; Libson, E.; Ramu, N.; Freeman, A.; Gozal, D.; Gross, E.; Sherman, Y.

2001-01-01

Background: Percutaneous image-guided needle biopsy in children has been slower to gain acceptance than in adults where it is regarded as the standard clinical practice in screening suspicious masses. Objectives: To report our experience with percutaneous image-guided needle biopsy in the pediatric population and assess its clinical use, efficacy and limitations. Material and methods: Sixty-nine percutaneous image-guided needle biopsies were performed in 57 children. The age of the children ranged from 4 days to 14 years (mean 5.6 years). We used 16- to-20-gauge cutting-edge needles. Sixty-two biopsies were core-needle biopsies and 7 fine-needle aspiration biopsies. Results: There were 50 malignant lesions, 10 benign lesions and 2 infectious lesions. In 55 (88.7 %) lesions the needle biopsy was diagnostic. In 7 (11.3 %) the biopsy was non-diagnostic and the diagnosis was made by surgery. Core-needle biopsy was diagnostic in 47 of 50 (94 %) of the malignant solid tumors. In 3 out of 5 children with lymphoma, an accurate diagnosis was obtained with needle aspiration. Seven children underwent a repeated core-needle biopsy, (5 for Wilms' tumor and 2 for neuroblastoma) that was diagnostic in all cases. All the biopsies were performed without complications. Conclusion: Percutaneous image-guided needle biopsy is a simple, minimally invasive, safe and accurate method for the evaluation of children with suspicious masses. These data suggest that image-guided needle biopsy is an excellent tool for diagnosing solid tumors in the pediatric population. Negative studies should be considered nondiagnostic and followed by excisional surgical biopsies when clinical suspicion of malignancy is high. (orig.)

Investigation of tissue cellularity at the tip of the core biopsy needle with optical coherence tomography.

Science.gov (United States)

Iftimia, Nicusor; Park, Jesung; Maguluri, Gopi; Krishnamurthy, Savitri; McWatters, Amanda; Sabir, Sharjeel H

2018-02-01

We report the development and the pre-clinical testing of a new technology based on optical coherence tomography (OCT) for investigating tissue composition at the tip of the core biopsy needle. While ultrasound, computed tomography, and magnetic resonance imaging are routinely used to guide needle placement within a tumor, they still do not provide the resolution needed to investigate tissue cellularity (ratio between viable tumor and benign stroma) at the needle tip prior to taking a biopsy core. High resolution OCT imaging, however, can be used to investigate tissue morphology at the micron scale, and thus to determine if the biopsy core would likely have the expected composition. Therefore, we implemented this capability within a custom-made biopsy gun and evaluated its capability for a correct estimation of tumor tissue cellularity. A pilot study on a rabbit model of soft tissue cancer has shown the capability of this technique to provide correct evaluation of tumor tissue cellularity in over 85% of the cases. These initial results indicate the potential benefit of the OCT-based approach for improving the success of the core biopsy procedures.

Histological diagnosis of ultrasound-visible breast lesions by large core needle biopsy

International Nuclear Information System (INIS)

Sanchis-Querol, E.; Valeros, O.; Collado, A.; Gimenez, J.; Yanguas, C.

1999-01-01

We present our experience in the histological diagnosis of breast lesions using ultrasound-guided large core needle biopsy (LCNB), assessing its utility as an alternative to excisional biopsy. We have studied retrospectively a series of 146 cases involving the performance of LCNB. The results were comparable with those of FNAB in 59 cases and with those of surgical aspiration biopsy in 105. Of the 113 lesions identified as malignant by percutaneous large core needle aspiration biopsy, 96 were resected. Surgical aspiration biopsy agreed with LCNB in 100% of cases. Of the 33 lesions identified as benign by LCNB, surgical biopsy detected malignancy in 5. The results obtained establish a specificity for LCNB of 100% and a sensitivity of 96%, both of which are superior to the values for FNAB. Thus, this technique can be considered valid for preoperative diagnosis. LCNB is useful in the preoperative diagnosis of breast lesions, making FNAB and surgical biopsy unnecessary. Moreover, it constitutes a significant change in the management of patients with malignant or undetermined breast lesions. (Author) 8 refs

Fiber Bragg gratings-based sensing for real-time needle tracking during MR-guided brachytherapy

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Borot de Battisti, Maxence, E-mail: M.E.P.Borot@umcutrecht.nl; Maenhout, Metha; Lagendijk, Jan J. W.; Vulpen, Marco van; Moerland, Marinus A. [Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX (Netherlands); Denis de Senneville, Baudouin [Imaging Division, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands and IMB, UMR 5251 CNRS/University of Bordeaux, Talence 33400 (France); Hautvast, Gilion; Binnekamp, Dirk [Philips Group Innovation Biomedical Systems, Eindhoven 5656 AE (Netherlands)

2016-10-15

Purpose: The development of MR-guided high dose rate (HDR) brachytherapy is under investigation due to the excellent tumor and organs at risk visualization of MRI. However, MR-based localization of needles (including catheters or tubes) has inherently a low update rate and the required image interpretation can be hampered by signal voids arising from blood vessels or calcifications limiting the precision of the needle guidance and reconstruction. In this paper, a new needle tracking prototype is investigated using fiber Bragg gratings (FBG)-based sensing: this prototype involves a MR-compatible stylet composed of three optic fibers with nine sets of embedded FBG sensors each. This stylet can be inserted into brachytherapy needles and allows a fast measurement of the needle deflection. This study aims to assess the potential of FBG-based sensing for real-time needle (including catheter or tube) tracking during MR-guided intervention. Methods: First, the MR compatibility of FBG-based sensing and its accuracy was evaluated. Different known needle deflections were measured using FBG-based sensing during simultaneous MR-imaging. Then, a needle tracking procedure using FBG-based sensing was proposed. This procedure involved a MR-based calibration of the FBG-based system performed prior to the interventional procedure. The needle tracking system was assessed in an experiment with a moving phantom during MR imaging. The FBG-based system was quantified by comparing the gold-standard shapes, the shape manually segmented on MRI and the FBG-based measurements. Results: The evaluation of the MR compatibility of FBG-based sensing and its accuracy shows that the needle deflection could be measured with an accuracy of 0.27 mm on average. Besides, the FBG-based measurements were comparable to the uncertainty of MR-based measurements estimated at half the voxel size in the MR image. Finally, the mean(standard deviation) Euclidean distance between MR- and FBG-based needle position

Endoscopic needle-knife treatment for symptomatic esophageal Zenker's diverticulum: A meta-analysis and systematic review.

Science.gov (United States)

Li, Lian Yong; Yang, Yong Tao; Qu, Chang Min; Liang, Shu Wen; Zhong, Chang Qing; Wang, Xiao Ying; Chen, Yan; Spandorfer, Robert M; Christofaro, Sarah; Cai, Qiang

2018-04-01

The aim of this study was to assess the efficacy and safety following endoscopic management of Zenker's diverticulum (ZD) using a needle-knife technique. A systematic search of PubMed, Embase and Cochrane library databases was performed. All original studies reporting efficacy and safety of needle-knife technique for treatment of ZD were included. Pooled event rates across studies were expressed with summative statistics. Main outcomes, such as rates of immediate symptomatic response (ISR), adverse events and recurrence, were extracted, pooled and analyzed. Heterogeneity among studies was assessed using the R statistic. The random effects model was used and results were expressed with forest plots and summative statistics. Thirteen studies included 589 patients were enrolled. Pooled event rates for ISR, overall complication, bleeding and perforation were 88% (95% confidence interval [CI] 79-94%), 13% (95% CI 8-22%), 5% (95% CI 3-10%) and 7% (95% CI 4-12%), respectively. The pooled data demonstrated an overall recurrence rate of 14% (95% CI 9-21%). Diverticulum size of at least 4 cm and less than 4 cm demonstrated pooled adverse event rates of 17% (95% CI 10-27%) and 7% (95% CI 2-18%), respectively. When using diverticuloscope as an accessory, pooled ISR and adverse events rates were 84% (95% CI 58-95%) and 10% (95% CI 3-26%), respectively. Flexible endoscopic procedures using needle-knife offers a relatively safe and effective treatment of symptomatic ZD, especially for ZD of <4 cm in diameter. © 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Fine needle aspiration cytology in leprosy

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Prasad PVS

2008-01-01

Full Text Available Background: Laboratory diagnosis of leprosy by slit skin smear and skin biopsy is simple but both techniques have their own limitations. Slit skin smear is negative in paucibacillary cases whereas skin biopsy is an invasive technique. Fine needle aspiration cytology (FNAC from skin lesions in leprosy with subsequent staining with May-Grunwald-Giemsa (MGG stain has been found useful. Aim: To evaluate the possible role of cytology in classifying leprosy patients. Methods: Seventy-five untreated cases of leprosy attending the outpatient department were evaluated. Smears were taken from their skin lesions and stained using the MGG technique. Skin biopsy was also done from the lesions, which was compared with cytology smears. Results: A correlation of clinical features with FNAC was noticed in 87.5% of TT, 92.1% of BT, 81% of BL, and 66% of LL cases. Correlation of clinical with histopathological diagnoses revealed 12.5% specificity in TT leprosy, 55.3% in BT, 52.4% in BL and 50% in LL, and 100% in neuritic and histoid leprosy cases. Both correlations were found to be statistically significant by paired t test analysis. Thus, it was possible to distinguish the tuberculoid types by the presence of epithelioid cells and the lepromatous types by the presence of lymphocytes and foamy macrophages. Conclusion: FNAC may be used to categorize the patients into paucibacillary and multibacillary types, but is not a very sensitive tool to classify the patients across the Ridley-Jopling spectrum.

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

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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

Accumulation of Cs 137 by needles of pinus silvestris in various types of forest

International Nuclear Information System (INIS)

Golushko, R.M.

2002-01-01

It is researched accumulation of Cs 137 by needles of pine trees during growing old. It is shown, that needles of the one year old have more high radioactivity than needles of the two or three years old. Needles of pine trees accumulated more Cs 137 on good wet soils

Fertilization Changes Chemical Defense in Needles of Mature Norway Spruce (Picea abies

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Line Nybakken

2018-06-01

Full Text Available Nitrogen availability limits growth in most boreal forests. However, parts of the boreal zone receive significant levels of nitrogen deposition. At the same time, forests are fertilized to increase volume growth and carbon sequestration. No matter the source, increasing nitrogen in the boreal forest ecosystem will influence the resource situation for its primary producers, the plants, with possible implications for their defensive chemistry. In general, fertilization reduces phenolic compound concentrations in trees, but existing evidence mainly comes from studies on young plants. Given the role of the phenolic compounds in protection against herbivores and other forest pests, it is important to know if phenolics are reduced with fertilization also in mature trees. The evergreen Norway spruce is long-lived, and it is reasonable that defensive strategies could change from the juvenile to the reproductive and mature phases. In addition, as the needles are kept for several years, defense could also change with needle age. We sampled current and previous year needles from an N fertilization experiment in a Norway spruce forest landscape in south-central Norway to which N had been added annually for 13 years. We analyzed total nitrogen (N and carbon (C, as well as low-molecular phenolics and condensed tannins. Needles from fertilized trees had higher N than those from controls plots, and fertilization decreased concentrations of many flavonoids, as well as condensed tannins in current year needles. In previous year needles, some stilbenes and condensed tannins were higher in fertilized trees. In control trees, the total phenolic concentration was almost five times as high in previous year needles compared with those from the current year, and there were great compositional differences. Previous year needles contained highest concentrations of acetophenone and stilbenes, while in the current year needles the flavonoids, and especially coumaroyl

Fabrication and optical characterization of cadmium sulfide needles using nuclear track membrane

International Nuclear Information System (INIS)

Peng, L.Q.; Wang, S.C.; Ju, X.; Xiao, H.; Chen, H.; He, Y.J.

1999-01-01

Cadmium sulfide needles with a diameter of 0.2 μm have been fabricated in nuclear track polyethylene-terephthalate (PET) membrane by electrochemically depositing from organic solvent dimethylsulfoxide (DMSO) containing CdCl 2 and elemental sulfur at the temperature 110 deg. C. The characterization of the sample of CdS needles was studied by scanning electron microscope, X-ray diffraction, absorption and photoluminescence spectra. The optical experiments show that in the sample of CdS needles there is an absorption peak that could be assigned to the interface states of the CdS needles

Fabrication and optical characterization of cadmium sulfide needles using nuclear track membrane

Energy Technology Data Exchange (ETDEWEB)

Peng, L.Q.; Wang, S.C.; Ju, X.; Xiao, H.; Chen, H.; He, Y.J

1999-06-01

Cadmium sulfide needles with a diameter of 0.2 {mu}m have been fabricated in nuclear track polyethylene-terephthalate (PET) membrane by electrochemically depositing from organic solvent dimethylsulfoxide (DMSO) containing CdCl{sub 2} and elemental sulfur at the temperature 110 deg. C. The characterization of the sample of CdS needles was studied by scanning electron microscope, X-ray diffraction, absorption and photoluminescence spectra. The optical experiments show that in the sample of CdS needles there is an absorption peak that could be assigned to the interface states of the CdS needles.

An ultrasound needle insertion guide in a porcine phantom model.

Science.gov (United States)

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

2013-08-01

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

Should fine needle aspiration cytology in breast assessment be abandoned?

International Nuclear Information System (INIS)

Litherland, Janet C.

2002-01-01

Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. Litherland, J.C. (2002)

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

Science.gov (United States)

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.

Enhanced Visualization of Fine Needles Under Sonographic Guidance Using a MEMS Actuator

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Zhiyuan Shen

2015-01-01

Full Text Available Localization of a needle tip is important for biopsy examinations in clinics. However, the needle tip is sometimes difficult to discern under the guidance of sonography due to its poor visibility. A mini actuator that radiates a low-intensity ultrasound wave was manufactured using micro-electro-mechanical system (MEMS technology. Interference between the radiated and diagnostic ultrasound pulses was observed as bright lines in the B-mode ultrasound image, from which the mini actuator could be recognized with ease. Because the distance between the mini actuator and the needle tip is fixed, the needle tip can be determined despite its inconsistent appearance in the sonography. Both gel phantom and ex vivo tissue evaluation showed that the needle tip can be determined reliably utilizing the acoustic interference pattern.

Effect of ponderosa pine needle litter on grass seedling survival.

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Burt R. McConnell; Justin G. Smith

1971-01-01

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

Percutaneous Extraction of Cement Leakage After Vertebroplasty Under CT and Fluoroscopy Guidance: A New Technique

International Nuclear Information System (INIS)

Amoretti, Nicolas; Huwart, Laurent

2012-01-01

Purpose: We report a new minimally invasive technique of extraction of cement leakage following percutaneous vertebroplasty in adults. Methods: Seven adult patients (five women, two men; mean age: 81 years) treated for vertebral compression fractures by percutaneous vertebroplasty had cement leakage into perivertebral soft tissues along the needle route. Immediately after vertebroplasty, the procedure of extraction was performed under computed tomography (CT) and fluoroscopy guidance: a Chiba needle was first inserted using the same route as the vertebroplasty until contact was obtained with the cement fragment. This needle was then used as a guide for an 11-gauge Trocar t’am (Thiebaud, France). After needle withdrawal, a 13-gauge endoscopy clamp was inserted through the cannula to extract the cement fragments. The whole procedure was performed under local anesthesia. Results: In each patient, all cement fragments were withdrawn within 10 min, without complication. Conclusions: This report suggests that this CT- and fluoroscopy-guided percutaneous technique of extraction could reduce the rate of cement leakage-related complications.

Driven Around the Bend: Novel Use of a Curved Steerable Needle

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Murphy, Darra T., E-mail: darra.murphy@vch.ca; Korzan, Jeffrey R.; Ouellette, Hugue A.; Liu, David M. [Vancouver General Hospital, Department of Radiology (Canada); Clarkson, Paul W. [Vancouver General Hospital, Department of Orthopedic Surgery (Canada); Munk, Peter L. [Vancouver General Hospital, Department of Radiology (Canada)

2013-04-15

This technical note describes the novel use of a curved, steerable needle to access symptomatic osseous lesions in the pelvis and sacrum for palliative percutaneous treatment that would otherwise be difficult to treat using conventional straight needles. Seven patients with lytic bone lesions were treated. One patient had multiple myeloma; the remaining had metastatic disease: breast carcinoma (n = 2), colorectal carcinoma (n = 1), renal cell carcinoma (n = 1), squamous cell carcinoma (n = 1), and leiomyosarcoma (n = 1). Five of the seven patients had lesions in the posterior acetabulum, and the two other patients had lesions in the sacrum. Four of the seven patients received radiofrequency ablation followed by cementoplasty; three patients received cementation alone. We used a novel needle designed for vertebroplasty, which has an articulating tip allowing it to be guided into lytic bone lesions located in difficult-to-access regions of the pelvis and sacrum. All patients were successfully treated with cementoplasty either with or without thermal ablation. No serious adverse events were reported. The needle was difficult to withdraw in two patients. Steerable curved needles can be successfully used to treat lytic osseous metastases with cementoplasty when lesions are located in sites that may be difficult to reach using conventional straight needles.

Darning Needle Impacted in the Male Urethra | Singla | African ...

African Journals Online (AJOL)

Foreign bodies of varied nature have been introduced into the urethra to achieve sexual stimulation. We report the case of a long (9.5 cm) darning needle impacted in the urethra of a male patient following urethral masturbation. After a failed trial at endoscopic extraction the needle had to be removed via open surgery.

Ultrasound-guided core needle biopsy for breast cancer

International Nuclear Information System (INIS)

Naqvi, S.Q.H.; Solangi, R.A.; Memon, M.; Solangi, R.A.

2008-01-01

To evaluate the efficacy of ultrasound-guided core needle biopsy (US-CNB) as a preoperative diagnostic modality for breast cancer. Females with solid and/or intermediate breast lesions visualized on ultrasonography. Apart from clinical work-up, all the above mentioned patients underwent ultrasound-guided core needle biopsy and excisional biopsy of their breast lesions. The histopathological diagnosis on ultrasound-guided core needle biopsy was then compared with the findings of the excisional biopsy. Out of the total 93 cases, 47(50.5%) had benign lesions on ultrasound; US-CNB showed 24 as fibroadenomata, four with chronic non-specific mastitis, five chronic suppurative mastitis, one tuberculosis, four fat necrosis, two lactational adenoma and seven cases with benign ductal hyperplasia without atypia. Nine (9.7%) cases showed suspicious abnormality on ultrasound; US-CNB revealed five cases with atypical ductal hyperplasia, one ductal carcinoma in situ and three invasive ductal carcinoma. Thirty seven (39.8%) cases were highly suggestive of malignancy on ultrasound; US-CNB showed 34 as invasive ductal carcinoma, two invasive lobular and one medullary carcinoma. Excisional biopsy confirmed the diagnosis of ultrasound-guided core needle biopsy in all cases except four; one case of chronic suppurative mastitis was diagnosed as that of tuberculosis and three cases of atypial ductal hyperplasia as invasive ductal carcinoma. Hence there was no false positive case, but four (4.3%) false negative cases. The sensitivity of the US-CNB was thus 100% and specificity 91.1%. Ultrasound guided core needle biopsy is a satisfactory procedure for the histopathological diagnosis of breast lesions. Any unsatisfactory, suspicious or atypical change on US-CNB should be followed by an open biopsy. (author)

Needle displacement during HDR brachytherapy in the treatment of prostate cancer

International Nuclear Information System (INIS)

Damore, Steven J.; Syed, A.M. Nisar; Puthawala, Ajmel A.; Sharma, Anil

2000-01-01

Purpose: We used clinical patient data to examine implant displacement between high dose rate (HDR) brachytherapy fractions for prostate cancer to determine its impact on treatment delivery. Materials and Methods: We analyzed the verification films taken prior to each fraction for 96 consecutive patients treated with HDR brachytherapy boosts as part of their radiation therapy for definitive treatment of organ-confined prostate cancer at our institution. Patients were treated with 18-24 Gy in 4 fractions of HDR delivered in 40 hours followed by 36-39.6 Gy external beam radiation to the prostate. We determined the mean and maximum displacement distances of marker seeds placed in the prostate and of the implanted needles between HDR fractions. Results: Mean and maximum displacement distances between fractions were documented up to 7.6 mm and 28.5 mm, respectively, for the implant needles and 3.6 mm and 11.4 mm, respectively, for the gold marker seeds. All displacement of implant needles occurred in the caudal direction. At least 1 cm caudal displacement of needles occurred prior to 15.5% all fractions. Manual adjustment of needles was required prior to 15% of fractions, and adjustment of the CLP only was required in 24%. Most of the displacement for both the marker seeds and needles occurred between the first and second fractions. Conclusions: There is significant caudal displacement of interstitial implant needles between HDR fractions in our prostate cancer patients. Obtaining verification films and making adjustments in the treatment volume prior to each fraction is necessary to avoid significant inaccuracies in treatment delivery

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

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Bauer, Helmut; Plattner, Karin; Volgger, Waltraud

2000-02-01

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

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

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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

Tattoo machines, needles and utilities.

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Rosenkilde, Frank

2015-01-01

Starting out as a professional tattooist back in 1977 in Copenhagen, Denmark, Frank Rosenkilde has personally experienced the remarkable development of tattoo machines, needles and utilities: all the way from home-made equipment to industrial products of substantially improved quality. Machines can be constructed like the traditional dual-coil and single-coil machines or can be e-coil, rotary and hybrid machines, with the more convenient and precise rotary machines being the recent trend. This development has resulted in disposable needles and utilities. Newer machines are more easily kept clean and protected with foil to prevent crosscontaminations and infections. The machines and the tattooists' knowledge and awareness about prevention of infection have developed hand-in-hand. For decades, Frank Rosenkilde has been collecting tattoo machines. Part of his collection is presented here, supplemented by his personal notes. © 2015 S. Karger AG, Basel.

Learning Ultrasound-Guided Needle Insertion Skills through an Edutainment Game

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