Sample records for surgical aspirator cusa

  1. Cavitron ultrasonic surgical aspirator and visual evoked potential monitoring for chiasmal gliomas in children. Report of two cases. (United States)

    Albright, A L; Sclabassi, R J


    The Cavitron ultrasonic surgical aspirator (CUSA) and intraoperative visual evoked potentials (VEP's) were found to be helpful in treating two children with difficult chiasmal gliomas. Approximately 60% of one tumor and 85% of the other was resected without change in the intraoperative VEP's and with no change in postoperative visual fields or acuity. The CUSA-VEP technique is useful in the infant to "buy time" for brain maturation, delaying or obviating subsequent radiotherapy. This approach may be helpful in the older child to reduce the tumor burden for subsequent chemotherapy. Chiasmal gliomas can be subtotally resected with the CUSA while visual function is monitored by intraoperative VEP's.

  2. Glioma Surgical Aspirate: A Viable Source of Tumor Tissue for Experimental Research

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    Perry F. Bartlett


    Full Text Available Brain cancer research has been hampered by a paucity of viable clinical tissue of sufficient quality and quantity for experimental research. This has driven researchers to rely heavily on long term cultured cells which no longer represent the cancers from which they were derived. Resection of brain tumors, particularly at the interface between normal and tumorigenic tissue, can be carried out using an ultrasonic surgical aspirator (CUSA that deposits liquid (blood and irrigation fluid and resected tissue into a sterile bottle for disposal. To determine the utility of CUSA-derived glioma tissue for experimental research, we collected 48 CUSA specimen bottles from glioma patients and analyzed both the solid tissue fragments and dissociated tumor cells suspended in the liquid waste fraction. We investigated if these fractions would be useful for analyzing tumor heterogeneity, using IHC and multi-parameter flow cytometry; we also assessed culture generation and orthotopic xenograft potential. Both cell sources proved to be an abundant, highly viable source of live tumor cells for cytometric analysis, animal studies and in-vitro studies. Our findings demonstrate that CUSA tissue represents an abundant viable source to conduct experimental research and to carry out diagnostic analyses by flow cytometry or other molecular diagnostic procedures.

  3. Real time analysis of brain tissue by direct combination of ultrasonic surgical aspiration and sonic spray mass spectrometry. (United States)

    Schäfer, Karl-Christian; Balog, Júlia; Szaniszló, Tamás; Szalay, Dániel; Mezey, Géza; Dénes, Júlia; Bognár, László; Oertel, Matthias; Takáts, Zoltán


    Direct combination of cavitron ultrasonic surgical aspirator (CUSA) and sonic spray ionization mass spectrometry is presented. A commercially available ultrasonic surgical device was coupled to a Venturi easy ambient sonic-spray ionization (V-EASI) source by directly introducing liquified tissue debris into the Venturi air jet pump. The Venturi air jet pump was found to efficiently nebulize the suspended tissue material for gas phase ion production. The ionization mechanism involving solely pneumatic spraying was associated with that of sonic spray ionization. Positive and negative ionization spectra were obtained from brain and liver samples reflecting the primary application areas of the surgical device. Mass spectra were found to feature predominantly complex lipid-type constituents of tissues in both ion polarity modes. Multiply charged peptide anions were also detected. The influence of instrumental settings was characterized in detail. Venturi pump geometry and flow parameters were found to be critically important in ionization efficiency. Standard solutions of phospholipids and peptides were analyzed in order to test the dynamic range, sensitivity, and suppression effects. The spectra of the intact tissue specimens were found to be highly specific to the histological tissue type. The principal component analysis (PCA) and linear discriminant analysis (LDA) based data analysis method was developed for real-time tissue identification in a surgical environment. The method has been successfully tested on post-mortem and ex vivo human samples including astrocytomas, meningeomas, metastatic brain tumors, and healthy brain tissue.

  4. Sor Juana and Nicholas of Cusa

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    Rocío Olivares Zorrilla


    Full Text Available Without evaluating the extraordinary and consistent impression that Nicholas of Cusa exerted on the works by Sor Juana Inés de la Cruz, it would be hardly possible to achieve a profound comprehension of one of the most prominent women writers of the Latin American Baroque period. The Cusan’s legacy provided Sor Juana with the symbol of the opposing pyramids of light and shadow, and with the metaphor of the circle and the center, already sifted by the Spanish mystics. Both symbols in her poem The Dream inscribe within a Renaissance change of episteme, in which a mathematical and optical version of the ideas was always produced through the elucidation of oneself, of the individual as part of a cyclic, spherical universe in which a central, all-seeing eye is described in various works by Nicholas of Cusa. The idea of divine contemplation with our bodily eyes closed, for the incorporeal is only accessible by getting rid of the corporeal; the mathematical and geometrical speculations about divinity and the conceptions of the world as a combination of signs; how the infinite and the finite encounter and the knowledge of the world is always a probability and a conjecture, all these are philosophical traces which enlighten The Dream, one of the most captivating intellectual poems in Spanish literature.

  5. A computer model of soft tissue interaction with a surgical aspirator. (United States)

    Mora, Vincent; Jiang, Di; Brooks, Rupert; Delorme, Sébastien


    Surgical aspirators are one of the most frequently used neurosurgical tools. Effective training on a neurosurgery simulator requires a visually and haptically realistic rendering of surgical aspiration. However, there is little published data on mechanical interaction between soft biological tissues and surgical aspirators. In this study an experimental setup for measuring tissue response is described and results on calf brain and a range of phantom materials are presented. Local graphical and haptic models are proposed. They are simple enough for real-time application, and closely match the observed tissue response. Tissue resection (cutting) with suction is simulated using a volume sculpting approach. A simulation of suction is presented as a demonstration of the effectiveness of the approach.

  6. Cervical priming with misoprostol before manual vacuum aspiration versus electric vacuum aspiration for first-trimester surgical abortion. (United States)

    Mittal, Suneeta; Sehgal, Rohini; Aggarwal, Sagarika; Aruna, Janaki; Bahadur, Anupama; Kumar, Guresh


    To compare the efficacy of manual vacuum aspiration (MVA) with electric vacuum aspiration (EVA) and to evaluate whether cervical priming with misoprostol facilitates cervical dilation and reduces complications associated with first-trimester medical abortion performed up to 10 weeks of pregnancy. A total of 600 women who requested termination of pregnancy were randomized into 4 groups (150 women in each group). Group I and II received a vaginal placebo 3 hours before MVA or EVA, respectively. Group III and IV received 400 μg of vaginal misoprostol 3 hours before MVA or EVA, respectively. Complete abortion rates after MVA and EVA were both 97.9%; after cervical priming with misoprostol complete abortion rates were 98.6% versus 97.3% after cervical priming with placebo (P>0.05). Administration of misoprostol into the vagina before MVA resulted in 99.3% complete abortions (P=0.40), and the least operative blood loss, operating time, and need for cervical dilation (P0.05). For surgical evacuation, EVA and MVA did not differ in efficacy. Cervical priming 3 hours before MVA for termination of pregnancy significantly reduced the need for cervical dilation and the operative time, and improved the efficacy of the procedure. Pretreatment with vaginal misoprostol before MVA is a safe and effective method for terminating pregnancies of up to 10 weeks of gestation. CTRI/2009/091/000008. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Ignorància i saber en Nicolau de Cusa

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    Jesús Mansilla Navarro


    Full Text Available Después de un acercamiento al pensamiento de Nicolás de Cusa, este artículo profundiza en su obra Idiota de sapientia (1450. A partir de su estudio, el autor plantea la paradoja que se establece en torno a la noción de verdad ya que, de acuerdo con la tradición socrática, la ignorancia a la que se refiere Nicolás de Cusa no consiste en la obscuridad del no-saber sino en una ignorancia sapiencial que constituye un punto de partida para el estudio de cualquier realidad aceptando la humildad como actitud intelectual. ____________________________________________________________________________________________________________________________________________________________ Après une approche de la pensée de Nicolas de Cusa, cet article approfondit l’étude de son oeuvre Idiota de sapientia (1450. À partir de son étude, l’auteur propose le paradoxe qui est posé autour de la notion de vérité. En effet, conformément à la tradition socratique, l’ignorance à laquelle se réfère Nicolas de Cusa ne consiste pas en l’obscurité du nonsavoir sinon en une ignorance sage, qui constitue un point de départ pour l’étude de n’importe quelle réalité en acceptant l’humilité comme attitude intellectuelle.Following a review of the thinking of Nicholas of Cusa, this article undertakes a detailed study of his work, Idiota de Sapientia (1450. From this study, the author discusses the paradox that has grown up around the notion of truth since, in accordance with the Socratic tradition, the ignorance to which Nicholas of Cusa refers does not consist of the darkness of not knowing but rather of a learned ignorance that constitutes a starting point for the study of any reality accepting humility as an intellectual attitude.Después de un acercamiento al pensamiento de Nicolás de Cusa, este artículo profundiza en su obra Idiota de sapientia (1450. A partir de su estudio, el autor plantea la paradoja que se establece en torno a la noci

  8. [Iatrogenic extravasations of cytotoxic or hyperosmolar aqueous solutions. Value of surgical emergency by aspiration and lavage]. (United States)

    Lambert, F; Couturaud, B; Arnaud, E; Champeau, F; Revol, M; Servant, J M


    Iatrogenic extravasations are characterized by their unpredictable course, the possible repercussions of functional, cosmetic and psychological sequelae, and the absence of a therapeutic consensus. The authors present the protocol used in Hôpital Saint-Louis, based on a synthesis of current procedures, consisting of emergency conservative surgical aspiration and lavage, performed in a context of close collaboration with oncolosits, intensive care physicians and radiologists. From 1994 to March 1997, fifteen patients were operated following extravasation during seven chemotherapeutic protocols, three radiographic examinations with injection of contrast agents and five resuscitation procedures. This simple protocol, applied systematically, achieved cure without cutaneous or functional sequelae in all patients. Aspiration-lavage during the first twelve hours therefore constitutes the treatment of choice of iatrogenic extravasation with cytotoxic or hyperosmolar aqueous solutions.

  9. Conceptual affinities between Plotinus and Nicholas of Cusa

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    Malena Tonelli


    Full Text Available Twelve centuries separate to Plotinus from Nicholas of Cusa. There are twelve centuries and several developments and philosophical intricacies occurred during a period both rich and troubled. However, one tradition includes both thinkers in the same line of thought, the first as its starting point, the second, perhaps, as its culmination. In this regard, I will try to establish which aspects of the thought of Plotinus persist in Nicholas of Cusa so that we can legitimately try to understand why and in what sense these two philosophers can both be called "Neoplatonists". In this paper, then, I will contend that both ways of conceiving reality can be understood as complementary –without neglecting, however, the various differences that subsist among them–. Certainly, Plotinus and Nicholas of Cusa differ in certain doctrinal issues that can be considered relevant enough to deny the possibility of thinking of them as members of the same tradition. Moreover, to these differences one add that nothing indicates that Nicholas has had any contact whatsoever with Plotinus’ works. In fact, the Neoplatonic influence on his thought is more likely to be attributed to authors like Proclus and Dionysius. On account of these reasons, it is not possible to ground the analysis in terms of a direct textual influence, the inquiry will rather be formulated in terms of "schools of thought". Indeed, Plotinus and Nicholas of Cusa have thought about similar questions and have provided, each in their own way and in their own time, possible answers in some cases parallel, something that allow us to undertake a comparative study

  10. Differences between CusA and AcrB crystallisation highlighted by protein flexibility.

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    Aurélien Deniaud

    Full Text Available BACKGROUND: Until very recently, AcrB was the only Resistance Nodulation and cell Division transporter for which the structure has been elucidated. Towards a general understanding of this protein family, CusA and AcrB were compared. METHODOLOGY/PRINCIPAL FINDINGS: In dodecylmaltoside, AcrB crystallised in many different conditions, while CusA does not. This could be due to the difference in dynamic between these proteins as judged from limited proteolysis assays. Addition of various compounds, in particular heavy metal cations, stabilises CusA. CONCLUSION/SIGNIFICANCE: This approach could constitute a first step towards CusA crystallisation.

  11. Fine Needle Aspiration Cytology of Thyroid Nodules: Correlation with Surgical Histopathology Histopathology

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    Nargess Ghazaleh


    Full Text Available Objective: Approximately 7% of people have thyroid nodules. The most important consideration in evaluating patients with thyroid nodules is whether the nodule is malignant. Fine needle aspiration (FNA biopsy is the best, safest, and most cost-effective measure for distinguishing malignancy, thus preventing unnecessary surgeries. In this survey, adequacy of smears, cytologic findings, histologic findings, and their concordance, have been studied. Materials and Methods: FNA biopsy was performed in 200 patients with palpable thyroid nodules in 2004-2005. Cytologic findings and adequacy of specimens were recorded. Of the 200 patients, 39 had surgery; postoperative histological results were compared with FNA biopsy results.Results: Of FNA smears, 88% were adequate; of these adequate smears, 57.2% were benign, 34.2% were suspicious for malignancy, and 8.6% were reported as malignant. When results of surgical pathology were compared with FNA cytology results, all benign surgical specimens also had benign cytology results, and all malignant surgical specimens had malignant results on cytology evaluation. In nodules with suspicious cytology, histopathology showed that 50% were malignant and 50% were benign.Conclusions: FNA is a simple and cost-effective procedure for identifying benign and malignant nodules. The incidence of malignant pathology in nodules with suspicious cytology was higher than other studies.Turk Jem 2008; 12: 73-4

  12. A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses. (United States)

    Kasraeian, Sina; Allison, Daniel C; Ahlmann, Elke R; Fedenko, Alexander N; Menendez, Lawrence R


    Biopsy tissue can be obtained through a fine needle, a wider coring needle, or through an open surgical incision. Though much literature exists regarding the diagnostic yield of these techniques individually, none compare accuracy of diagnosis in the same mass. We asked how the diagnostic accuracy of fine-needle aspiration, core biopsy, and open surgical biopsy compare in regard to identifying malignancy, establishing the exact diagnosis, and guiding the appropriate treatment of soft tissue masses. We prospectively studied 57 patients with palpable extremity soft tissue masses, performing fine-needle aspiration, followed by core biopsy, followed by surgical biopsy of the same mass. Open surgical biopsy was 100% accurate on all accounts. With regard to determining malignancy, fine-needle aspiration and core biopsy had 79.17% and 79.2% sensitivity, 72.7% and 81.8% specificity, 67.9% and 76% positive predictive value, 82.8% and 84.4% negative predictive value, and an overall accuracy of 75.4% and 80.7%, respectively. In regard to determining exact diagnosis, fine-needle aspiration had a 33.3% accuracy and core biopsy had a 45.6% accuracy. With regard to eventual treatment, fine-needle aspiration was 38.6% accurate and core biopsy was 49.1% accurate. In soft tissue mass diagnosis, core biopsy is more accurate than fine-needle aspiration on all accounts, and open biopsy is more accurate than both in determining malignancy, establishing the exact diagnosis, and the guiding appropriate treatment.

  13. Visio intellectualis: Nicolás de Cusa y Schelling

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    Harald Schwaetzer


    Full Text Available Este trabajo pretende descubrir una proximidad sistemática entre el pensamiento de Nicolás de Cusa y el idealismo alemán, en particular, en torno a la noción de "visio intellectualis" entendida en el plano teórico del conocimiento. Pretende demostrar que lo que el Cusano piensa como "visión intelectual" acaba por no ser otra cosa que el "Yo que se contempla a sí mismo" ["selbst anschauende Ich"] en el que piensa Schelling y, así, que aquello que está en la base del pensamiento cusano y que se ha sido pensado a su manera en su tiempo, es lo mismo que fue mostrado en el tiempo de Schelling y a la manera de Schelling.

  14. A Note on Jordan, Adamović-Mitrinović, and Cusa Inequalities

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    Zhen-Hang Yang


    Full Text Available We improve the Jordan, Adamović-Mitrinović, and Cusa inequalities. As applications, several new Shafer-Fink type inequalities for inverse sine function and bivariate means inequalities are established, and a new estimate for sine integral is given.

  15. Ultrasonic Surgical Aspirate is a Reliable Source For Culturing Glioblastoma Stem Cells (United States)

    Behnan, Jinan; Stangeland, Biljana; Langella, Tiziana; Finocchiaro, Gaetano; Murrell, Wayne; Brinchmann, Jan E.


    Glioma stem cells (GSCs) are thought to be the source of tumor growth and therapy resistance. To understand the biology of GSCs, and target these tumors therapeutically, we need robust strategies for in vitro expansion of primary GSCs. To date, tumor core biopsies have been the main established source of GSCs. Since these samples are used for diagnostic purposes, the available tissue for cell culture and therapeutic targeting can be limited. In addition, a core biopsy is usually taken from one part of the tumor, thus would be unlikely to represent intra-tumor heterogeneity. To overcome these problems, tissue fragments from all over the tumor can be collected using an ultrasonic aspirator during surgery, thus assembling a “global tumor biopsy”. Usually, this ultrasonic aspirate (UA) sample is considered as biological waste after operations. Here, we show that UA samples offer a large and reliable source of live cells. Similar to core biopsies, UA samples enriched for GSCs that differentiated into neural lineages, showed inter-individual variation of GSC markers, and induced tumors. Molecular profiling showed that UA samples cover tumor heterogeneity better than core biopsies. These results suggest that UA samples can be used to establish large scale cultures for therapeutic applications. PMID:27605047

  16. Surgical closure of the larynx for intractable aspiration pneumonia: cannula-free care and minimizing the risk of developing trachea-innominate artery fistula. (United States)

    Ise, Kazuya; Kano, Makoto; Yamashita, Michitoshi; Ishii, Show; Shimizu, Hirofumi; Nakayama, Kei; Gotoh, Mitsukazu


    There is a risk of developing a fatal trachea-innominate artery fistula following laryngotracheal separation for the prevention of intractable aspiration pneumonia. We developed a novel technique of surgical closure of the larynx to avoid this complication and provide long-term cannula-free care.

  17. Crystal structures of the CusA efflux pump suggest methionine-mediated metal transport

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    Long, Feng; Su, Chih-Chia; Zimmermann, Michael T.; Boyken, Scott E.; Rajashankar, Kanagalaghatta R.; Jernigan, Robert L.; Yu, Edward W. (Cornell); (Iowa State)


    Gram-negative bacteria, such as Escherichia coli, frequently use tripartite efflux complexes in the resistance-nodulation-cell division (RND) family to expel various toxic compounds from the cell. The efflux system CusCBA is responsible for extruding biocidal Cu(I) and Ag(I) ions. No previous structural information was available for the heavy-metal efflux (HME) subfamily of the RND efflux pumps. Here we describe the crystal structures of the inner-membrane transporter CusA in the absence and presence of bound Cu(I) or Ag(I). These CusA structures provide new structural information about the HME subfamily of RND efflux pumps. The structures suggest that the metal-binding sites, formed by a three-methionine cluster, are located within the cleft region of the periplasmic domain. This cleft is closed in the apo-CusA form but open in the CusA-Cu(I) and CusA-Ag(I) structures, which directly suggests a plausible pathway for ion export. Binding of Cu(I) and Ag(I) triggers significant conformational changes in both the periplasmic and transmembrane domains. The crystal structure indicates that CusA has, in addition to the three-methionine metal-binding site, four methionine pairs - three located in the transmembrane region and one in the periplasmic domain. Genetic analysis and transport assays suggest that CusA is capable of actively picking up metal ions from the cytosol, using these methionine pairs or clusters to bind and export metal ions. These structures suggest a stepwise shuttle mechanism for transport between these sites.

  18. Influencia del Pseudo Dionisio en Nicolás de Cusa

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    Andrés Hubert R


    Full Text Available Nicolás de Cusa (1401-1464 reconoce la influencia del Pseudo Dionisio en su propio pensamiento, especialmente en su teología negativa. Este trabajo busca mostrar esta influencia en el libro referencia del Cusano: el De Docta Ignorantia (la Docta Ignorancia. Esta obra consta de 3 partes. Solo en la primera parte, Nicolás sigue de cerca las ideas del Pseudo Dionisio y solo en ella lo cita. En las demás, aunque se nota la influencia, nuestro autor se siente más libre: las fundaciones están firmes, el constructor puede construir libremente. Para probar esta tesis, se toman dos ejemplos: el tema de las tinieblas y la coincidencia de los opuestos. Este ejercicio permite conocer cómo y por qué se recibió al Pseudo Dionisio en la historia de la teología. Permite también profundizar el sentido de la teología de Nicolás de CusaThe reflections of Nicolas of Cusa (1401-1464 recognise the influence of Pseudo Dyonisius, particularly in his negative theology. The present study shows this influence on Nicolas' most important book: the De Docta Ignorantia (the Learned Ignorance. The book is divided into three parts and it is in the first part that Nicolas directly pursues the ideas of Pseudo Dyonisius and it is only here that he quotes them. In the other parts of the book although the influence is noted, the foundations have been set and are solid and the author or builder can construct with freedom. To prove this thesis, 2 examples are presented: the theme of darkness and the coincidence of opposites. This exercise shows how and why Pseudo Dyonisius has been accepted into the history of the theology. It also deepens the meaning of the Nicolas of Cusa's theology

  19. Aspiration pneumonia (United States)

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

  20. Subtyping of Non-Small Cell Lung Carcinoma in Fine Needle Aspiration Specimens: A Study of 252 Patients with Surgical Correlations

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    Beyhan Varol Mollamehmetoğlu


    Full Text Available Objective: Fine-needle aspiration (FNA cytology performed by either transthoracic or transbronchial procedures is an important approach to obtain tumor tissue for histological diagnosis. We investigated the accuracy of FNA in differentiating NSCLCs of adenocarcinoma from squamous cell carcinoma histological types to correlate cytological findings with histological features and immunohistochemistry confirmation in some cases. Methods: From 2010 to 2015, a total of 635 transbronchial needle aspirations or transthoracic needle aspirations were performed. 332 cases were diagnosed as NSCLC, with or without an indication of a specific subtype, while 303 cases were not diagnosed as NSCLC. Out of 332 cases diagnosed as NSCLC, 252 had a histological follow-up. Subsequently, histological samples included 161 surgical resections and 91 biopsies. In cases with histopathological diagnosis accompanied by FNA cytology, an immunohistochemical study was carried out and the diagnostic results of the two methods were compared to each other. Results: The specific subtype of NSCLC was provided in 217 cases (86% based on cytomorphology which included 115 adenocarcinomas (46% and 102 squamous cell carcinomas (40%. The diagnosis NSCLC-NOS by FNA was set in 35 cases. At histology, 251 cases (99.6% were sub-classified: 122 adenocarcinomas (48%, 104 squamous cell carcinomas (41%, 11 large cell carcinomas (4% , and 14 adenosquamous carcinomas (6%. Agreement between cytological and histological typing was found in 181 of 197 cases (92% (K=0.837; p<0.001. Conclusion: Our study proved that most NSCLC can be sub-classified as adenocarcinoma or squamous cell carcinoma by FNA through cytomorphology and the application of immunocytochemistry.

  1. Bone marrow aspiration (United States)

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

  2. Strategic Aspirations

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    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole


    Strategic aspirations are public announcements designed to inspire, motivate, and create expectations about the future. Vision statements or value declarations are examples of such talk, through which organizations announce their ideal selves and declare what they (intend to) do. While aspirations...... aspirations, in other words, have exploratory and inspirational potential—two features that are highly essential in complex areas such as sustainability and CSR. This entry takes a communicative focus on strategic aspirations, highlighting the value of aspirational talk, understood as ideals and intentions...

  3. A reappraisal of the role of Gram's stains of tracheal aspirates in guiding antibiotic selection in the surgical intensive care unit. (United States)

    Namias, N; Harvill, S; Ball, S; McKenney, M G; Sleeman, D; Ladha, A; Civetta, J


    Tracheal aspirate Gram's stains are used to guide antibiotic selection in empiric pneumonia treatment in the surgical intensive care unit (SICU). We questioned whether Gram's stains predict the organism cultured. A retrospective review of prospectively collected data. Gram's stains correlated with the cultured organism in 284 of 543 (52%) SICU cultures and in 226 of 403 (56%) trauma intensive care unit (TICU) cultures. Gram-negative rod (GNR) stains yielded GNR organisms in 182 of 205 (89%) SICU cultures and in 160 of 176 (91%) TICU cultures. Gram-positive coccus (GPC) stains yielded GPC organisms in 75 of 228 (33%) SICU cultures and in 52 of 149 (35%) TICU cultures. Noncorrelates in the GPC group were predominantly GNRs (185 of 250 (74%)). When the clinical decision has been made that empiric antibiotic coverage is necessary, GNR coverage should be instituted regardless of Gram's stain result. The decision to institute GPC coverage needs to be supported by clinical data other than the Gram's stain.

  4. Amor, caritas e dilectio : elementos para uma hermenêutica do amor no pensamento de Nicolau de Cusa


    Nogueira, Maria Simone Marinho


    Tese de doutoramento em Filosofia apresentada à Fac. de Letras da Univ. de Coimbra A presente investigação procura evidenciar a existência de uma hermenêutica do amor no pensamento de Nicolau de Cusa. Para a consecução deste objectivo, analisa as ocorrências e os significados das palavras amor, caritas e dilectio nos textos cusanos e estabelece relações entre o amor e outros temas presentes na sua filosofia. Busca, ainda, explicitar a importância do amor no contexto da relação entre affect...

  5. Management of pulmonary aspiration

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    Janda, Matthias; Scheeren, Thomas W L; Nöldge-Schomburg, Gabriele F E


    Pulmonary aspiration of gastric contents in the perioperative phase is associated with increased postoperative morbidity and mortality. For the management of aspiration, differentiation between acid-associated aspiration pneumonitis and aspiration pneumonia as a consequence of a secondary bacterial

  6. Concordance between HER-2 status determined by qPCR in Fine Needle Aspiration Cytology (FNAC) samples compared with IHC and FISH in Core Needle Biopsy (CNB) or surgical specimens in breast cancer patients. (United States)

    Rodriguez, Claudia; Suciu, Voichita; Poterie, Audrey; Lacroix, Ludovic; Miran, Isabelle; Boichard, Amélie; Delaloge, Suzette; Deneuve, Jacqueline; Azoulay, Sandy; Mathieu, Marie-Christine; Valent, Alexander; Michiels, Stefan; Arnedos, Monica; Vielh, Philippe


    Determining the status of HER2-neu amplification and overexpression in breast cancer is crucial for prognosis but mostly for treatment purposes. Standard techniques include the determination of IHC in combination with in situ hybridization techniques to confirm a HER2-neu amplification in case of IHC2+ using either a core-needle biopsy or a surgical specimen. qPCR has been also demonstrated to be able to determine HER2 status, mostly in core biopsies or in surgical specimens. Fine-needle aspiration is a reliable, quicker and less invasive technique that is widely used for diagnosis of invasive breast cancer. In this study, we assessed the performance of qPCR in invasive breast carcinomas to determine HER2-neu status by using fine-needle aspiration samples and comparing to standard IHC and FISH. From a total of 154 samples from patients who had nodular breast lesions and attended the 1-day-stop clinic at the Gustave Roussy from March 2013 to October 2014, qPCR was able to determine the HER2 status in a mean of 3.7 days (SD 3.1). The overall concordance with standard HER2-testing was very high: 97% (95% CI 0.94 to 0.99); sensitivity was 96% (0.87-1), specificity 98% (0.95-1) and positive and negative predictive values 88% (0.75-1) and 99% (0.98-1), respectively. In conclusion, our study demonstrates that qPCR performed using fine-needle aspiration samples from a primary tumour is a reliable and fast method to determine HER2/neu status in patients with early breast cancer.

  7. Balthasar y el ´nudo´ de la metafísica de Nicolás de Cusa

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    André Hubert


    Full Text Available En su libro ´Gloria´, H.-U von Balthasar escribió un capítulo dedicado a Nicolás de Cusa. Es un pequeño tratado sobre la búsqueda de la analogia entis a través del sistema propio del Cusano. Siguiendo el desarrollo del capítulo, el trabajo muestra cómo Nicolás expresa su búsqueda de una explicación del mundo. Parte de Dios a través de la Docta Ignorancia, se atreve a hacer conjeturas: ¿cómo explicar, cómo unir lo uno y lo múltiple? Nicolás busca nombres de donde sostenerse, pero sólo encuentra a un Dios que contiene en sí a su creación y una creación que explicita a Dios. Es la complicatio-explicatio que permite entender la teoría cusana de la coincidencia de los opuestos. Sobre todo, ve que el hombre es medida de todo, el que es imagen de Dios.In his masterwork Glory of the Lord, Hans Urs von Balthasar wrote a chapter dedicated to Nicholas of Cusa. It´s a short treatise on the search for the analogia entis using the Cusan system. As the chapter develops, this work shows how Nicholas expresses his own search for an explanation of the world. It begins with God through Docta ignorancia, daring to ask, how does one explain a way to join the one and the many? Nicholas searches for names from which to sustain himself, but only finds a God who contains within himself his Creation and a Creation that makes God explicit. It is the complicatio-explicatio that allows one to understand the Cusan theory of the coincidence of opposites. Above all, one sees that man is the measure of all, he who is the image of God.

  8. Surgical area contamination--comparable bacterial counts using disposable head and mask and helmet aspirator system, but dramatic increase upon omission of head-gear: an experimental study in horizontal laminar air-flow. (United States)

    Friberg, B; Friberg, S; Ostensson, R; Burman, L G


    The effect of different head coverings on air-borne transmission of bacteria and particles in the surgical area was studied during 30 strictly standardized sham operations performed in a horizontal laminar air flow (LAF) unit. The operating team members wore disposable gowns plus either a non-sterile head covering consisting of a squire type disposable hood and triple laminar face mask, a sterilized helmet aspirator system or no head cover at all. In the wound area both types of head cover resulted in low and comparable air (means of 8 and 4cfu/m(3)) and surface contamination (means of 69 and 126cfu/m(2)/h) rates. Omission of head-gear resulted in a three- to five-fold increase (P > or = 0.01- 0.001), depending on site sampled air contamination rate (mean of 22cfu/m(3)) whereas the bacterial sedimentation rate in the wound area increased about 60-fold ( P > or = 0.0001). A proper head cover minimized the emission of apparently heavy particles that were not removed by the horizontal LAF and contained mainly streptococci, presumably of respiratory tract origin. Dust particle counts revealed no differences between the three experimental situations. No correlation between air and surface contamination rates or between air contamination and air particle counts was found. We conclude that, from a bacteriological point of view, disposable hoods of squire type and face masks are equally as efficient as a helmet aspirator system and both will efficiently contain the substantial emission of bacteria-carrying droplets from the respiratory tract occurring when head cover is omitted. Finally, the use of bacterial air counts to assess surgical site surface contamination in horizontal LAF units must be seriously questioned.

  9. Infinitud Divina y Visión Mística en Nicolás de Cusa

    Directory of Open Access Journals (Sweden)

    Manuel Cabada Castro


    Full Text Available Nicolás de Cusa, desde su modo unitario, filosófico y teológico a un tiempo, de pensar, no dejó de abordar la cuestión de lo místico en relación con la temática de la infinitud, tan central en él. Tal cuestión constituye el eje de las reflexiones de su escrito De visione Dei, dedicado y enviado a los monjes benedictinos de Tegernsee, y de la comunicación epistolar que mantiene asimismo con éstos. El Cusano profundiza aquí en el «ver» (un «ver» de Dios y del hombre en mutua y dispar relación. Es la infinitud divina la que hace que la divinidad se convierta en el Cusano, en «la invisibilidad de lo visible». En este artículo se analizan la conexión del pensamiento del Cusano con la teología mística del Pseudo-Dionisio Areopagita, la relación entre conocimiento y afectividad en la dimensión mística en el contexto de las discusiones de su época al respecto y, en general, el entronque de la concepción mística del Cusano con su propia sistemática filosófica y con su visión cristiana del mundo.

  10. Transbronchial and transesophageal fine-needle aspiration using a single ultrasound bronchoscope in the diagnosis of locoregional recurrence of surgically-treated lung cancer. (United States)

    Sanz-Santos, José; Serra, Pere; Andreo, Felipe; Torky, Mohamed; Centeno, Carmen; Morán, Teresa; Carcereny, Enric; Fernández, Esther; García-Reina, Samuel; Ruiz-Manzano, Juan


    The present study sought to evaluate the usefulness of EBUS-TBNA in the diagnosis of locoregional recurrence of lung cancer in a cohort of lung cancer patients who were previously treated surgically, and describe our initial experience of EUS-B-FNA in this clinical scenario. We retrospectively studied the clinical records of all patients with a previous surgically-treated lung cancer who were referred to our bronchoscopy unit after suspicion of locoregional recurrence. The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of EBUS-TBNA for the diagnosis of locoregional recurrence were evaluated. Seventy-three patients were included. EBUS-TBNA confirmed malignancy in 40 patients: 34 confirmed to have locoregional recurrence, six had metachronous tumours. Of the 33 patients with non-malignant EBUS-TBNA; 2 had specific non-malignant diseases, 26 underwent radiological follow up and 5 patients underwent surgery. Of the 26 patients who had radiological follow up; 18 remained stable, three presented thoracic radiological progression and 5 presented extrathoracic progression. Of the 5 patients who underwent surgery; 3 had metachronous tumours, one confirmed to be a true negative and one presented nodal invasion. Seven patients underwent EUS-B-FNA, four of them confirmed to have recurrence. The sensitivity, specificity, NPV, PPV and overall accuracy of EBUS-TBNA for the diagnosis of locoregional recurrence were 80.9, 100, 69.2, 100 and 86.6% respectively. EBUS-TBNA is an accurate procedure for the diagnosis of locoregional recurrence of surgically-treated lung cancer. EUS-B-FNA combined with EBUS-TBNA broads the diagnostic yield of EBUS-TBNA alone.

  11. A transsumptio e o uso de enigmas como "saída" para um discurso sobre o divino em De docta ignorantia (1440 de Nicolau de Cusa [The transsumptio and the use of puzzles as a "way out" for a discourse on divine in Nicholas of Cusa's De docta ignorantia (1440

    Directory of Open Access Journals (Sweden)

    Klédson Tiago Alves de Souza


    Full Text Available Este artigo traz traços de uma importante discussão dentro do contexto da filosofia de Nicolau de Cusa, a saber, a discussão sobre o conceito de transsumptio e o uso de enigmas como uma saída para um discurso acerca do princípio primeiro, isto é, Deus. O objetivo é mostrar como esta perspectiva enigmática ou simbólica aparece na filosofia cusana, especialmente nas três obras que se propõe a discutir este trabalho: De docta ignorantia (1440, De visione dei (1453 e De non aliud (1462. [This article brings out traces of an important discussion in the context of the philosophy of Nicholas of Cusa, i.e. the discussion about the concept of transsumptio and the use of puzzles as a way out for a discourse on the first principle, that is, God. The objective is to show how this enigmatic or symbolic perspective appears in the Cusan philosophy especially in the three works that this work proposes to discuss: De docta ignorantia (1440, De visione dei (1453 and De non aliud (1462.

  12. Aspirations of Life

    Institute of Scientific and Technical Information of China (English)

    Zhou; Ningxin


    After entering Senior Three, besides strenuous revisions and examinations, what the students think most and discuss most is aspirations of life. As far as I know, most of my classmates have already specified their choices of majors and their aspirations of life. Some classmates excel in science subjects, so they have chosen science and engineering subjects, hoping that they will become scientists or engineers.

  13. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.


    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this behaviora

  14. Aspiration and leadership

    NARCIS (Netherlands)

    Jagersma, P.K.


    Management needs an aspiration as to how the company will work in the future. It needs a guide for corporate priorities. Any company - local or global - must be driven by an aspiration that energizes and motivates the company from top to bottom. Yet very few managers and executives know how a corpor

  15. Aspiration in Jaffna Tamil (United States)

    Thananjayarajasingham, S.


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

  16. Aspirations of Rural Youth. (United States)

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


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

  17. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.


    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this behaviora

  18. Comparative cost-effectiveness of fine needle aspiration biopsy versus image-guided biopsy, and open surgical biopsy in the evaluation of breast cancer in the era of Affordable Care Act: a changing landscape. (United States)

    Masood, Shahla; Rosa, Marilin; Kraemer, Dale F; Smotherman, Carmen; Mohammadi, Amir


    Proven as a time challenged and cost-effective sampling procedure, the use of FNAB has still remained controversial among the scientific community. Currently, other minimally invasive sampling procedures such as ultrasound guided fine needle aspiration biopsy (US-FNAB) and image guided core needle biopsy (IG-CNB) have become the preferred sampling procedures for evaluation of breast lesions. However, changes in the medical economy and the current growing emphasis on cost containment in the era of the Affordable Care Act make it necessary to stimulate a renewed interest in the use of FNAB as the initial diagnostic sampling procedure. This study was designed to define the changing trend in the practice of tissue sampling during the last several years, and to assess the comparative effectiveness and appropriateness of the procedure of choice for breast cancer diagnosis. After Institutional Review Board (IRB) approval, the computer database of the Pathology Department, University of Florida, College of Medicine-Jacksonville at UF Health was retrospectively searched to identify all breast biopsy pathology reports issued during the period of January 2004 to December 2011. The inclusion criteria were all women that underwent any of the following biopsy types: FNAB, US-FNAB, IG-CNB, and surgical biopsy (SB). Diagnostic procedures were identified using current procedural terminology (CPT) codes recorded on claims from the UF Health Jacksonville patient accounting application files. The data obtained was used to determine which technique has the best cost-effectiveness in the diagnosis of breast cancer. The outcome variable for this project was a positive breast cancer diagnosis resulting from these methodologies. The predictor variable was the biopsy type used for sampling. The rate of cancer detection for each procedure was also determined. Among the four groups of procedures compared, the lower cost was attributed to FNAB, followed by US-FNAB, and SB. IG-CNB was the most

  19. La gracia como posibilidad del encuentro entre Dios y el hombre en la obra De visione Dei de Nicolás de Cusa The Grace as a possibility of the encounter among God and Man, in De visione Dei piece of work by Nicholas of Cusa

    Directory of Open Access Journals (Sweden)



    Full Text Available El artículo presenta los aportes más importantes y significativos de la gracia en Nicolás de Cusa específicamente en la obra De visione Dei, en torno al tema de la gracia como posibilidad del encuentro entre Dios y el hombre. Específicamente se tratará el tema de la gracia en torno a tres dimensiones: en tanto gracia de Dios en la dinámica del rostro, del hombre como ser agraciado en relación constitutiva con Dios y los frutos que la gracia realiza en cada ser humano. A su vez el escrito pretende ser un aporte a la renovación del tratado de gracia en orden a la mística, por lo que se propone un esbozo sistemático en orden a la posibilidad del encuentro desde la dimensión ontológica, gnoseológica y escatológica.The article presents the most important and significant contribution of the Grace in Nicolás de Cusa, specifically in the piece of work ´De Visione Dei´, related to the subject of the Grace as a possibility of the encounter among God and Man. Specifically it will deal with the matter of Grace in three dimensions: as a God´s grace in the face dynamic, of man as a graceful being in a constituent relationship with God and the fruits that the grace makes in every human being. At the same time, the book pretends to be a contribution to the renovation of the treatise of grace related to the mysticism, that´s why it shows a systematic outline in order to the possibility of the encounter from the ontological, epistemological and eschatological dimension.

  20. Recurrent Aspiration Pneumonia due to Anterior Cervical Osteophyte

    Directory of Open Access Journals (Sweden)

    Jae Jun Lee


    Full Text Available A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.

  1. Core Needle Biopsy and Fine Needle Aspiration Alone or in Combination: Diagnostic Accuracy and Impact on Management of Renal Masses. (United States)

    Cate, Frances; Kapp, Meghan E; Arnold, Shanna A; Gellert, Lan L; Hameed, Omar; Clark, Peter E; Wile, Geoffrey; Coogan, Alice; Giannico, Giovanna A


    Fine needle aspiration with and without concurrent core needle biopsy is a minimally invasive method to diagnose and assist in management of renal masses. We assessed the pathological accuracy of fine needle aspiration compared to and associated with core needle biopsy and the impact on management. We performed a single institution, retrospective study of 342 cases from 2001 to 2015 with small and large renal masses (4 or less and greater than 4 cm, respectively). Diagnostic and concordance rates, and the impact on management were analyzed. Adequacy rates for fine needle aspiration only, core needle biopsy only and fine needle aspiration plus core needle biopsy were 21%, 12% and 8% (aspiration vs aspiration plus biopsy p aspiration plus biopsy group adding aspiration to biopsy and biopsy to aspiration reduced the inadequacy rate from 23% to 8% and from 27% to 8% for a total reduction rate of 15% and 19%, respectively, corresponding to 32 cases (9.3%). Rapid on-site examination contributed to a 22.5% improvement in fine needle aspiration adequacy rates. In this cohort 30% of aspiration only, 5% of biopsy only and 12% of aspiration plus biopsy could not be subtyped (aspiration vs biopsy p aspiration vs aspiration plus biopsy p biopsy vs aspiration plus biopsy p = 0.06). The diagnostic concordance rate with surgical resection was 99%. Conversion of an inadequate specimen to an adequate one by a concurrent procedure impacted treatment in at least 29 of 32 patients. Limitations include the retrospective design and accuracy measurement based on surgical intervention. Fine needle aspiration plus core needle biopsy vs at least fine needle aspiration alone may improve diagnostic yield when sampling renal masses but it has subtyping potential similar to that of core needle biopsy only. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  2. Bone Marrow Aspiration and Biopsy (United States)

    ... Advertising & Sponsorship: Policy | Opportunities Bone Marrow Aspiration and Biopsy Share this page: Was this page helpful? Also ... Examination Formal name: Bone Marrow Aspiration; Bone Marrow Biopsy Related tests: Complete Blood Count ; WBC Differential ; Reticulocyte ...

  3. Small intestine aspirate and culture (United States)

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

  4. Rising Aspirations Dampen Satisfaction (United States)

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


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

  5. Rising Aspirations Dampen Satisfaction (United States)

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


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

  6. Aspirated High Pressure Compressor (United States)


    of Technology Aamir Shabbir Cambridge, Massachusetts 02139, USA University of Toledo Toledo , Ohio 43606, USA ABSTRACT transport engine aspirated...special thanks to Jack Costa, James Letendre, and Victor Dubrowski for their tireless work in the lab. The instruments were partially the result of

  7. «El ser y la cuchara»: Meditación sobre el ser en el De Mente de Nicolás de Cusa «Being and spoon»: Meditation on being in De Mente of Nicholas of Cusa

    Directory of Open Access Journals (Sweden)



    Full Text Available El De Mente de Nicolás de Cusa quiere ser un estudio de la mente como medida del universo y como imagen de Dios. En este libro, Nicolás se presenta a sí mismo como un Idiota o Ignorante y toma el ejemplo de la fabricación de una cuchara. La cuchara, instrumento simple, llega a ser símbolo del ser. El arte y la fabricación de este instrumento reflejan el ser humano y su esfuerzo por entender y construir el mundo (co-crear, por acercarse a Dios y a su obra de creación. La cuchara se transforma en un espejo que permite ver la realidad aunque sea de lejos; permite sobre todo acercarse al primer espejo que es Cristo.Nicholas de Cusa’s De Mente pretends to be a study of the mind as the measure of the universe and the image of God. In this book, Nicolas presents himself as an idiot or ignorant and takes the example of manufacture of a spoon. The spoon, simple tool, becomes a symbol of being. The human ability to create this tool expresses the human nature and his effort to understand and cocreate the world, God and His work of creation. Thus, the spoon becomes a mirror that allows us to discover reality, even from afar; and moreover allows us to approach to Christ also our first or main mirror.

  8. Charged Amino Acids (R83, E567, D617, E625, R669, and K678) of CusA Are Required for Metal Ion Transport in the Cus Efflux System

    Energy Technology Data Exchange (ETDEWEB)

    Su, Chih-Chia; Long, Feng; Lei, Hsiang-Ting; Reddy Bolla, Jani; Do, Sylvia V.; Rajashankar, Kanagalaghatta R.; Yu, Edward W. (Cornell); (Iowa State)


    Gram-negative bacteria expel various toxic chemicals via tripartite efflux pumps belonging to the resistance-nodulation-cell division superfamily. These pumps span both the inner and outer membranes of the cell. The three components of these tripartite systems are an inner-membrane, substrate-binding transporter (or pump); a periplasmic membrane fusion protein (or adaptor); and an outer-membrane-anchored channel. These three efflux proteins interact in the periplasmic space to form the three-part complexes. We previously presented the crystal structures of both the inner-membrane transporter CusA and membrane fusion protein CusB of the CusCBA tripartite efflux system from Escherichia coli. We also described the co-crystal structure of the CusBA adaptor-transporter, revealing that the trimeric CusA efflux pump assembles with six CusB protein molecules to form the complex CusB{sub 6}-CusA{sub 3}. We here report three different conformers of the crystal structures of CusBA-Cu(I), suggesting a mechanism on how Cu(I) binding initiates a sequence of conformational transitions in the transport cycle. Genetic analysis and transport assays indicate that charged residues, in addition to the methionine pairs and clusters, are essential for extruding metal ions out of the cell.

  9. Pulmonary aspiration in hospitalized adults. (United States)

    Elpern, E H


    Until recent years, pulmonary aspiration attracted remarkably little clinical investigation. Although aspiration was considered a common occurrence in hospitalized individuals, with serious and even fatal consequences, clinicians had limited scientific data to guide practice. Consequently, approaches to this problem were based largely on unsystematic observations, intuition, and tradition. Recent investigations on the subjects of aspiration have increased our understanding of patients at risk for aspiration, the value of diagnostic methods, and the efficacy of interventions to prevent or limit aspirations. Results of these studies call to question many time-honored adages and practices. Considerable uncertainty remains and more investigation is necessary before management decisions can be characterized clearly and clinical strategies defined. This review focuses on pulmonary aspiration and enteral feeding in the critically ill adult. Factors implicated in aspiration in this population are highlighted and evidence to support the application of interventions prescribed commonly is presented.

  10. CSR as Aspirational Talk

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole


    Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing and that such discrepan......Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing...... and that such discrepancies have the potential to stimulate CSR improvements. We draw on a research tradition that regards communication as performative to challenge the conventional assumption that CSR communication is essentially superficial, as opposed to CSR action. In addition, we extend notions of organizational...... hypocrisy to argue that aspirational CSR talk may be an important resource for social change, even when organizations do not fully live up to their aspirations....

  11. Ultrasound-guided Transvaginal Aspiration in the Management of Actinomyces Pelvic Abscess



    Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified. Case: A 38-year-old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound-guided needle aspiration. It resulted in marked improvement and avoided surgical treatment. Conclusion: Transvaginal needle aspiration of Actinomyc...

  12. Robotics in hepatobiliary surgery-initial experience, first reported case series from India

    Directory of Open Access Journals (Sweden)

    S. Goja


    Conclusion: This initial series adds to existing data on the feasibility of robotic hepatobiliary cases with inherent advantages of minimal invasive surgery, however with limitation of availability and use of devices like cavitron ultrasonic surgical aspirator (CUSA and higher operative cost.

  13. Diagnostic Value of Processing Cytologic Aspirates of Renal Tumors in Agar Cell (Tissue) Blocks

    DEFF Research Database (Denmark)

    Smedts, F.; Schrik, M.; Horn, T.;


    Objective To adapt a method enabling utilization of most of the harvest from a fine needle aspirate in an effort to improve diagnostic accuracy in the assessment of a renal tumor in a single histologic slide. Study Design In a series of 43 renal tumors, 2 fine needle aspirations were performed, 4...... smears were prepared after each aspiration for conventional cytology and the remaining aspirate was processed for the improved agar microbiopsy (AM) method. Conventional cytology slides, AM slides and surgical specimens were diagnosed separately, after which the diagnoses were compared...

  14. GEAR UP Aspirations Project Evaluation (United States)

    Trimble, Brad A.


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

  15. Workload, Aspiration, and Fun

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Pedersen, Michael; Alvesson, Mats


    Contemporary working life highlights the challenge between exploitation and exploration both on a general and a more individual level. Here, we focus on the latter, and connect the critical debate regarding selfmanagement to March’s exploitation/exploration trade-off, as this forms a useful...... study of a large group of management consultants, we explore how they perform and make sense of selfexploitation and self-exploration through three specific discourses: the discourse of workload, the discourse of aspiration, and the discourse of fun. Through these, the consultants try to identify...... optimal amounts of work, play, and ambition, all while handling the trade-off between selfexploitation and self-exploration. We show how this keeps failing, but how it reappears as a necessary condition for avoiding future failures. In all three discourses, the trade-off therefore presents itself...

  16. Aspirated Compressors for High Altitude Engines Project (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences proposes to incorporate aspirated compressor technology into a high altitude, long endurance (HALE) concept engine. Aspiration has been proven...

  17. Drain removal and aspiration to treat low output chylous fistula. (United States)

    Dhiwakar, Muthuswamy; Nambi, G I; Ramanikanth, T V


    Chylous fistula following neck dissection is difficult to treat. We hypothesized that timely removal of the suction drain followed by daily aspiration might aid in resolution of the condition. The study model is prospective cohort study. Out of 170 consecutive neck dissections, 7 (4 %) developed chylous fistula postoperatively. Retaining the suction drain was associated with resolution of the fistula in only one case. The remaining six had peak 24 h outputs between 85 and 675 ml that showed no significant fall despite maximal conservative treatment. Suction drain removal followed by daily needle aspiration however led to cessation of the fistula in all six cases. No patient required surgical re-exploration. Drain removal was associated with a significant fall in the volume of chylous output (p = 0.002). In selected cases of low output chylous fistula, suction drain removal and daily needle aspiration is an effective treatment option.

  18. Ultrasound-guided Transvaginal Aspiration in the Management of Actinomyces Pelvic Abscess (United States)

    Rahav, Galiya; Hanoch, Josef; Shimonovitz, Shlomo; Yagel, Simcha; Laufer, Neri


    Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified. Case: A 38-year-old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound-guided needle aspiration. It resulted in marked improvement and avoided surgical treatment. Conclusion: Transvaginal needle aspiration of Actinomyces pelvic abscess may be an alternative to surgical therapy, thereby allowing the preservation of pelvic organs. PMID:18476111

  19. Infrared Thermal Imaging During Ultrasonic Aspiration of Bone (United States)

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

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

  20. Percutaneous aspiration thromboembolectomy: a preliminary experience. (United States)

    Murray, J G; Brown, A L; Wilkins, R A


    Percutaneous aspiration thromboembolectomy (PAT) is a radiological alternative to surgical embolectomy or thrombolysis in the treatment of acute arterial thromboembolic disease. We report our experience in eight patients aged 63-83 years (mean 71 years). Indications were graft thrombosis (1) or emboli from atrial fibrillation (3), abdominal aneurysm (2) or proximal angioplasty (2). PAT was performed at 10 arterial sites; common iliac (1), profunda femoris (1), superficial femoral (2), femoro-popliteal graft (1), popliteal (2) and arteries of the trifurcation (3). PAT was used as an adjunct to thrombolysis or angioplasty in five patients and as the sole procedure in three patients. It was successful in six patients (seven sites) with mean ABI rising from 0.4 pre- to 0.8 post-procedure. Two of the failures required amputations. One of these was a completely thrombosed dacron femoro-popliteal graft with poor run-off, and the second case had a failed surgical embolectomy prior to amputation. There were no major complications, and no mortality on follow-up at 1 month. PAT is a useful adjunct to thrombolysis and balloon angioplasty in the radiological treatment of acute thromboembolic disease. In patients in whom thrombolysis is contraindicated, it offers an alternative to surgical embolectomy.

  1. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.


    INTRODUCTION: In the year 2000 a quality assurance programme for the preoperative breast diagnostics was introduced in Denmark. The programme was based on the "European guidelines for quality assurance in breast cancer screening and diagnosis" where - among other measures - five cytological...... diagnostic classes were introduced. The aim of this study was to evaluate the quality assurance programme in a screening population to determine whether fine needle aspiration cytology (FNAC) as first choice remains a useful tool in the preoperative diagnostics, or if needle core biopsy should be the first...... of 66% of the 783 FNACs had a malignant cytology diagnosis, which in 99% of the cases turned out to be the correct diagnosis. Four lesions were false positives all of which represented benign proliferative breast diseases. The surgical procedures in these cases were either excisional biopsy...

  2. Abortion - surgical (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  3. Aspiration of biological viscoelastic drops

    CERN Document Server

    Guevorkian, Karine; Durth, Mélanie; Dufour, Sylvie; Brochard-Wyart, Françoise


    Spherical cellular aggregates are in vitro systems to study the physical and biophysical properties of tissues. We present a novel approach to characterize the mechanical properties of cellular aggregates using micropipette aspiration technique. We observe an aspiration in two distinct regimes, a fast elastic deformation followed by a viscous flow. We develop a model based on this viscoelastic behavior to deduce the surface tension, viscosity, and elastic modulus. A major result is the increase of the surface tension with the applied force, interpreted as an effect of cellular mechanosensing.

  4. ASPIRE: Added-value Sensing

    DEFF Research Database (Denmark)

    Anggorojati, Bayu; Cetin, Kamil; Mihovska, Albena D.


    FP7 ICT project ASPIRE is one of the coordinated European efforts to further the advancement of this technology, in the areas of enabling technology development for RFID. The focus of ASPIRE is on the design, development and adoption of an innovative, programmable, royalty-free, lightweight...... and privacy friendly RFID middleware. Advances in active RFID integration with WSNs allow for more RFID-based applications to be developed. In order to fill the gap between the active RFID system and the existing middleware, a HAL for active reader and ALE server extension to support sensing data from active...

  5. Aspiration of Nasopore nasal packing. (United States)

    Smith, Jonathan; Reddy, Ekambar


    We present a case of postoperative Nasopore aspiration in an otherwise fit and well 11-year-old. An endoscopic adenoidectomy had been performed without incident and Nasopore packing placed into each nasal cavity. Immediately after extubation, there was marked hypoxia, tachypnoea and high clinical suspicion of pack aspiration. The patient returned to theatre for emergency rigid bronchoscopy and retrieval of nasal packing. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Applying a Typology to Vocational Aspirations. (United States)

    Holland, John L.; Gottfredson, Gary D.

    The psychological meaning and predictive value of a person's vocational aspirations were examined by applying Holland's typology to the vocational aspirations of high school juniors (N=1,005), college juniors (N=692), employed adults (N=140), and a second sample of college students studied over a 1 year interval (N=624). The aspirational data were…

  7. Aspirations of Latina Adolescent Suicide Attempters (United States)

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


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

  8. Fine-needle aspiration of the thyroid: an overview

    Directory of Open Access Journals (Sweden)

    Nguyen Gia-Khanh


    Full Text Available Abstract Thyroid nodules (TN are a common clinical problem. Fine needle aspiration (FNA of the thyroid now is practiced worldwide and proves to be the most economical and reliable diagnostic procedure to identify TNs that need surgical excision and TNs that can be managed conservatively. The key for the success of thyroid FNA consists of an adequate or representative cell sample and the expertise in thyroid cytology. The FNA cytologic manifestations of TNs may be classified into seven working cytodiagnostic groups consisting of a few heterogenous lesions each to facilitate the differential diagnosis. Recent application of diagnostic molecular techniques to aspirated thyroid cells proved to be useful in separating benign from malignant TNs in several cases of indeterminate lesions.

  9. Percutaneous aspiration of fluid for management of peritonitis in space (United States)

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


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

  10. Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules

    Directory of Open Access Journals (Sweden)

    Ayper KAÇAR


    Full Text Available Objective: The objectives were to evaluate fine needle aspiration cytology results of 39 pediatric patients, and the pathologies that cause childhood thyroid nodules, and to review the literature on the subject.Material and Method: Thyroid fine needle aspiration cytology results of 39 pediatric patients were retrospectively reviewed. Associated diseases, thyroid functions, anti-thyroid antibody levels, ultrasonographic findings and number of nodules were also evaluated.Results: The vast majority of patients with thyroid nodules were cytopathologically diagnosed as benign (97.3%. Of these patients, 64.8% (24 patients were diagnosed as nodular goiter and 35.2% (13 patients as lymphocytic thyroiditis. Thyroid malignancy was found in two patients; one was diagnosed as follicular neoplasm/ minimal invasive follicular carcinoma on surgical evaluation while the other was a secondary tumor (Burkitt's lymphoma. The majority of our subjects were females (66.6%: the female/male ratio was 2:1 for nodular goiter and 3.3:1 for thyroiditis. Surgical resection was performed in 5 patients (4 cases of nodular goiter, 1 suspicious for malignancy and cytological diagnoses were confirmed by histology.Conclusion: Our study confirmed the utility of fine needle aspiration cytology in childhood thyroid disorders along with a possible higher incidence of nodular thyroiditis in childhood. Nodular autoimmune thyroiditis, focal thyroiditis and thyroid cancer in children are discussed and attention is drawn to some special subtypes of thyroid cancer and some benign lesions that can cause difficulty in interpreting fine needle aspiration cytology and frozen sections at this age.

  11. Surgical Assisting (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  12. The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration. (United States)

    Epstein, Nancy E; Baisden, Jamie


    The surgical management of lumbar synovial cysts that have extruded into the spinal canal remains controversial (e.g. decompression with/without fusion). The neurological presentation, anatomy, pathophysiology, and surgical challenges posed by synovial cysts in the lumbar spine are well known. Neurological complaints typically include unilateral or, more rarely, bilateral radicular complaints, and/or cauda equina syndromes. Anatomically, synovial cysts constitute cystic dilatations of synovial sheaths that directly extrude from facet joints into the spinal canal. Pathophysiologically, these cysts reflect disruption of the facet joints often with accompanying instability, and potentially compromise both the cephalad and caudad nerve roots. Aspiration of lumbar synovial cysts, which are typically gelatinous and non-aspirable, and typically performed by "pain specialists" (e.g. pain management, rehabilitation, radiologists, others) utilizing fluoroscopy or CT-guided aspiration, is associated with 50-100% failure rates. Surgical decompression with/without fusion (as the issue regarding fusion remains unsettled) results in the resolution of back and radicular pain in 91.6-92.5% and 91.1-91.9% of cases, respectively. After a thorough review of the literature, it appears that the treatment with the best outcome for patients with synovial cysts is cyst removal utilizing surgical decompression; the need for attendant fusion remains unsettled. The use of an alternative treatment, percutaneous aspiration of cysts, appears to have a much higher recurrence and failure rate, but may be followed by surgery if warranted.

  13. Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Undiagnosed Chest Tumors

    DEFF Research Database (Denmark)

    Eckardt, Jens; Olsen, Karen E; Licht, Peter B


    BACKGROUND: A number of patients with radiologically suspicious chest tumors remain undiagnosed despite bronchoscopy or CT-guided fine-needle aspiration (CT-FNA). Such patients are often referred for mediastinoscopy, which is an invasive surgical procedure that poses a small but significant risk...

  14. Non-surgical treatment of esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Vito Annese; Gabrio Bassotti


    Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration,weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia.

  15. Ingested and Aspirated Foreign Bodies. (United States)

    Green, S Sarah


    Esophageal and aspirated foreign bodies have important clinical significance, and both should be considered carefully when the history or physical examination findings raise sufficient suspicion. The published evidence regarding the diagnosis and management of foreign body ingestion or aspiration is weighted disproportionately with observational studies, case controls, expert opinion, and systematic reviews. Most of the publications would receive a categorization of C (observational studies including case-control and cohort design) and D (expert opinion, case reports, and clinical reasoning). One of the few prospective studies examining the diagnostic evaluation of foreign body aspiration in children could be considered level B evidence (randomized clinical trials, systematic reviews, or diagnostic studies with minor limitations). This study found that the medical history is the most important predictive part of the evaluation. There is evidence for considering bronchoscopy if there is significant history suggestive of foreign body aspiration, even in the setting of normal physical examination findings. (28). Most ingested foreign bodies spontaneously pass without incident. However, special attention should be paid to objects in the esophagus as well as to batteries and magnets. Based on a systematic review of the literature (level B evidence) and the potential for rapid and life-threatening damage, batteries in the esophagus should be removed immediately. (10) Other objects, such as coins, may be observed for passage in an asymptomatic patient. In addition, given the high risk of significant complications, ingestion of high-powered magnets should be quickly and carefully evaluated. Although single magnets are likely to pass without complication, multiple magnets or magnets ingested with other metal objects can cause significant damage and should be removed if there is any concern for mural entrapment, bowel perforation, or failure to progress. (10

  16. An aspiration material preparation system: application of a new liquid-based cytology technique for fine-needle aspiration of the breast. (United States)

    Sakakibara, Eiichi; Kimachi, Setsuo; Hashimoto, Katsunori; Inagaki, Hiroshi; Nagasaka, Tetsuro; Wakusawa, Shinya; Yokoi, Toyoharu


    To evaluate the usefulness of our original liquid-based cell preparation system AMAPS (aspiration material preparation system) and to compare it with the AutoSmear system in breast aspiration cytology. A total of 487 specimens of fine-needle aspiration cytology of the breast were retrieved, of which 250 were processed with AMAPS and 237 with the AutoSmear method (before the introduction of AMAPS). A final histological diagnosis was obtained by an excisional biopsy or a surgical resection in 148 cases. Cell recovery rates were significantly improved with AMAPS (96.8 and 99.1% in Papanicolaou and Diff-Quik, respectively) compared with the AutoSmear method (40.9 and 42.3%, respectively; pcytology, the unsatisfactory rate decreased significantly (from 16.0 to 8.8%; pliquid-based cytology systems. Copyright © 2010 S. Karger AG, Basel.

  17. An Aspirational Community Theory of the Firm

    DEFF Research Database (Denmark)

    Li, Xin

    contractual labor and aspirational labor, the former being defined as services provided by a laborer in fulfillment of a contract while the latter as services provided by a laborer in pursuit of an aspiration; and argue that firms exist because while the market may be effective and efficient for allocating...... propose an aspirational community theory of the firm (ACT) as a candidate theory by conceptualizing the firm as an aspirational community, the core of which is a group of like-minded people sharing similar or same aspiration/vision. To explain the existence of the firm, we make a distinction between...... contractual labor it is less effective and efficient than the firms for allocating aspirational labor....

  18. Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Ataman Köse


    Full Text Available It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

  19. Endometrial aspiration cytology in gynecological disorders


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


    Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histo...

  20. Application of frameless stereotactic aspiration in the treatment of hypertension cerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    You-san ZHANG


    Full Text Available Objective  To investigate the technical points and clinical outcomes of frameless stereotactic aspiration in treatment of patients with hypertension cerebral hemorrhage (HPCH. Methods  The clinical data of 68 consecutive patients with HPCH, treated with frameless stereotactic aspiration from Jan. 2012 to Jun. 2014, were retrospectively analyzed, and compared to that of 45 patients treated in the meantime by frame-based stereotactic aspiration. The surgical results, procedure-related complications and clinical prognosis were evaluated. Results  For the patients treated with frameless stereotactic aspiration, the median age was 53.3 years (range 36-80, the mean initial Glasgow coma scale score was over 5. Among them seven patients died within a month after operation: 3 died of respiratory failure, 2 of cerebral edema and 2 of rehemorrhage. At the six-months follow-up, the good recovery rate (gradeⅠ-Ⅲof ADL was 77.9%(53/68, better than that of patients treated with frame-based stereotactic aspiration (60.0%, P<0.05. Conclusion  Frameless stereotactic aspiration for HPCH is easy to operate, minimal invasion and safe procedure with low mortality and rehemorrhage rate. DOI: 10.11855/j.issn.0577-7402.2016.08.12

  1. Thrombus aspiration catheter is a Dottering balloon. (United States)

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


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

  2. The role of aspiration in corporate fiduciary duties

    National Research Council Canada - National Science Library

    Velasco, Julian


    ... duty standards of conduct are aspirational and unenforceable. This theory, which I will call the "aspirational view," is misguided. The use of the term "aspirational" is especially problematic. Whatever else "aspirational" may mean, it does not mean obligatory or mandatory. Whether by design or only by effect, the aspirational view has the ...

  3. Prevention strategies for surgical complications of sphenoid wing meningiomas%蝶骨嵴脑膜瘤手术并发症的防治

    Institute of Scientific and Technical Information of China (English)

    迁荣军; 张佳栋; 李治晓; 史锡文


    Objective To explore the prevention strategies for surgical complications of sphenoid wing meningiomas.Methods A total of 76 cases of sphenoid wing meningiomas were included from The People's Hospital of Henan Province from 2011 to 2014.Based on the preoperative imaging data, the patients were divided into 28 cases of lateral type, 16 cases of middle type and 32 cases of medial type.According to the different characteristics of different types of sphenoid wing meningiomas, appropriate preoperative, intraoperative and postoperative measures to prevent complications were carried out.Results A total of 2 cases of facial nerve injury occurred in 28 cases with lateral type;1 case of intraoperative subarachnoid hemorrhage and brain swelling occurred in 16 cases with middle type;3 cases of oculomotor nerve damage, 1 case of optic nerve injury and 4 cases of vascular injury occurred in 32 cases with the medial type.The total incidence of complications was 14.5% (11/76).Conclusion Detailed preoperative planning according to the characteristics of different types of sphenoid wing meningiomas, intraoperative use of microsurgery and Cavitron Ultrasonic Surgical Aspirator (CUSA), following the principle of in situ removal, controlling the extent of resection of tumor adhering to cavernous sinus and the great vessels, the severe surgery complications of sphenoid wing meningiomas can be reduced.%目的 探讨蝶骨嵴脑膜瘤手术并发症的防治对策.方法 对象为河南省人民医院2010至2014年收治蝶骨嵴脑膜瘤患者76例,根据术前影像资料分为外侧型28例,中间型16例,内侧型32例,依据不同分型的不同特点,分别采取相应的术前、术中、术后措施预防并发症.结果 28例外侧型患者中出现面神经损伤2例;16例中间型患者中出现术中蛛网膜下腔出血并脑肿胀1例;32例内侧型患者中出现动眼神经损伤3例,视神经损伤1例,血管性损伤4例.并发症总发生率为14.5%(11/76).结论

  4. Fine needle aspiration cytology of rectal masses. (United States)

    Kochhar, R; Rajwanshi, A; Wig, J D; Gupta, N M; Kesiezie, V; Bhasin, D K; Malik, A K; Gupta, S K; Mehta, S K


    This paper describes the results of transproctoscopic fine needle aspiration cytology in the diagnosis of rectal lesions. Fifty one consecutive patients referred with a presumptive diagnosis of rectal mass were subjected to proctoscopic examination when fine needle aspiration cytology, brush cytology and biopsy samples were taken. Of the 30 patients of malignancy of rectum in whom all the three sampling techniques were applied, the biopsy was positive in 27 (90%), brush cytology in 25 (83.3%) and fine needle aspiration cytology in 29 (96.6%). A combination of fine needle aspiration cytology with brush cytology gave a positive yield in 96.6% while that fine needle aspiration cytology with brush cytology gave a yield of 100%. Fine needle aspiration cytology was most helpful in infiltrative tumours. All 10 patients with secondaries in the pouch of Douglas or rectovesical pouch, and the single patient with submucosal rectal carcinoma were correctly diagnosed at fine needle aspiration cytology. There were no false positive results with fine needle aspiration cytology and no complications were encountered with the procedure. Images Figure 1 Figure 2 Figure 3 PMID:2323600

  5. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav


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

  6. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid (United States)

    ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy uses sound waves ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration biopsy of the ...

  7. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid (United States)

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

  8. Clinical profile of children with kerosene aspiration. (United States)

    Venkatesh, C; Sriram, P; Adhisivam, B; Mahadevan, S


    Accidental aspiration of kerosene is a common problem among children in developing countries. This descriptive study involved the retrospective analysis of children admitted with kerosene aspiration in a tertiary care hospital in South India for a year. Kerosene aspiration contributed to 60.4% of poisoning cases. Boys aged less than three years and from a rural background formed a significant proportion. Tachypnoea, cough and crepitations were the predominant clinical findings. Male gender and malnutrition (weight for age <80%) were significantly associated with prolonged hospital stay.

  9. Coronary air embolism treated with aspiration catheter. (United States)

    Patterson, M S; Kiemeneij, F


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

  10. Fine needle aspiration biopsy to reestablish cell culture in an animal model of uveal melanoma. (United States)

    Correa, Zelia Maria da Silva; Marshall, Jean-Claude; Souza Filho, João Pessoa; Odashiro, Alexandre Nakao; Burnier Jr, Miguel Noel


    To access the reliability of fine-needle aspiration biopsy in harvesting a sufficient amount of viable melanoma cells to establish a cell culture and maintain a melanoma cell line from an animal model of uveal melanoma. For this study, fifteen male New Zealand albino rabbits had their right eye surgically inoculated with uveal melanoma cell line 92.1. The animals were immunosupressed with cyclosporine A using a dose schedule previously published. The animals were followed for 12 weeks. Intraocular tumor growth was monitored weekly by indirect ophthalmoscopy. After the fourth week, one animal was sacrificed per week preceded by fine-needle aspiration biopsy using a sharp 25-gauge, 1-inch long needle. Two separate aspirates were made from different areas of the tumor. Each aspirate was flushed to a separate cell culture media and sent for cell culture. The cells were frozen after two weeks when there were at least 1 million cells, which is enough to maintain a cell line. Cells were defrosted for HMB-45 immuno-stains to confirm the melanoma origin. Cell growth was observed from the samples harvested from 11 out of the 15 animals inoculated with uveal melanoma. All cell cultures, after defrost, immunoassayed positive for HMB-45. Fine needle aspiration biopsy seems to be a reliable method to harvest cells from solid intraocular melanomas in an animal model, to establish cell culture and to maintain a melanoma cell line.

  11. CT-guided percutaneous aspiration of Tarlov cyst as a useful diagnostic procedure prior to operative intervention. (United States)

    Lee, J-Y; Impekoven, P; Stenzel, W; Löhr, M; Ernestus, R-I; Klug, N


    Tarlov or perineural cysts are lesions of the nerve root most often found in the sacral region. Several authors recommend surgical treatment of symptomatic Tarlov cysts. However, successful surgical treatment is dependent on appropriate patient selection. In this article, we report three cases of a sacral perineural cyst, causing sciatic pain, and emphasize the usefulness of CT-guided percutaneous aspiration as an important diagnostic and prognostic procedure prior to definitive operative treatment.

  12. Diagnostic Value of Processing Cytologic Aspirates of Renal Tumors in Agar Cell (Tissue) Blocks

    DEFF Research Database (Denmark)

    Smedts, F.; Schrik, M.; Horn, T.


    smears were prepared after each aspiration for conventional cytology and the remaining aspirate was processed for the improved agar microbiopsy (AM) method. Conventional cytology slides, AM slides and surgical specimens were diagnosed separately, after which the diagnoses were compared....... Immunohistochemistry was performed as required on the AM sections. Surgical specimens served as the gold standard. Results In 53% of conventional cytologic smears, the cellular yield was sufficient to render a correct diagnosis. In 12% the diagnosis was incorrect, in 21% only a differential diagnosis could be fin......-initiated, and in 14% too few diagnostic cells were present in the conventional smears for cytologic diagnosis. It was, however, possible to correctly diagnose histologic sections from 97% of AM tissue blocks. In 11 cases this was facilitated with immunochemistry. In only 1 case did the AM tissue block contain too few...

  13. Fine needle aspiration biopsy to reestablish cell culture in an animal model of uveal melanoma


    Correa, Zelia Maria da Silva; Marshall,Jean-Claude; Souza Filho,João Pessoa de; Odashiro, Alexandre Nakao; Burnier, Jr.,Miguel Noel


    PURPOSE: To access the reliability of fine-needle aspiration biopsy in harvesting a sufficient amount of viable melanoma cells to establish a cell culture and maintain a melanoma cell line from an animal model of uveal melanoma. METHODS: For this study, fifteen male New Zealand albino rabbits had their right eye surgically inoculated with uveal melanoma cell line 92.1. The animals were immunosupressed with cyclosporine A using a dose schedule previously published. The animals were followed fo...

  14. Nasocardiac reflex during aspiration and injection through a nasogastric tube: An infrequent occurrence. (United States)

    Haldar, Rudrashish; Kaur, Jasleen; Bajwa, Sukhminder Jit Singh


    Nasocardiac reflex is a relatively less discussed variant of trigeminovagal reflex where the afferent arc of the reflex is represented by any of the branches of the trigeminal nerves, and the efferent arc is via the vagus nerve. Elicitation of this reflex is commonly seen during surgical manipulation and is manifested as bradycardia or even asystole. We report a case where nasocardiac reflex was unusually observed in a patient when aspiration and injection were done through a nasogastric tube.

  15. Treatment of cranial epidural hematoma in a neonate by needle aspiration of a communicating cephalhematoma. (United States)

    Smets, Koenraad Jan; Vanhauwaert, Dimitri


    A newborn presented on day 15 of life with an epidural hematoma, extending through a diastatic sutura squamosa in an external cephalhematoma. There was no skull fracture. The cephalhematoma was punctured twice with 24-h interval, reducing both the cephalhematoma and the epidural component. In the absence of neurological signs or symptoms, aspirating a cephalhematoma to evacuate the communicating epidural hematoma in a newborn infant may avoid more invasive surgical intervention.

  16. [The immediate interpretation for fine-needle aspiration cytology]. (United States)

    Chang, M C; Ho, W L


    From December 1990 to November 1992, 2005 cases of immediate interpretation for fine-needle aspiration (FNA) cytology were performed, of which 727 cases were confirmed by surgical pathology. A mobile cytologic laboratory (a cart loaded with a dual viewing microscope, Liu's staining solutions, hair dryer, and slides) can be moved to the Out-patient Department, wards and Computed Tomography room, where clinicians perform aspiration and pathologists read smears. Immediate verbal diagnoses are documented to patients' charts and listed in cytopathologic files. Immediate interpretation in this entire series yielded a sensitivity 92.5%; specificity, 98.1%; false-positive rate, 1.1%; false-negative rate, 3.2%; positive predictive value (PV), 97.3%; negative PV, 94.7% and efficiency, 95.7%. The cause of false-negative results in the 23 cases probably came from the hesitation in making an immediate diagnosis. Most of these cases were malignant lymphoma or breast carcinoma. The roles of immediate cytodiagnosis are (1) to decrease the inadequate rate of FNA specimens; (2) to render preliminary diagnosis for clinicians to make decisions; (3) to provide on-site teaching material for both clinicians and pathology residents to better understand clinicopathological correlations; (4) to act as the initial diagnostic procedure in the evaluation of a superficial palpable mass. This study shows that immediate interpretation for FNA cytology is a simple, rapid, accurate and noninvasive diagnostic procedure that can be routinely used for superficial palpable masses.

  17. Diagnostic Efficacy of Fine Needle Aspiration in Parotid Mass

    Directory of Open Access Journals (Sweden)

    Ebrahim Razmpa


    Full Text Available Introduction: The preoperative diagnostic evaluation of the parotid lesion is a valuable aid in planning the operation and the approach to intervention. Among different diagnostic tools, Fine Needle Aspiration has a key role. However, the exact efficacy of this technique in our center had not been thoroughly investigated. Materials and Methods: Between January 2000 and June 2007 a subset of 64 patients who had agreed to undergo preoperative FNAB was selected. The FNAB diagnoses were compared with those of the surgical specimens as the gold standard. Then, sensitivity, specificity, predictive value, and pertinent characteristics of the patients were evaluated. Finally, the results were analyzed with SPSS version14. Results: During the study period, 81 patients underwent parotidectomy, only 64 of whom had the FNA before surgery, so only the data collected from 64 patients were evaluated. The most common clinical presentation 75% (48 patients was a parotid mass. The second common presentation was facial paralysis at 17.2% (11 patients, followed by pain at 7.8%.  The result of FNA sensitivity was 82.5% and specificity was 93.3%. The accuracy of the test was 87.5%. Positive predictive value was 93.3% and negative predictive value was 82.35%. Conclusion: Fine-needle aspiration cytology is a reliable method in the evaluation of parotid tumors with a fairly high specificity and sensitivity rate.

  18. Hepatic epithelioid hemangioendothelioma: A diagnostic pitfall in aspiration cytology

    Directory of Open Access Journals (Sweden)

    Gupta Ruchika


    Full Text Available Hepatic epithelioid hemangioendothelioma (EH is a rare vascular neoplasm. An accurate radiologic diagnosis is usually difficult due to the presence of multiple nodules, simulating metastatic carcinoma. Though histologic features of this tumor are well described, cytologic reports of hepatic EH are very few in the available literature. We describe a case of a young healthy adult male who was found to have multiple hepatic masses on radiologic investigations. A guided fine needle aspiration demonstrated a poorly differentiated neoplasm. The diagnosis was made on core biopsy assisted by immunohistochemistry, which showed characteristic features of EH. He is doing well 14 months after diagnosis, without surgical excision or chemotherapy. An accurate diagnosis of hepatic EH on aspiration cytology requires an adequate specimen and awareness of its cytologic features, including discohesive atypical cells with intracytoplasmic lumina and intranuclear inclusions. Since this tumor is usually unresectable but has a favorable prognosis as compared to hepatocellular carcinoma, a correct diagnosis is essential for appropriate management and prognostication.

  19. Incisional endometriosis: Diagnosed by fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    P Veda


    Full Text Available Incisional endometriosis (IE is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC. Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  20. Incisional endometriosis: diagnosed by fine needle aspiration cytology. (United States)

    Veda, P; Srinivasaiah, M


    Incisional endometriosis (IE) is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC). Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  1. Feasibility of fine-needle aspiration biopsy and its applications in superficial cervical lesion biopsies. (United States)

    Xu, Dong; Xu, Hai-Miao; Li, Ming-Kui; Chen, Li-Yu; Wang, Li-Jing


    The aim of the study was to investigate the feasibility and value of clinical application of fine-needle aspiration histological biopsy via ultrasound-guided thyroid nodule and enlarged cervical lymph node fine-needle aspiration histological biopsy. Fine-needle aspiration cytological and histological biopsies and surgical treatments were performed on 982 patients with thyroid nodule and 1435 patients with enlarged cervical lymph nodes. A comparative study of the histological and cytological examination results and post-surgical etiology results was subsequently conducted. Among the 982 thyroid nodule patients, the acquisition rates were 89.8% (882/982) for fine-needle aspiration histological biopsy and 96.2% (945/982) for cytological biopsy, while among the 1435 patients with enlarged cervical lymph nodes, the acquisition rate for fine-needle aspiration cytological biopsy was slightly higher than that for histological biopsy, with values of 95.7% (1374/1435) and 91.4% (1312/1435), respectively. For the thyroid nodule patients, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 98.5%, 100%, and 98.9%, respectively, whereas those of the cytological results were 86.8%, 82.9%, and 85.6%, respectively; the differences between the 2 biopsy methods were statistically significant (P < 0.05). For the patients with enlarged cervical lymph nodes, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 96.3%, 99.8%, and 97.6%, respectively, whereas the those of the cytological results were 76.8%, 92.1%, and 82.2%, respectively; again, the differences between the 2 methods were statistically significant (P < 0.05). In conclusion, Fine-needle aspiration histological biopsy is a reliable and highly

  2. Modified technique of endocapsular lens aspiration for severely subluxated lenses. (United States)

    Khokhar, S; Aron, N; Yadav, N; Pillay, G; Agarwal, E


    PurposeSeverely subluxated crystalline lenses pose a difficult situation to anterior segment surgeons and can only be managed surgically by removal of the lens as well as the capsular bag. Several techniques have been described in literature for the management of such cases. We describe a modified technique of endocapsular lens aspiration by the limbal route for lens extraction through small incisions on the cornea.Patients and methodsThirty-two eyes of 16 consecutive patients with severely subluxated crystalline lenses were recruited in the study. All eyes underwent a modified technique of lens aspiration within the capsular bag using a single instrument, vitrectomy cutter, and irrigation cannula, followed by sacrificing of the capsular bag. The patients were either left aphakic or implanted with an open loop anterior chamber intraocular lens (ACIOL Kelman Multiflex) and prospectively followed up for a period of 3 months.ResultsThe mean age of the patients was 9 years 3 months±3 years (range 5-15 yrs). All eyes underwent complete lens aspiration within the capsular bag with no dislocation of the lens matter. ACIOL was inserted in 22 eyes (68.7%) and 10 eyes (31.2%) were left aphakic. All the surgeries were uneventful. The mean best corrected visual acuity (BCVA) at 3 months post surgery was 0.47±0.11 logMAR which was significantly better than pre-operative BCVA (P=0.001). The percentage endothelial cell loss at 3 months was 7.1%. There was no evidence of glaucoma, corneal decompensation, or retinal detachment. The astigmatism which increased from 1.45D±086 preoperatively to 3.76D±2.02 1 week post-operatively due to sutures reduced to 1.97D±0.81 post suture removal at 3 months.ConclusionThe modified technique of endocapsular lens aspiration proves to be a simple and effective method of removal of the lens-capsular bag complex in severely subluxated lenses.Eye advance online publication, 11 August 2017; doi:10.1038/eye.2017.160.

  3. Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Tomas, Xavier; Garcia-Diez, Ana Isabel; Pomes, Jaime [Universidad de Barcelona, Department of Radiology, Hospital Clinic, Barcelona (Spain); Bori, Guillem; Garcia, Sebastian; Gallart, Xavier; Martinez, Juan Carlos; Riba, Josep [Universidad de Barcelona, Department of Orthopaedics, Hospital Clinic, Barcelona (Spain); Soriano, Alex; Mensa, Josep [Universidad de Barcelona, Department of Infectious Diseases, Hospital Clinic, Barcelona (Spain); Rios, Jose [Statistical Unit de Suport a la Estadistica I Metodologia IDIBAPS, Barcelona (Spain); Almela, Manel [Universidad de Barcelona, Department of Microbiology, Hospital Clinic, Barcelona (Spain)


    To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery. Sixty-three patients (35 women and 28 men; age range, 29-86 years; mean age, 71 years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microbiological cultures of aspirated fluid and several computed tomography imaging findings such as periprosthetic fluid collections, prosthetic acetabular malposition, and heterotopic ossification were analyzed. All patients underwent revision surgery and infection was finally diagnosed in 33 patients. Statistical comparative analysis was performed comparing computed tomography aspiration and surgical findings (95% CI; level of significance at P = 0.05 two-sided) with 70% sensitivity, 100% specificity, 84% accuracy, 100% positive predictive value, and 75% negative predictive value. Using Fisher's exact test, the presence of periprosthetic fluid collections (P = 0.001), prosthetic acetabular malposition (P = 0.025) and aspirated fluid volume (P = 0.009) were significantly higher in infected than in non-infected prostheses, whereas heterotopic ossification was not (P = 0.429). Computed tomography aspiration is accurate to preoperatively diagnose septic hip prosthesis on the basis of volume and bacterial cultures of aspirated joint fluid. Furthermore, imaging findings such as periprosthetic fluid collections and prosthetic acetabular malposition strongly suggest infected prosthesis. (orig.)

  4. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan


    were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. Conclusions: SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure...... in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve....

  5. A Comparison Study of Oral RU486/Cytotec and Vacuum Aspiration for Termination of Early Preganacy

    Institute of Scientific and Technical Information of China (English)

    杜明昆; 应玉娣; 郑怀美; 闻珍; 倪如珏


    Objective : This study is to compare the personal acceptability and effect of Oral RU486/PG versus surgical vacuum aspiration on termination of early pregnancy. Method: Subjects were recruited by their voluntary choice of methods. One hundred women aged 20~34 with amenorrhea of 35~42 days chose the medical method (RU486 600 mg on the lst day and cytotec 0. 4 mg on the 3rd day). One hundred women aged 20~34 with amenorrbea < 56 days chose vacuum aspiration. Subjects were asked to return on the 17th day in the medical group and 14th day in the surgical group for follow-up. Results: Complete abortion rates in the medical and surgical groups were 89% and 100% respectively. The main reason for choosing medicalabortion was "less painful" (94%) while that for choosing surgical abortion was "quick and saving time (55 % ), with removing or insering IUD (45 % ) following surgical abortion", Conclusion : For pregnancy termination RU486/Cytotec (PGE1) and vacuum aspiration are both highly acceptable, Each method has its own advantages and disadvantages and they can not replace each other. Selective use can provide advantages of either method. The earlier the termination, the safer the event.

  6. Evaluation of ventilatory therapy for acid aspiration. (United States)

    Flint, L; Gosdin, G; Carrico, C J


    Aspiration of hydrochloric acid in experimental animals results in severe, progressive hypoxia which is due to intrapulmonary shunting and depressed cardiac output. This preparation is useful therefore in studying the therapy of hypoxia. Mongrel dogs were subjected to acid aspiration and the effects of several ventilatory patterns on intrapulmonary shunt fractions and lung water accumulation observed. The combination of large tidal volumes (30 c.c. per kilogram) with positive end-expiratory pressure was effective in preventing intrapulmonary shunting and other ventilatory patterns were ineffective. Pulmonary edema uniformly followed acid aspiration and was not affected by ventilatory therapy. When ventilatory therapy was delayed for 4 hours, the progression of shunting apparently was limited, but the existing shunt was not reduced.

  7. Operative hysteroscopy versus vacuum aspiration for incomplete spontaneous abortion (HY-PER): study protocol for a randomized controlled trial. (United States)

    Huchon, Cyrille; Koskas, Martin; Agostini, Aubert; Akladios, Cherif; Alouini, Souhail; Bauville, Estelle; Bourdel, Nicolas; Fernandez, Hervé; Fritel, Xavier; Graesslin, Olivier; Legendre, Guillaume; Lucot, Jean-Philippe; Matheron, Isabelle; Panel, Pierre; Raiffort, Cyril; Fauconnier, Arnaud


    Incomplete spontaneous abortions are defined by the intrauterine retention of the products of conception after their incomplete or partial expulsion. This condition may be managed by expectant care, medical treatment or surgery. Vacuum aspiration is currently the standard surgical treatment in most centers. However, operative hysteroscopy has the advantage over vacuum aspiration of allowing the direct visualization of the retained conception product, facilitating its elective removal while limiting surgical complications. Inadequately powered retrospective studies reported subsequent fertility to be higher in patients treated by operative hysteroscopy than in those treated by vacuum aspiration. These data require confirmation in a randomized controlled trial comparing fertility rates between women undergoing hysteroscopy and those undergoing vacuum aspiration for incomplete spontaneous abortion. After providing written informed consent, 572 women with incomplete spontaneous abortion recruited from 15 centers across France will undergo randomization by a centralized computer system for treatment by either vacuum aspiration or operative hysteroscopy. Patients will not be informed of the type of treatment that they receive and will be cared for during their hospital stay in accordance with standard practices at each center. The patients will be monitored for pregnancy or adverse effects by a telephone conversation or questionnaire sent by e-mail or post over a period of two years. In cases of complications, failure of the intervention or diagnosis of uterine cavity disease, patient care will be left to the discretion of the medical center team. If our hypothesis is confirmed, this study will provide evidence that the use of operative hysteroscopy can increase the number of pregnancies continuing beyond 22 weeks of gestation in the two-year period following incomplete spontaneous abortion without increasing the incidence of morbidity and peri- and postoperative

  8. CT detection and aspiration of abdominal abscesses. (United States)

    Haaga, J R; Alfidi, R J; Havrilla, T R; Cooperman, A M; Seidelmann, F E; Reich, N E; Weinstein, A J; Meaney, T F


    Computed tomography (CT) is effective in detecting intraabdominal abscesses. Loculations of fluid and extraluminal gas are clearly localized in relation to other organs. Of 22 abscess in this series, CT successfully detected 20; comparative information with gallium, techneticum, and ultrasound scans is presented. In addition to localizing these collections, CT can be used to guide needle aspiration and drainage procedures. Three sizes of needles were used to aspirate specimens and/or provide drainage. This was accomplished successfully in 12 of 14 CT-guided procedures.

  9. Fine-needle aspiration cytology in children with superficial lymphadenopathy

    Directory of Open Access Journals (Sweden)

    F. De Corti


    Full Text Available Introduction: In pediatric population Fine-Needle Aspiration Citology (FNAC is slowly gaining acceptance in clinical management of Superficial Lymphadenopathy (SL. Our experience adds some data about the usefulness of this technique in diagnosing the cause of a SL and therefore guiding further treatment. Patients and Methods: 238 FNAC were performed in 217 patients with SL, observed at our Institution from 2002 to 2006. The neck was the most frequent localization. The results were available within few hours. In cases of granulomatous findings, the samples were processed for microbiological and PCR test, in order to identify Mycobacteria. Results: 174 were reactive lesions, 38 granulomatous lymphadenopathies, 24 malignant lesions, 2 specimens inadequate for diagnosis. Among the 174 reactive SL, 22 required an incisional biopsy after 1 month follow-up. Among the granulomatous lymphadenopathies, 13 children with Cat-Scratch Disease recovered, 25 with Mycobacteria infection underwent surgical excision. For 24 malignant lesions, the diagnosis was confirmed by further biopsy. Two false negative and no false positive were detected (sensitivity 92%, specificity 100%. No complications were encountered. Conclusions: In our experience FNAC, performed by experienced cytopathologist, has revealed to be a fast, safe, non invasive and inexpensive method to achieve diagnosis in persistent SL. The use of FNAC gave us the possibility to select patients for further investigation and/or surgical treatment. Incisional biopsy remains necessary to confirm the diagnosis in case of malignancy or doubtful lesions.

  10. Occupational Aspirations and Expectations of Australian Adolescents (United States)

    Patton, Wendy; Creed, Peter


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

  11. Income Aspirations and Cooperation : Experimental Evidence

    NARCIS (Netherlands)

    Dalton, P.S.


    This article is the first attempt to study the empirical link between income aspirations and cooperation in a one shot public good game. By combining experimental with survey data, we find evidence that the more frustrated people are with their income, the lower is their propensity to cooperate with

  12. Aspiring Girls: Great Expectations or Impossible Dreams? (United States)

    Richards, Gill; Posnett, Carol


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


    Directory of Open Access Journals (Sweden)

    Nafia Ozlem Kazanci


    Full Text Available Foreign body aspiration (FBA is common under 3 years of age. FBA can cause sudden respiratory failure. Furthermore, it leads to many respiratory system complications. Therefore, FBA is an important cause of mortality and morbidity for this age group. FBA cases are usually followed by diagnoses like pneumonia, bronchitis or bronchial asthma in the late period that history, clinical and laboratory findings suggesting foreign body aspiration can not be detected. We reported a 2-year-old male patient with pneumonia, who were administered various treatments. In thorax CT of this case, an image compatible with foreign body was seen in the right middle lobe-upper lobe separation area. Granulation tissue was detected in the entrance of the right main bronchus by rigid bronchoscopy and marked improvement occured in lung aeration after bronchoscopy. This case was reported to emphasize the importance of early diagnosis of foreign body aspiration because of high mortality and morbidity and the necessity of considering the foreign body aspiration in children with recurrent pulmonary infections. [J Contemp Med 2013; 3(1.000: 58-61

  14. Uitwerking en implementatie Aspire voor witte asperges

    NARCIS (Netherlands)

    Kruistum, van G.; Wilms, J.A.M.


    In vervolg op het afgesloten project ‘Valideren van het AspireNZ systeem voor asperges in Nederland’ is medio 2006 dit vervolgproject gestart. Doelstelling is de ontwikkeling van een werkend Beslissing Ondersteunend Systeem (BOS) op basis van regelmatige meting van suikergehalten van de wortels en b

  15. Turban pin aspiration: new fashion, new syndrome. (United States)

    Ilan, Ophir; Eliashar, Ron; Hirshoren, Nir; Hamdan, Kasem; Gross, Menachem


    Turban pin aspiration syndrome is a new clinical entity afflicting young Islamic girls wearing a turban.The goal of this study was to present our experience in diagnosis and treatment of this new entity, define its clinical and epidemiologic features, and shed a new light on the role of fashion in the increased incidence. A retrospective study in a tertiary university hospital. Review of clinical parameters and epidemiologic features of 26 patients diagnosed with turban pin aspiration syndrome admitted to the Hadassah-Hebrew University Hospitals in Jerusalem from 1990 to 2010. All patients were Muslim females with an average age of 16 years. In all cases, the history was positive for accidental aspiration. Most of the pins were located in the trachea (42%). In 20 cases, the pins were extracted by rigid bronchoscopy without major complications. Fluoroscopy-assisted rigid bronchoscopy was used successfully in three cases. In one case, the object was self-ejected by coughing before the bronchoscopy, and two patients were referred to the chest unit for thoracotomy. Clinicians should be aware of this distinct form of foreign body aspiration, its method of diagnosis, and extraction techniques. A cultural investigation showed a difference in the turban-fastening technique of young girls as compared with their mothers. Removal by rigid bronchoscopy is a safe method with a high success rate and should be considered as the preferred extraction method of choice. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  16. Occupational Aspirations and Expectations of Australian Adolescents (United States)

    Patton, Wendy; Creed, Peter


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

  17. Factors Influencing High School Students' Career Aspirations (United States)

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


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

  18. The Gap between Aspiration and Practice (United States)

    Tuckett, Alan


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

  19. AngioVac Aspiration for Paradoxical Emboli Protection through a Fenestrated Fontan During Central Venous Thrombus Manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hakim, Ramsey, E-mail: [University of California, Department of Radiology, Division of Interventional Radiology (United States); Patel, Komal, E-mail: [University of California, Department of Anesthesiology, Division of Cardiothoracic Anesthesiology (United States); Moriarty, John M., E-mail: [University of California, Department of Radiology, Division of Interventional Radiology (United States)


    This case reports describes a 39-year-old female with a history of surgically repaired hypoplastic left heart syndrome who presented with a left peripherally inserted central catheter (PICC) with associated large volume subclavian and brachiocephalic vein thrombus. Due to the presence of a right-to-left shunt via a fenestrated Fontan, there was clinical concern for a paradoxical embolism during removal of the PICC. The AngioVac aspiration system was successfully utilized to aspirate thromboemboli from the level of the proximal Glenn shunt during manipulation and removal of the PICC. This is the first reported case to demonstrate the safe and effective use of the AngioVac aspiration system for protection of paradoxical emboli through a cardiac right-to-left shunt during a procedure at high risk for thromboembolism.

  20. Gender and Leadership Aspiration : The Impact of the Organizational Environment

    NARCIS (Netherlands)

    C. Erlemann


    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely

  1. Thin-needle aspiration biopsy of the prostate. (United States)

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


    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.

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

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Putten, G.J. van der; Visschere, L.M. De; Bronkhorst, E.M.; Baat, C. de; Schols, J.M.


    Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five experi

  3. Gender and Leadership Aspiration : The Impact of the Organizational Environment

    NARCIS (Netherlands)

    C. Erlemann


    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely under

  4. Hemi-hepatectomy in pediatric patients using two-surgeon technique and a liver hanging maneuver

    Institute of Scientific and Technical Information of China (English)

    Kyoko Mochizuki; Susumu Eguchi; Ryuichiro Hirose; Taiichiro Kosaka; Mitsuhisa Takatsuki; Takashi Kanematsu


    AIM: To evaluate the efficacy of the two-surgeon technique with the liver hanging maneuver (LHM) for hepatectomies in pediatric patients with hepatoblastoma. METHODS: Three pediatric patients with hepatoblastoma were enrolled in this study. Two underwent right hemi-hepatectomies and one underwent a left hemihepatectomy using the two-surgeon technique by means of saline-linked electric cautery (SLC) and the Cavitron Ultrasonic Surgical Aspirator (CUSA; Valleylab, Boulder, CO) and the LHM. RESULTS: The mean operative time during the parenchymal transections was 50 min and the mean blood loss was 235 g. There was no bile leakage from the cut surface after surgery. No macroscopic or microscopic-positive margins were observed in the hepatic transections. CONCLUSION: The two-surgeon technique using SLC and CUSA with the LHM is applicable to even pediatric patients with hepatoblastoma.

  5. Ultrasonic gas alloy atomization under near-zero aspiration pressure (United States)

    Yan, Pengfei; Wang, Deping; Yan, Biao


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

  6. [Surgical treatment of chiasmal gliomas in children]. (United States)

    Helcl, F


    Chiasmal gliomas are rare brain tumors occurring especially in children. Their proper treatment is still controversial and consists of surgery, radiotherapy and chemotherapy. Surgical removal of these tumors can usually be only partial or subtotal and radiotherapy frequently follows. There are supporters of surgical approach, as well as its enemies. The author has been engaged in problems of optimal treatment of this entity for more than 10 years. He is offering a review of knowledge from the literature concerning surgical treatment of this disease in children. The great majority of articles in the literature are dealing with retrospective analysis of relatively small series of patients usually treated in single neurosurgical department and the surgical treatment is enclosed like a part of combined therapy. Articles dealing only with surgical treatment of chiasmal gliomas are few and reviews determining the contemporary role of surgery of this entity are also lacking. This was the main impulse for writing this compilation. The short history of surgical therapy is reviewed. Some new trends of this therapy are also mentioned (microsurgery, Cavitron Ultrasonic Surgical Aspirator and peroperative use of visual evoked potentials). Up to date criteria for surgical treatment of chiasmal gliomas in children are given-exploration of chiasmal region and performing a biopsy in all cases, radical surgery only in extrinsic gliomas of the chiasmal region and conservative surgical approach to intrinsic chiasmal gliomas. It is emphasized that the significance of obstructive hydrocephalus in this entity has not been fully estimated till now, as well as the role of shunting procedures. Surgical treatment remains, nevertheless, an important armamentarium in the management of chiasmal gliomas in children. (Ref. 20.)

  7. The sweet lung: Chewing gummi bear aspiration (United States)

    Tavladaki, Theonimfi; Fitrolaki, Michaela-Diana; Spanaki, Anna-Maria; Ilia, Staurula; Geromarkaki, Elissabet; Briassoulis, George


    Inhalation of foreign bodies, a leading cause of accidental death, is most common in preschool children. In this article we report our experience with a 5-year-old Greek girl who presented with a 24-hour history of sore throat, chest pain, and shortness of breath. Emergency bronchoscopy was performed and multiple small chewing gummi bear (HARIBO) particles impacted in the orifices of the right main bronchus and right lobar and segmentalinic bronchi were successfully removed and aspirated. Aspiration of gummi bears, which is for the first time reported, may cause a silent choking episode leading to life-threatening bronchi obstruction at multiple sites, even in children older than 4 years. PMID:22919167

  8. Air Bag Momentum Force Including Aspiration

    Directory of Open Access Journals (Sweden)

    Guy Nusholtz


    Full Text Available A gas-jet momentum force drives the air bag into position during a crash. The magnitude of this force can change as a result of aspiration. To determine the potential magnitude of the effect on the momentum force and mass flow rate in an aspirated system, a series of experiments and simulations of those experiments was conducted. The simulation consists of a two-dimensional unsteady isentropic CFD model with special “infinite boundaries”. One of the difficulties in simulating the gas-jet behavior is determining the mass flow rate. To improve the reliability of the mass flow rate input to the simulation, a sampling procedure involving multiple tests was used, and an average of the tests was adopted.

  9. Fine needle aspiration biopsy of ophthalmic tumors☆ (United States)

    Singh, Arun D.; Biscotti, Charles V.


    A majority of intraocular tumors can be diagnosed based on clinical examination and ocular imaging studies, which obviate the need for diagnostic ophthalmic fine needle aspiration biopsy (FNAB). Overall, diagnostic accuracy of ophthalmic FNAB is high but limited cellularity can compromise the diagnostic potential of ophthalmic aspirate samples. The role of ophthalmic FNAB is limited in retinal tumors. Orbital FNAB should be considered in the evaluation of lacrimal gland tumors, orbital metastasis, and lymphoproliferative lesions. Negative cytologic diagnosis of malignancy should not be considered unequivocal proof that an intraocular malignancy does not exist. With improved understanding of genetic prognostic factors of uveal melanoma, ophthalmic FNAB is gaining popularity for prognostic purposes in combination with eye conserving treatment of the primary tumor. In special clinical indications, ancillary studies such as immunohistochemistry and FISH can be performed on ophthalmic FNAB samples. Assistance of an experienced cytopathologist cannot be overemphasized. PMID:23960981

  10. Coronary air embolism treated with aspiration catheter


    Patterson, M S; Kiemeneij, F.


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

  11. Ultrasound-guided fine needle aspiration cytology as an addendum to sentinel lymph node biopsy can perfect the staging strategy in melanoma patients

    NARCIS (Netherlands)

    C. Voit (Christiane); S.L.M. Gooskens (Saskia); P. Siegel (Petra); G. Schaefer (Gregor); A. Schöngen (Alfred); J. Röwert (Joachim); A.C.J. van Akkooi (Alexander); A.M.M. Eggermont (Alexander)


    textabstractBackground Ultrasound guided fine needle aspiration cytology (US-guided FNAC) can identify microscopic involvement of lymph nodes as in breast cancer and avoid surgical sentinel node (SN). Its utility in melanoma patients is controversial and subject of this study. Methods Between 2001 a

  12. Utility of Fine-Needle Aspiration Biopsy in the Evaluation of Pediatric Head and Neck Masses. (United States)

    Huyett, Phillip; Monaco, Sara E; Choi, Sukgi S; Simons, Jeffrey P


    Fine-needle aspiration biopsy (FNAB) has a well-established role in the evaluation of an adult head and neck mass (HNM) but remains underused in children. The objectives of this study were to assess the diagnostic accuracy, safety profile, use of anesthesia, and influence on surgical decision making of FNAB of HNM in the pediatric population. Case series with chart review. Tertiary care children's hospital. In total, 257 consecutive patients with HNM who underwent 338 FNABs from July 2007 to July 2014 were reviewed. Patients ranged in age from 0 to 21 years (mean, 9.3 years); lesions ranged in size from 0.3 to 12.5 cm (mean, 2.4cm). Fine-needle aspiration biopsies were performed in the interventional radiology suite, operating room, clinic, or ward. The most common patient final diagnoses included reactive lymphadenopathy (n = 99, 38.5%), benign thyroid colloid nodule (n = 31, 12.1%), malignancies (n = 21, 8.2%), and atypical mycobacterial infection (n = 15, 5.8%). On surgical histopathologic and clinical follow-up, overall sensitivity of FNAB was 94.6% and specificity was 97.7%. The complication rate was 2.1%, and general anesthesia or sedation was used for 73% of FNAB. Surgery occurred only 9 times following the 191 patients with negative FNAB results, indicating that 95.3% of unnecessary surgeries were avoided with the assistance of the FNAB result. Fine-needle aspiration biopsy is an accurate and safe diagnostic tool for guiding management of persistent lymphadenopathy, thyroid nodules, and other HNM in pediatric patients. Negative FNABs can often obviate the need for surgical intervention. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.


    Directory of Open Access Journals (Sweden)



    Full Text Available Filariasis is a tropical and subtropical disease caused by Wuchereria Bancrofti and Brugia Malayi and transmitted by Culex mosquito. Lymphatic Filariasis is a major health problem in countries like India, China, Indonesia, and Africa. Diagnosis of Filari a is done by conventional methods like peripheral blood smear examination, Fluorescent capillary method and filarial antigen detection by Rapid card method. Here we present four unusual cases with swellings presented in surgical outdoor and referred for FN AC. Our aim is to evaluate and emphasize the utility and importance of Fine Needle Aspiration in diagnosing Microfilarasis in clinically unsuspected cases.

  14. Clinicopathological characteristics of thyroid cancer misdiagnosed by fine needle aspiration (United States)

    Maeda, Hideki; Kutomi, Goro; Satomi, Fukino; Shima, Hiroaki; Mori, Mitsuru; Hirata, Koichi; Takemasa, Ichiro


    Fine-needle aspiration (FNA) is commonly used as a preoperative assessment to diagnose thyroid cancer. However, misdiagnosis of malignancy by FNA is not rare, even if image examination suggests the possibility of thyroid cancer. In the present study, the clinicopathological factors of patients whose preoperative FNA examination had not led to a diagnosis of thyroid cancer were examined. In total, 125 patients with thyroid cancer who underwent FNA and surgery (total thyroidectomy, subtotal thyroidectomy or hemithyroidectomy) at the Department of Surgery, Surgical Oncology and Science of the Sapporo Medical University Hospital between 2006 and 2013 were retrospectively analyzed. The patients were divided into two groups: Group A, malignancy determined by FNA, and group B, no malignancy. The groups were then compared by gender, age, tumor size, stage, tumor stage, lymph node metastasis, histology, surgical procedure methods, presence or absence of calcification and thyroglobulin levels. The mean age of the patients in group A (5 males and 59 females) was 53.0 years. The mean age in group B (11 males and 49 females) was 54.2 years. The mean tumor size in both groups was 1.6 cm. The mean thyroglobulin levels were 82.7 ng/ml in Group A and 525.5 ng/ml in group B. There were also significant differences between the groups for tumor stage (P=0.046), histological type (P=0.024) and thyroglobulin levels (P=0.035). The results of the present study suggested that it may be difficult to diagnose thyroid cancer by FNA in cases with non-papillary carcinoma and higher thyroglobulin levels. PMID:27698782

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

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    Ada P Lee


    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.

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

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    Katharine H Greenaway

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

  17. Correlation of gastroesophageal reflex with aspiration pneumonia after surgery

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    Hirashima, Tokuji; Hashimoto, Hajime; Noro, Toshio; Takahashi, Tadao; Hino, Yasunori; Kuroiwa, Kouzirou [Tokyo Metropolitan Geriatric Medical Center (Japan)


    In order to elucidate the correlation of gastroesophageal reflex (GER) with aspiration pneumonia after surgery, 48 patients (mean, 75.6 years) with gastric cancer treated at the hospital from March, 1994 to December, 1994 were subjected to this prospective study. The pharyngeal stimulation test, nutritional assessment, radionuclide esophageal scintigraphy (34 cases) were performed before surgery and relationship between those results and aspiration pneumonia were studied. Aspiration pneumonia occurred in 3 cases, and all of them were in, significantly, poor nutritional status, compared with other. A significant increase in the frequency of GER was observed when a naso-gastric tube (NGT) was placed, but surprisingly, all the patients with aspiration pneumonia were 3 out of 4 patients who had continuous GER without NGT. It is noteworthy, continuous GER without NGT was significantly (p<0.001) affected postoperative aspiration pneumonia and impaired phalyngeal reflex was frequently correlated with development of aspiration pneumonia, when malnutritional status existed. (author)

  18. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students. (United States)

    Greenaway, Katharine H; Frye, Margaret; Cruwys, Tegan


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

  19. Risk Factors for Aspiration Pneumonia in Older Adults



    BackgroundsAspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.Methodology and Principal FindingsWe conducted an observational study using data from a nationwide survey of geri...

  20. Risk Factors for Aspiration Pneumonia in Older Adults



    Backgrounds Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly. Methodology and Principal Findings We conducted an observational study using data from a nationwide survey of g...

  1. Changing educational aspirations of children living in poverty in Ethiopia



    Using both qualitative and quantitative data, this paper examines the changing educational and occupational aspirations and educational achievements of children living in poor communities in Ethiopia. The results suggest that children had high aspirations at an earlier age but that these changed later, with poverty rarely influencing their earlier aspirations but having a strong impact later on. Children with high educational achievement, mostly urban children and some rural girls, maintained...

  2. Foreign Body Aspiration in Children-a Diagnostic Challenge

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    Slobodanka Petrovic


    Full Text Available The clinical presentation of foreign body aspiration in children is variable. Clinicians should maintain a high index of suspicion in order to make a prompt and correct diagnosis. In this paper,we present a case of foreign body aspiration that had gone unrecognized for 54 days. Foreign body aspiration should be considered whenever a previously healthy child suddenly exhibits unexplained symptoms usually consistent with airway obstruction which is refractory to medical treatment.

  3. Contrast-enhanced harmonic endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic lesions: a retrospective study. (United States)

    Hou, Xiaojia; Jin, Zhendong; Xu, Can; Zhang, Minmin; Zhu, Jianwei; Jiang, Fei; Li, Zhaoshen


    The negative predictive value of endoscopic ultrasonography-guided fine needle aspiration for the diagnosis of solid pancreatic lesions remains low, and the biopsy specimens are sometimes inadequate for appropriate pathological diagnosis. To evaluate the usefulness of a novel method of contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration for the differential diagnosis and adequate sampling of solid pancreatic lesions. Patients with a diagnosis of solid pancreatic lesions who underwent fine-needle aspiration guided by contrast-enhanced harmonic endoscopic ultrasonography or by endoscopic ultrasonography from October 2010 to July 2013 were retrospectively identified and classified into the CH-EUS or EUS group, respectively. Surgical pathology and/or follow-up results were defined as the final diagnosis. Operating characteristics and adequacy of biopsy specimens by fine-needle aspiration were compared between the two groups. Operating characteristics for contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration in solid pancreatic lesions were as follows: area under the curve = 0.908, sensitivity = 81.6%, specificity = 100%, positive predictive value = 100%, negative predictive value = 74.1%, and accuracy = 87.9%. The percentage of adequate biopsy specimens in the CH-EUS group (96.6%) was greater than that in the EUS group (86.7%). Simultaneous contrast-enhanced harmonic endoscopic ultrasonography during fine-needle aspiration is useful for improving the diagnostic yield and adequate sampling of solid pancreatic lesions.

  4. Image-Guided Fine Needle Cytology with Aspiration Versus Non-Aspiration in Retroperitoneal Masses: Is Aspiration Necessary?

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    Rajiv Kumar Misra


    Full Text Available Background: Although using fine needle cytology with aspiration (FNC-A for establishing diagnoses in the retroperitoneal region has shown promise, there is scant literature supporting a role of non-aspiration cytology (FNC-NA for this region. We assessed the accuracy and reliability of FNC-A and FNC-NA as tools for preoperative diagnosis of retroperitoneal masses and compared the results of both techniques with each other and with histopathology. Methods: Fifty-seven patients with retroperitoneal masses were subjected to FNC-A and FNC-NA. Smears were stained with May-Grunwald Giemsa and hematoxylin and eosin stain. An individual slide was objectively analysed using a point scoring system to enable comparison between FNC-A and FNC-NA. Results: By FNC-A, 91.7% accuracy was obtained in cases of retroperitoneal lymph node lesions followed by renal masses (83.3%. The diagnostic accuracy of other sites by FNC-A varied from 75.0%–81.9%. By FNC-NA, 93.4% diagnostically accurate results were obtained in the kidney, followed by 75.0% in adrenal masses. The diagnostic accuracy of other sites by FNC-NA varied from 66.7%–72.8%. Conclusions: Although both techniques have their own advantages and disadvantages, FNC-NA may be a more efficient adjuvant method of sampling in retroperitoneal lesions.

  5. Performing a Better Bone Marrow Aspiration. (United States)

    Friedlis, Mayo F; Centeno, Christopher J


    Bone marrow aspiration (BMA) is increasingly being used to harvest stem cells for use in regenerative medicine. The focus of BMA in interventional orthopedics is to maximize the yield of mesenchymal stem cells. The authors present an improved method for BMA that involves fluoroscope or ultrasound guidance combined with anesthesia; in the authors' experience, it produces the highest possible stem cell yield and is well tolerated by patients. The authors provide a step-by-step guide to the process, along with a discussion of technical and other considerations and quick reference guides for ultrasound- and fluoroscope-guided BMA. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Role of aspiration-induced migration in cooperation

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    Yang, Han-Xin; Wang, Bing-Hong


    Both cooperation and migration are ubiquitous in human society and animal world. In this Rapid Communication, we propose an aspiration-induced migration in which individuals will migrate to new sites provided that their payoffs are below some aspiration level. It is found that moderate aspiration level can best favor cooperative behavior. In particular, moderate aspiration level enables cooperator clusters to maintain and expand whereas induces defector clusters to disintegrate, thus promoting the diffusion of cooperation among population. Our results provide insights into understanding the role played by migration in the emergence of cooperative behavior.

  7. Laser-Assisted Removal of Aspirated Thumbtacks by Flexible Bronchoscopy

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    Oren Fruchter


    Objectives. To describe a technique for removal of sharp aspirated metal objects employing laser through flexible bronchoscopy. Methods. We report two patients in whom a new technique for removal of sharp aspirated metal objects utilizing Nd-Yag laser flexible bronchoscopy was used. Results. Successful and uncomplicated removal of the aspirated thumbpack by flexible bronchoscopy under conscious sedation was accomplished in the two patients described. Both patients were discharged within 24 hours. Conclusions. In patients with aspirated thumbtack laser-assisted breakage of the object through flexible bronchoscopy may obviate the need for rigid bronchoscopy or thoracotomy.

  8. Silent aspiration: results of 2,000 video fluoroscopic evaluations. (United States)

    Garon, Bernard R; Sierzant, Tess; Ormiston, Charles


    The purpose of this retrospective study of aspiration and the lack of a protective cough reflex at the vocal folds (silent aspiration) was to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. Of the 2,000 patients evaluated in this study, 51% aspirated on the video fluoroscopic evaluation. Of the patients who aspirated, 55% had no protective cough reflex (silent aspiration). The diagnostic pathology groups with the highest rates of silent aspiration were brain cancer, brainstem stroke, head-neck cancer, pneumonia, dementia/Alzheimer, chronic obstructive lung disease, seizures, myocardial infarcts, neurodegenerative pathologies, right hemisphere stroke, closed head injury, and left hemisphere stroke. It is of high concern that the diagnostic groups identified in this research as having the highest risk of silent aspiration be viewed as "red-flag" patients by the nursing staff caring for them. Early nursing dysphagia screens, with close attention to the clinical symptoms associated with silent aspiration, and early referral for formal dysphagia evaluation are stressed.

  9. Predictive factors for early aspiration in liver abscess

    Institute of Scientific and Technical Information of China (English)

    Rustam Khan; Saeed Hamid; Shahab Abid; Wasim Jafri; Zaigham Abbas; Mohammed Islam; Hasnain Shah; Shaalan Beg


    AIM: To determine the predictive factors for early aspiration in liver abscess.METHODS: A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess.RESULTS: A total of 966 patients, 738 (76%) male, mean age 43 ± 17 years, were evaluated: 540 patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 patients. Predictive factors for aspiration of liver abscess were: age ≥ 55 years, size of abscess ≥ 5 cm, involvement of both lobes of the liver and duration of symptoms ≥ 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group.CONCLUSION: Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.

  10. Splenic abscess in typhoid fever -Surgical management

    Institute of Scientific and Technical Information of China (English)

    Col Prasan Kumar Hota


    Splenic abscess is an uncommon clinical presentation in surgical practice,associated with high morbidity and mortality.Mortality may be 100 % if left untreated.Splenic abscess is also rarely encountered as a complica-tion of typhoid fever.We present here a case of multiple splenic abscesses with neuropsychiatric complications due to typhoid fever,which was managed successfully with splenectomy and other supportive therapies.Anoth-er case of single splenic abscess due to enteric fever was treated successfully with CT-guided aspiration and ap-propriate antibiotics.Being a rare entity in clinical practice,splenic abscess has been poorly studied.Haemat-ogenous seeding of the spleen due to typhoid is a common cause of splenic abscess in the tropical countries.In multiple or multiloculated abscesses aspiration usually does not succeed,which happened in our case.Sple-nectomy remains the definitive choice of treatment.However,Ultra sonography (USG)or CT-guided aspira-tion may be tried in selective cases.

  11. Myofibromatosis: Utility of fine needle aspiration cytology in the diagnosis of an underreported entity (United States)

    Poflee, Sandhya V; Bode, Anjali N; Chavarkar, Sneha; Umap, Pradeep S


    Myofibromatosis (MFS) was recognized as a distinct form of childhood fibromatosis. Infantile myofibromatosis (IMF) is now identified as a solitary or multicentric tumor that predominantly occurs in neonates and infants. The adult counterpart of IMF, though of rare occurrence, is identified and is known as MFS. Morphological diagnosis of MFS is made by histopathological examination of the biopsy or surgically excised mass and confirmed on the basis of specific immunoprofile. We report a case of multicentric MFS occurring in an adolescent in whom diagnosis was suggested on the basis of fine needle aspiration cytology (FNAC) that avoided surgical excision of multiple nodules. The diagnosis was later confirmed on histopathological study and contributory immunohistochemical markers. Details of the clinical features and cytological diagnosis of the case are provided to diminish the paucity of available literature on FNAC diagnosis of the rare disease. PMID:28182064

  12. Gender, aspirations, and achievements : Relating work and family aspirations to occupational outcomes

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    van der Horst, Mariska


    Although women have increased their labour market participation and educational level they still lag behind men in their occupational achievements. An important discussion in the literature as well as in popular media is whether this is due to a gender difference in aspirations. In this study the im

  13. Stereotactic aspiration versus craniotomy for primary intracerebral hemorrhage: a meta-analysis of randomized controlled trials.

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    Jia-Wei Wang

    Full Text Available BACKGROUND: A wealth of evidence based on the randomized controlled trials (RCTs has indicated that surgery may be a better choice in the management of primary intracerebral hemorrhage (ICH compared to conservative treatment. However, there is considerable controversy over selecting appropriate surgical procedures for ICH. Thus, this meta-analysis was performed to assess the effects of stereotactic aspiration compared to craniotomy in patients with ICH. METHODS: According to the study strategy, we searched PUBMED, EMBASE and Cochrane Central Register of Controlled Trials. Other sources such as the internet-based clinical trial registries, relevant journals and the lists of references were also searched. After literature searching, two investigators independently performed literature screening, assessment of quality of the included trials and data extraction. The outcome measures included death or dependence, total risk of complication, and the risk of rebleeding, gastrointestinal hemorrhage and systematic infection. RESULTS: Four RCTs with 2996 participants were included. The quality of the included trials was acceptable. Stereotactic aspiration significantly decreased the odds of death or dependence at the final follow-up (odds ratio (OR: 0.80, 95% confidence interval (CI: 0.69-0.93; P = 0.004 and the risk of intracerebral rebleeding (OR: 0.44, 95% CI: 0.26-0.74; P = 0.002 compared to craniotomy with no significant heterogeneity among the study results. CONCLUSIONS: The present meta-analysis provides evidence that the stereotactic aspiration may be associated with a reduction in the odds of being dead or dependent in primary ICH, which should be interpreted with caution. Further trials are needed to identify those patients most likely to benefit from the stereotactic aspiration.

  14. Aspiration Alone, Aspiration Plus Steroid Injection and Aspiration Plus Ethanol Injection for Treatment of Dorsal Wrist Ganglions: A Comparative Study among Three Methods

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    Khandoker Abdur Rahim


    Full Text Available Background: There are varieties of treatment modalities to treat dorsal wrist ganglion cysts. But none of these has been the standard. So, we designed this study to compare among different treatment modalities. Objective: To compare the effects of aspiration alone, aspiration plus methylprednisone injection and aspiration plus ethanol injection into the dorsal wrist ganglions. Materials and Methods: This prospective study was performed in Dhaka Medical College Hospital, Dhaka from March 2010 to May 2011. Sixty six patients with dorsal wrist ganglions were treated in three groups –– aspiration alone in 24 patients (Group A, aspiration plus methylprednisolone injection into the cyst in 20 patients (Group B and aspiration plus ethanol injection, then reaspiration of the ethanol from the cyst after 3–5 minutes, in 22 patients (Group C. Elastic compression bandage was applied in all patients and recommended for 3 weeks. Follow-up was done at 1, 3, 6 and 12 months and conclusive assessment was done during final visit. Results: The success rate in Group A was seen in 9 patients (37.5%, in Group B in 11 (55% and in Group C in 14 (63.5% patients. The most frequent side-effect was pain during ethanol injection which was relieved by reaspiration of cyst. Conclusion: Injection of ethanol into the dorsal wrist ganglion was associated with higher success rate compared to aspiration and methylprednisolone injection. Further studies with larger sample size should be performed to assess the effect of ethanol injection in this disease.

  15. Robinson′s cytological grading on aspirates of breast carcinoma: Correlation with Bloom Richardson′s histological grading

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    Sinha S


    Full Text Available Background : Cytological grading (CG on aspirates of breast carcinoma is a useful tool for surgical maneuver and prognosis. Aims : An endeavor was made to use CG on aspirates of breast carcinoma using Robinson′s grade and to correlate it with Bloom Richardsons′ histopathological grading. Materials and Methods : A total of 59 patients of breast carcinoma, aged 28-57 years, were aspirated and the smears were graded using Robinson′s criteria. All the cases were correlated with Bloom Richardson′s grade on histopathology in mastectomy specimens. Lymphadenopathy in 38 cases was aspirated and stained with Papanicolaou and Romanowsky stain. Results : Robinson′s CG correlated well with Bloom Richardson′s histopathological grading. For grade I and II tumors, there was substantial strength of agreement between cytology and histopathology, while in grade III, the concordance was nearly perfect. Lymph node metastasis was found in 27 of 32 axillary nodes, three of five cervical nodes and the only palpable supraclavicular node. Lymph node metastasis was observed in three with cytological grade II, 28 of grade III and none of grade I. All grade I had stage A, two of grade II had stage B, while all grade III had either stage B or stage C disease. Conclusions : Thus, CG of breast carcinoma correlates well with histopathological grading and may well be useful as a prognostic marker.


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    Renata Nobre MOURA


    Full Text Available Context Tissue sampling of renal masses is traditionally performed via the percutaneous approach or laparoscopicaly. The utility of endoscopic ultrasound to biopsy renal lesions it remains unclear and few cases have been reported. Objectives To evaluate the feasibility and outcome of endoscopic ultrasound fine needle aspiration of renal tumors. Methods Consecutive subjects undergoing attempted endoscopic ultrasound fine needle aspiration of a kidney mass after evaluation with computerized tomography or magnetic resonance. Results Ten procedures were performed in nine male patients (median age 54.7 years on the right (n = 4 and left kidney (n = 4 and bilaterally (n = 1. Kidney masses (median diameter 55 mm ; range 13-160 mm were located in the upper pole (n = 3, the lower pole (n = 2 and the mesorenal region (n = 3. In two cases, the mass involved more than one kidney region. Surgical resection confirmed renal cell carcinoma in six patients in whom pre-operative endoscopic ultrasound fine needle aspiration demonstrated renal cell carcinoma. No complications were reported. Conclusions Endoscopic ultrasound fine needle aspiration appears as a safe and feasible procedure with good results and minimal morbidity.

  17. Surgical abortion prior to 7 weeks of gestation. (United States)

    Lichtenberg, E Steve; Paul, Maureen


    The following guidelines reflect a collation of the evaluable medical literature about surgical abortion prior to 7 weeks of gestation. Early surgical abortion carries lower risks of morbidity and mortality than procedures performed later in gestation. Surgical abortion is safe, practicable and successful as early as 3 weeks from the start of last menses (no gestational sac visible on vaginal ultrasound) provided that (a) routine sensitive pregnancy testing verifies pregnancy, (b) the tissue aspirate is immediately examined for the presence of a gestational sac plus villi and (c) a protocol to identify ectopic pregnancy expeditiously--including calculation of readily obtained serial serum quantitative human chorionic gonadotropin titers when clinically appropriate--is in place and strictly adhered to. Manual and electric vacuum aspiration methods for early abortion demonstrate comparable efficacy, safety and acceptability. Current data are inadequate to determine if any of the following techniques substantially improve procedure success or safety: use of rigid versus flexible cannulae, light metallic curettage following uterine aspiration, uterine sounding or routine use of intraoperative ultrasound. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Students' Aspirations, Expectations and School Achievement: What Really Matters? (United States)

    Khattab, Nabil


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

  19. Predictive Value and Psychological Meaning of Vocational Aspirations (United States)

    Holland, John L.; Gottfredson, Gary D.


    The psychological meaning and predictive value of a person's vocational aspirations were examined by applying Holland's typology to the vocational aspirations of high school juniors (N=140), and a second sample of college students studied over a one-year interval (N-624). (Author)

  20. Life Aspirations, Values and Moral Foundations in Mongolian Youth (United States)

    Bespalov, Alexander; Prudnikova, Marina; Nyamdorj, Bavuu; Vlasov, Mikhail


    Life aspirations have aroused much interest in youth studies. Yet, their psychological correlates remain unclear, especially in countries outside the US. The aim of this study was to explore associations among aspirations, values and moral foundations in 157 Mongolian youth, through questionnaires used widely around the world. Correlational and…

  1. 21 CFR 886.4150 - Vitreous aspiration and cutting instrument. (United States)


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

  2. Study of Educational Aspirations of Preparatory School Students in Yemen. (United States)

    Edington, Everett D.

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

  3. Students' Aspirations, Expectations and School Achievement: What Really Matters? (United States)

    Khattab, Nabil


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

  4. Psychological Empowerment and Adolescent Girls' Aspirations in India


    Roy, Sanchari; Morton, Matthew; Bhattacharya, Shrayana


    This paper studies the role of social-emotional or psychological capital in determining the education and employment aspirations of adolescent girls and young women in India. The study finds that girls' self-efficacy and mental health are important determinants of their educational and employment aspirations, suggesting that these hidden forms of human capital may serve as critical targets...

  5. Efficiency and Power Consumption of Aspiration Systems at Woodworking Plants

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    P. I. Diachek


    Full Text Available The paper analyzes present state of the equipment and organization of aspiration at wood-working shops. Proposals pertaining to higher efficiency and reduction of power intensity of aspiration systems are given in the paper. Materials presented at the stage of designing make it possible to select a rational system scheme and reduce power expenditure at woodworking industry.

  6. Aspiration of two permanent teeth during maxillofacial injuries. (United States)

    Xiao, Wen-lin; Zhang, Dai-zun; Wang, Yan-hui


    Aspiration of a tooth in maxillofacial injuries is a known complication necessitating prompt recognition and early treatment to minimize potentially serious and, sometimes, even fatal consequences. Here, we report a rare and unusual case in its presentation, the patient having aspirated 2 permanent teeth after maxillofacial, cervical vertebrae, and thoracic region crush injuries due to a motor vehicle accident. The diagnosis of teeth aspiration was delayed until 2 weeks after the event. An aspirated anterior tooth was expectorated by the patient himself, and the other aspirated anterior tooth was removed by flexible bronchoscopy. The paper also emphasizes that clinicians must be aware of dental injury resulting from maxillofacial injuries and account for all teeth as part of their evaluation, keeping an open mind as to where a missing tooth might be located. A rapid diagnosis depends on high clinical suspicion, clinical signs, and radiologic findings.

  7. Acid aspiration-induced airways hyperresponsiveness in mice. (United States)

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


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

  8. Foreign body aspiration masquerading as difficult asthma

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    Rai S


    Full Text Available It is important to assess patients of difficult/therapy resistant asthma carefully in order to identify whether there are any correctable factors that may contribute to their poor control. It is critical to make a diagnosis of asthma and to exclude other airway diseases. A 65-years-old lady presented with repeated acute episodes of dyspnoea and wheezing. She was on regular medication for bronchial asthma for 18 years. There was no history of foreign body aspiration or loss of consciousness. Her chest radiograph was normal. She showed poor response to corticosteroids and bronchodilators. Fibreoptic bronchoscopy (FOB showed intracordal cyst of the left vocal cord and 1cm size irregular piece of betel nut in right main bronchus, which was removed endoscopically with the help of dormia basket, following which her condition improved and asthma was controlled on inhaled bronchodilators.

  9. Religiosity and Migration Aspirations among Mexican Youth (United States)

    Marsiglia, Flavio Francisco; Ayers, Stephanie L.


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

  10. Transbronchial needle aspiration "by the books"

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    Kupeli Elif


    Full Text Available Background : Training for advanced bronchoscopic procedures is acquired during the interventional pulmonology (IP Fellowship. Unfortunately a number of such programs are small, limiting dissemination of formal training. Objective : We studied success of conventional transbronchial needle aspiration (C-TBNA in the hands of physicians without formal IP training. Methods : A technique of C-TBNA was learned solely from the literature, videos and practicing on inanimate models at "Hands-On" courses. Conventional TBNA with 21 and/or 19 gauge Smooth Shot Needles (Olympus® , Japan was performed on consecutive patients with undiagnosed mediastinal lymphadenopathy. Results : Thirty-four patients (male 23, mean age 54.9 ± 11.8 years underwent C-TBNA. Twenty-two patients had nodes larger than 20 mms. Suspected diagnoses were malignancy in 20 and nonmalignant conditions in 14. Final diagnoses were malignancy 17, sarcoidosis 4, reactive lymph nodes 12, and tuberculosis 1. Final diagnosis was established by C-TBNA in 14 (11 malignancy, 3 sarcoidosis; yield 41.1%, mediastinoscopy in 14, transthoracic needle aspiration in 3, peripheral lymph node biopsies in 2 and by endobronchial biopsy in 1. Nodal size had an impact on outcome (P = 0.000 while location did not (P = 0.33. C-TBNA was positive in 11/20 when malignancy was suspected (yield 55%, while 3/14 when benign diagnosis was suspected (yield 21.4% (P = 0.05. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 66.6%, 100%, 100%, 65%, and 79.4%, respectively. There were no complications or scope damage. Conclusion : Conventional-TBNA can be learned by the books and by practicing on inanimate models without formal training and results similar to those published in the literature could be achieved.

  11. Surgical treatment of a large congenital cavernous hemangioma on the thorax of a foal

    DEFF Research Database (Denmark)

    Jacobsen, Stine; Christophersen, Mogens Teken; Tnibar, Aziz;


    A 3-day-old male foal was presented with a fluctuant 25 × 15 cm mass on the thorax. The mass had increased in size since birth. The mass did not respond to conservative treatment consisting of aspiration of serohaemorrhagic contents and compression bandages, and it was therefore surgically remove...

  12. Ileus development in the trauma/surgical intensive care unit: a process improvement evaluation. (United States)

    Phipps, Marcy; Bush, Jeffrey A; Buhrow, Dianne; Tittle, Mary B; Singh, Deepak; Harcombe, Julianne; Riddle, Evanthia


    Ileus development has been associated with a wide range of complications among hospitalized patients, ranging from increased patient pain and discomfort to malnutrition, aspiration, delayed rehabilitation, and sepsis. This article examines factors that appeared to correlate with an increase in ileus development among patients in a trauma/surgical intensive care unit, with the goal of preventing the condition through nursing practice changes.

  13. Liver resection in children, using a water-jet. (United States)

    Hata, Y; Sasaki, F; Takahashi, H; Ohkawa, Y; Taguchi, K; Une, Y; Uchino, J


    The water-jet method has been used during hepatic resection in children. The instrument cuts the hepatic tissue by means of a high-pressure fine water-jet, while the exposed intrahepatic vessels are spared injury. Physiological saline was used for the jet water, and pressure of 12 to 15 kilograms of force per square centimeter (kgf/cm2) through a 0.15-mm-diameter nozzle was found to be optimal for cutting the liver parenchyma. The authors evaluated the usefulness of the water-jet dissector (n = 8) during bisegmentectomy or trisegmentectomy in comparison to the Cavitron Ultrasonic Surgical Aspirator (CUSA) (n = 5). The mean operation time was 4.08 +/- 0.87 hours for the water-jet group and 5.08 +/- 1.33 hours for the CUSA group. The mean blood loss was 602 +/- 659 mL for the water-jet group and 1,036 +/- 521 mL for the CUSA group. Although there were no significant differences with respect to operation time, blood loss, or postoperative complications, the liver parenchyma was dissected more easily using the water-jet. The authors believe that the mechanical simplicity and safety of the water-jet method will lead to its more widespread use in liver resection in children.

  14. Chin tuck for prevention of aspiration: effectiveness and appropriate posture. (United States)

    Ra, Jong Yun; Hyun, Jung Keun; Ko, Kyung Rok; Lee, Seong Jae


    Chin tuck has been has been widely used to prevent aspiration in the patients with dysphagia. This study was performed to investigate the effectiveness and the degree of optimal neck flexion of chin tuck. Ninety-seven patients who showed aspiration in the videofluoroscopic swallow study (VFSS). Participants were grouped into the effective (patients who showed effect with chin tuck) and ineffective group (those who did not show effect with chin tuck). VFSS was performed in neutral and chin tuck position and findings were compared between the groups. Severity of aspiration was assessed by the point penetration-aspiration scale. Duration of dysphagic symptoms, history of tracheostomy, and other possible contributing factors were also compared. Neck flexion angle was measured to find appropriate posture in which aspiration was prevented with chin tuck. Aspiration was reduced or eliminated in only 19 patients (19.6 %) with chin tuck. Oral transit time, pharyngeal delayed time and pharyngeal transit time were significantly shortened in both groups (p neck flexion was required to achieve an effect with chin tuck. The effectiveness of chin tuck was less than anticipated. Patients without residue in pyriform sinus were more likely to benefit from chin tuck. Sufficient neck flexion was important in chin tuck to prevent aspiration.

  15. Multi-dimension Aspiration Control Mode in Phacoemulsification

    Institute of Scientific and Technical Information of China (English)

    Xiangqun Wang; Mingguang He; Junwen Zeng


    Purpose: Multi-dimension aspiration control mode was put forward in this study.Accuracy of multi-dimension aspiration control model was compared to simple traditional pedal control model.Methods: Induced by high aspiration pressure (200~250 mmHg), hard nucleus (≥Grade Ⅲ ) of senile cataract was chopped before phacoemulsification in 170 patients (174 eyes). Ninety-one patients (94 eyes) accepted multi-dimension aspiration control model in which aspiration direction, distance and targets prevention were adjusted by phaco-tip besides traditional pedal control. Another 79 patients (80 eyes) were compared as reviewed group, aspiration of which was controlled simply by traditional pedal control. Postcapsular rupture rates (PCRR) were compared between two groups.Results: Multi-dimension control model could make the terminal effects cooperate with phacoemulsification more precisely and protect post capsular from damage (x2 =5.41, P < 0.02).Conclusion: Multi-dimension control model could improve the accuracy of aspiration effects and protect postcapsular from damage.

  16. Reliability of fine needle aspiration biopsy in large thyroid nodules. (United States)

    Bozbıyık, Osman; Öztürk, Şafak; Ünver, Mutlu; Erol, Varlık; Bayol, Ümit; Aydın, Cengiz


    Fine needle aspiration biopsy provides one of the most important data that determines the treatment algorithm of thyroid nodules. Nevertheless, the reliability of fine needle aspiration biopsy is controversial in large nodules. The aim of this study was to evaluate the adequacy of fine needle aspiration biopsy in thyroid nodules that are four cm or greater. We retrospectively examined 219 patients files who underwent thyroidectomy for thyroid nodules that were greater than four centimeter between May 2007 and December 2012. Seventy-four patients with hyperthyroidism, and 18 patients without preoperative fine needle aspiration cytology were excluded from the study. Histopathologic results after thyroidectomy were compared with preoperative cytology results, and sensitivity and specificity rates were calculated. False-negativity, sensitivity and specificity rates of fine needle aspiration biopsy of thyroid nodules were found to be 9.7%, 55.5%, and 85%, respectively. Within any nodule of the 127 patients, 28 (22.0%) had thyroid cancer. However, when only nodules of at least 4 cm were evaluated, thyroid cancer was detected in 22 (17.3%) patients. In this study, fine needle aspiration biopsy of large thyroid nodules was found to have a high false-negativity rate. The limitations of fine-needle aspiration biopsy should be taken into consideration in treatment planning of thyroid nodules larger than four centimeters.

  17. Gastric reflux: association with aspiration and oral secretion pH as marker of reflux: a descriptive correlational study. (United States)

    Schallom, Marilyn; Orr, James A; Metheny, Norma; Kirby, John; Pierce, Janet


    Gastric reflux leading to pulmonary aspiration is a frequent event in mechanically ventilated, gastric-fed patients, which can lead to ventilator-associated complications and pneumonia. The objectives of this study were to determine the association between gastric reflux and aspiration using the presence of pepsin in oral or tracheal secretions as a marker of reflux or aspiration and to determine the association between the pH (range, 0-14) and the presence of pepsin in oral secretions. A descriptive correlational study was conducted in mechanically ventilated surgical or medical patients receiving gastric tube feedings. Oral secretions were suctioned hourly and tracheal secretions every 2 to 3 hours for 12-hour periods over 1 to 2 days in 15 patients. There were 142 paired samples of oral tracheal secretions. A majority of samples (60%) had the same results, with 32% both pepsin-positive and 27% both pepsin-negative. The range of pH measurements was 4 to 8, with a mean of 6.3 ± 0.05. Ninety oral specimens had a pH of 4 to 6. Forty-seven of the oral specimens with pH measures between 4 and 6 (52%) were pepsin-positive. The correlation of pH percent pepsin-positive oral secretions was not significant. Aspiration events were more frequent than reflux events. Measurement of actual pepsin concentration to detect new reflux and aspiration events is recommended in future studies. Bedside pH measures of oral secretions are not a valid marker of gastric reflux.

  18. Baseline urologic surgical skills among medical students: Differentiating trainees. (United States)

    Gupta, Vishaal; Lantz, Andrea G; Alzharani, Tarek; Foell, Kirsten; Lee, Jason Y


    Urology training programs seek to identify ideal candidates with the potential to become competent urologic surgeons. It is unclear whether innate technical ability has a role in this selection process. We aimed to determine whether there are any innate differences in baseline urologic technical skills among medical students. Second-year medical students from the University of Toronto were recruited for this study and stratified into surgical and non-surgical cohorts based on their reported career aspirations. After a pre-test questionnaire, subjects were tested on several urologic surgical skills: laparoscopy, cystoscopy and robotic surgery. Statistical analysis was performed using chi-squared test, student t-tests and Spearman's correlation where appropriate. A total of 29 students participated in the study and no significant baseline differences were found between cohorts with respect to demographics and prior surgical experience. For laparoscopic skills, the surgical cohort outperformed the non-surgical cohort on several exercises: Lap Beans Missed (4.9 vs. 9.3, p robotic surgery performance metrics: Task Time (50.6 vs. 76.3, p robotics, may differ between early trainees interested in a surgical career compared to those interested in a non-surgical career. Further studies are required to illicit what impact such differences have on future performance and competence.

  19. Pediatric foreign body aspiration: A nidus for Aspergillus colonization. (United States)

    Mitchell, Candace A; Kreiger, Portia; Goff, Christopher; Shah, Udayan K


    We describe an immunocompetent child with bronchial fungus following foreign body aspiration. A two-year-old male presented with cough. Workup revealed air trapping and bronchoscopy showed aspirated foreign material in the right mainstem bronchus. Histopathology revealed fungal organisms suggestive of Aspergillus within an ulcer of the adjacent bronchial mucosa. Foreign body aspiration has been posited as a nidus for aspergilloma formation but is not yet described in the available English-language pediatric literature. Here, the foreign body provided a site for fungal growth in the bronchus of an otherwise healthy child. This case suggests that bronchial foreign body may pose risk of fungal colonization even in immunocompetent children.

  20. Decrease in use of manual vacuum aspiration in postabortion care in Malawi: a cross-sectional study from three public hospitals, 2008-2012.

    Directory of Open Access Journals (Sweden)

    Maria L Odland

    Full Text Available OBJECTIVES: To investigate the use of manual vacuum aspiration in postabortion care in Malawi between 2008-2012. METHODS: A retrospective cross-sectional study was done at the referral hospital Queen Elisabeth Central Hospital, and the two district hospitals of Chiradzulu and Mangochi. The data were collected simultaneously at the three sites from Feb-March 2013. All records available for women admitted to the gynaecological ward from 2008-2012 were reviewed. Women who had undergone surgical uterine evacuation after incomplete abortion were included and the use of manual vacuum aspiration versus sharp curettage was analysed. RESULTS: Altogether, 5121 women were included. One third (34.2% of first trimester abortions were treated with manual vacuum aspiration, while all others were treated with sharp curettage. There were significant differences between the hospitals and between years. Overall there was an increase in the use of manual vacuum aspiration from 2008 (19.7% to 2009 (31.0%, with a rapid decline after 2010 (28.5% ending at only 4.9% in 2012. Conversely there was an increase in use of sharp curettage in all hospitals from 2010 to 2012. CONCLUSION: Use of manual vacuum aspiration as part of the postabortion care in Malawi is rather low, and decreased from 2010 to 2012, while the use of sharp curettage became more frequent. This is in contrast with current international guidelines.

  1. Micro-surgical endodontics. (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I


    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  2. Surgical innovation as sui generis surgical research. (United States)

    Lotz, Mianna


    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

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

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


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

  4. Surgical Craniotomy for Intracerebral Haemorrhage. (United States)

    Mendelow, A David


    Craniotomy is probably indicated for patients with superficial spontaneous lobar supratentorial intracerebral haemorrhage (ICH) when the level of consciousness drops below 13 within the first 8 h of the onset of the haemorrhage. Once the level drops below 9, it is probably too late to consider craniotomy for these patients, so clinical vigilance is paramount. While this statement is only backed up by evidence that is moderately strong, meta-analysis of available data suggests that it is true in the rather limited number of patients with ICH. Meta-analyses like this can often predict the results of future prospective randomised controlled trials a decade or more before the trials are completed and published. Countless such examples exist in the literature, as is the case for thrombolysis in patients with myocardial infarction in the last millennium: meta-analysis determined the efficacy more than a decade BEFORE the last trial (ISIS-2) confirmed the benefit of thrombolysis for myocardial infarction. Careful examination of the meta-analysis' Forest plots in this chapter will demonstrate why this statement is made at the outset. Other meta-analyses of surgery for ICH have also indicated that minimal interventional techniques using topical thrombolysis or endoscopy via burrholes or even twist drill aspiration may be particularly successful for the treatment of supratentorial ICH, especially when the clot is deep seated. Ongoing clinical trials (CLEAR III and MISTIE III) should confirm this in the fullness of time. There are 2 exceptions to these generalisations. First, based on trial evidence, aneurysmal ICH is best treated with surgery. Second, cerebellar ICH represents a special case because of the development of hydrocephalus, which may require expeditious drainage as the intracranial pressure rises. The cerebellar clot will then require evacuation, usually via posterior fossa craniectomy, rather than craniotomy. Technical advances suggest that image-guided surgery


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND: Male infertility is a common problem and needs a minimally invasive method to arrive at the appropriate diagnosis . Alternative to open testicular biopsy the fine needle aspiration cytology of the testis is being increasingly used as a minimally invasive method of evaluating testicular function . AIM OF THE STUDY: To know whether FNAC of testes is as informative as biopsy in cases of male infertility . To establish that FNAC is cost effective , safe , out p atient investigation with no complications . METHODOLOGY: Fifty patients with primary male infertility in the age group of 20 - 40 years were included in the study . All the cases with oligospermia and azoospermia were subjected for Doppler study to rule out varicocele . Cord block was achieved with 1% lignocaine and aspiration was done with 23 gauge 1 . 5 inch needle . Smears were made on albuminised slides and stained with Leishman Stain . Forresta et al scoring system was adopted to analyse the smears . In the same sitting testicular biopsy was taken , fixed in Bouins fluid , routinely processed and stained with H&E stain . RESULTS: The commonest group with infertility were in the age group 21 - 30 years . On semen analysis 78% were azoospermic and 22% were oligozoospermic . The testicular size was normal in 90 % of subjects and 10% had small testis . Out of fifty subjects with infertility , 40% subjects had varicocele . Varicocele was commonly associated with duct obstruction . The commonest patterns observed on cytology were; normal spermatogenesis ( 14/50 , 28 % , duct obstruction ( 8/50 , 16 % , maturation arre st ( 7/50 , 14 % and testicular atrophy ( 7/50 , 14 % . In the present study diagnostic accuracy was 93 . 4% . CONCLUSION: Fine needle aspiration cytology is as informative as biopsy and can be done as a routine procedure . It is a simple and cost effective . In cases where FNAC shows normal spermatogenesis with azoospermia and oligospermia , biopsy and doppler study

  6. Fine needle aspiration cytology in leprosy

    Directory of Open Access Journals (Sweden)

    Prasad PVS


    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.

  7. Dermal mass aspirate from a Persian cat. (United States)

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


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

  8. Fine needle aspiration cytology of dermal cylindroma

    Directory of Open Access Journals (Sweden)

    Parikshaa Gupta


    Full Text Available In this paper, we have described fine needle aspiration cytology (FNAC of a rare case of dermal cylindroma. A 40-year-old female presented with a lateral mid-cervical swelling fixed to the skin. FNAC smears showed multiple clusters of small, round to oval cells with hyperchromatic nuclei, inconspicuous nucleoli and scant cytoplasm. In addition, the background showed deposits of basement membrane type material. This was dark magenta colored pinkish globular material. The globules were occasionally surrounded by the basal type of cells. Occasional cells with elongated nuclei were also noted. Cytological diagnosis of skin adnexal tumor possibly cylindroma was offered. Subsequent histopathology of the swelling showed sheets and clusters of cells in a jigsaw puzzle-like fashion. Deposition of abundant basement membrane-like material was noted in between the tumor cells. A diagnosis of cylindorma was offered. FNAC along with the subcutaneous location of the tumor and absence of primary salivary gland tumor may help to diagnose such rare case.

  9. Nipple Aspirate Test Is No Substitute for Mammogram (United States)

    ... Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Consumer Updates Nipple Aspirate Test is No Substitute for Mammogram Share Tweet Linkedin Pin it More ...

  10. The efficiency of routine endotracheal aspirate cultures compared to ...

    African Journals Online (AJOL)

    The efficiency of routine endotracheal aspirate cultures compared to ... VAP EA) twice weekly in all patients until the endotracheal tube was removed. ... 62%; specificity: 95%, positive predictive value: 87%, negative predictive value: 82%).

  11. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

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    P. J. Corsi


    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  12. The role of incentives in nurses' aspirations to management roles. (United States)

    Wong, Carol A; Spence Laschinger, Heather K; Cziraki, Karen


    The objective of this study was to describe findings from a study examining nurses' perceptions of incentives for pursuing management roles. Upcoming retirements of nurse managers and a reported lack of interest in manager roles signal concerns about a leadership shortage. However, there is limited research on nurses' career aspirations and specifically the effect of perceived incentives for pursuing manager roles. Data from a national, cross-sectional survey of Canadian nurses were analyzed (n = 1241) using multiple regression to measure the effect of incentives on nurses' career aspirations. Twenty-four percent of nurses expressed interest in pursuing management roles. Age, education, and incentives explained 43% of the variance in career aspirations. Intrinsically oriented incentives such as new challenges, autonomy, and the opportunity to influence others were the strongest predictors of aspirations to management roles. Ensuring an adequate supply of nurse managers will require proactive investment in the identification, recruitment, and development of nurses with leadership potential.

  13. Micronuclei in breast aspirates. Is scoring them helpful?

    Directory of Open Access Journals (Sweden)

    A Hemalatha


    Conclusion: An increase in micronuclei values was seen from fibroadenoma to infiltrating ductal carcinoma. Micronuclei scoring can be used as a biomarker on fine needle aspiration cytology smears of breast carcinoma.

  14. Fine-needle aspiration biopsy of lymph nodes

    African Journals Online (AJOL)


    Feb 2, 2012 ... Lymph nodes in the posterior cervical triangle and supraclavicular nodes are more suspicious for malignancy. ... exclusively primary or recurrent breast carcinoma in aspirates ... Lung carcinoma – small cell and non- small cell.

  15. Handling Rejection as Failure: Aspiring Writers Getting the Rejection Slip

    Directory of Open Access Journals (Sweden)

    Henrik Fürst


    Full Text Available Included in the definition of being an aspiring person is the risk of failure. Aspiring fiction writers are no exception. This article shows that the role of aspiring fiction writer involves managing three issues: the hope of being published, rejection by a publisher, and the perception of the rejection as a failure. Drawing on 47 interviews with fiction writers who have attempted to become first-time writers, the analysis shows that aspiring writers' responses to rejection are related to accepting and dismissing responsibility for having failed and admitting or dismissing the rejection as a perceived failure. Based on these findings, the article presents procedures associated with four main approaches to dealing with failure: conceding, excusing, justifying, and refusing. This conceptual framework for understanding failure contributes to a theoretical understanding of evaluation and valuation processes and their consequences and to empirical studies of rejection as career failure; it also systematizes and extends Goffmans work on cooling out strategies.

  16. Cognitive correlates of adolescents' aspirations to leadership: a developmental study. (United States)

    Singer, M


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

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

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


    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.

  18. Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma


    Basheer Tashtoush; Jonathan Schroeder; Roya Memarpour; Eduardo Oliveira; Michael Medina; Anas Hadeh; Jose Ramirez; Laurence Smolley


    The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of...

  19. Aspiration cytology of metastatic chordoma. A case report. (United States)

    Elliott, E C; McKinney, S; Banks, H; Fulks, R M


    A patient with previously diagnosed sacrococcygeal chordoma presented with multiple skin nodules. Cytologic examination of an aspirate from one of these nodules showed syncytial clusters of hyperchromatic cells surrounded by extracellular mucin. The characteristic physaliphorous cells, although present in a biopsy of the primary sacrococcygeal tumor, were not observed in the aspirate or on histopathologic examination of three excised skin metastases. That chordoma metastases may lack physaliphorous cells should be recognized.

  20. Some Unresolved Issues in Ocean Pipes Aspirating Fluid

    Institute of Scientific and Technical Information of China (English)

    QIAN Qin; WANG Lin; NI Qiao; HUANG Yu-ying


    This paper reviews the dynamics of ocean pipes aspirating fluid and presents a selective review of the research undertaken on it. It focuses on the equations of motion, fluid-solid interaction at the inlet of the free end of the pipe, the stability mechanism of pipes aspirating steady fluid, etc. In particular, some unresolved or partly resolved issues on these important aspects are discussed. Finally, the promising future development in this area is discussed.

  1. A Case of Bipolar Affective Disorder and Aspiration Pneumonia

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    Alessandro Gerada


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

  2. Fine needle aspiration biopsy diagnosis of metastatic neoplasms of the breast. A three-case report

    Directory of Open Access Journals (Sweden)

    Raquel Garza-Guajardo


    Full Text Available Abstract Metastases to the breast are unusual lesions that make up approximately 2% of all malignant mammary neoplasms and may mimic both benign and malignant primary neoplasms from a clinical point of view, as well as in imaging studies. Arriving at a correct diagnosis is therefore essential in order to establish appropriate management. We present three cases of metastatic neoplasms diagnosed through fine needle aspiration biopsy and immunocytochemistry. The cytological diagnoses were: medulloblastoma in an 18-year-old woman, melanoma in a 26-year-old man, and an exceptional case of ovarian sarcoma originating from a granulosa cell tumor with metastases to both breasts. A metastatic disease should be considered in the differential diagnosis of a palpable mass in the breast, especially if there is a history of an extramammary malignant neoplasm. Fine needle aspiration biopsy is the method of choice for the management of these cases. Whenever possible the exam of the material obtained should be compared to the previous biopsy, which is usually enough to arrive at a correct diagnosis, thus preventing unnecessary surgical procedures.

  3. Training and certification in endobronchial ultrasound-guided transbronchial needle aspiration. (United States)

    Naur, Therese Maria Henriette; Konge, Lars; Nayahangan, Leizl Joy; Clementsen, Paul Frost


    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.

  4. Sodium polystyrene sulfonate (kayexalate) aspiration: histologic appearance and infrared microspectrophotometric analysis of two cases. (United States)

    Fenton, J J; Johnson, F B; Przygodzk, R M; Kalasinsky, V F; Al-Dayel, F; Travis, W D


    Sodium polystyrene sulfonate (kayexalate) is a cation-exchange resin given enterally for the treatment of hyperkalemia. Aspiration of this material is a rare occurrence, but when visualized in the alveolus, it has a characteristic microscopic appearance that is virtually diagnostic. In two cases, recognition of the characteristic morphology of the foreign material raised the question of sodium polystyrene sulfonate. We used infrared spectroscopy to demonstrate the presence of this material in lung biopsies of two patients by identifying foreign body particles. Histories of the patients were reviewed for exposure to sodium polystyrene sulfonate. Two lung specimens were referred to the Armed Forces Institute of Pathology with an unknown foreign material identified within the air spaces. The lung biopsies were from two children, one postterm female infant who died at 3 days of life and a 4-year-old girl who underwent lung biopsy during surgical repair for tetralogy of Fallot. Both patients had received sodium polystyrene sulfonate previously for control of hyperkalemia. The lung specimens showed characteristic basophilic, amorphous foreign material in airspaces on histologic sections. The identity of this material was confirmed by Fourier transform infrared microspectrophotometry. To our knowledge, we report the first two cases of sodium polystyrene sulfonate aspiration in children. This material has a distinctive morphologic appearance on histologic sections, and its identity can be confirmed by Fourier transform infrared microspectrophotometry.

  5. Diagnosis and reporting of follicular-patterned thyroid lesions by fine needle aspiration. (United States)

    Faquin, William C


    Over the past 3 decades, fine needle aspiration (FNA) has developed as the most accurate and cost-effective initial method for guiding the clinical management of patients with thyroid nodules. Thyroid FNA specimens containing follicular-patterned lesions are the most commonly encountered and include various forms of benign thyroid nodules, follicular carcinomas, and the follicular variant of papillary thyroid carcinoma. Based primarily upon the cytoarchitectural pattern, FNA is used as a screening test for follicular-patterned lesions to identify the majority of patients with benign nodules who can be managed without surgical intervention. The terminology and reporting of thyroid FNA results have been problematic due to significant variation between laboratories, but the recent multidisciplinary NCI Thyroid FNA State of the Science Conference has provided a seven-tiered diagnostic solution. A key element of this approach is the category "atypical cells of undetermined significance" (ACUS) which is used for those aspirates which cannot be easily classified as benign, suspicious, or malignant. Lesions in this category represent approximately 3-6% of thyroid FNAs and have a risk of malignancy intermediate between the "benign" category and the "suspicious for a follicular neoplasm" category. The recommended follow-up for an ACUS diagnosis is clinical correlation and in most cases, repeat FNA sampling.

  6. Individual idea about the micro-invasive aspiration and drainage of intracranial hematoma

    Institute of Scientific and Technical Information of China (English)


    AIM:This study aimed to expound the individual idea of micro-invasive surgery from pre-operative preparation,intra-operative processing and post-operative management.METHODS:Pre-operative preparation was improved by analyzing pathological factors and hematoma property,and considering patients' age,basic disease,blood pressure control,with persistent haemorrhagia/rehaemorrhagia or not,operative occasion choice,positioning and other procedures.In the surgery,positioner was used.Initial aspiration volume was cautiously controlled.After operation,vital signs of patients were kept stable by cautiously using hematoma liquefacient and combining with free radical scavenger.RESULTS:The core content of individual micro-invasive surgery was mainly to relieve intracranial pressure.Under the condition of sufficient pre-operative preparation known by patients' family members,precise positioning was determined and individual therapeutic regimen was made.Meanwhile,caution should be taken in hematoma aspiration.Liquefaction and drainage should be paid more attention,and complications were processed actively.CONCLUSION:During the process of micro-invasive evacuation of intracranial hematoma for treating cerebral hemorrhage,attention should be paid to analyzing cerebral hematoma etiology and pathophysiological mechanism,and individual idea should be considered in surgical treatment aiming at patients' concrete disease condition.

  7. Ultrasonography-Guided Fine-Needle Aspiration Biopsy of Predominantly Cystic Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Hye Jin; Kim, Dong Wook [Busan Paik Hospital, Busan (Korea, Republic of)


    The aim of this study is to present our biopsy technique and to determine the efficacy of the ultrasound- guided fine-needle aspiration biopsy (US-FNAB) for predominantly cystic thyroid nodules (PCTNs). This study included patients that underwent US-FNABs on PCTNs, and were sampled for the solid component following the aspiration of a cystic component through one needle puncture between January to December of 2008. We retrospectively reviewed the cytopathology results as well as any complication associated with the procedure. Of the 76 PCTNs (range of maximal diameter: 0.4 cm-6.1 cm, mean: 2.39 cm) observed in the 75 patients (females: males = 63: 12, age range: 19-72, mean: 45.3 years old), the incidence rate of adequate and inadequate samples was 90.8% (69/76) and 9.2% (7/76) in the first US-FNAB, respectively. Further, 23 PCTNs were surgically removed in 22 patients, of which 15 PCTNs were benign and 8 were confirmed malignant nodules. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for USFNAB of PCTNs were 95.2%, 100%, 100%, 76.9%, and 95.8%, respectively. The data suggest that our technique for US-FNAB of PCTNs was effective and accurate.


    Directory of Open Access Journals (Sweden)

    Joanna Sokołowska


    Full Text Available The presented experiments are aimed at determining: (1 whether risk perception and risk acceptance are two distinct psychological processes and (2 how aspirations affect each process. It has been tested whether risk is independent of and preferences are depend on aspirations. In Experiment 172 employees of a high-tech company were presented with pairs of risky projects. The aspiration level was de fined as the target return on the project and was set through an explicit instruction. In Experiment 2 93 bridge players were presented with pairs of contracts – one a sure thing and the other a risky one. The aspiration level was related to the team IMP points after the first part of a knockout tournament and was set through an instruction. In both experiments with a between-subject design, two different aspiration levels were set for each group. All respondents were asked to judge riskiness of presented options and to select one. The results indicate that risk perception is insensitive to changes in aspirations, but preferences are. This supports distinctness of risk perception and risk cceptance.

  9. Coevolution of aspirations and cooperation in spatial prisoner's dilemma game (United States)

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


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

  10. Ameliorative effect of Leflunomide on lung injury following an aspiration. (United States)

    Yilmaz, M Z; Torun, A C; Guzel, A; Murat, N; Okuyucu, A; Yilmaz, N; Gacar, A; Guvenc, T; Guzel, A


    We aimed to investigate the therapeutic effectiveness of leflunomide (LEF) in lung injury after an aspiration of unknown pathophysiology. Forty-two healthy Sprague Dawley rats were anesthetized and allocated to six experimental groups: saline (S) aspirated, S+LEF, hydrochloric acid (HCl) aspirated, HCl+LEF, formula aspirated (FOR), and FOR+LEF. The treatment groups (S+LEF, HCl+LEF, and FOR+LEF) received 20 mg/kg/day intraperitoneal (i.p.) injection of LEF for seven days. At the end of the seven days, blood and tissue samples were taken from the rats for histopathological, biochemical, and immunohistochemical examination. There was a significant increase in serum levels of YKL-40, a chitinase-like protein, in the HCl group after the aspiration (pacid-reactive species (TBARS) values in the HCl and FOR groups compared to the control group (p=0.001 and p<0.01, respectively). In both treatment groups, the serum TBARS values significantly decreased after treatment with LEF (p=0.001 and p<0.05, respectively). There was a significant improvement in the histopathological scores, which deteriorated after the aspiration, and in the number of inducible nitric oxide synthase (iNOS)-positive cells after treatment with LEF.

  11. Aortic valve debridement by ultrasonic surgical aspirator: a word of caution. (United States)

    Craver, J M


    Aortic stenosis was relieved in 11 patients by ultrasonic debridement of the valve and annulus, while 102 other patients underwent valve replacement for aortic stenosis during 1988. Debridement was selectively applied based on findings of small annulus size (19 mm or less) and extensive calcification. Additional patient characteristics were mean transvalvular gradient of 78 mm Hg, advanced age, and marked left ventricular hypertrophy. Six patients had no residual gradient and 5 others a mean gradient less than 10 mm Hg. There were no complications related to the debridement process. Intraoperative transesophageal Doppler echocardiography demonstrated improved leaflet mobility and elimination of the gradient in all patients and elimination of associated valvular insufficiency in 2 patients. Follow-up echocardiography demonstrated late onset of new valvular regurgitation in 5 patients that was progressive and required reoperation in 3. Thickened, hardened, and retracted valve leaflets with loss of central coaptation were found in all 3 patients who underwent reoperation. Ultrasonic debridement can effectively relieve aortic stenosis, provide an excellent immediate hemodynamic result, and decrease operative time. However, the early occurrence of aortic insufficiency in a high percentage of patients makes it an unacceptable alternative to valve replacement, and the technique should be abandoned as a treatment for severe calcific aortic stenosis.

  12. The effect of bone marrow aspirate, bone graft and collagen composites on fixation of bone implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren


    or allograft (control group). The bone marrow was harvested by aspiration from the proximal part of the tibia. Autologous bone graft harvested from the four drill holes in the femoral condyles. A standardised surgical procedure was used. After surgery the sheep were observed at the outdoor facilities...... part of the implant. Specimens are preserving now at - 20°C and wait for the push-out test which is destructive and will be performed on an 858 Bionex MTS hydraulic material testing machine (MTS system cooperation, Minneapolis, Minnesota, USA). The specimens for histological analysis were taken from...

  13. Treatment of penile strangulation by the rotating saw and 4-needle aspiration method: Two case reports

    Directory of Open Access Journals (Sweden)

    Raidh A. Talib


    Full Text Available Introduction: The aim of this article was to describe our experience in using rotating saw and also combination of the instrument with 4-needle aspiration. Methods: A comprehensive review of the literature was performed using PubMed. “Penile strangulation, -constriction, -incarceration, -entrapment” were used as search terms, and a manual bibliographic review of cross referenced items was performed. Results: Search results yielded nearly 70 cases of penile strangulation caused by a variety of objects. Various instruments have been described in the literature for their safe removal, each with its own pros and cons. Conclusions: Penile strangulation should be accepted as a self-induced priapism and managed as an emergency in order to preserve erectile function and to prevent penile necrosis. Surgical creativity and patience are necessary in order to have a successful outcome.

  14. Treatment of penile strangulation by the rotating saw and 4-needle aspiration method: two case reports. (United States)

    Talib, Raidh A; Canguven, Onder; Al Ansari, Abdulla; Shamsodini, Ahmad


    The aim of this article was to describe our experience in using rotating saw and also combination of the instrument with 4-needle aspiration. A comprehensive review of the literature was performed using PubMed. "Penile strangulation, -constriction, -incarceration, -entrapment" were used as search terms, and a manual bibliographic review of cross referenced items was performed. Search results yielded nearly 70 cases of penile strangulation caused by a variety of objects. Various instruments have been described in the literature for their safe removal, each with its own pros and cons. Penile strangulation should be accepted as a self-induced priapism and managed as an emergency in order to preserve erectile function and to prevent penile necrosis. Surgical creativity and patience are necessary in order to have a successful outcome.

  15. Primary subcutaneous inguinal hydatid cyst: diagnosis by fine needle aspiration cytology. (United States)

    Bagga, Permeet Kaur; Bhargava, Satish Kumar; Aggarwal, Neema; Chander, Yogesh


    Hydatid disease or human cystic echinococcosis, recognized by ancient scholars such as Hippocrates, Galen and Rhazes, is one of the oldest diseases known to man. Though hydatid cyst may develop in almost any part of the body, a solitary primary subcutaneous localization is an extremely rare entity. We herein report a case of primary subcutaneous inguinal hydatid cyst which was diagnosed by fine needle aspiration cytology. Radiological examination done subsequently corroborated with the cytodiagnosis of Hydatid cyst and did not show involvement of any other organ or site. Histopathological examination of surgically removed cyst confirmed the diagnosis of Hydatid cyst. Hydatid disease should be considered in the differential diagnosis of all unusual swellings in soft tissues, especially in regions where the disease is endemic.

  16. Fine needle aspiration cytology of primary thyroid lymphoma: a report of ten cases

    Directory of Open Access Journals (Sweden)

    Gupta Nalini


    Full Text Available Abstract Primary lymphoma is an uncommon malignancy of the thyroid, comprising of 0.6 to 5 per cent of thyroid cancers in most series. Primary thyroid lymphomas (PTL occur most commonly in elderly women and are commonly of B- cell origin. These frequently present in clinical stage IE and IIE. We report here ten cases of PTL diagnosed over a period of about 7 years in our institute. Out of these ten cases, nine were diagnosed on fine needle aspiration cytology (FNAC and one case was misdiagnosed as lymphocytic thyroiditis. This case was diagnosed as Non- Hodgkin's lymphoma on surgical specimen. Five patients are disease free and doing well, while two died of disease and the other two were lost to follow-up. One patient is currently on chemotherapy. The salient clinical, biochemical, radiological features, FNA findings along with diagnostic difficulties are discussed.

  17. Endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of pancreatic masses. (United States)

    Jinga, Mariana; Gheorghe, Cristian; Dumitrescu, Marius; Gheorghe, Liana; Nicolaie, Tudor


    Endoscopic ultrasound (EUS) represents a highly sensitive method for the detection of pancreatic masses. When available, EUS-guided fine needle aspiration (FNA) is the best technique for the diagnosis and staging of pancreatic cancer due to its ability to obtain tissue for diagnosis. The standardized indications for pancreatic EUS-FNA comprise the definite diagnosis of malignancy and histopathological confirmation of adenocarcinoma before surgical resection, chemo/radiotherapy, or celiac plexus neurolysis. The technique of performing EUS-FNA is described in detail, from the vizualization of the target lesion and adequate placement of the transducer to allow optimal needle access, to needle penetration and sampling of the targeted lesion. We report a series of 9 patients who underwent EUS-FNA and shortly review the indications, technique, results and impact of EUS-FNA on the management of these patients.

  18. Meconium aspiration syndrome: do we know? (United States)

    Yurdakök, Murat


    Meconium is a common finding in amniotic fluid and placental specimens, particularly in the term or post-term pregnancy. The most important consequence of meconium-stained amniotic fluid (MSAF) is meconium aspiration syndrome (MAS), and at least 5% of infants born through MSAF develop MAS. MAS continues to be a threat to many newborns throughout the world, with a case fatality rate of 5% (as much as 40%), in addition to short- and long-term pulmonary and neurodevelopmental sequelae. The exact pathophysiology of meconium passage into the amniotic fluid and consequences of meconium aspiration are unknown. There are three prevailing and possibly compatible theories for mechanisms of meconium release. Firstly, meconium passage is probably related with the maturation of the gastrointestinal tract, because meconium passage in the preterm third trimester fetus has been reported to be a rare event, as typically it occurs near or post-term. Secondly, an alternate hypothesis for in utero meconium passage is that pathologic processes, such as stress via hypoxia or infection, can trigger meconium passage. However, the predictive values of MSAF for fetal distress and acidosis at birth are poor and controversial. Thirdly, an alternative route for the presence of MSAF in the presence of fetal hypoxia is reduced clearance of defecated meconium due to impaired fetal swallowing or unidentified placental dysfunction in addition to or instead of an increase in its passage. The pathophysiology of MAS is multifactorial and extremely complex. Meconium causes mechanical obstruction and pulmonary air leak, induces surfactant inactivation, causes pulmonary inflammation, and induces apoptosis. Preventing prolonged pregnancy by labor induction might reduce the risk of MSAF. Labor induction with prostaglandins appears to be associated with the occurrence of MSAF. Amnioinfusion for suspected umbilical cord compression has no clear effect on the occurrence of MSAF. Intrapartum suctioning of the

  19. Micro and macro factors affecting childbearing aspirations. (United States)

    He, Y


    The conclusion of the discussion of factors affecting childbearing aspirations is that both a micro and a macro perspective must be included in an empirical analysis which would be useful for policy decisions. Micro factors tend to the economic function of the family, the economic value of children, cost of labor training, women's occupation, social security, household consumption, and education level. Attention to micro factors is important in the link between individual interests and state family planning (FP) policy. Macro factors tend to be ignored, but also impact on childbearing decisions. Macro factors are economic conditions, social and political factors, culture, and environmental factors such as ecology, natural resources, employment, economic development, and education. Macro factors affect the population as a whole and indirectly impact on individuals and the family. China's achievements in FP policy have been identified as a reduction of 200 million people, a shift in the population reproduction cycle downwards, increased standard of living, reduction in the burden of working people, and stabilization of macro factors. Successful policy should not rely on forced implementation. The past and present policies were successful not because of forced implementation, but because of awareness of macro and micro factors and voluntary use of FP. The voluntary nature of acceptance of FP suggests support for the FP policies. The current focus is on rural areas, and farmers in particular who are only aware of their needs and may feel state policy may interfere with their own interests. Implementation of FP among the rural population would be enhanced with an emphasis on their concerns such as social security in old age, the practical issues of having only daughters, and educational status. Educational campaigns promoting awareness of population pressure are needed and will benefit all the people. Social democratic doctrines can be introduced only from the outside

  20. Risk Factors for Aspiration Pneumonia in Older Adults.

    Directory of Open Access Journals (Sweden)

    Toshie Manabe

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

  1. Hernia Surgical Mesh Implants (United States)

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  2. Urogynecologic Surgical Mesh Implants (United States)

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  3. American Pediatric Surgical Association (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  4. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin


    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  5. Abortion - surgical - aftercare (United States)

    ... this page: // Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  6. Medical versus surgical abortion efficacy, complications and leave of absence compared in a partly randomized study

    DEFF Research Database (Denmark)

    Rørbye, Christina; Nørgaard, Mogens; Nilas, Lisbeth


    To provide optimal information to women choosing between early medical and surgical abortion, rigorous comparisons of the two methods are warranted. We compared the outcome of 1135 consecutive women with gestational age (GA) ... gemeprost) or a surgical abortion (vacuum aspiration in general anesthesia). One hundred eleven of these women were randomized for abortion method. Surgical interventions and complications leading to readmission within the following 15 weeks were identified through a computer system. Information about...... extra unscheduled consultation apart from a routine follow-up visit. We conclude that the chance of a primary successful termination at GA

  7. A 5-year-old girl with a congenital ganglioneuroma diagnosed by fine needle aspiration biopsy: a case report

    Directory of Open Access Journals (Sweden)

    Ponce-Camacho Marco


    Full Text Available Abstract Introduction Ganglioneuroma is a rare, benign, neuroblastic tumor arising mainly from the central or peripheral autonomic nervous system, especially the sympathetic system. The most affected anatomical sites are the posterior mediastinum, retroperitoneum, adrenal gland and head and neck soft tissue. In the current literature, reports of ganglioneuroma diagnosed by fine-needle aspiration and its cytological appearance are scarce. Case Presentation A 5-year-old girl presented with a mass in the cervical region since birth. Laboratory routine tests were within normal limits, ultrasonography demonstrated a solid and well-circumscribed lesion in the soft tissues of the cervical region. Fine needle aspiration biopsy was carried out, and the obtained smears showed a mixture of mature ganglion cells and groups of spindle cells suggestive of schwann cell origin. A diagnosis of ganglioneuroma was suggested. Core biopsy and surgical resection confirmed this diagnosis. Conclusion Congenital ganglioneuroma of the cervical region is an uncommon soft tissue benign neoplasm of neuroblastic origin, and it should be considered in the differential diagnosis of head and neck pediatric soft tissue tumors. Fine needle aspiration biopsy technique is a reliable method that can be used with confidence when dealing with pediatric soft tissue tumors.

  8. Solitary metastatic cancer to the thyroid: a report of five cases with fine-needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Batoroev Yuri


    Full Text Available Abstract Three men and 2 women with ages ranging from 37 to 70 years, clinically and histologically confirmed solitary, palpable metastatic cancers to the thyroid (SMCT and preoperative cytologic investigation of their thyroid lesions by fine-needle aspiration (FNA, were reviewed. Four patients were known to have a solid cancer treated by radical surgery 1 to 4 years prior [1 bronchogenic squamous cell carcinoma, 1 parotid adenoid cystic carcinoma, 1 renal cell carcinoma (RCC and 1 cutaneous melanoma], and 1 patient had no past history of cancer. Direct smears prepared from the patients' thyroid FNAs were fixed in 95% ethanol and stained with the Papanicolaou method. In 3 cases, immunostaining of the aspirated tumor cells with thyroglobulin antibody was performed, and in 1 case an aspiration smear was stained with commercial HMB-45 antibody. A correct cytodiagnosis of metastatic cancer to the thyroid was made in all 5 cases. In 1 patient the thyroid FNA revealed a metastatic RCC that led to the discovery of a clinically occult RCC. All 5 patients died of metastatic disease 27 to 40 months after surgical resection of their SMCTs.

  9. Aspiration in injections: should we continue or abandon the practice? (United States)

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


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

  10. Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients

    Directory of Open Access Journals (Sweden)

    Xiaowen Hu


    Full Text Available OBJECTIVE: Aspiration can cause a variety of pulmonary syndromes, some of which are not well recognized. The objective of this study was to assess the demographic, clinical, radiological, and histopathological correlates of diffuse aspiration bronchiolitis (DAB, a bronchiolocentric disorder caused by recurrent aspiration. METHODS: This was a retrospective study of 20 consecutive patients with DAB seen at the Mayo Clinic in Rochester, Minnesota, between January 1, 1998 and June 30, 2014. RESULTS: The median age of the patients was 56.5 years (range, 22-76 years, and the male/female ratio was 2.3:1.0. In 18 patients, the diagnosis of DAB was based on the results of a lung biopsy; in the 2 remaining patients, it was based on clinical and radiological features, together with documented aspiration observed in a videofluoroscopic swallow study. In 19 patients (95%, we identified predisposing factors for aspiration, including gastroesophageal reflux disease (GERD, drug abuse, and dysphagia. Common presenting features included cough, sputum production, dyspnea, and fever. Twelve patients (60% had a history of recurrent pneumonia. In all of the patients, chest CT revealed bilateral pulmonary infiltrates consisting of micronodules and tree-in-bud opacities. In the majority of patients, interventions aimed at preventing recurrent aspiration (e.g., anti-GERD therapies led to improvement in the symptoms of DAB. CONCLUSIONS: Young to middle-aged subjects with recognizable predisposing factors for aspiration and who report a history of recurrent pneumonia are at increased risk for DAB. Although DAB is not well recognized, certain chest CT features are characteristic of the disorder.

  11. Thermal Measurements of Resonant Ultrasonic Surgical Horn (United States)

    Manandhar, Prakash; Gupta, Saurav V.; Kosenko, Igor V.; Cotter, Daniel J.

    Temperatures at the distal end of the tip in ultrasonic surgical instruments are of interest because this is the applied part to a patient. It is difficult to directly measure these temperatures using contacting temperature sensors due to high vibration levels. Non-contact infrared (IR) thermography could be an important tool to experimentally determine the tip temperature. However, the low emissivity and polished cylindrical geometry of the tips complicate accurate IR thermography. In this study, we use Cr2O3 high emissivity paint to coat the tip for increased accuracy in IR measurements. Temperature measurements are consistent with heat generation models based on mechanical quality factor of about 5000 for the titanium tip material. It was found that no heat is generated at the tip distal end where strain is low. Air cooling by aspiration is effective at keeping tip distal end temperatures at near ambient levels even with heat transfer by conduction from warmer parts of the tip.

  12. Irrigants in non-surgical endodontic treatment. (United States)

    Regan, John D; Fleury, Alex A P


    This paper highlights that one of the main goals of root canal treatment is the elimination of microorganisms from the contaminated root canal system. Instrumentation alone will not allow for adequate debridement and disinfection of the complex and diverse root canal system. Chemomechanical debridement is required. The importance of the use of irrigants during non-surgical root canal treatment has frequently been neglected both during instruction of dental students and later in the clinical practice of endodontics. The article highlights 'shape, clean and fill' vs. 'clean, shape and fill' to enable chemomechanical debridement. Our protocol advises mechanical debridement and copious irrigation for a minimum of twenty minutes with 2.5% to 6% solutions of sodium hypochlorite, followed by a rinse with a 17% solution of ethylenediaminetetraacetic acid and a final rinse with 2% chlorhexidine. The canals are dried with high volume aspirators and sterile paper points.

  13. Clinical practice guideline: tonsillitis II. Surgical management. (United States)

    Windfuhr, Jochen P; Toepfner, Nicole; Steffen, Gregor; Waldfahrer, Frank; Berner, Reinhard


    morbidity in terms of pain and bleeding. Although tonsillar tissue remains along the capsule, the outcome appears not to differ from TE, at least in the pediatric population and young adults. Age and a history of tonsillitis are not a contraindication, abscess formation in the tonsillar remnants is an extremely rare finding. The volume of the tonsils should be graded according to Brodsky and a grade >1 is considered to be eligible for TT. The number of episodes during 12 months prior to presentation is crucial to indicate either TE or TT. While surgery is not indicated in patients with less than three episodes, a wait-and-see policy for 6 months is justified to include the potential of a spontaneous healing before surgery is considered. Six or more episodes appear to justify tonsil surgery. (2) Needle aspiration, incision and drainage, and abscess tonsillectomy are effective methods to treat patients with peritonsillar abscess. Compliance and ability of the patient to cooperate must be taken into account when choosing the surgical method. Simultaneous antibiotic therapy is recommended but still subject of scientific research. Abscess tonsillectomy should be preferred, if complications have occurred or if alternative therapeutic procedures had failed. Simultaneous TE of the contralateral side should only be performed when criteria for elective TE are matched or in cases of bilateral peritonsillar abscess. Needle aspiration or incision and drainage should be preferred if co-morbidities exist or an increased surgical risk or coagulation disorders are present. Recurrences of peritonsillar abscesses after needle aspiration or incision and drainage are rare. Interval TE should not be performed, the approach is not supported by contemporary clinical studies. (3) In patients with infectious mononucleosis TE should not be performed as a routine procedure for symptom control. TE is indicated in cases with clinically significant upper airway obstruction resulting from inflammatory

  14. Laryngeal Elevation Velocity and Aspiration in Acute Ischemic Stroke Patients (United States)

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


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

  15. Can nature make us more caring? Effects of immersion in nature on intrinsic aspirations and generosity. (United States)

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


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

  16. Surgical versus non-surgical management for pleural empyema. (United States)

    Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L


    Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

  17. Development of biopsy gun for aspiration and drug injection. (United States)

    Kang, Hyun Guy; Cho, Sung Ho; Cho, Chang Nho; Kim, Kwang Gi


    Tumor samples are required for pathological examinations, and different instruments are generally used to obtain samples of different types of tumors. Among the many methods available for obtaining tumor tissues, gun biopsy is widely used because it is much simpler than incisional biopsy and can collect many more samples than aspiration biopsy. However, conventional biopsy guns cannot simultaneously perform biopsy aspiration, bleeding prevention, and marker injection. In this study, we developed a biopsy gun that can simultaneously perform biopsy aspiration and sample collection, in addition to injecting a styptic agent and marker to prevent bleeding and contamination in the biopsy track. We then used a prototype to evaluate the feasibility of the developed device. The collectable sample size was also assessed. Performance of the biopsy aspiration feature was also evaluated, including the maximum aspiration viscosity. Finally, we tested the maximum amount of drug that can be injected. We found that the biopsy gun developed here is an alternative tool for biopsy collection with improved procedure safety and diagnostic accuracy.

  18. Thermal blooming on laser propagation in an aspirating pipe (United States)

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


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

  19. Dental prosthesis aspiration: An uncommon cause of respiratory distress. (United States)

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


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

  20. Physiological factors related to aspiration risk: a systematic review. (United States)

    Steele, Catriona M; Cichero, Julie A Y


    Penetration-aspiration is considered the most serious component of oropharyngeal dysphagia. Clinicians regularly evaluate the pathophysiology of swallowing and postulate reasons or mechanisms behind penetration-aspiration. In this article we share the results of a two-stage literature review designed to elucidate the association between abnormalities in physiological measures of swallowing function and the occurrence of penetration-aspiration. In the first stage, a broad scoping review was undertaken using search terms for nine different structures involved in oropharyngeal swallowing. In the second stage, based on the results of the initial search, a more focused systematic review was undertaken which explored the association between aspiration and abnormalities in respiratory, tongue, hyoid, and laryngeal function in swallowing. A total of 37 articles underwent detailed quality review and data extraction in the systematic review. The results support measurement of tongue strength, anatomically normalized measures of hyoid movement, bolus dwell time in the pharynx while the larynx remains open, respiratory rate, and respiratory swallow phasing as parameters relevant to aspiration risk.

  1. Implications of stroke for caregiver outcomes: findings from the ASPIRE-S study. (United States)

    Atteih, Samar; Mellon, Lisa; Hall, Patricia; Brewer, Linda; Horgan, Frances; Williams, David; Hickey, Anne


    Informal caregivers are vital to the long-term care and rehabilitation of stroke survivors worldwide. However, caregiving has been associated with negative psychological outcomes such as anxiety and depression, which leads to concerns about caregiver as well as stroke survivor well-being. Furthermore, caregivers may not receive the support and service provision they require from the hospitals and community. This study examines caregiver psychological well-being and satisfaction with service provision in the context of stroke. Caregiver data were collected as part of the ASPIRE-S study, a prospective study of secondary prevention and rehabilitation which assessed stroke patients and their carers at six-months post stroke. Carer assessment included measurement of demographics, satisfaction with care (UK Healthcare Commission National Patient Survey of Stroke Care), psychological distress (Hospital Anxiety and Depression Scale), and vulnerability (Vulnerable Elders Scale). Logistic regression analyses and chi-squared tests were performed using stata version 12. Analyses from 162 carers showed substantial levels of dissatisfaction (37·9%) with community and hospital services, as well as notable levels of anxiety (31·3%) and depressive symptoms (18·8%) among caregivers. Caregiver anxiety was predicted by stroke survivor anxiety (OR = 3·47, 95% CI 1·35-8·93), depression (OR = 5·17, 95% CI 1·83-14·58), and stroke survivor cognitive impairment (OR 2·35, 95% CI 1·00-5·31). Caregiver depression was predicted by stroke survivor anxiety (OR = 4·41, 95% CI 1·53-12·72) and stroke survivor depression (OR = 6·91, 95% CI 2·26-21·17). Findings indicate that caregiver and stroke survivor well-being are interdependent. Thus, early interventions, including increased training and support programs that include caregivers, are likely to reduce the risk of negative emotional outcomes. © 2015 World Stroke Organization.

  2. Surgical Lasers In Gynecology (United States)

    Schellhas, Helmut F.; Barnes, Alfonso E.


    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  3. Performance comparison of the Alcon Legacy 20000 straight and flared 0.9 mm Aspiration Bypass System tips. (United States)

    Davison, James A


    To compare the efficiency of surgical procedures using 2 phacoemulsification tips. Wolfe Clinic, Marshalltown, Iowa, USA. A randomized prospective study of 256 consecutive cases was conducted. The patients were adults having phacoemulsification by a modified in situ fracture technique. All cases were done by 1 surgeon using the Alcon Legacy 20000 phacoemulsification machine with high-vacuum cassettes and tubing. One of 2 45-degree Aspiration Bypass System (ABS) phacoemulsification tips was used. The straight tip has a 0.9 mm outside diameter (n = 127). The flared tip has a 0.76 mm outside diameter shaft that flares to a 1.02 mm tip (n = 129). Measurements at the time of surgery included metered phacoemulsification time, percentage power used, total phacoemulsification time, and milliliters of balanced salt solution (BSS(R)) used. No posterior capsule tear, vitreous loss, incision thermal damage, incision leak, or suture closure occurred. There were no cases of iris aspiration into the working end of the phacoemulsification needle; however, the iris was aspirated into the ABS opening of the flared tip in 1 case. Similar measurements for the straight and flared tips included, respectively, metered phacoemulsification time, 1.4 minutes each; mean power percentage, 41% and 39%; total phacoemulsification time, 2 minutes 11 seconds and 2 minutes 15 seconds; and overall BSS volume, 77 mL and 75 mL. The anterior capsule tear rates for straight (5.5%) and flared (1.6%) tips were similar. The flared ABS phaco tip with a 0.76 mm shaft outside diameter provided the physical advantages of shaft diameter reduction and required ultrasonic energy expenditures, BSS volumes, and surgical times similar to those of the straight ABS ultrasonic tip with a 0.9 mm outside diameter.

  4. Fine needle aspiration cytology of bone tumours- the experience from the National Orthopaedic and Lagos University Teaching Hospitals, Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Nnodu Obiageli E


    Full Text Available Abstract Background Due to difficulty in confirming clinical suspicions of malignancy in patients presenting with bone tumours, the cost of surgical biopsies where hospital charges are borne almost entirely by patients, competition with bone setters and healing homes with high rate of loss to follow up; we set out to find if sufficient material could be obtained to arrive at reliable tissue diagnosis in patients with clinical and radiological evidence of bone tumours in our hospitals. Methods After initial clinical and plain radiographic examinations, patients were sent for fine needle aspirations. Aspirations were carried out with size 23G needles of varying lengths with 10 ml syringes in a syringe holder (CAMECO, Sebre Medical, Vellinge, Sweden. The aspirates were air dried, stained by the MGG method and examined microscopically. Histology was performed on patients who had subsequent surgical biopsy. These were then correlated with the cytology reports. Results Out of 96 patients evaluated, [57 males, 39 females, Mean age 31.52 years, Age Range 4–76 years,] material sufficient for diagnosis was obtained in 90 patients. Cytological diagnosis of benign lesions was made in 40 patients and malignant in 47. Of these, 27 were metastases, osteogenic sarcoma 16, giant cell tumour 19, infection 11. Histology was obtained in 41 patients. Correct diagnosis of benignity was made in 17 out of 18 cases, malignancy in 21 out of 22 cases. One non-diagnostic case was malignant. The accuracy of specific cytological diagnosis was 36/41 (87.8% and incorrect in 5/41 (12.2%. Conclusion We conclude that FNAC can be useful in the pre-operative assessment of bone tumours especially where other diagnostic modalities are unavailable.

  5. Going beyond "Basaloid neoplasm": Fine needle aspiration cytology of epithelial-myoepithelial carcinoma of the parotid gland. (United States)

    Molnar, Stacy L; Zarka, Matthew A; De Las Casas, Luis E


    Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland malignancy with variable cytologic findings. Its rarity, variable morphologic findings, and similarities with more common salivary gland entities make it a difficult cytologic diagnosis. As the name signifies, the key feature of this tumor is presence of an epithelial and myoepithelial component. However, when one of these two components is scant on the fine needle aspiration (FNA) smears, it may be overlooked. We present a case from a 62 year-old female who presented to the clinic with a parotid nodule and episodes of sharp, throbbing pain. A fine needle aspiration was performed which revealed a highly cellular specimen comprised primarily of aggregates of cells with small, round nuclei and scant to absent cytoplasm. Abundant hyaline stromal material was also noted. The case was signed out as basaloid neoplasm with a recommendation for surgical resection. The subsequent resection specimen revealed EMC. By reviewing the FNA specimen following the surgical resection of the tumor, we were able to utilize the benefit of hindsight to more clearly identify the subtle, biphasic components of the tumor.

  6. Different approaches to caudate lobectomy with "curettage and aspiration" technique using a special instrument PMOD: A Report of 76 cases

    Institute of Scientific and Technical Information of China (English)

    Shu-You Peng; Cheng-Hong Peng; Jiang-Tao Li; Yi-Ping Mou; Ying-Bin Liu; Yu-Lian Wu; He-Qing Fang; Li-Ping Cao; Li Chen; Xiu-Jun Cai


    AIM: To study different approaches to caudate lobectomy with "curettage and aspiration" technique using Peng's multifunctional operative dissector (PMOD). The surgical procedure of isolated complete caudate lobectomy was specially discussed.METHODS: In 76 cases of various types of caudate lobectomy, three approaches were used including left side approach, right side approach, and anterior approach.Among the 76 cases, isolated complete caudate lobectomy was carried out in 6 cases with transhepatic anterior approach. The surgical procedure consisted of mobilization of the total liver, ligation and separation of the short hepatic veins, splitting the liver parenchyma through the Cantlie's plane, ligation and division of the caudate portal triads from the hilum, dissection of the root of major hepatic veins,detachment of the caudate lobe from liver parenchyma.RESULTS: The mean operative time was 285±51 min,the mean blood loss was 1 600 mi. No severe complications were observed. Among the 6 cases receiving isolated complete caudate lobectomy with transhepatic anterior approach, one case died 17 months after operation due to disease recurrence and liver failure, the other 5 cases have been alive without recurrence, with one longest survival of 49 months.CONCLUSION: The choice of approach is essential to the success of caudate lobectomy. As PMOD and "curettage and aspiration" technique can delineate intrahepatic or extrahepatic vessels clearly, caudate lobe resection has become safer, easier and faster.

  7. Analysis of fatty acid composition in human bone marrow aspirates. (United States)

    Deshimaru, Ryota; Ishitani, Ken; Makita, Kazuya; Horiguchi, Fumi; Nozawa, Shiro


    In the present study, the fatty acid composition of bone marrow aspirates and serum phospholipids in nine patients with hematologic diseases was investigated, and the effect of fatty acids on osteoblast differentiation in ST2 cells was examined. The concentrations of oleic acid and palmitic acid were significantly higher in bone marrow aspirates than in serum phospholipids, but the concentrations of other fatty acids did not differ. The rate of alkaline phosphatase positive ST2 cells induced by BMP2 was significantly increased by oleic acid, but was unaffected by the presence or absence of palmitic acid. We conclude that the fatty acid composition of bone marrow aspirates differs from that of serum phospholipids. This difference may affect osteoblast differentiation in the bone marrow microenvironment.

  8. [Recommendations for the prevention of foreign body aspiration]. (United States)

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


    The aspiration of a foreign body remains a common paediatric problem, with serious consequences that can produce both acute and chronic disease. Aspiration usually causes a medical emergency that requires a prompt diagnosis and an urgent therapeutic approach as it may result in the death of the child or severe brain injury. It typically involves organic foreign bodies (mainly food or nuts) aspirated by children under 5 years old, and usually at home. In this statement, the Committee on Safety and Prevention of Non-Intentional Injury in Childhood of the Spanish Paediatrics Association provides a series of recommendations, both educational (while eating and playing), as well as legal, to prevent such episodes. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Fine needle aspiration cytology of palpable supraclavicular lymph nodes

    Directory of Open Access Journals (Sweden)

    RC Adhikari


    Full Text Available Background: Fine needle aspiration cytology as a first line of investigation has assumed importance in diagnosing a variety of disease process. The aim of this study was to assess the diagnostic value of fine needle aspiration cytology in the evaluation of palpable supraclavicular lymph nodes. Materials and methods: This was a retrospective study of fine needle aspiration cytology of palpable supraclavicular lymph node done between January 1, 2007 and December 31, 2009. Fine needle aspiration cytology was performed on 149 patients (49 cases at Om Hospital & Research Centre and 100 cases at Tribhuvan University Teaching Hospital. Results: The right supraclavicular lymph node was enlarged in 55% cases, while the left supraclavicular lymph node alone was palpable in 40.3% cases and in 7 of 149 (4.7% cases, bilateral supraclavicular lymph nodes were palpable. Cytological diagnoses were categorized as reactive (8.7%, tuberculosis (41.6%, lymphoma (4.8% and metastasis (44.9%. Of a total of 74 cases of malignancy, 90.5% were non-lymphoid and 9.5% were lymphoid (5 Non-Hodgkin lymphoma and 2 Hodgkin lymphoma. Of the 67 cases of metastatic disease, three major types of malignancy found in supraclavicular lymph nodes were Squamous cell carcinoma (28 cases, adenocarcinoma (21 cases and others (small cell carcinoma, papillary thyroid carcinoma etc. Adenocarcinoma tended to metastasize to the left supraclavicular lymph node. Lung was the most common primary site (43.3%, followed by stomach, ovary, breast and larynx. However, in 28.4% cases, no primary site was found. Conclusion: The fine needle aspiration cytology can be used as a first line investigation in the evaluation of supraclavicular lymphadenopathy due to its low cost, simplicity and minimal invasiveness. Keywords: Supraclavicular lymph node; Fine needle aspiration cytology; Metastasis DOI: 10.3126/jpn.v1i1.4441 Journal of Pathology of Nepal (2011 Vol.1, 8-12  


    Directory of Open Access Journals (Sweden)

    Jathin Sam


    Full Text Available Intratonsillar abscess is a rare complication of acute tonsillitis. It is a rarely diagnosed infection occurring in both children and adults. Herein, we present a case of intratonsillar abscess in a 25-year-old female patient, who was managed by needle aspiration which is a minimally invasive procedure and it is low cost, safe and effective along with antibiotic therapy. The aspiration of the pus from the tonsil confirms the diagnosis of intratonsillar abscess. So intratonsillar abscesses are uncommon, but should be considered in the differential diagnosis of peritonsillar abscess and tonsillitis.

  11. Frontal sinus osteoma removal with the ultrasonic bone aspirator. (United States)

    Ehieli, Eric; Chu, Jaemi; Gordin, Eli; Pribitkin, Edmund A


    Osteomas, the most common skull tumors, are typically excised through either an open or endoscopic ostectomy using a high-speed drill, a technically challenging procedure that can result in injury to adjacent soft tissue structures. Osteoma removal through ultrasonic bone emulsification and aspiration (UBA) offers the advantages of decreased blood loss, preservation of adjacent soft tissue structures, and precise bone removal. UBA was used to successfully remove a forehead osteoma without injury to adjacent nerves and with a satisfactory cosmetic outcome. We describe skull osteoma removal with an ultrasonic bone aspirator, which offers potential advantages over conventional bone removal techniques.

  12. AstroBiology Explorer Mission Concepts (ABE/ASPIRE) (United States)

    Sandford, Scott; Ennico, Kimberly A.


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

  13. The utility of p16 immunostaining in fine needle aspiration in p16-positive head and neck squamous cell carcinoma. (United States)

    Xu, Bin; Ghossein, Ronald; Lane, Jason; Lin, Oscar; Katabi, Nora


    Many patients with human papillomavirus (HPV)-related head and neck squamous cell carcinoma present initially with cervical nodal metastasis. Fine needle aspiration (FNA) of the nodal disease might be the only diagnostic material available for p16 immunohistochemistry (IHC) and HPV testing. The current study aims to evaluate p16 IHC in FNA and establish guidelines for its interpretation. The percentage and intensity of p16 IHC staining were examined in 60 matched FNA and surgical cases. Cytomorphologic features were included in the analysis. p16 IHC staining was correlated with the results seen in the surgical specimens and with HPV in situ hybridization (ISH). Analysis of different thresholds demonstrated that the threshold of 10% p16 tumor cell positivity had the best overall concordance rate with surgical p16 IHC (κ = 0.650) and with FNA HPV-ISH (κ = 0.714). Applying the recommended p16 positivity threshold for surgical specimens (70%) on FNA materials resulted in low sensitivity (39%) and low negative predictive value (26%). In comparison with p16 IHC in surgical specimens, 6/46 FNA cases (13%) were falsely negative for p16. All 6 cases were associated with necrotic background, two (33%) lacked large tumor clusters, and one (17%) had low cellularity. The recommended threshold for p16 IHC on surgical specimens should not be used in cytology materials. The cutoff value for p16 immunostain in FNA specimens showing best results in our series is 10%. When p16 IHC is negative in FNA specimens, a repeat stain on a surgical specimen is recommended to avoid a false-negative diagnosis.

  14. Endoscopic ultrasound with fine needle aspiration and biopsy in lung cancer and isolated mediastinal lymphadenopathy.

    LENUS (Irish Health Repository)

    Nadarajan, P


    Endoscopic ultrasound with fine-needle aspiration and biopsy (EUS-FNAB) is well established in diagnosing and staging lung cancer in patients with mediastinal adenopathy. EUS-FNAB is highly sensitive, less invasive and has lower complication rates when compared to surgical staging of mediastinal nodes. In this study we describe our experience of EUS-FNAB in lung cancer and other causes of mediastinal lymphadenopathy. EUS-FNAB was performed for assessment of PET positive mediastinal lymph nodes between January 2007 and March 2009 in AMNCH. The endpoints of our study were sensitivity and specificity of EUS-FNAB, morbidity and length of hospital stay. Thirty four patients underwent EUS-FNAB during the study period for both diagnosis and staging. Thirty patients had positive lymph node invasion and 4 had no evidence of malignant invasion. In these 4 patients negative cytology was confirmed on mediastinoscopy giving EUS-FNAB a sensitivity and specificity of 100%. EUS-FNAB upstaged the disease in 12 patients. EUS-FNAB is a reliable tool for mediastinal staging in lung cancer, significantly reducing the need for surgical staging procedures in patients with suspected mediastinal involvement.

  15. A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis. (United States)

    Kim, Joon Yub; Chung, Seok Won; Kim, Joo Hak; Jung, Jae Hong; Sung, Gwang Young; Oh, Kyung-Soo; Lee, Jong Soo


    Olecranon bursitis might be a minor problem in the outpatient clinic but relatively be common to occur. However, there are few well-designed studies comparing approaches to treatment. (1) Which treatment (compression bandaging with nonsteroidal antiinflammatory drugs [NSAIDs], aspiration, or aspiration with steroid injections) is associated with the highest likelihood of resolution of nonseptic olecranon bursitis? (2) Which treatment is associated with earliest resolution of symptoms? (3) What factors are associated with treatment failure by 4 weeks? We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each). The groups were similar at baseline in terms of age and gender. Seven patients (four from Group A and three from Group AS) were lost to followup. All patients were followed up weekly for 4 weeks, and the same treatment procedure was repeated if the bursitis recurred with any substantial fluid collection. At 4 weeks, the state of resolution and pain visual analog scale (VAS) were evaluated. Failed resolution was defined as presence of persistent olecranon bursal fluid collection at Week 4 after the initiation of the treatment; on the contrary, if bursal fluid collection was clinically reduced or completely disappeared by the end of Week 4, the treatment was considered successful. We compared the proportion of resolution by Week 4 and the median times to resolution among the treatment groups. In addition, we evaluated whether the resolution affected pain VAS and what factors were associated with the resolution. There were no differences in the proportion of patients whose bursitis resolved by Week 4

  16. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría


    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  17. Spinal epidural abscess successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy: case report and review of the literature. (United States)

    Lyu, Rong-Kuo; Chen, Chi-Jen; Tang, Lok-Ming; Chen, Sien-Tsong


    We describe a case of a posterior spinal epidural abscess that was successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy. A 48-year-old man experienced acute pain in the paralumbar region for 1 week, followed by gait disturbance and micturition difficulty. Laboratory studies demonstrated leukocytosis and hyperglycemia. Blood cultures yielded Staphylococcus aureus. Magnetic resonance imaging scans of the thoracolumbar spine revealed a posterior spinal epidural abscess located between L2 and the lower cervical spine. The patient's low back pain persisted despite 10 days of antibiotic therapy. Therefore, percutaneous, computed tomography-guided, needle aspiration was performed. The low back pain was relieved dramatically and immediately after the procedure. The spinal epidural abscess completely resolved after 6 weeks of antibiotic treatment. Surgical decompression and antibiotic therapy are the treatments of choice for patients with spinal epidural abscesses. Selected patients may be treated nonsurgically. Rarely, percutaneous drainage of the abscess has been reported to be helpful. Our case suggests that percutaneous, computed tomography-guided, needle aspiration might be a rational alternative to surgical decompression for treatment of spinal epidural abscesses.

  18. Adaptive aspirations and performance heterogeneity : Attention allocation among multiple reference points

    NARCIS (Netherlands)

    Blettner, D.P.; He, Z.; Hu, S.; Bettis, R.


    Organizations learn and adapt their aspiration levels based on reference points (prior aspiration, prior performance, and prior performance of reference groups). The relative attention that organizations allocate to these reference points impacts organizational search and strategic decisions. Howeve

  19. The Path Taken: Consequences of Attaining Intrinsic and Extrinsic Aspirations in Post-College Life. (United States)

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


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

  20. Sex Differences in the Determination of Adolescent Aspirations: A Review of Research. (United States)

    Marini, Margaret Mooney


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

  1. Clinical audit of ultrasound guided fine needle aspiration in a general cytopathology service

    Directory of Open Access Journals (Sweden)

    Gunjan Mangla


    Conclusions: Reporting practices varied and did not conform to a uniform structure. The inadequacy rates of breast and thyroid aspirates were comparable to the rates in the literature. Comparable studies were not available for intra-abdominal aspirates.

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

    Directory of Open Access Journals (Sweden)

    Mgando Joseph


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

  3. Optimal timing for a repeat fine-needle aspiration biopsy of thyroid nodule following an initial nondiagnostic fine-needle aspiration. (United States)

    Deniwar, Ahmed; Hammad, AbdulRahman Y; Ali, Daniah Bu; Alsaleh, Nuha; Lahlouh, Maha; Sholl, Andrew B; Moroz, Krzysztof; Aslam, Rizwan; Thethi, Tina; Kandil, Emad


    In the case of a nondiagnostic thyroid fine-needle aspiration (FNA) biopsy result, recent guidelines from the Bethesda system recommend repeat thyroid FNA after 3 months to prevent false-positive results. We aimed to examine our institutional data to determine whether the 3-month period affects the diagnostic yield of repeat biopsies. A retrospective review of patient records over a 5-year period at our institution was performed. Patients who required repeat FNA due to nondiagnostic results were included. The time between the FNA biopsies, adequacy of the FNA specimens, as well as the surgical pathology diagnosis were analyzed. We identified 317 patients who required a repeat FNA. Of these, 96 (30.3%) patients had repeat FNAs less than 3 months after initial biopsy, while 221 (69.7%) patients had repeat FNAs in greater than 3 months. One hundred five patients were referred to our clinic with an initial nondiagnostic biopsy from an outside institution. Repeat FNA was nondiagnostic in 35 patients (11.04%) in the total study population. There was no difference in satisfactory diagnostic yield between repeat FNAs performed greater than 3 months (201 patients, 90.95%) or less than 3 months (81 patients, 84.38%) after the initial biopsy (P = .117). Of the 35 patients with repeat nondiagnostic biopsy, 17 patients underwent diagnostic lobectomy and 3 (17.6%) patients were found to have malignant disease. Early (biopsy interval would alleviate stress on patients with benign nodules and expedite surgical intervention in patients with malignancy. Published by Elsevier Inc.

  4. Adolescent Boys' Science Aspirations: Masculinity, Capital, and Power (United States)

    Archer, Louise; DeWitt, Jennifer; Willis, Beatrice


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

  5. Pain During Bone Marrow Aspiration: Prevalence and Prevention

    NARCIS (Netherlands)

    Vanhelleputte, P.; Nijs, K.A.N.D.; Delforge, M.; Evers, G.; Vanderschueren, S.


    The Prevalence, intensity, determinants and prevention of pain during bone marrow aspiration (BMA) in adults are not well defined. In the first part of this prospective study (observational phase), 132 adult hematological patients undergoing BMA after local anesthesia scored the procedural pain by

  6. Auditing Inequity: Teaching Aspiring Administrators to Be Social Justice Leaders (United States)

    Hernandez, Frank; Marshall, Joanne


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

  7. First-Year Student Aspirations: A Multinodal Analysis (United States)

    Grellier, Jane


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

  8. Women Teachers' Aspirations to School Leadership in Uganda (United States)

    Sperandio, Jill; Kagoda, Alice Merab


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

  9. Bacteriology of aspiration pneumonia in patients with acute coma. (United States)

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


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

  10. Women Teachers' Aspirations to School Leadership in Uganda (United States)

    Sperandio, Jill; Kagoda, Alice Merab


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

  11. The Intangibles: Advice for New and Aspiring Heads (United States)

    Walsh, Matthew J.


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

  12. Experimental Investigation of a High Pressure Ratio Aspirated Fan Stage (United States)

    Merchant, Ali; Kerrebrock, Jack L.; Adamczyk, John J.; Braunscheidel, Edward


    The experimental investigation of an aspirated fan stage designed to achieve a pressure ratio of 3.4:1 at 1500 ft/sec is presented in this paper. The low-energy viscous flow is aspirated from diffusion-limiting locations on the blades and flowpath surfaces of the stage, enabling a very high pressure ratio to be achieved in a single stage. The fan stage performance was mapped at various operating speeds from choke to stall in a compressor facility at fully simulated engine conditions. The experimentally determined stage performance, in terms of pressure ratio and corresponding inlet mass flow rate, was found to be in good agreement with the three-dimensional viscous computational prediction, and in turn close to the design intent. Stage pressure ratios exceeding 3:1 were achieved at design speed, with an aspiration flow fraction of 3.5 percent of the stage inlet mass flow. The experimental performance of the stage at various operating conditions, including detailed flowfield measurements, are presented and discussed in the context of the computational analyses. The sensitivity of the stage performance and operability to reduced aspiration flow rates at design and off design conditions are also discussed.

  13. Pain During Bone Marrow Aspiration: Prevalence and Prevention

    NARCIS (Netherlands)

    Vanhelleputte, P.; Nijs, K.A.N.D.; Delforge, M.; Evers, G.; Vanderschueren, S.


    The Prevalence, intensity, determinants and prevention of pain during bone marrow aspiration (BMA) in adults are not well defined. In the first part of this prospective study (observational phase), 132 adult hematological patients undergoing BMA after local anesthesia scored the procedural pain by m

  14. The Role of Parent Expectations on Adolescent Educational Aspirations (United States)

    Kirk, Chris Michael; Lewis-Moss, Rhonda K.; Nilsen, Corinne; Colvin, Deltha Q.


    Parental expectations have long been studied as a factor in increasing adolescent educational aspirations, often linking these expectations to parental level of education and involvement in academic endeavours. This study further explores this relationship in a statewide Midwestern sample of parents and their adolescent children. Regression…

  15. Occurrence of aspiration pneumonia in dysphagic children post video fluoroscopy

    Directory of Open Access Journals (Sweden)

    Lagos, Hellen Nataly Correia


    Full Text Available Introduction: The literature reports that when it comes of instrumental assessment of swallowing in children, undoubtedly, video fluoroscopy of swallow offers great advantages over the endoscopic study. Objective: Check the risk of aspiration pneumonia after the study of swallowing by video fluoroscopy, in children with dysphagia. Method: In a study of prospective cutting, participated 16 children aged between 6 months and 10 years, with an average of 5,2 years, referred for study of swallowing by video fluoroscopy. Were tested 4 consistencies, pudding, nectar, honey and liquid. The presences of signs and/or respiratory symptoms were evaluated pre and post study of deglutition by video fluoroscopy, through history and clinical exam. When necessary was asked chest x-ray. Results: Of 16 children, 5 didn't presented dysphagia. In 11 children the exam showed 4 with mild dysphagia, 2 moderate and 5 severe, as classification of OTT (1996 - Classification of severity of dysphagia to the video fluoroscopy. Of the 7 children who aspirated during the exam, only 1 presented respiratory symptoms after the deglutition study, but without signal of pneumonia to the physical examination. Conclusion: In the studied population there were no occurrences of aspiration pneumonia after the study of deglutition was performed by video fluoroscopy, despite the occurrence of aspiration during the exam in about 50% of cases.

  16. A microfluidic AFM cantilever based dispensing and aspiration platform

    NARCIS (Netherlands)

    Van Oorschot, R.; Perez Garza, H.H.; Derks, R.J.S.; Staufer, U.; Ghatkesar, M.K.


    We present the development of a microfluidic AFM (atomic force microscope) cantilever-based platform to enable the local dispensing and aspiration of liquid with volumes in the pico-to-femtoliter range. The platform consists of a basic AFM measurement system, microfluidic AFM chip, fluidic interface

  17. Understanding Graduate School Aspirations: The Effect of Good Teaching Practices (United States)

    Hanson, Jana M.; Paulsen, Michael B.; Pascarella, Ernest T.


    This study examined the effects of good teaching practices on post-baccalaureate degree aspirations using logistic regression techniques on a multi-institutional, longitudinal sample of students at 4-year colleges and universities in the USA. We examined whether eight good teaching practices (non-classroom interactions with faculty, prompt…

  18. Transtracheal aspiration in pulmonary infection in children with cystic fibrosis. (United States)

    Brook, I; Fink, R


    Six transtracheal aspirations (TTA) and expectorated sputum specimens were collected from four children suffering from cystic fibrosis who had pulmonary infection. Specimens obtained from both sites were cultured for aerobic bacteria and TTA aspirates were also cultured for anaerobes. Differences in bacteria isolated in TTA and sputum aspirates were present in all instances. Six isolates were recovered in both sites (three Pseudomonas aeruginosa, two Staphylococcus aureus and one Aspergillus flavus). Five aerobic isolates were recovered only in the expectorated sputum and not in TTA aspirations (two Klebsiella pneumoniae and one each of P. aeruginosa, Escherichia coli and Proteus mirabilis). Nine organisms were isolated only from the TTA (two each of Veillonella parvula and Alpha hemolytic streptococci, and one each of Bacteroides fragilis, B. melaninogenicus, Lactobacillus sp., Haemophilus influenzae and Gamma hemolytic streptococci). The recovery of anaerobic organisms from four of the six TTA specimens suggests a possible role for these organisms in the etiology of pulmonary infection in cystic fibrosis. We found TTA to be helpful in the bacterial diagnosis and management of pulmonary infections in cystic fibrosis.

  19. Factors Affecting the Career Aspirations of Asian Americans. (United States)

    Leung, S. Alvin

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

  20. Bio rapid prototyping by extruding/aspirating/refilling thermoreversible hydrogel

    Energy Technology Data Exchange (ETDEWEB)

    Iwami, K; Noda, T; Ishida, K; Umeda, N [Department of Mechanical Systems and Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588 (Japan); Morishima, K [Department of Bio-Applications and Systems Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588 (Japan); Nakamura, M, E-mail: [Department of Life Sciences and Bioengineering, University of Toyama, 3190 Gofuku, Toyama, 930-8555 (Japan)


    This paper reports a method for rapid prototyping of cell tissues, which is based on a system that extrudes, aspirates and refills a mixture of cells and thermoreversible hydrogel as a scaffold. In the extruding mode, a cell-mixed scaffold solution in the sol state is extruded from a cooled micronozzle into a temperature-controlled substrate, which keeps the scaffold in the gel state. In the aspiration mode, the opposite process is performed by Bernoulli suction. In the refilling mode, the solution is extruded into a groove created in the aspiration mode. The minimum width of extruded hydrogel pattern is 114 +- 15 mum by employing a nozzle of diameter 100 mum, and that of aspirated groove was 355 +- 10 mum using a 500 mum-diameter nozzle. Gum arabic is mixed with the scaffold solution to avoid peeling-off of the gel pattern from the substrate. Patterning of Sf-9 cell tissue is demonstrated, and the stability of the patterned cell is investigated. This system offers a procedure for rapid prototyping and local modification of cell scaffolds for tissue engineering.

  1. Effects of coda voicing and aspiration on Hindi vowels (United States)

    Lampp, Claire; Reklis, Heidi


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

  2. Surgical ethics and the challenge of surgical innovation. (United States)

    Angelos, Peter


    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  3. Surgical Treatment of Hashimoto's with Thyroid Microcarcinoma. (United States)

    Tao, Liu; Xi-Lin, H; Xiang-Dong, M


    The aim of this study is to explore the surgical strategies for treating Hashimoto's disease complicated with thyroid microcarcinoma. We analyzed the clinical data of 25 patients with Hashimoto's disease with thyroid microcarcinoma who were treated in our hospital from January 1995 to September 2011. The incidence of Hashimoto's disease with thyroid microcarcinoma was 9.8 % (25/256) in our hospital. Amongst them, 19 patients had papillary thyroid carcinoma and six had follicular thyroid carcinoma. There were 24 cases (96 %) confirmed by the frozen section examination and one (4 %) after surgery. One patient did not undergo remedial surgery. The surgical approaches were determined based on preoperative examinations and intraoperative frozen pathology, including thyroid lobe and isthmus resection with contralateral lobe subtotal resection in 19 cases, and bilateral subtotal thyroid lobectomy in one case. Central lymph node dissection was conducted for all patients except one who was not diagnosed until after the surgery. No recurrence occurred during the follow-up (range: 6 months to 17 years) and all patients have survived to date. The preoperative diagnosis rate of Hashimoto's disease with thyroid cancer (in particular thyroid microcarcinomas) is low. Preoperative palpation, color Doppler ultrasound, fine needle aspiration, and the frozen section examination are helpful to improve the diagnosis rate of Hashimoto's disease with thyroid microcarcinoma. Surgery procedure is the most effective approach.

  4. Surgical management of polycystic liver disease

    Institute of Scientific and Technical Information of China (English)


    Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is a distinct form of autosomal dominant PCLD that arises without concomitant ADPKD. Early knowledge of the pathogenesis was gained from the study of hepatic cysts in patients with ADPKD. Bile duct overgrowth after embryogenesis results in cystic hepatic dilatations that are known as biliary microhamartomas or von Meyenburg complexes. Further dilatation arises from cellular proliferation and fluid secretion into these cysts.There is a variable, broad spectrum of manifestations of PCLD. Although PCLD is most often asymptomatic,massive hepatomegaly can lead to disabling symptoms of abdominal pain, early satiety, persistent nausea,dyspnea, ascites, biliary obstruction, and lower body edema. Complications of PCLD include cyst rupture and cyst infection. Also, there are associated medical problems, especially intracranial aneurysms and valvular heart disease, which clinicians need to be aware of and evaluate in patients with PCLD. In asymptomatic patients, no treatment is indicated for PCLD. In the symptomatic patient, surgical therapy is the mainstay of treatment tailored to the extent of disease for each patient. Management options include cyst aspiration and sclerosis, open or laparoscopic fenestration, liver resection with fenestration, and liver transplantation.The surgical literature discussing treatment of PCLD,including techniques, outcomes, and complication rates,are summarized in this review.

  5. 77 FR 38884 - Professional Transportation, Inc.-Asset Acquisition-CUSA ES, LLC and CUSA CSS, LLC (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION.... 105(a), 363 and 365 and Fed. R. Bankr. P. 2002, 6004, 6006, and 9014, and the bankruptcy court's order...., Washington, DC 20530; (3) the U.S. Department of Transportation, Office of the General Counsel, 1200...

  6. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.


    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  7. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.


    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  8. Validity of Vocational Aspirations and Interest Inventories: Extended, Replicated, and Reinterpreted. (United States)

    Holland, John L.; And Others


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

  9. Swiss Adolescents' Career Aspirations: Influence of Context, Age, and Career Adaptability (United States)

    Hirschi, Andreas


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

  10. Parental Influence on Mainland Chinese Children's Career Aspirations: Child and Parental Perspectives (United States)

    Liu, Jianwei; McMahon, Mary; Watson, Mark


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

  11. Treatment of bacterial brain abscess by repeated aspiration. Follow up by serial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Masaaki; Fukushima, Takeo; Hirakawa, Katsuyuki; Kimura, Hideo; Tomonaga, Masamichi [Fukuoka Univ. (Japan). School of Medicine


    Bacterial brain abscess often requires repeated aspiration before the abscess finally resolves. However, there are no guidelines for treatment by aspiration; for example, when should the abscess be tapped again, or when can an abscess be treated by antibiotics alone without further aspiration. Eleven patients with bacterial brain abscess treated by aspiration were evaluated to establish treatment guidelines for brain abscess, in particular the abscess size on serial computed tomography (CT) after aspiration. CT was performed about 24 hours after aspiration to evaluate the size of the abscess, and almost weekly during follow up. The diameter of the brain abscess before and after the initial and last aspirations were reviewed. In eight of the 11 patients, abscesses were aspirated repeatedly: two to three times in most patients. The diameter of the abscesses was 2.5-4.5 cm (mean 3.5 cm) before the last aspiration, and 1.4-3.4 cm (mean 2.3 cm) after the last aspiration, or when continuous drainage was discontinued. Perifocal edema was moderately decreased within 3 weeks after the last aspiration by medical treatment alone, with a concomitant decrease in the volume of the abscess. There were no deaths, and most patients had a favorable outcome. These results suggest that after the diameter of the abscess becomes less than 2 to 3 cm and does not increase anymore on serial CT, medical treatment alone can be anticipated to give satisfactory results without further aspiration. (author)

  12. Career Decision-Making, Career Barriers and Occupational Aspirations in Chinese Adolescents (United States)

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


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

  13. Fine needle aspiration cytology stained with Rius method in quicker diagnosis of medullary thyroid carcinoma. (United States)

    Hsieh, Min-Huang; Hsiao, Yung-Lien; Chang, Tien-Chun


    The cytologic features of medullary thyroid carcinoma (MTC) have been described and documented in the literature. Most of the studies were related to the Papanicolaou stain or the May-Grnwald-Giemsa stain. The aim of the present study was to analyze detailed cytologic characteristics of MTC diagnosed by fine-needle aspiration cytology (FNAC) stained with a quick method, Rius stain. We collected the FNAC slides of 38 cases with MTC that were proven by surgical pathology. The cytologic findings were reviewed under a light microscope. The median age at diagnosis was 46.5 years, ranging from 13 to 83 years; 20 were women and 18 were men. Among them, seven cases were familial forms and the others were sporadic. The majority of these cases showed moderate to abundant cellularity. Small round cells, spindle-shaped cells and large oval to polygonal cells formed the usual components. Twenty-seven cases were categorized as pleomorphic cell type and 11 cases as monomorphic type. Except in one case, cohesive and clustered small round cells predominated in all cases, alone or coupled with cohesive spindle cells and/or scattered large oval to polygonal cells. The diagnosis of mixed medullary-follicular thyroid carcinoma was made in the case composed solely of grouped polygonal cells. Cytoplasmic granularities were noted in 14 cases and vacuolations were seen in eight. Binucleated and multinucleated cells were not uncommon, while intranuclear cytoplasmic inclusions were less frequent. The diagnostic sensitivity for MTC by FNAC was 89%. The distinctive cytopathologic characteristics of MTC by Rius stain allowed us to make the diagnosis in aspiration biopsies accurately and quickly.

  14. "In patient" medical abortion versus surgical abortion: patient's satisfaction. (United States)

    Di Carlo, Costantino; Savoia, Fabiana; Ferrara, Cinzia; Sglavo, Gabriella; Tommaselli, Giovanni Antonio; Giampaolino, Pierluigi; Cagnacci, Angelo; Nappi, Carmine


    To compare patients' satisfaction with medical and surgical abortion, implementing the Italian guidelines on medical abortion entailing an "in patient" procedure. A total of 1832 pregnant chose between surgical (vacuum aspiration) or medical abortion (mifepristone p.o. followed after 3 days by sublingual misoprostol) and expressed their expected satisfaction on a visual analog scale (VAS). A total of 885 women chose surgical and 947 medical abortion. The primary end-point was satisfaction VAS score 20 days after the procedure. Secondary end-points were: difference between pre- and post-abortion VAS score; difference in satisfaction VAS scores according to parity and previous abortion; incidence of side effects. VAS score was high in each group but significantly higher for the 1-day surgical than for the 3-day medical abortion procedure (7.9 ± 1.0 versus 7.2 ± 1.2; p after the treatment (6.9 ± 1.6 versus 7.9 ± 1.0, p abortion; women with a previous abortion preferred surgical abortion. Both procedures are considered satisfactory by the patients. Performing medical abortion as a 3-day "in patient" procedure, decreased women's satisfaction scores from their baseline expectations.

  15. Content of RNA originating from thyroid in washouts from fine-needle and core-needle aspiration biopsy - preliminary study. (United States)

    Woliński, Kosma; Stangierski, Adam; Szczepanek-Parulska, Ewelina; Gurgul, Edyta; Wrotkowska, Elżbieta; Biczysko, Maciej; Ruchała, Marek


    In the evaluation of molecular markers in washouts from fine-needle aspiration biopsy (FNAB) the extremely small amount of material can be a major problem. Some authors tried to use washouts from core-needle aspiration biopsy (CNABs) to gain more material from larger needles. However, according to some studies, CNAB samples are commonly contaminated with blood. The aim of our study was to evaluate the proportion of nucleic acids from thyroid cells in washouts from FNAB and CNAB by measuring the relative expression of cytokeratin 17 (KRT17) on the mRNA level. Relative expression of KRT17 and GADPH (reference gene) in washouts from FNAB and CNAB was measured using real-time PCR technique and compared to the results from surgical specimens. Surgical specimens form 22 nodules, FNAB samples from 20 lesions and CNAB samples from 24 lesions were analysed. The median difference in cycle threshold (Ct) between FNAB samples and surgical specimens was 3.3 (p = 0.047). In CNAB samples KRT17 was undetectable in most cases (median incalculable; proportion of samples with undetectable KRT17 significantly higher than in FNAB samples). Samples obtained with different biopsy techniques had different proportions of contents. The proportionally low content of epithelial cells in CNAB can result in underestimated expression of molecular markers of malignancy. Consequently, the risk of malignancy or unfavourable prognosis can also be underestimated. To conclude, results obtained from samples gained with one biopsy technique cannot be directly related to thresholds, and generally with experiences gained with other techniques, because it can lead to incorrect clinical interpretation of the results. (Endokrynol Pol 2016; 67 (6): 550-553).

  16. The Values Adolescents Aspire to, Their Well-Being and the Values Parents Aspire to for Their Children (United States)

    Casas, Ferran; Figuer, Cristina; Gonzalez, Monica; Malo, Sara


    This paper presents a study of the relationship between the psychological well-being of Spanish adolescents from 12 to 16 years old and the values they aspire to for the future (N = 1,618). Adolescents' well-being is explored through (a) their satisfaction with 19 specific life domains, (b) the Personal Well-Being Index (Cummins, "Social…

  17. Surgical ethics: surgical virtue and more. (United States)

    Vercler, Christian J


    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  18. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L


    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  19. Ectopic parathyroid glands and their anatomical, clinical and surgical implications. (United States)

    Noussios, G; Anagnostis, P; Natsis, K


    Ectopic parathyroid glands result from aberrant migration during early stages of development and lack of successful identification may lead to lack of success in parathyroid surgery. They constitute a common etiology of persistent or recurrent hyperparathyroidism, when they are missed at initial diagnosis. Their prevalence is about 2-43% in anatomical series and up to 16% and 14% in patients with primary and secondary hyperparathyroidism, respectively. Ectopic inferior parathyroids are most frequently found in the anterior mediastinum, in association with the thymus or the thyroid gland, while the most common position for ectopic superior parathyroids is the tracheoesophageal groove and retroesophageal region. Neck ultrasound and 99mTc Sestamibi scan are first-line imaging modalities, although with low sensitivity and specificity. However, their combination with modern techniques, such as single photon emission computed tomography (SPECT) alone or in combination with CT (SPECT/CT) increases their diagnostic accuracy. Fine needle-aspiration cytology of a lesion suspicious for parathyroid tissue and measurement of parathyroid hormone (PTH) in the aspired material further assist to the successful preoperative localization of ectopic glands. Common sites for surgical investigation are the upper thyroid pole and the upper vascular thyroid stalk behind the hypopharynx and cervical esophagus for the superior parathyroids, and the carotid artery bifurcation and the thymic tongue, for the inferior parathyroids. Radioguided minimally invasive parathyroidectomy after successful localization, assisted by rapid PTH measurement postoperatively, significantly improves surgical outcomes in patients with ectopic parathyroid adenomas.

  20. Oocyte Pickup from Live Cows Through Laparoscopic Guided Aspiration

    Institute of Scientific and Technical Information of China (English)


    In this experiment, the bovine follicular oocytes were aspirated from the ovaries of Chinese Holsteins with laparoscope made in China. The results were as following: for identifying the suitable negative aspiration pressure, six different pressures (50, 100, 150, 200, 250 and 300mmHg)were tested. The aspiration pressure of 100mmHg was the best. Its oocyte recovery rate was 37. 2%, and G I , G Ⅱ oocyte rate was 89. 5%. The heifers were picked up by laparoscope once or twice a week. Each heifer was collected with 2. 4 oocytes once a week or 4. 4 oocytes twice a week.Its oocyte recovery rate was 48. 0% and the G Ⅰ ,G Ⅱ oocyte rate was 93. 5%. In addition, 1.9 oocytes were collected from each cow once a week or 5.4 oocytes from each cow twice a week. Its oocyte recovery rate was 51.7% and the G Ⅰ , G Ⅱ oocyte rate was 85. 1%. It showed that it was possible to pick up bovine oocyte twice a week. Two cows were picked up twice a week for several weeks(53 times). 268 follicles were aspirated(5.1 follicles per cow per time), and 141 oocytes were recovered(2.7 oocytes per cow per time). The oocyte recovery rate was 52.5%, and the G Ⅰ , G Ⅱ oocyte rate was 85. 1%. It was advisable to pick up oocytes twice a week continuously. Some cows in estrous cycles were superovulated with PMSG(500IU). Each of them could be recovered 2.3 follicles and 1.1 oocytes, the others were superovulated with FSH(0. 7mg) , each of them could be aspirated with 4.4 follicles and 2.3 oocytes. It was obvious that the effect of OPU(oocyte pick up) by superovulation with FSH was much better than that with PMSG. The best time for OPU with laparoscope was at the beginning of cow's estrous cycles. At the first day of their estrus, each of them could be averagely aspirated with 8 follicles and 5.7 oocytes.

  1. Fine needle aspiration biopsy: role in diagnosis of pediatric head and neck masses. (United States)

    Anne, Samantha; Teot, Lisa A; Mandell, David L


    To assess the feasibility and role of fine needle aspiration biopsy (FNAB) as a diagnostic tool in children with neck masses. Retrospective chart review. Tertiary care children's hospital. Consecutive series of 71 children with a head and neck mass who underwent FNAB as the primary diagnostic modality. FNAB was performed and interpreted by a pediatric cytopathologist. Rapid on-site analysis was performed to allow immediate assessment of specimen adequacy and to attain a preliminary diagnosis, after which routine cytologic staining was performed. Flow cytometry was performed on cytological specimens when malignancy was suspected, and open biopsy was performed when the cytologic diagnosis was in question. Technical feasibility of FNAB in children, complications, cytopathological diagnoses, accuracy of rapid on-site analysis, need for subsequent diagnostic evaluations, clinical outcomes and follow-up. Mean age was 8.4 years (S.D. 5.3 years), with mean follow-up of 4.1 months (S.D. 9.6 months). FNAB was performed under general anesthesia in 54 cases (76%). There were no technical complications. On-site rapid interpretation was completed in 55 cases, 18/55 confirmed adequacy of specimen only, 37/55 yielded a preliminary diagnosis, and in 34/37 cases, was same as final cytopathologic result. Overall, FNAB biopsy demonstrated 64 benign lesions, 3 malignant diagnoses, 2 follicular thyroid neoplasms, and 2 non-diagnostic specimens. FNAB was the only pathological test performed in 54 (76%) cases. The most common diagnosis was reactive lymphoid hyperplasia (n = 39), followed by benign granulomatous disease (n = 8). Flow cytometry was performed on 7 specimens (non-diagnostic in 5, negative for malignancy in 2). Of the 15 cases with surgical specimens, 3 revealed a pathologic diagnosis different from initial FNAB. There were no cases in which FNAB missed a malignancy, and there were 2 cases where FNAB suggested malignancy, with benign disease subsequently found on open biopsy

  2. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) in insulinomas: Indications and clinical relevance in a single investigator cohort of 47 patients. (United States)

    Kann, Peter Herbert; Moll, Roland; Bartsch, Detlef; Pfützner, Andreas; Forst, Thomas; Tamagno, Gianluca; Goebel, Joachim N; Fourkiotis, Verena; Bergmann, Simona Raluca; Collienne, Maike


    This study was aimed to investigate the role and relevance of endoscopic ultrasound-guided fine-needle aspiration biopsy in the diagnostic work-up of insulinomas. We have analysed the frequency, clinical indications, success rate (obtaining diagnostic tissue), diagnostic accuracy (in comparison to the pathological diagnosis after surgery), complications, and tolerability of endoscopic ultrasound-guided fine-needle aspiration biopsy and the localization and size of the lesions in 47 consecutive patients (29 females, 18 males; 46 ± 15 years) who had surgery for insulinoma following fasting test and were explored by single investigator EUS 1994-2015. Endoscopic ultrasound-guided fine-needle aspiration biopsy was performed in 21 % (10/47) of the patients. The clinical indications for endoscopic ultrasound-guided fine-needle aspiration biopsy were non-conclusive result of fasting test (n = 7), missing toxicology (n = 2), suspected malignancy at EUS (n = 1), suspicious extra-pancreatic localization of the lesion (n = 1). The diagnostic success rate of the procedure was 80 % (8/10 cases), the diagnostic accuracy of the fine-needle aspiration biopsy 70 % (7/10 cases). The lesions undergoing endoscopic ultrasound-guided fine-needle aspiration biopsy were localized in the cauda (n = 5), corpus (n = 2), caput/processus uncinatus (n = 3), the diameter of the tumors was 21 ± 18 (10-70) mm. Only one accidental vascular puncture without any clinical complication occurred and all patients tolerated the procedure well. In the majority of cases, positive fasting test, negative toxicology, and detection of a typical pancreatic lesion at endoscopic ultrasound is sufficient for the diagnosis of insulinoma and the definition of the appropriate surgical strategy. Based on our data, we suggest including endoscopic ultrasound-guided fine-needle aspiration biopsy in the diagnostic work-up of organic hyperinsulinism in selected patients with

  3. Guide to Surgical Specialists (United States)

    ... have expertise in the following areas of responsibility: neonatal surgery (specialized knowledge in the surgical repair of ... and non-operative management of certain types of pain. Common conditions managed by neurologic surgeons include disorders ...

  4. Surgical Critical Care Initiative (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  5. Ambulatory Surgical Measures - National (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  6. Ambulatory Surgical Measures - Facility (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  7. Surgical site infections

    African Journals Online (AJOL)

    and mortality as well as significant financial implications. Worldwide it has ... common nosocomial infection amongst surgical patients with up to 38% .... antibiotics as soon as the sensitivity results are available. ... Breast surgery. Staph Aureus/ ...

  8. Measurement of membrane elasticity by micro-pipette aspiration

    DEFF Research Database (Denmark)

    Henriksen, Jonas Rosager; Ipsen, John H.


    The classical micro-pipette aspiration technique, applied for measuring the membrane bending elasticity, is in the present work reviewed and extended to span the range of pipette aspiration pressures going through the °accid (low pressures) to tense (high pressures) membrane regime. The quality...... of the conventional methods for analysing data is evaluated using numerically generated data and a new method for data analysis, based on thermodynamic analysis and detailed statistical mechanical modelling, is introduced. The analysis of the classical method, where the membrane bending modulus is obtained from micro...... experiments conducted on SOPC (stearoyl-oleoyl-phosphatidyl-choline) lipid vesicles in the °uid phase. The data analysis, which is extended by detailed image analysis and a ¯tting procedure based on Monte Carlo integration, gives an estimate of the bending modulus, that agrees with previously published...

  9. ASPIRE: Teachers and researchers working together to enhance student learning

    Directory of Open Access Journals (Sweden)

    Lollie Garay


    Full Text Available Abstract Science, Technology, Engineering, and Math (STEM disciplines have become key focus areas in the education community of the United States. Newly adopted across the nation, Next Generation Science Standards require that educators embrace innovative approaches to teaching. Transforming classrooms to actively engage students through a combination of knowledge and practice develops conceptual understanding and application skills. The partnerships between researchers and educators during the Amundsen Sea Polynya International Research Expedition (ASPIRE offer an example of how academic research can enhance K-12 student learning. In this commentary, we illustrate how ASPIRE teacher–scientist partnerships helped engage students with actual and virtual authentic scientific investigations. Crosscutting concepts of research in polar marine science can serve as intellectual tools to connect important ideas about ocean and climate science for the public good.

  10. Stainless steel crown aspiration during sedation in pediatric dentistry. (United States)

    Adewumi, A; Kays, David W


    Foreign body aspiration (FBA) causes death in more than 300 children every year in the United States. Morbidity and mortality are increased in children due to narrow airways and immature protective mechanisms. Factors to consider in pediatric dentistry are: (1) the patient's age and behavior; (2) presence and extent of disability; (3) local anesthesia; (4) body positioning; and (5) loose teeth. FBA requires prompt recognition and early treatment to minimize potentially serious and sometimes fatal consequences. The purpose of this case report was to describe the aspiration of a stainless steel crown in a 5-year-old boy during conscious sedation. It also discusses how a prompt and accurate diagnosis, early referral, and immediate treatment helped prevent serious complications.


    Directory of Open Access Journals (Sweden)

    Arina Isti'anah


    Full Text Available This  paper  tries  to  observe  the  English  teachers’  awareness  and representation  of  the  English  aspiration  and  stress  rules.  The research purposes to find out whether or not the teachers are aware of the English aspiration and stress rules,  and to find out how the teachers represent the English aspiration and stress rules. Based on the analysis, it can be concluded that the teachers’ awareness of the English aspiration and stress rules is very low. It is indicated with the percentage which equals to 44% and 48% for English aspiration and  stress  rules.  In  representing  the  English  aspiration  and  stress rules, the teachers face the problems in producing aspiration in the pronunciation,  placing  the  right  stress  and  pronouncing  three  and four  X  in  the  coda  position.  There  are  two  reasons  affecting  the teachers’  awareness  of  the  English  aspiration  and  stress  rules namely exposure and L1 influence. Artikel  ini  bertujuan  untuk  meneliti  kesadaran  dan  representasi aturan aspirasi dan tekanan oleh guru bahasa Inggris. Penelitian ini bertujuan  untuk  menjelaskan  apakah  guru  bahasa  Inggris mempunyai  kesadaran  atas  aturan  aspirasi  dan  tekanan  dalam bahasa  Inggris,  dan    untuk  menunjukkan  bagaimana  guru  Bahasa Inggris  mewujudkan  aturan  aspirasi  dan  tekanan  dalam  pelafalan mereka.  Berdasarkan  analisis  yang  dilakukan,  dapat  disimpulkan bahwa  kesadaran  guru  Bahasa  Inggris  atas  aturan  aspirasi  dan tekanan  dalam  Bahasa  Inggris  masih  sangat  rendah.  Hal  tersebut ditunjukkan  oleh  rendahnya  prosentase  dalam  perwujudan  aturan aspirasi  dan  tekanan:  44%  dan  48%.  Dalam  mewujudkan  aturan aspirasi dan tekanan, guru Bahasa Inggris menemui masalah dalam menghasilkan  aspirasi  dalam  pelafalan,  meletakkan  tekanan  pada

  12. Mechanism of Corneal Endothelial Cells Lesion during Phacoemulsification and Aspiration

    Institute of Scientific and Technical Information of China (English)

    Songtao Yuan; Lina Xie; Qinghuai Liu; Nanrong Yuan


    Purpose: To evaluate the proportions of corneal endothelial lesion caused by differentfactors during phacoemulsification and aspiration.Methods: Fourteen cats (twenty eight eyes) were divided into four groups. The processedfactors were ultrasonic power, lens extraction by phacoemulsification or not, and lensextraction using different levels of ultrasonic power. The density of central cornealendothelial cells was measured before and after operation.Results: There is no statistic difference between pre-operation density and post-operationdensity for releasing ultrasonic power only without lens extraction group. But for the lensextraction group, there is difference in density of central corneal endothelial cells andthe higher level of ultrasonic power, the more the central corneal endothelial cells densitydecreased through operation.Conclusion: The primary factor that causes corneal endothelial lesion duringphacoemulsification and aspiration procedure is debris of lens nucleus, and the otherfactors cause the lesion of corneal endothelium in normal operations just in very smalldegree.

  13. Cisapride decreases gastric content aspiration in mechanically ventilated patients (United States)

    Pneumatikos, John; Koulouras, Basil; Frangides, Christ; Goe, Dian; Nakos, George


    Objective: To determine the effect of the prokinetic agent cisapride in the prevention of aspiration of gastric contents. Design: A prospective randomized two-period crossover study. Setting: Fourteen-bed polyvalent intensive care unit in a University Hospital. Patients: Eighteen intubated, mechanically ventilated patients who were seated in a semirecumbent position were studied. Method: Tc-99 m sulfur colloid (80 megabecquerels) was administered via nasogastric tube on 2 consecutive days. Patients randomly received cisapride (10 mg, via nasogastric tube) one day and a placebo the other. Bronchial secretions were obtained before and for 5 consecutive h after Tc-99 m administration. The radioactivity was measured in a standard amount (1ml) of bronchial fluid using a gamma counter and expressed as counts per min (cpm) after correction for decay. Results: Sixteen out of 18 (88%) patients had increased radioactivity in bronchial secretions. The radioactivity increased over time both with and without cisapride, although it was lower in patients receiving cisapride than in those receiving a placebo. The cumulative bronchial secretion radioactivity obtained when patients received cisapride was significantly lower than when patients received a placebo: 7540 ± 5330 and 21965 ± 16080 cpm, respectively (P <0.05). Conclusion: Our results suggest that aspiration of gastric contents exists even in patients who are kept in a semirecumbent position. Moreover, cisapride decreases the amount of gastric contents aspiration in intubated and mechanically ventilated patients and may play a role in the prevention of ventilator associated pneumonia. Cisapride, even with the patient in the semirecumbent position, did not completely prevent gastric content aspiration. PMID:11056722

  14. Foreign body aspiration in children: experience from 2624 patients. (United States)

    Boufersaoui, A; Smati, L; Benhalla, K N; Boukari, R; Smail, S; Anik, K; Aouameur, R; Chaouche, H; Baghriche, M


    The objective of this study is to analyze the epidemiological, clinical, radiological and endoscopic characteristics of pediatric foreign body aspiration in Algeria. In this retrospective study, the results of 2624 children younger than 18 years admitted in our department for respiratory foreign body removal between 1989 and 2012, were presented. Most of them had an ambulatory rigid bronchoscopy. The children (62.34% males and 37.65% females) were aged 4 months to 18 years with 66% between 1 and 3 years. Choking was related in 65% of cases. The delay between aspiration and removal was 2-8 days in 65.8% and within 24 h in 9.2%. In the most cases, the children arrived with cough, laryngeal or bronchial signs and unilateral reduction of vesicular murmur. The examination was normal in 13%. The most common radiologic finding was pulmonary air trapping (40.7%). The aspirated bodies were organic in 66.7%, dominated by peanuts, while sunflower seeds, beans and ears of wheat were the most dangerous. In the other cases, they were metallic or plastic as pen caps and recently scarf pins. The endoscopic removal by rigid bronchoscopy was successful and complete in 97%. Cases with extraction failure (3%) limited to certain FBs, all of them inorganic were assigned to surgery. The complications related to the endoscopic procedure were 0.29% with a mortality of 0.26%. Foreign body aspiration is a real public health problem in Algeria. The best way to manage it is an early diagnosis and a rigid bronchoscopy removal under general anesthesia used by fully trained staff. The prevention of this domestic accident should consider the population lifestyle and cultural habits to be more effective. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Aspiration tests in aqueous foam using a breathing simulator

    Energy Technology Data Exchange (ETDEWEB)

    Archuleta, M.M.


    Non-toxic aqueous foams are being developed by Sandia National Laboratories (SNL) for the National Institute of Justice (NIJ) for use in crowd control, cell extractions, and group disturbances in the criminal justice prison systems. The potential for aspiration of aqueous foam during its use and the resulting adverse effects associated with complete immersion in aqueous foam is of major concern to the NIJ when examining the effectiveness and safety of using this technology as a Less-Than-Lethal weapon. This preliminary study was designed to evaluate the maximum quantity of foam that might be aspirated by an individual following total immersion in an SNL-developed aqueous foam. A.T.W. Reed Breathing simulator equipped with a 622 Silverman cam was used to simulate the aspiration of an ammonium laureth sulfate aqueous foam developed by SNL and generated at expansion ratios in the range of 500:1 to 1000:1. Although the natural instinct of an individual immersed in foam is to cover their nose and mouth with a hand or cloth, thus breaking the bubbles and decreasing the potential for aspiration, this study was performed to examine a worst case scenario where mouth breathing only was examined, and no attempt was made to block foam entry into the breathing port. Two breathing rates were examined: one that simulated a sedentary individual with a mean breathing rate of 6.27 breaths/minute, and one that simulated an agitated or heavily breathing individual with a mean breathing rate of 23.7 breaths/minute. The results of this study indicate that, if breathing in aqueous foam without movement, an air pocket forms around the nose and mouth within one minute of immersion.

  16. Migration and Education Aspirations - Another Channel of Brain Gain?



    International migration not only enables individuals to earn higher wages but also exposes them to new environments. The norms and values experienced at the destination country could change the behavior of the migrant but also of family members left behind. In this paper we argue that a brain gain could take place due to a change in educational aspirations of caregivers in migrant households. Using unique survey data from Moldova, we find that international migration raises parental aspiratio...

  17. Migration and educational aspirations: Another channel of brain gain?



    International migration not only enables individuals to earn higher wages but also exposes them to new environments. The norms and values experienced at the destination country could change the behavior of the migrant but also of family members left behind. In this paper we argue that a brain gain could take place due to a change in educational aspirations of caregivers in migrant households. Using unique survey data from Moldova, we find that international migration raises parental aspiratio...

  18. Adult sudden death caused by aspiration of chewing gum. (United States)

    Njau, S N


    A case of a fatal foreign material aspiration is presented in the following text. A 24-year-old white male died suddenly. A piece of chewing gum lodged in a pool of frothy fluid was revealed at autopsy. Microscopic examinations revealed atelectasia emphysema, eosinophilic exudate and empty spaces. Blood and urine samples were analyzed, for alcohol and drug use by fluorescence polarization immunoassay (FPIA) on an Abbott AXSYM system. No alcohol or other drugs were detected in blood or urine.

  19. Riedel thyroiditis: Fine needle aspiration findings of a rare entity. (United States)

    Weidner, Anna-Sophie; Molina, David; DeSimone, Robert A; Cohen, Marc A; Giorgadze, Tamar; Scognamiglio, Theresa; Hoda, Rana S


    Riedel thyroiditis is a rare fibrosing disorder characterized by extension of the fibroinflammatory process beyond the thyroid capsule. Due to the nature of this lesion, fine-needle aspiration often yields scant material and may be interpreted as non-diagnostic. In this report, we describe cytologic features that allow the cytopathologist to favor a diagnosis of Riedel thyroiditis, thereby guiding appropriate further work-up and management.

  20. The effect of hyperbaric oxygen treatment on aspiration pneumonia. (United States)

    Sahin, Sevtap Hekimoglu; Kanter, Mehmet; Ayvaz, Suleyman; Colak, Alkin; Aksu, Burhan; Guzel, Ahmet; Basaran, Umit Nusret; Erboga, Mustafa; Ozcan, Ali


    We have studied whether hyperbaric oxygen (HBO) prevents different pulmonary aspiration materials-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250 to 300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + HBO treated, BIO + HBO treated, and HCl + HBO treated. Saline, BIO, HCl were injected into the lungs in a volume of 2 ml/kg. A total of seven HBO sessions were performed at 2,4 atm 100% oxygen for 90 min at 6-h intervals. Seven days later, rats were sacrificed, and both lungs in all groups were examined biochemically and histopathologically. Our findings show that HBO inhibits the inflammatory response reducing significantly (P fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonar aspiration significantly increased the tissue HP content, malondialdehyde (MDA) levels and decreased (P < 0.05) the antioxidant enzyme (SOD, GSH-Px) activities. HBO treatment significantly (P < 0.05) decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase, TUNEL and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with HBO therapy. It was concluded that HBO treatment might be beneficial in lung injury, therefore, shows potential for clinical use.


    Directory of Open Access Journals (Sweden)

    Poonam Nanwani


    Full Text Available BACKGROUND The bone marrow examination is an essential investigation for the diagnosis of disorders of the blood and bone marrow. This simple and relatively safe procedure is important, particularly in resource poor centres since access to adjuvant diagnostic techniques are often lacking or absent. MATERIALS AND METHODS 189 patients of all age groups were studied for haematological and non-haematological disorders by bone marrow aspiration in the Department of Pathology, MGM Medical College during the period of 2014 to 2016. RESULTS Majority of the patients who had bone marrow aspiration were aged 0-15 years. The male-to-female ratio was 1:1.03. Most (97% of the marrow aspirate examined had definitive pathologic features, while 14 (7% were normal marrow elements. Out of 189 cases of bone marrow aspiration, acute leukaemia was the most common haematological disease diagnosed using this procedure. Acute lymphoblastic leukaemia was more common than acute myeloid leukaemia. Aplastic anaemia was seen in 16% cases. Megaloblastic anaemia occurred more commonly than other anaemias. Megaloblastic anaemia was seen in 13 cases (7% and microcytic anaemia was seen in 5 cases (3%. There were 10 cases (5% of Idiopathic Thrombocypenic Purpura. Myelodysplastic syndrome and multiple myeloma was seen in 7% and 2% cases respectively. Storage disorder was seen in 3 cases (2%, out of this 02 cases were Gaucher’s disease and one case was Niemann-Pick’s disease. CONCLUSION Bone marrow examination is an important step to arrive at the confirmatory diagnosis of many haematological disorders. This procedure remains a veritable tool in the diagnosis and management of a wide range of haematological diseases, especially in a resource poor centre.

  2. Can renal infarction occur after renal cyst aspiration? Case report. (United States)

    Emre, Habib; Soyoral, Yasemin Usul; Tanik, Serhat; Gecit, Ilhan; Begenik, Huseyin; Pirincci, Necip; Erkoc, Reha


    Renal infarction (RI) is a rarely seen disorder, and the diagnosis is often missed. The two major causes of RI are thromboemboli originhating from a thrombus in the heart or aorta, and in-situ thrombosis of a renal artery. We report a case of RI that developed due to renal artery and vein thrombosis, as confirmed by pathological evaluation of the nephrectomy material, three weeks after renal cyst aspiration.

  3. Aspirational characteristics for effective leadership of improvement teams. (United States)

    Donnelly, Lane F


    Working on quality improvement has become an innate part of managing a pediatric radiology service. To help radiologists effectively lead improvement teams, eight aspirational characteristics are discussed. These are: 1) Be a good listener, 2) Effectively communicate around an accountability cycle, 3) Stress simplicity: Prioritization and pace, 4) Expend energy to optimize people development, 5) Lead with optimism, 6) Create a culture of wellness and sustainability, 7) Have a progressive attitude toward failure and 8) Project humility over arrogance.

  4. Perfectionism and life aspirations in intrinsically and extrinsically religious individuals. (United States)

    Steffen, Patrick R


    Religiosity is related to positive health and life satisfaction but the pathways through which this occurs have not been clearly delineated. The purpose of this study was to examine potential mediators of the relationships between intrinsic and extrinsic religiosity and negative affect and life satisfaction. Perfectionism and life aspirations are two possible pathways through which religious orientation is related to outcome. It was hypothesized that adaptive perfectionism and intrinsic life aspirations would act as mediators between intrinsic religiosity and negative affect and life satisfaction, and that maladaptive perfectionism and extrinsic life aspirations would act as mediators between the extrinsic religiosity and negative affect and life satisfaction. Two consecutive samples of religious college students (N = 540 and N = 485) completed measures of the Age Universal Religious Orientation Index, the Frost Multi-Dimensional Perfectionism Scale, the Aspiration Index, the Beck Depression Inventory-II, the Spielberger State-Trait Anxiety Inventory, and the Satisfaction with Life Scale. Intrinsic religiosity had a direct negative relationship with negative affect and positive relationship with life satisfaction. Contrary to the hypotheses, intrinsic religiosity had its strongest indirect effect via maladaptive perfectionism such that increased intrinsic religiosity was related to decreased maladaptive perfectionism which in turn lead to better negative affect and life satisfaction. Extrinsic religiosity was related to increased maladaptive perfectionism and thereby indirectly contributed to worse negative affect and life satisfaction. Interestingly, when the effects of maladaptive perfectionism were controlled, the direct effects of extrinsic religiosity were related to reduced negative affect and increased life satisfaction. Overall, the strongest mediator in this study of both intrinsic and extrinsic religiosity was maladaptive perfectionism, with intrinsic



    Marlene Rodrigues; Joana Teixeira; Patrícia Nascimento; Susana Carvalho; Augusta Gonçalves; José Almeida; Cristiana Ribeiro


    Introduction: Foreign body aspiration (FBA) is a common pediatric emergency and an important cause of accidental death in children. The majority of cases occur with small organic or inorganic objects in preschool age. FBA may be associated with a broad spectrum manifestations and its diagnosis represents a challenge. Case report: We report a case of a two-year-old child admitted in the emergency department with cough, dysphonia and dysphagia. On physical examination she had persistent coug...

  6. Low coherence interferometry approach for aiding fine needle aspiration biopsies (United States)

    Chang, Ernest W.; Gardecki, Joseph; Pitman, Martha; Wilsterman, Eric J.; Patel, Ankit; Tearney, Guillermo J.; Iftimia, Nicusor


    We present portable preclinical low-coherence interference (LCI) instrumentation for aiding fine needle aspiration biopsies featuring the second-generation LCI-based biopsy probe and an improved scoring algorithm for tissue differentiation. Our instrument and algorithm were tested on 38 mice with cultured tumor mass and we show the specificity, sensitivity, and positive predictive value of tumor detection of over 0.89, 0.88, and 0.96, respectively.

  7. Medical versus surgical abortion efficacy, complications and leave of absence compared in a partly randomized study

    DEFF Research Database (Denmark)

    Rørbye, Christina; Nørgaard, Mogens; Nilas, Lisbeth


    antibiotic treatment, leave of absence and number of contacts to the health care system were obtained from mailed questionnaires. The number of complications was identical after the two methods, but surgical abortion was associated with a higher success rate [97.7% (708/725) vs. 94.1% (386/410), p ... gemeprost) or a surgical abortion (vacuum aspiration in general anesthesia). One hundred eleven of these women were randomized for abortion method. Surgical interventions and complications leading to readmission within the following 15 weeks were identified through a computer system. Information about......] and also with a higher risk of antibiotic treatment than medical abortion [7.8% (37/467) vs. 3.7% (13/356), p leave of absence was shorter in women choosing a medical (1 day) than a surgical termination (2 days), p

  8. Medical versus surgical abortion: comparing satisfaction and potential confounders in a partly randomized study

    DEFF Research Database (Denmark)

    Rørbye, Christina; Nørgaard, Mogens; Nilas, Lisbeth


    .05. Satisfaction with the medical procedure was inversely correlated with GA and the intensity of pain, nausea, vomiting and dizziness, while satisfaction with the surgical procedure was unaffected by these side effects. Fewer women with a failed medical than a failed surgical abortion were satisfied (17% vs 62......) or a surgical abortion (vacuum aspiration in general anaesthesia). The procedure was determined either by randomization (n = 111) or by choice (n = 922). Data on satisfaction, side effects and expectations were collected from questionnaires 2 and 8 weeks after termination. RESULTS: More women were very......BACKGROUND: The aim of the study was to compare satisfaction with medical and surgical abortion and to identify potential confounders affecting satisfaction. METHODS: 1033 women with gestational age (GA) medical (600 mg mifepristone followed by 1 mg gemeprost...

  9. Medical versus surgical abortion efficacy, complications and leave of absence compared in a partly randomized study

    DEFF Research Database (Denmark)

    Rørbye, Christina; Nørgaard, Mogens; Nilas, Lisbeth


    antibiotic treatment, leave of absence and number of contacts to the health care system were obtained from mailed questionnaires. The number of complications was identical after the two methods, but surgical abortion was associated with a higher success rate [97.7% (708/725) vs. 94.1% (386/410), p ...To provide optimal information to women choosing between early medical and surgical abortion, rigorous comparisons of the two methods are warranted. We compared the outcome of 1135 consecutive women with gestational age (GA) ... gemeprost) or a surgical abortion (vacuum aspiration in general anesthesia). One hundred eleven of these women were randomized for abortion method. Surgical interventions and complications leading to readmission within the following 15 weeks were identified through a computer system. Information about...

  10. Etiological Profile of Plasmacytosis on Bone Marrow Aspirates

    Directory of Open Access Journals (Sweden)

    Monika Gupta


    Full Text Available Objective: In recent years, during routine examination of bone marrow aspirates, an increased plasma cell per­centage has been noted in a good number of cases which included both neoplastic and non-neoplastic diseases. An attempt has been made to observe the spectra of condi­tions with plasmacytosis in bone marrow. Methods: The present study was conducted in the de­partment of pathology over a period of one year. A total of 114 bone marrow aspirates that showed increased plas­ma cells (>3.5% constitute the study material. A detailed relevant clinical examination followed by complete blood count, peripheral smear examination and bone marrow aspiration was done in all cases. Results: There was slight female predominance with male to female ratio of 1:1.1. The majority of patients were in 4th decade. The plasma cell concentration ranged from 5% to 36%. As far as the etiology is concerned, 96 cases (84.2% were non-neoplastic and 18 cases (15.7% had neoplastic etiology. Conclusion: Bone marrow plasmacytosis can present as diagnostic dilemma and some time can be challenging to differentiate reactive from neoplastic condition as there is an overlap both in counts and morphology. Each case with plasmacytosis especially in the overlap range requires complete clinical evaluation, individualized investigations and more specific tests like immunoelectrophoresis and bone marrow biopsy with immunohistochemistry to arrive at a final diagnosis for patient management.

  11. Thrombus aspiration in acute myocardial infarction:Rationale and indication

    Institute of Scientific and Technical Information of China (English)

    Gennaro; Sardella; Rocco; Edoardo; Stio


    Reperfusion of myocardial tissue is the main goal of primary percutaneous coronary intervention(PPCI) with stent implantation in the treatment of acute ST-segment elevation myocardial infarction(STEMI). Although PPCI has contributed to a dramatic reduction in cardiovascular mortality over three decades, normal myocardial perfusion is not restored in approximately one-third of these patients. Several mechanisms may contribute to myocardial reperfusion failure, in particular distal embolization of the thrombus and plaque fragments. In fact, this is a possible complication during PPCI, resulting in microvascular obstruction and no-reflow phenomenon. The presence of a visible thrombus at the time of PPCI in patients with STEMI is associated with poor procedural and clinical outcomes. Aspiration thrombectomy during PPCI has been proposed to prevent embolization in order to improve these outcomes. In fact, the most recent guidelines suggest the routine use of manual aspiration thrombectomy during PPCI(class Ⅱa) to reduce the risk of distal embolization. Even though numerous international studies have been reported, there are conflicting results on the clinical impact of aspiration thrombectomy during PPCI. In particular, data on long-term clinical outcomes are still inconsistent. In this review, we have carefully analyzed literature data on thrombectomy during PPCI, taking into account the most recent studies and meta-analyses.

  12. Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Basheer Tashtoush


    Full Text Available The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of steak from the airway, the patient remained hypotensive and required continued hemodynamic support. Repeated laboratory tests within 24 hrs of aspiration showed a significant decline in the hemoglobin level. A computed tomography (CT scan of the abdomen and pelvis showed a lacerated liver with a large subcapsular hematoma draining into the pelvis. Conclusion. Hepatic rupture is a rare complication of Heimlich maneuver; this paper represents the second case report in the literature. It emphasizes the necessity of early identification and surveillance of fatal Heimlich maneuver complications in a high risk population.

  13. Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma. (United States)

    Tashtoush, Basheer; Schroeder, Jonathan; Memarpour, Roya; Oliveira, Eduardo; Medina, Michael; Hadeh, Anas; Ramirez, Jose; Smolley, Laurence


    The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of steak from the airway, the patient remained hypotensive and required continued hemodynamic support. Repeated laboratory tests within 24 hrs of aspiration showed a significant decline in the hemoglobin level. A computed tomography (CT) scan of the abdomen and pelvis showed a lacerated liver with a large subcapsular hematoma draining into the pelvis. Conclusion. Hepatic rupture is a rare complication of Heimlich maneuver; this paper represents the second case report in the literature. It emphasizes the necessity of early identification and surveillance of fatal Heimlich maneuver complications in a high risk population.

  14. Laparoscopic hepatectomy by curettage and aspiration: a new technique

    Institute of Scientific and Technical Information of China (English)

    CAI Xiu-jun; LIANG Xiao; WANG Yi-fan; YU Hong; ZHENG Xue-yong; HUANG Di-yu; PENG Shu-you


    Background Laparoscopic surgery is advantageous for minimal invasiveness and rapid postoperative recovery. Since the use of laparoscopic hepatectomy in liver resection in the 1990s, it has been performed in a few institutions worldwide.Lack of efficient and safe techniques for liver transaction is the major obstacle preventing from its further development.We developed a new technique for laparoscopic hepatectomy by curettage and aspiration in 1998. In this paper we analyze the clinical outcomes of this technique after 7 years of practice.Methods Altogether 59 consecutive patients underwent laparoscopic hepatectomy by curettage and aspiration from August 1998 to January 2005 at our institution. These patients included 33 males and 26 females, with a mean age of 47 years. For liver transecsion laparoscopic Peng's multifunctional operative dissector (LPMOD) was used. Lesions included malignant liver tumors in 19 patients, benign liver tumors in 17, intrahepatic calculus in 18, and other liver lesions in 5.Procedures included local resections in 30 patients, left lateral segmentectomy in 28, and right hemihepatectomy in 1.Results Laparoscopic operation was completed in 57 patients. Two patients (3.4%) had the operation converted to laparotomy. The mean operating time was 143 minutes and the mean intraoperative blood loss was 456 mi. The mean length of postoperative hospital stay was 7 days. Complications occurred in 2 patients (3.4%), and there was no perioperative death.Conclusion Laparoscopic hepatectomy by curettage and aspiration is efficient and safe for liver resection.

  15. A novel technique to release sticking haptic of a single-piece hydrophobic acrylic IOL using irrigation-aspiration probe. (United States)

    Khokhar, Sudarshan Kumar; Midha, Neha; Patil, Bharat; Nayak, Bhagabat; Simakurthy, Sriram


    To describe a novel technique to release sticking haptic of a single-piece hydrophobic acrylic intraocular lens (IOL) using irrigation-aspiration (I/A) probe. In our technique, the I/A probe is introduced into the anterior chamber on Visco mode. Using the aspiration port of the I/A probe, the sticking haptic is held at its tip and suction force is built up until occlusion is noted. Then the haptic is nudged towards the center of the IOL along its curve. After the haptic is free from optic, the suction is released. Several techniques have been described to release the sticking haptic such as squeezing the haptic at the site where it sticks to the IOL or using Sinskey hook for releasing the adhesion. These techniques require extra manipulation of the IOL by introduction of surgical instruments. In our technique, we used the I/A probe itself for separating the sticky haptic successfully. This technique allows separation of sticking haptic without any extra instrumentation, thus reducing intraocular maneuvering and total surgery time.

  16. Repeated cyst formation in a patient with leukoencephalopathy, cerebral calcifications, and cysts: effectiveness of stereotactic aspiration with Ommaya reservoir placement. (United States)

    Ooba, Hiroshi; Abe, Tatsuya; Hisamitsu, Yoshinori; Fujiki, Minoru


    The combination of leukoencephalopathy, cerebral calcifications, and cysts (LCC) constitutes a rare cerebral disorder characterized by distinctive neuroradiological and clinical findings. Twenty-eight cases of LCC have been reported. Surgery is usually required to treat progressively expanding cysts, but surgical strategies have been varied. The authors present the case of a patient who underwent 4 surgical procedures for repeated cyst formation. The first operation was performed for the removal of a cyst and to make a histopathological diagnosis. The second and third operations were performed to treat de novo cysts. The fourth operation was performed to treat a recurrence. This is the first reported case of LCC in which it was necessary to perform surgery 4 times, in large part due to de novo cyst formation. It provides evidence that multiple cysts may develop in these patients and that several surgical operations may be needed to treat LCC. Stereotactic aspiration with Ommaya reservoir placement is an appropriate procedure for this condition because it is less invasive and more repeatable than open surgery.

  17. School students' attitudes and aspirations in science - (Symposium SBBq Brazil

    Directory of Open Access Journals (Sweden)

    J. Dillon


    Full Text Available Low participation rates in science are a matter of  international concern and existing evidence suggests that children’s science  aspirations are largely formed within the critical 10-14 age period. This presentation explores how families can shape young children’s science aspirations, using Bourdieu’s concept of  habitusto map family resources and practices. This paper  draws on two research projects: ASPIRES and Interests andRecruitment in Science (IRIS. Findings from the ASPIRES project draw on qualitative data from 160 semi-structured interviews (92 school children age 10 and 78 parents, collected as part of an ongoing 5-year longitudinal study in theUK. Findings are contextualised with reference to a survey of over 9,000 elementary school children in England (age 10 collected as part of the wider study. A typology of eight key family ‘habituses’ is developed, ranging  from families in which science is strongly embedded, through to ambivalentcontexts and those in which science is weakly or peripherally embedded. It discusses the implications of each for promoting, or deterring, children’s science aspirations. The IRIS project was aimed to develop knowledge andrecommendations informed by evidence on how young people, and womenin particular, may be attracted to, and retained in, STEM higher education. Specifically, the project addresses the following questions: 1. What are the  priorities, values and experiences on which young people base their educational choice? 2. What are the success factors for interventions aimed at  recruiting more young people (women in particular to higher STEM education? and 3. How do STEM students who drop out/opt out before graduation, explain their choice? The main instrument is a questionnaire (IRIS Q that was completed by almost 6,000 first-year STEM students in the five IRIS consortium countries in 2010. A range of smaller-scale, qualitative and quantitative modules

  18. Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series

    Directory of Open Access Journals (Sweden)

    Weijun Wang


    Full Text Available Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13–145 mL; postoperative follow-up was 3 months. Clinical data, including surgical trauma, surgery time, complications, and outcome of hematoma drainage, recovery, and Barthel index scores, were assessed, as well as treatment outcome. Results. Surgical trauma was minimal and surgery time was short (10–20 minutes; no anesthesia accidents or surgical complications occurred. Two patients died. Drainage was completed within 7 days in the remaining 57 cases. Barthel index scores of ADL were ≤40 (n=1, 41–60 (n=1, and >60 (n=55; scores of 100 were obtained in 48 cases, with no dysfunctions. Conclusion. Satisfactory results can be achieved with minimally invasive surgery in treating acute epidural hematoma with hematoma volumes ranging from 13 to 145 mL. For patients with hematoma volume >50 mL and even cerebral herniation, flexible application of minimally invasive surgery would help improve treatment efficacy.

  19. Clinical impact of endoscopic ultrasound-fine needle aspiration of left adrenal masses in established or suspected lung cancer

    DEFF Research Database (Denmark)

    Bodtger, Uffe; Vilmann, Peter; Clementsen, Paul


    , but the impact of EUS-fine needle aspiration (FNA) on tumor, node, metastasis (TNM)-staging, treatment, and survival is unknown. METHODS: The impact of EUS-FNA of the LAG on TNM staging, treatment, and survival was evaluated retrospectively in all patients (n = 40) referred to EUS during 2000-2006 for known...... or suspected lung cancer and where EUS disclosed an enlarged LAG. Conventional workup had preceded EUS. RESULTS: EUS-FNA of an enlarged LAG altered the TNM staging in 70% (downstaged: 26 of 28 patients) and treatment in 48% (gained surgery 25%, avoided surgery 5%, surgically verified benign disease 5...... a significant impact on TNM staging, treatment, and survival. The impact of routine visualization of the LAG in lung cancer workup needs to be prospectively validated....

  20. Fine-needle aspiration cytology of mammary fibroadenoma: a comparison of ThinPrep® and cytospin preparations. (United States)

    Ly, Thai Yen; Barnes, Penny J; Macintosh, Rebecca F


    Mammary fibroadenoma (FA) is a lesion frequently sampled and diagnosed by fine-needle aspiration (FNA). Accurate cytologic diagnosis of this common benign lesion is important as this can lead to non-surgical, conservative management when breast imaging and clinical examination are concordant. In most instances, a confident diagnosis of FA is possible because of a characteristic cytologic appearance that includes hypercellularity, large epithelial cell groups, staghorn epithelial configurations, stromal fragments, and numerous background stripped nuclei. Nevertheless, FAs can be diagnostically challenging because of shared cytomorphologic features with other benign lesions and low-grade carcinoma. As such, FA is a well-recognized source of false results on FNA cytology. Furthermore, there are reports that newer thin layer cytopreparatory techniques, including the ThinPrep® (TP) system (Hologic Corp., Bedford, MA), alter the appearance of FA on FNA compared to conventional preparations and may compromise accurate cytologic diagnosis. Copyright © 2010 Wiley-Liss, Inc.

  1. Subcutaneous metastases of sarcomatoid mesothelioma with its differential diagnosis on fine needle aspiration--a case report. (United States)

    Patel, Trupti; Bansal, Rimpi; Trivedi, Priti; Modi, Lopa; Shah, M J


    Metastasis of mesothelioma of the pleura, to the skin and subcutis is an extremely rare occurrence. A 25 year old woman, who had undergone chemotherapy, partial excision of tumor followed by radiotherapy of sarcomatoid mesothelioma of the pleura, presented three months later with painless widespread subcutaneous nodules. FNAC of these nodules reveled pleomorphic malignant spindle shaped cell with epithelioid morphology. The subcutis is a particularly rare site of metastatic sarcomatoid mesothelioma. It is essential to differentiate neoplasm metastatic to the skin and subcutis from primary and benign lesions of the same region. FNAC is accurate and efficient, in conjugation with clinical history, and it also prevents surgical biopsy in the diagnosis of metastatic subcutaneous lesion. To our knowledge, this is the first case, reported till date, in which the sarcomatoid mesothelioma metastasized to the subcutaneous tissue and was diagnosed by fine needle aspiration cytology (FNAC).

  2. Reliability of fine needle aspiration and ex tempore biopsy in the diagnosis of salivary glands lesions

    Directory of Open Access Journals (Sweden)

    Gajanin Radoslav


    Full Text Available Background/Aim. Interpretation of cytological material obtained by fine needle aspiration (FNA of salivary glands is one of the most challenging areas in cytopathology. FNA is performed easily, it is minimally invasive, inexpensive, fast, reliable and provides valuable information to clinicians about the nature of the lesion and therapeutic modalities. Ex tempore diagnosis, frozen section (FS is a diagnostic tool that is essential in determining the modalities of surgical treatment of lesions of the salivary glands. Today this method is used in determining the status of resection margins and infiltration of adjacent anatomical structures. The aim of this study was to present our experiences in the application of FNA and FS in the diagnosis of salivary gland lesions and to determine the sensitivity, specificity, predictive value, and diagnostic reliability of these methods. Methods. The study included 36 patients. In all the patients, cytological analysis was done before surgery and histological analysis of the surgical material. In 23 of the patients the FS diagnostics was done. Then we compared FNA and FS findings with histopathological findings. Results. Correlation of cytological and histological diagnosis showed sensitivity of 83.3%, specificity 96.67%, positive predictive value 83.3%, negative predictive value of 96.77% and diagnostic accuracy of 97.2%. Based on the relationship between FS diagnosis and histopathological diagnosis, the sensitivity was 100%, specificity 96.67%, while positive predictive value and diagnostic accuracy were 100% each. Conclusion. The study confirmed that FNA is a sensitive, reliable diagnostic method for differentiation of lesions of the salivary glands. In cases with no posibility to definite differentiation in FNA samples, and with the need to assess the resection margins and invasion of anatomical structures, it is recommended to use FS diagnostics.

  3. Results and complications of CT-guided transthoracic fine-needle aspiration biopsy of pulmonary lesions

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    Lima, Cristiano Dias de; Nunes, Rodolfo Acatauassu; Saito, Eduardo Haruo; Higa, Claudio; Cardona, Zanier Jose Fernando; Santos, Denise Barbosa dos, E-mail: [Hospital Universitario Pedro Ernesto (HUPE/UERJ), Rio de Janeiro, RJ (Brazil). Dept. Cirurgia Toracica


    Objective: to analyze the cytological findings of CT-guided percutaneous fine-needle aspiration biopsies of the lung, to demonstrate the diagnostic feasibility of the method in the investigation of pulmonary lesions, and to determine the complications of the procedure, evaluating its safety. Methods: a retrospective analysis of 89 patients with various types of pulmonary lesions who underwent 97 procedures over a period of five years. The patients were divided into groups regarding the indication for the procedure: suspicion of primary lung cancer (stages IIIB or IV); suspicion of lung cancer (stages I, II, or IIIA) and clinical contraindications for surgery; suspicion of pulmonary metastasis from other organs; and pulmonary lesions with benign radiological aspect. All of the procedures were performed with 25-gauge needles and were guided by spiral CT. The final diagnosis was confirmed by surgical biopsy and clinical/oncological follow-up. For the analysis of complications, the total number of procedures was considered. Results: the main indication for the procedure was suspicion of advanced stage primary lung cancer. The accuracy of the method for malignant lesions was 91.5%. The lesion was confirmed as cancer in 73% of the patients. The major complication was pneumothorax (27.8%), which required chest tube drainage in 12.4% of the procedures. Conclusions: the principal indication for CT-guided fine-needle biopsy was suspicion of primary lung cancer in patients who were not surgical candidates. The procedure has high diagnostic feasibility for malignant pulmonary diseases. The most prevalent complication was pneumothorax. However, in most cases, chest tube drainage was unnecessary. No deaths were related to the procedure. (author)

  4. 3D Surgical Simulation (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael


    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  5. Fine-needle aspiration cytology of ameloblastoma and malignant ameloblastoma: a study of 12 cases. (United States)

    Klapsinou, Eirini; Stavros, Archondakis; Smaragda, Angeli; Despoina, Proestou; Dimitra, Daskalopoulou


    Ameloblastoma is an odontogenic tumor with aggressive biological behavior, high recurrence rate, and a complex microscopic appearance with many different histologic patterns. Primary ameloblastoma is also described in extragnathic locations. Because of its wide morphologic spectrum, which is mirrored also in cytologic smears, a thorough study of distinctive features is required to reach a reliable diagnosis. Twelve cases of ameloblastoma were examined both cytologically and histologically. The patients were seven women and five men 24-85 years old, mean age being 64 years. Eleven cases were primary tumors of the mandible and maxilla, and one case was a lung tumor metastatic from the tibia. The epithelial element in the cytologic smears of the various cases was morphologically diverse. The basaloid pattern and minimal nuclear atypia were rather constant findings, and the most helpful features toward reaching a cytological diagnosis. However in most cases, careful consideration of the clinical, radiological, cytological, and occasionally immunocytochemical data was required to rule out other entities with similar cytological findings. In some cases, the final diagnosis was only possible by histologic examination. Due to their variable microscopic morphology, ameloblastomas are quite often misdiagnosed for other entities, both benign and malignant. Nevertheless, when one is aware of their distinctive features, an accurate diagnosis can be made by fine-needle aspiration cytology, in conjunction with clinical and radiological findings. Both the preoperative surgical planning and the postoperative follow-up of the patients benefit significantly from this method. Copyright © 2011 Wiley Periodicals, Inc.

  6. Endoscopic ultrasound guided fine needle aspiration of non‐pancreatic lesions: an institutional experience (United States)

    Anand, Dipti; Barroeta, Julieta E; Gupta, Prabodh K; Kochman, Michael; Baloch, Zubair W


    Background Endoscopic ultrasound guided fine needle aspiration biopsy (EUS‐FNA) has proven to be an effective diagnostic modality for the detection and staging of pancreatic malignancies. In recent years EUS‐FNA has also been used to diagnose lesions of non‐pancreatic sites such as structures in close proximity to the gut wall within the mediastinum, abdomen, pelvis and retro‐peritoneum. Aims To evaluate experience with EUS‐FNA of non‐pancreatic sites at a large university medical centre. Methods The study cohort included 234 patients who underwent EUS‐FNA of 246 lesions in non‐pancreatic sites (122 peri‐pancreatic and coeliac lymph nodes; 9 peri‐pancreatic masses; other sites: mediastinum 12, gastric 25, liver 27, oesophagus 17, duodenum/colon/rectum 15, retro‐peritoneum 8, lung 7, miscellaneous 4). Results The cytology diagnoses were classified as non‐neoplastic/reactive in 82 (33%), atypical/suspicious for malignancy in 25 (10%), malignant in 86 (35%) and non‐diagnostic in 53 (22%) cases. Surgical pathology follow‐up was available in 75 (31%) cases. Excluding the non‐diagnostic cases there were 7 false negative and 3 false positive cases. The sensitivity, specificity and positive predictive value of EUS‐FNA in the diagnosis of lesions of non‐pancreatic sites was 92%, 98% and 97%, respectively. Conclusions EUS‐FNA can be effectively used as a diagnostic modality in the diagnosis of lesions from non‐pancreatic sites. PMID:17220205

  7. Diagnosis of Follicular Lesions of Undetermined Significance in Fine-Needle Aspirations of Thyroid Nodules (United States)

    Ratour, J.; Polivka, M.; Dahan, H.; Hamzi, L.; Kania, R.; Dumuis, M. L.; Cohen, R.; Laloi-Michelin, M.; Cochand-Priollet, B.


    Aim. We aimed to analyze the diagnostic criteria proposed by the Bethesda System for Reporting Thyroid Cytopathology for follicular lesions of undetermined significance (FLUS), the risk of cancer and diagnostic improvement with use of immunocytochemistry. Methods. For each FLUS diagnosis, we analyzed the cytological criteria (9 Bethesda criteria), secondary fine-needle aspiration (FNA) results, surgical procedures, contribution of immunocytochemistry with the antibodies cytokeratin 19 (CK19) and monoclonal anti-human mesothelial cell (HBME1). Results. Among patients with 2,210 thyroid FNAs, 244 lesions (337 nodules) were classified as FLUS (11% of all thyroid FNAs). The 3 criteria most often applied were cytological atypia suggesting papillary carcinoma (36%), microfollicular architecture but sparse cellularity (23.1%), cytological atypia (21.5%). With secondary FNA, 48.8% of nodules were reclassified as benign. For about half of all cases (41.4% for the first FNA, 57.6% for the second FNA), immunocytochemistry helped establishing a diagnosis favoring malignant or benign. No benign immunocytochemistry results were associated with a malignant lesion. In all, 22.5% of the 39 removed nodules were malignant. Conclusion. The FLUS category is supported by well-described criteria. The risk of malignancy in our series was 22.5%. Because we had no false-negative immunocytochemistry results, immunocytochemistry could be helpful in FLUS management. PMID:23634318

  8. Decisional conflict in patients considering diagnostic thyroidectomy with indeterminate fine needle aspirate cytopathology. (United States)

    Taylor, Benjamin A; Hart, Robert D; Rigby, Matthew H; Trites, Jonathan; Taylor, S Mark; Hong, Paul


    Fine needle aspiration (FNA) cytopathology is the gold standard work-up for thyroid nodules. However, indeterminate lesions are encountered commonly and can lead to difficult treatment decisions. We sought to determine whether patients experienced decisional conflict surrounding management with diagnostic thyroidectomy in the setting of indeterminate FNA results. Patients with indeterminate results of thyroid nodule FNA were prospectively enrolled. All consultations were carried out by three otolaryngologists in a consistent manner. After consultation, participants completed a demographics form and the Decisional Conflict Scale (DCS) questionnaire. Thirty-five patients (28 female) between the ages of 30 and 88 years (mean age 54.89) participated. The median total DCS score was 10.94 (interquartile range, 4.69-25.0). Twelve patients (34%) scored at or above 25 on the DCS, indicating clinically significant level of decisional conflict. Patients reported feeling significantly more confident about their decision after the surgical consultation compared to before the consultation (p = 0.00). The total DCS score was significantly negatively correlated with self-reported confidence after the consultation (r = -0.421, p = 0.012). Many patients experienced clinically significant decisional conflict when considering thyroidectomy for management of a thyroid nodule with indeterminate cytopathology. Future research should be directed at developing decision support tools for this patient group, and exploring the impact of decisional conflict on health outcomes.

  9. Induction of parotitis by fine-needle aspiration in parotid Warthin's tumor. (United States)

    Suzuki, Kensuke; Iwai, Hiroshi; Kaneko, Toshihiko; Sakaguchi, Mariko; Hoshino, Shoichi; Inaba, Muneo


    To estimate parotitis caused by fine-needle aspiration (FNA) in parotid Warthin tumor. Case series with chart review. Hospital records were reviewed for 104 parotid tumors (103 patients) including 35 Warthin tumors, which underwent FNA within our department. Three patients with four Warthin tumors among them noticed parotid pain, swelling, and abscess formation as a consequence of acute parotitis after FNA. Examinations of the materials obtained from tumor puncture or drainage before the start of antibiotic therapy showed no bacterial association in any patient. Two of the patients with Warthin tumor underwent parotidectomy, and the surgical specimens indicated histopathological changes with necrosis, abscess, granuloma, and the infiltration of inflammatory cells including Langhans-type multinucleated giant cells. It is conceivable that Warthin tumor bears the characteristics of inflammation induced by the FNA procedure without any relation to infection. Therefore, it may be better to avoid routine FNA and give priority to diagnostic imagings over FNA in the diagnosis of tumors strongly suspected as Warthin tumor.

  10. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff


    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  11. Surgical bleeding in microgravity (United States)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd


    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  12. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA


    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  13. Significance of nuclear morphometry in cytological aspirates of breast masses

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    Kalhan Shivani


    Full Text Available Background : Breast carcinoma is the most common malignancy globally. Cytological evaluation in breast lesions is largely subjective. Gradual progression of cells from normal to invasive involves nuclear changes that need to be viewed objectively. Aims : This study aims to apply nuclear morphometry on cytological breast aspirates. It evaluates its utility in differentiating benign vs. malignant lesions and correlates it with cytologic grading in malignant cases. Setting and Design : Nuclear morphometric parameters of malignant and benign cases were compared. Parameters of malignant cases were correlated with cytologic grading. Materials and Methods : Cytology was used to categorize aspirates from breast lumps into malignant (53 cases and benign (29 cases. One hundred cells per case in both groups were mapped on DEBEL Cytoscan and six geometrical and three textural parameters obtained were compared. In malignant cases, morphometry was correlated with Robinson′s cytologic grading, which was further correlated in tissue sections (45 cases with modified Scarff-Bloom-Richardson histologic grading. Statistical Analysis : Students "t"-test was applied for comparison between benign and malignant cases. One-way ANOVA followed by Bonferroni′s post hoc comparison was applied to compare the three cytologic grades. Results were considered significant when P<0.05. Results : Nuclear morphometry successfully differentiated between benign and malignant aspirates and correlated significantly with cytologic grades. Morphometry was especially useful in the diagnosis of atypical ductal hyperplasia and ductal carcinoma in situ. Useful parameters were mean nuclear area, long axis, short axis and total run length. Cytohistologic correlation was 83.3%, 88.9% and 88.9% for cytological grades 1, 2 and 3 respectively. Conclusions : Nuclear morphometry was thus a useful objective tool in the evaluation of breast masses.

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

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    Gomez-Macias G


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

  15. Heterogeneous aspirations promote cooperation in the prisoner's dilemma game.

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    Matjaž Perc

    Full Text Available To be the fittest is central to proliferation in evolutionary games. Individuals thus adopt the strategies of better performing players in the hope of successful reproduction. In structured populations the array of those that are eligible to act as strategy sources is bounded to the immediate neighbors of each individual. But which one of these strategy sources should potentially be copied? Previous research dealt with this question either by selecting the fittest or by selecting one player uniformly at random. Here we introduce a parameter u that interpolates between these two extreme options. Setting u equal to zero returns the random selection of the opponent, while positive u favor the fitter players. In addition, we divide the population into two groups. Players from group A select their opponents as dictated by the parameter u, while players from group B do so randomly irrespective of u. We denote the fraction of players contained in groups A and B by v and 1 - v, respectively. The two parameters u and v allow us to analyze in detail how aspirations in the context of the prisoner’s dilemma game influence the evolution of cooperation. We find that for sufficiently positive values of u there exist a robust intermediate v ≈ 0.5 for which cooperation thrives best. The robustness of this observation is tested against different levels of uncertainty in the strategy adoption process K and for different interaction networks. We also provide complete phase diagrams depicting the dependence of the impact of u and v for different values of K, and contrast the validity of our conclusions by means of an alternative model where individual aspiration levels are subject to evolution as well. Our study indicates that heterogeneity in aspirations may be key for the sustainability of cooperation in structured populations.

  16. Organizational Socialization and Personnel Career Aspiration in Workplace

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    Mohammadali Nadi


    Full Text Available This research administer with the purpose of investigate relationship between organizational socialization (include training, understanding, co-worker support and future perspectives with career aspirations (include technical – functional competence, general managerial competence, organizational stability and dedication to cause, geographical security, entrepreneurial creativity, autonomy/independence, life style and pure challenges among personnel of organization related to petroleum ministry in Esfahan city. Research method was correlation and statistical population were the total of male and females of above mentioned organizations. Research sample were the 501 persons (405 males and 96 females which selected from personnel’s list of each organization with using simple random sampling. Research instruments were: organizational socialization inventory with 20 items (and four subscales and career aspiration questionnaire with 25 items (and eight subscales. Face, content and construct validity of research instruments along with internal consistency studied and verified. Data analyzed with using Pearson’s correlation coefficient and enter regression analysis. Results revealed that some of organizational socialization subscales have predictive power for career aspirations subscales as below: training and future perspectives for entrepreneurial creativity (=0.235 and =-0.204 respectively, future perspectives for pure challenges (=0.223, understanding and future perspectives for organizational stability and dedication to cause (=0.258 and =-0.275 respectively, training for technical – functional competence (=-0.260, training for general managerial competence (=-0.204, training, co-worker support and future perspectives for life style (=-0.229, =0.272 and =-0.205 respectively and training for geographical stability (=-0.2.

  17. Interpretation of bone marrow aspiration in hematological disorder

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    S Pudasaini


    Full Text Available Background: Hematological disorders are quite frequent in all age group. Most of this hematological disorder first present as anemia. Bone Marrow Aspiration plays a major role in the diagnosis of its underlying cause. The aim of this study was to analyze the causes of hematological disorders, its spectrum and to interprete the bone marrow aspiration findings.Materials and Methods: This was a retrospective and prospective study carried out in the department of Pathology of Nepal Medical College in a period of two years. (July 2010 - June 2012. Bone marrow examination of 57 cases of suspected hematological disorders was carried out. All details of the patients were obtained from the record file in the department of pathology.Results: Out of 57 cases of bone marrow aspiration, erythroid hyperplasia was seen in 12 cases (21%. Megaloblastic anemia was seen in 7 cases (12.3% and microcytic anemia was seen in 4 cases (7%. There were 6 cases (10.5% of Idiopathic Thrombocypenic Purpura. Acute leukemia was diagnosed in 7 cases (12.3% and among this acute myeloid leukemia (10.5% was more common than acute lymphoid leukemia (1.8%. Myelodysplastic syndrome and multiple myeloma was seen in 3.5 % cases each. Aplastic anemia and kalaazar was seen in 5.3% and 1.8% cases respectively.Conclusion: Bone marrow examination is an important step to arrive at the confirmatory diagnosis of many hematological disorders.Journal of Pathology of Nepal (2012 Vol. 2, 309-312DOI:

  18. Neighborhood poverty, aspirations and expectations, and initiation of sex. (United States)

    Cubbin, Catherine; Brindis, Claire D; Jain, Sonia; Santelli, John; Braveman, Paula


    Cross-sectional research has demonstrated associations between neighborhood socioeconomic characteristics and adolescents' initiation of heterosexual intercourse. Prospective designs are needed to move toward causal inference, and to identify mediating and moderating influences to inform policies and programs. Among 5,838 nonsexually active participants in wave I (1994-1995) of the National Longitudinal Study of Adolescent Health, multilevel logistic regression analyses were used to predict initiation of sex by wave II (1996); models were stratified by gender and age group (11-14 and 15-17 yr). Predictors measured at wave I included census tract-level (neighborhood) poverty concentration, family-level income, parental education, race/ethnicity, and family structure. Adolescent college aspirations and life expectations were tested as possible mediators or moderators of the neighborhood poverty-sexual initiation association. Neighborhood poverty concentration predicted older (15-17 yr) girls' and boys' sexual initiation, after considering individual-level covariates. However, adolescent college aspirations and life expectations were not found to mediate the prediction relationship. Moderating effects were identified for girls (college aspirations) and boys (positive life expectations) in high-poverty neighborhoods, paradoxically reflecting increased risk. In this longitudinal study, moderating effects generally considered protective against sexual initiation were not protective or were harmful for adolescents living in high-poverty neighborhoods. Subsequent research to understand how to reduce the health risks of living in poor neighborhoods must examine an even wider range of variables and/or use different methodologies. Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. [Optimizing surgical hand disinfection]. (United States)

    Kampf, G; Kramer, A; Rotter, M; Widmer, A


    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  20. [Phenotype B primitive adrenal lymphoma, diagnosed by percutaneous aspiration biopsy]. (United States)

    Dahami, Z; Debbagh, A; Dakir, M; Hafiani, M; Joual, A; Bennani, S; el Mrini, M; Benjelloun, S


    The authors report a case of primary adrenal lymphoma in a 30-year old-female who complained of lumbar pain and was in poor general condition. Ultrasonography and CT scan revealed a heterogeneous mass with necrosis in the left adrenal gland. Non-Hodgkin's lymphoma of B-cell origin was determined by ultrasound-guided aspiration biopsy of the adrenal mass. Taking this case and the findings in the literature into consideration, the features of this disease have been reviewed and the problem of diagnosis, treatment and prognosis have been examined.

  1. Fine-needle aspiration biopsy: a historical overview. (United States)

    Rosa, Marilin


    Fine needle aspiration biopsy is a safe, inexpensive and accurate technique for the diagnosis of benign and malignant conditions. Its increase in popularity in the present days has made it a technique used on daily basis in the majority of medical centers in United States and around the world. However, the situation was not always like this. In its beginnings the procedure suffered from all kinds of criticism and attacks. The purpose of this manuscript is to provide an overview about the development of this technique from its birth to our days.

  2. Ductal lavage, nipple aspiration, and ductoscopy for breast cancer diagnosis. (United States)

    Dooley, William C


    The intraductal approach to breast cancer has been invigorated this year by a series of papers exploring ductal-based screening through nipple aspiration and lavage and ductal exploration through endoscopy. The merging of these efforts to define the earliest biologic changes in the progression toward breast cancer is opening new fields for both bench-translational and clinical research. These techniques have already begun to show value in defining the presence and extent of proliferative disease in high-risk patients, allowing for more informed therapeutic decision making.

  3. Fine needle aspiration cytology of thymic carcinoid tumor. (United States)

    Wang, D Y; Kuo, S H; Chang, D B; Yang, P C; Lee, Y C; Hsu, H C; Luh, K T


    Carcinoid tumors of the thymus are very rare, and their cytologic findings have not been reported previously in English. Retrospective study of fine needle aspiration (FNA) cytologic features in four histopathologically verified thymic carcinoid tumors are described here in detail. The FNA cytology of thymic carcinoids is characterized by predominantly single and some loose clusters of small, round to oval cells with scanty cytoplasm, interspersed with some larger cells with moderate to abundant, granular cytoplasm. The differential diagnosis of the cytologic features between carcinoid tumor and other mediastinal tumors is also discussed.

  4. Perineal nodule due to enterobiasis: an aspiration cytologic diagnosis. (United States)

    Kumar, Neeta; Sharma, Prashant; Sachdeva, Ritesh; Jain, Shyama


    Subcutaneous swelling due to Enterobious vermicularis infection is rare. Their presence in perineal subcutaneous tissue is unusual and a clinical curiosity. A case of subcutaneous nodule in the perineum due to E. vermicularis infection diagnosed on fine-needle aspiration is described. Tissue reaction was granulomatous with neutrophils and eosinophils. Lack of familiarity with the morphology of parasites or its eggs, degeneration, and inadequate sampling may make the diagnosis difficult. This case report provides the morphologic clues to cytopathologists toward rendering a diagnosis and alerts them to the possibility of parasitic infection in unusual locations.

  5. Aspiration spiral-flow type centrifugal flotation machine

    Institute of Scientific and Technical Information of China (English)



    Aspiration spiral flow type centrifugal flotation machine takes full advantage of centrifugal force field and gravitational field, and strengthens flotation of coal slurry. As a new-type flotation machine of high efficiency, its key component is bubble generator. Which completes the process of ore pulp inflation and liberalization. The design, parameters and working principle of bubble generator provide the design of the same device in similar equipment with reference. The result of industrial operation shows that this machine is of such features as small occupational area, greater concentration ratio, high processing capacity, high efficiency and lower investment etc.

  6. Aspiration of tracheoesophageal prosthesis in a laryngectomized patient

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    Conte Sergio C


    Full Text Available Abstract Background The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation We describe a case of tracheoesophageal prosthesis’ (TEP aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature.

  7. Plasmacytoma of tonsil diagnosed by fine-needle aspiration cytology

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    Bhat Ramachandra


    Full Text Available Extramedullary plasmacytoma of tonsil is rare. Even though biopsy is necessary for final diagnosis, fine-needle aspiration cytology (FNAC can provide useful information in the management of such cases. We report a case of plasmacytoma of tonsil diagnosed by FNAC in a 43-year-old man who presented with a swelling in the right tonsillar area. FNAC smears revealed sheets of plasma cells at various stages of maturation. Subsequent histopathological and immunohistochemical studies confirmed the diagnosis of plasmacytoma. This case is reported for the rarity of site for extramedullary plasmacytoma and to highlight the usefulness of FNAC in lesions of tonsil.


    Directory of Open Access Journals (Sweden)

    Dijana Močnik


    Full Text Available The purpose of the paper is to explore the growth aspirations of south-eastern European (SEE countries (Bosnia and Herzegovina,Croatia, Greece, Hungary, Macedonia, Montenegro, Romania and Slovenia early stage entrepreneurs, concentrating on therelationship between a firm's innovative and international orientation and its growth aspirations. Innovative orientation andinternational orientation are referred as the most important dimensions of the growth aspirations and can be used for strengthening of a firm from SEE countries. We used firm's aspirations about the future employment as the operational measure of entrepreneurial growth. The data for our analysis is obtained from the 2010 Global Entrepreneurship Monitor Adult Population Survey (APS in which 1,106 early stage entrepreneurs from eight countries were identified. The results of the binary logistic regression show that innovative orientation is negatively related to the firms' growth aspirations. This means that the adoption of new technology as well as offering new products/services weakens the growth aspirations of the early stage entrepreneurial SEE countries firms. The predictor of international orientation, too, is negatively and significantly associated with the growth aspirations. This means that internalisation impedes SEE countries firms’ growth aspirations. The results also show that firms from innovation driven countries haveless negative growth aspirations compared to those from efficiency driven countries.

  9. Aspirated safety pin requiring thoracotomy: report of a case and review. (United States)

    Causey, A L; Talton, D S; Miller, R C; Warren, E T


    Foreign body aspirations in children are relatively uncommon occurrences, but they can be a serious events, causing respiratory distress, atelectasis, chronic pulmonary infections, or death. Safety pins are not commonly aspirated objects and account for less than 3% of all foreign bodies found in the tracheobronchial tree. Fewer than 2% of patients require thoracotomy, and most aspirated materials can be removed by bronchoscopy, with low morbidity and mortality. A discussion of airway foreign bodies follows the presentation of a case of an older child who aspirated a safety pin, which required open thoracostomy for removal.

  10. Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study. (United States)

    Terré, R; Mearin, F


    The chin-down posture is generally recommended in patients with neurogenic dysphagia to prevent tracheal aspiration; however, its effectiveness has not been demonstrated. To videofluoroscopically (VDF) assess the effectiveness of chin-down posture to prevent aspiration in patients with neurogenic dysphagia secondary to acquired brain injury. Randomized, alternating, cross-over study (with and without the chin-down posture) in 47 patients with a VDF diagnosis of aspiration [31 stroke, 16 traumatic brain injury (TBI)] and 25 controls without aspiration (14 stroke, 11 TBI). During the chin-down posture, 55% of patients avoided aspiration (40% preswallow aspiration and 60% aspiration during swallow). The percentage was similar in both etiologies (58% stroke and 50% TBI). Fifty-one percent of patients had silent aspiration; of these, 48% persisted with aspiration while in the chin-down posture. A statistically significant relationship was found between the existence of pharyngeal residue, cricopharyngeal dysfunction, pharyngeal delay time and bolus volume with the persistence of aspiration. The chin-down posture did not change swallow biomechanics in patients without aspiration. Only half the patients with acquired brain injury avoided aspiration during cervical flexion; 48% of silent aspirators continued to aspire during the maneuver. Several videofluoroscopic parameters were related to inefficiency of the maneuver. Therefore, the indication for chin-down posture should be evaluated by videofluoroscopic examination. © 2012 Blackwell Publishing Ltd.

  11. [da Vinci surgical system]. (United States)

    Watanabe, Gou; Ishikawa, Norihiro


    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  12. Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature

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    Mehrotra Ravi


    Full Text Available Abstract Background Fine needle aspiration biopsy (FNAB is gaining increasing popularity in the diagnosis of musculoskeletal lesions; and in many patients, a definitive diagnosis can be rendered from aspiration smears alone. Its applicability in bone pathology, however, has been controversial due to a high percentage of inadequate smears, difficulty in evaluation of tissue architecture and nonspecific results in the diagnosis of primary bone lesions. In this study, the value of aspiration as the first pathological investigation in the diagnosis of a bone lesion was evaluated. Methods 91 cases of clinically suspected cases of bone lesions were aspirated over a period of two years. Direct or cytospin smears were fixed in 95% alcohol and stained by Hematoxylin and Eosin or air-dried and later fixed in methanol for May Grŭnwald Giemsa staining. Results Of the 91 patients who were subjected to FNAB, 81 were considered satisfactory and 10.9 % (10 were inadequateinconclusive for diagnosis. Cyto-histological concordance was obtained in 78.5 % (51/65 patients. Positive and negative predictive values were 87.5% and 97.2 % respectively. Sensitivity as a preliminary diagnostic technique was 93.3%, whereas specificity was 94.5 %. Overall, diagnostic accuracy was 94.2 %. Metastatic lesions were detected with 100% accuracy. Two cases were reported as false positive and one case as false negative. Conclusion Cytology provides valuable information to the clinician to make an informed decision regarding appropriate therapy. We conclude that time-consuming and costly investigations may be reduced by choosing FNAB as the initial pathological diagnostic method for skeletal lesions of unknown origin. The choice of radiological examinations, laboratory tests and surgical biopsies can be determined after the FNAB diagnosis.

  13. Aspiring to leadership--identifying teacher-leaders. (United States)

    Rogers, John


    Educational institutions need effective leaders at many levels. This paper explores the applicability of the Porter/Mazlow need-priority and Herzberg maintenance-motivation models to the challenge of identifying individuals who aspire to leadership. The review includes literature from teaching, engineering, medicine, astronomy, business, and the military. Autonomy need and achievement motivation consistently distinguished leaders from non-leaders in several studies. Affiliation and esteem needs also characterized leaders in two studies. These empirical data support the use of these theoretical models, which are intuitively appealing and have potential for practical applications. One such application could be the identification and recruitment of education "champions" who would be teacher-leaders at dispersed sites. Through self-reflection faculty members could become aware of their needs and motivations and may realize their leadership aspirations and accept the teacher-leader role. For an education "champions" program to be successful, the department leadership would need to attend to the organizational culture and provide release time for the teacher-leaders. A blueprint for the development of teacher-leaders is outlined.

  14. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration. (United States)

    Berumen-Nafarrate, Edmundo; Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene


    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  15. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

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    Edmundo Berumen-Nafarrate


    Full Text Available The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

  16. Functional morphology and evolution of aspiration breathing in tetrapods. (United States)

    Brainerd, Elizabeth L; Owerkowicz, Tomasz


    In the evolution of aspiration breathing, the responsibility for lung ventilation gradually shifted from the hyobranchial to the axial musculoskeletal system, with axial muscles taking over exhalation first, at the base of Tetrapoda, and then inhalation as well at the base of Amniota. This shift from hyobranchial to axial breathing freed the tongue and head to adapt to more diverse feeding styles, but generated a mechanical conflict between costal ventilation and high-speed locomotion. Some "lizards" (non-serpentine squamates) have been shown to circumvent this speed-dependent axial constraint with accessory gular pumping during locomotion, and here we present a new survey of gular pumping behavior in the tuatara and 40 lizard species. We observed gular pumping behavior in 32 of the 40 lizards and in the tuatara, indicating that the ability to inflate the lungs by gular pumping is a shared-derived character for Lepidosauria. Gular pump breathing in lepidosaurs may be homologous with buccal pumping in amphibians, but non-ventilatory buccal oscillation and gular flutter have persisted throughout amniote evolution and gular pumping may have evolved independently by modification of buccal oscillation. In addition to gular pumping in some lizards, three other innovations have evolved repeatedly in the major amniote clades to circumvent the speed-dependent axial constraint: accessory inspiratory muscles (mammals, crocodylians and turtles), changing locomotor posture (mammals and birds) and respiratory-locomotor phase coupling to reduce the mechanical conflict between aspiration breathing and locomotion (mammals and birds).

  17. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration (United States)

    Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene


    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis. PMID:24392235

  18. Thyroid fine-needle aspiration biopsy and thyroid cancer diagnosis: a nationwide population-based study.

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    Li-Ying Huang

    Full Text Available Thyroid cancer is the most common endocrine gland malignancy and fine-needle aspiration biopsy is widely used for thyroid nodule evaluation. Repeated aspiration biopsies are needed due to plausible false-negative results. This study aimed to investigate the overall relationship between aspiration biopsy and thyroid cancer diagnosis, and to explore factors related to shorter diagnostic time.This nationwide retrospective cohort study retrieved data from the Longitudinal Health Insurance Database in Taiwan. Subjects without known thyroid malignancies and who received the first thyroid aspiration biopsy after 2004 were followed-up from 2004 to 2009 (n = 7700. Chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were used for data analysis.Of 7700 newly-aspirated patients, 276 eventually developed thyroid cancer (malignancy rate 3.6%. Among the 276 patients with thyroid cancer, 61.6% underwent only one aspiration biopsy and 81.2% were found within the first year after the initial aspiration. Cox proportional hazards model revealed that aspiration frequency (HR 1.07, 95% CI 1.06-1.08, ultrasound frequency (HR 1.02, 95% CI 1.01-1.03, older age, male sex, and aspiration biopsies arranged by surgery, endocrinology or otolaryngology subspecialties were all associated with shorter time to thyroid cancer diagnosis.About 17.4% of thyroid cancer cases received more than two aspiration biopsies and 18.8% were diagnosed one year after the first biopsy. Regular follow-up with repeated aspiration or ultrasound may be required for patients with clinically significant thyroid nodules.

  19. [Fine-needle Aspiration of Thyroid Nodules: Is it Worth Repeating? (United States)

    Fernandes, Vera; Pereira, Tânia; Eloy, Catarina


    The fine-needle aspiration has a significant role in assessing the malignancy risk of thyroid nodules. There is uncertainty regarding the value of repeat fine-needle aspiration in benign nodules. This study aims to evaluate the concordance of results in consecutive fine-needle aspiration and to study the relevance of repetition in benign results. Retrospective study of the 4800 thyroid nodules fine-needle aspiration held in Instituto de Patologia e Imunologia Molecular da Universidade do Porto between January 1, 2014 and May 2, 2016. Of the initial sample, we selected the repeated fine-needle aspiration on the same nodule. The first fine-needle aspiration result of the 309 nodules underwent revaluation was non-diagnostic in 103 (33.3%), benign in 120 (38.8%) and atypia/follicular lesion of undetermined significance in 86 (27.8%). The agreement between the first and second fine-needle aspiration was significantly higher in cases with an initial benign result (benign: 85.8%, non-diagnostic: 27.2% and atypia/follicular lesion of undetermined significance: 17.4%, p < 0.005). The fine-needle aspiration repeating motifs in initially benign nodules (n = 78) were repetition suggestion in 58, nodule growth in 17 and suspicious ultrasonographic features in 3. The fine-needle aspiration repetition in nodules with initial non-diagnostic and atypia/follicular lesion of undetermined significance result changed the initial diagnosis in a significant proportion of patients, modifying their therapeutic approach. The high concordance of results in initially benign nodules makes fine-needle aspiration repetition not cost-effective in most cases. The fine-needle aspiration should be repeated when the initial cytology result is non-diagnostic or atypia/follicular lesion of undetermined significance.

  20. Vitiligo- A surgical approach

    Directory of Open Access Journals (Sweden)

    Deepti Ghia


    Full Text Available Aims and objective- To describe the spectrum of surgical modalities for stable vitiligo patients Methods- Patients having stable vitiligo since past 2 years with no improvement with medical line of treatment were enrolled for surgery after informed consent. Depending upon the size and location of vitiligo patch different modalities were performed. Suction blister, mini-punch grafting, split thickness skin grafting, trypsinised melanocyte-keratinocyte transfer and non-trypsinised melanocyte- keratinocyte transfer (Jodhpur technique and follicular grafting technique have been described photographically which have been performed at a tertiary care hospital. Conclusion- Vitiligo is often difficult to treat, stable patches resistant to medical line of management do respond to surgical treatment; however it is very important to choose the modality of surgery according location of the patch, size of the lesion and available resources.

  1. Spacecraft surgical scrub system (United States)

    Abbate, M.


    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  2. Surgical removal of cataracts due to Diplostomum species in Gulf sturgeon (Acipenser oxyrinchus desotoi). (United States)

    Bakal, Robert S; Hickson, Brian H; Gilger, Brian C; Levy, Michael G; Flowers, James R; Khoo, Lester


    Twenty 6-yr-old (1995-yr-class) Gulf of Mexico sturgeon (Acipenser oxyrinchus desotoi) were diagnosed as having bilateral cataracts. Histopathologic assessment of the lenses of two of the fish revealed the presence of a diplostomid trematode. Pharmacological treatment of the trematodes may be effective for killing the parasites, but the damage to the lenses and resulting cataracts are nonreversible. Because these animals were to be used in a subsequent study as sentinels in the natural environment, it was necessary to return the animals' vision to as close to normal as possible. Electroretinograms were performed on each fish's eyes to ensure that retinal function was present. Cataracts then were surgically removed by phacoemulsification and aspiration. The animals tolerated the surgical procedures well. This report is the first known report of surgical correction of cataracts in sturgeon species. It also is the first known attempt to correct vision problems in fish being returned to the wild.

  3. Empiric therapy for pneumonia in the surgical intensive care unit. (United States)

    Fabian, T C


    Empiri c therapy of ventilator-associated pneumonia (VAP) in surgical patients should be based on intensive care unit (ICU)-specific surveillance data, because microbial flora patterns vary widely between geographic regions as well as within hospitals. Surgical ICUs have higher VAP rates than other units. Data from the National Nosocomial Infection Surveillance (NNIS) System report Pseudomonas aeruginosa and Staphylococcus aureus to be the most frequent isolates (each 17.4%). Data from the NNIS documents high resistance patterns in ICUs compared with hospitals at large, as well as unit-specific patterns. VAP risk factors for surgical patients include thoracoabdominal surgery, altered level of consciousness, advanced age, diabetes mellitus, malnutrition, chronic obstructive pulmonary disease, and prior antibiotic administration. Promising prevention strategies include restricting ventilator circuit changes, in-line heat moisture exchange filters, semi-recumbant positioning, and continuous subglottic aspiration. Pharmacodynamics should be considered when choosing antibiotic regimens. Postantibiotic effect and time-dependent versus concentration-dependent killing should be studied in clinical trials. Current guidelines for choosing regimens have been well developed by the American Thoracic Society.

  4. Gossypiboma—Retained Surgical Sponge

    Directory of Open Access Journals (Sweden)

    Hung-Shun Sun


    Full Text Available Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary retention. She had a history of vaginal hysterectomy for uterine prolapse 18 years previously, performed at our hospital. Retained surgical sponge in the pelvic cavity was suspected by abdominal computed tomography. The surgical gauze was removed by laparotomy excision and the final diagnosis was gossypiboma.

  5. Hepatic surgical anatomy. (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros


    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  6. Louis Pasteur surgical revolution. (United States)

    Toledo-Pereyra, Luis H


    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  7. Guideline implementation: Surgical attire. (United States)

    Cowperthwaite, Liz; Holm, Rebecca L


    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  8. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel


    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  9. Surgical treatment and histopathology of a symptomatic free-floating primary pigment epithelial iris cyst in the anterior vitreous

    Directory of Open Access Journals (Sweden)

    Eman Al-Kahtani


    Full Text Available We report the surgical removal of an iris pigment epithelial cyst that was floating freely in the posterior chamber of an 18-month-old child. The reason for surgical removal was disturbance in near vision secondary to the movement of the cyst across the visual axis. Visual disturbance secondary to a unilateral anterior vitreous iris cyst at this age is a rare presentation and, to the best of our knowledge, has not been reported previously as an indication for surgery. We performed histopathological study of the cyst aspirate to determine its contents and its possible origin.

  10. Bounded Aspirations: Rural, African American High School Students and College Access (United States)

    Means, Darris R.; Clayton, Ashley B.; Conzelmann, Johnathan G.; Baynes, Patti; Umbach, Paul D.


    This qualitative case study explores the career and educational aspirations, college choice process, and college barriers and opportunities of 26 rural, African American high school students. Data included interviews with 26 students and 11 school staff members. Findings suggest that the students' rural context shapes aspirations. In addition,…

  11. Giving It the Old College Try: Understanding Degree Commitment among Division I FBS NFL Aspirants (United States)

    Martinez, Guadalupe Federico.


    Building on sociological studies regarding college choice and persistence, this qualitative study investigates the college and post college experiences of 15 current students with NFL aspirations and 13 former students who held NFL aspirations, all from Division I Football Bowl Series (FBS) programs. A phenomenological design is implemented to…

  12. Parents Influencing Secondary Students' University Aspirations: A Multilevel Approach Using School-SES (United States)

    Watson, Stuart; Vernon, Lynette; Seddon, Sarah; Andrews, Yolanda; Wang, Angela


    Students' university aspirational capacity and expectancies are key factors in predicting future university participation. Aspirations and expectations to attend university are strongly influenced by parent educational socialisation and school culture. This study investigates associations between students' university discussions with parents and…

  13. Developing Conceptual Understandings of the Capacity to Aspire for Higher Education (United States)

    Prodonovich, Samuel; Perry, Laura B.; Taggart, Andrew


    This paper reviews research and theory relating to aspirations for higher education as a cultural capacity. Understanding the social and cultural dimensions of aspirations for higher education is important as they are increasingly becoming part of social commentary and more recently educational policy, research and practice. This paper synthesises…

  14. Constructing New Identities? The Role of Gender and Education in Rural Girls' Life Aspirations in Peru (United States)

    Ames, Patricia


    This paper focuses on rural and indigenous girls and their mothers in Peru, examining how they position schooling and education in their current life and future aspirations, in order to better understand girls' increasing participation in education. It is argued here that the high educational aspirations girls and their families have are not only…

  15. African American Career Aspirations: Examining the Relative Influence of Internalized Racism (United States)

    Brown, Danice L.; Segrist, Daniel


    The present study examined the relative influence of aspects of internalized racism on the career aspirations of a sample of African American adults. Participants (N = 315), ranging in age from 18 to 62 years, completed measures of internalized racism and career aspirations online. A hierarchical multiple regression analysis was conducted to…

  16. Counter-Stereotypes and Feminism Promote Leadership Aspirations in Highly Identified Women. (United States)

    Leicht, Carola; Gocłowska, Małgorzata A; Van Breen, Jolien A; de Lemus, Soledad; Randsley de Moura, Georgina


    Although women who highly identify with other women are more susceptible to stereotype threat effects, women's identification might associate with greater leadership aspirations contingent on (1) counter-stereotype salience and (2) feminist identification. When gender counter-stereotypes are salient, women's identification should associate with greater leadership aspiration regardless of feminism, while when gender stereotypes are salient, women's identification would predict greater leadership aspirations contingent on a high level of feminist identification. In our study US-based women (N = 208) attended to gender stereotypic (vs. counter-stereotypic) content. We measured identification with women and identification with feminism, and, following the manipulation, leadership aspirations in an imagined work scenario. The interaction between identification with women, identification with feminism, and attention to stereotypes (vs. counter-stereotypes) significantly predicted leadership aspirations. In the counter-stereotypic condition women's identification associated with greater leadership aspirations regardless of feminist identification. In the stereotypic condition women's identification predicted leadership aspirations only at high levels of feminist identification. We conclude that salient counter-stereotypes and a strong identification with feminism may help high women identifiers increase their leadership aspirations.

  17. The Role of Educational Aspirations and Expectations in the Discontinuity of Intergenerational Low-Income Status (United States)

    Lee, Jungeun Olivia; Hill, Karl G.; Hawkins, J. David


    This study investigated one potential mechanism mediating continuity and discontinuity in low-income status across generations: children's educational aspirations and expectations. Data were drawn from a community sample of 808 participants who were followed from age 10 to 30. Four trajectory groups of children's educational aspirations and…

  18. Improved histopathological evaluation of gliomas using tissue fragments obtained by ultrasonic aspiration

    DEFF Research Database (Denmark)

    Neckelmann, K; Kristensen, B W; Schrøder, H D


    Ultrasonic aspirators are commonly used to resect brain tumors because they allow safe, rapid and accurate removal of dissected tissue. However, the tissue fragments removed by ultrasonic aspirators are used surprisingly little in daily diagnostics and in clinical research. A comparison between d...

  19. Independent School Department Heads: The Influence of Role Ambiguity, Relationships, and Professional Development on Career Aspirations (United States)

    Kinsella, Shane


    Little research exists on the career aspirations of department heads in independent schools. What does exist focuses on public school teachers in the United States and the United Kingdom. This study sought to determine the career aspirations, job satisfaction, and job efficacy of department heads. Using data from an original survey instrument…

  20. Middle School Children's Career Aspirations: Relationship to Adult Occupations and Gender (United States)

    Schuette, Christine T.; Ponton, Michael K.; Charlton, Margaret L.


    The authors explored the relationship between the career aspirations of 89 preadolescents from low socioeconomic backgrounds and the actual occupations of the working adults in their homes with regard to status, job gender identification, and interest (Holland, 1997). There was a significant relationship between boys' career aspirations and the…

  1. Glioma spheroids obtained via ultrasonic aspiration are viable and express stem cell markers

    DEFF Research Database (Denmark)

    Jensen, Stine Skov; Aaberg-Jessen, Charlotte; Andersen, Claus


    Ultrasonic aspirators allow safe, rapid, and accurate removal of brain tumors. However, the tissue fragments removed are used surprisingly little in research.......Ultrasonic aspirators allow safe, rapid, and accurate removal of brain tumors. However, the tissue fragments removed are used surprisingly little in research....

  2. Oral health care and aspiration pneumonia in frail older people: a systematic literature review

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Vanobbergen, J.N.; Bronkhorst, E.M.; Schols, J.M.; Baat, C. de


    OBJECTIVE: To systematically review the literature on oral health care interventions in frail older people and the effect on the incidence of aspiration pneumonia. BACKGROUND: Oral health care seems to play an important role in the prevention of aspiration pneumonia in frail older people. METHODS: P

  3. Career Aspirations and Expectations of College Students: Demographic and Labor Market Comparisons (United States)

    Metz, A. J.; Fouad, Nadya; Ihle-Helledy, Kris


    Replicating previous research, this study examined differences in 677 diverse college students' career aspirations and expectations based on gender and ethnicity, and compared their career expectations to the U.S. workforce. This study extended the literature base by exploring discrepancies between occupational aspirations and expectations…

  4. Bounded Aspirations: Rural, African American High School Students and College Access (United States)

    Means, Darris R.; Clayton, Ashley B.; Conzelmann, Johnathan G.; Baynes, Patti; Umbach, Paul D.


    This qualitative case study explores the career and educational aspirations, college choice process, and college barriers and opportunities of 26 rural, African American high school students. Data included interviews with 26 students and 11 school staff members. Findings suggest that the students' rural context shapes aspirations. In addition,…

  5. Intralesional saline injection for effective ultrasound-guided aspiration of benign viscous cystic thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Eun Sook; Shin, Jung Hee [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Sung, Jin Yong [Dept. of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, Seoul (Korea, Republic of)


    We aimed to evaluate the efficacy and safety of vigorous saline injection for viscous cystic thyroid nodules. Eighteen patients who underwent ultrasound-guided aspiration for viscous cystic thyroid nodules using a saline injection were included in our study. After failing to aspirate the cyst by the usual method, we vigorously injected saline into the cyst in multiple directions to break up and liquefy the viscous cystic contents to enable aspiration. The initial and the residual volume of the nodule were calculated, and the volume reduction rate and the time taken to perform the aspiration were recorded. The mean volume of the cystic nodules before aspiration was 11.0 mL (range, 1.2 to 26.0 mL), while the postaspiration volume was 4.2 mL (range, 0.2 to 14.5 mL). The mean aspirated volume was 63.7% of the initial volume. The mean procedure time was 12.4 minutes (range, 5 to 26 minutes). There were no significant complications related to the procedure. A vigorous saline injection followed by aspiration can be a useful method to aspirate viscous cystic thyroid nodules as a prestep for further intervention or simple management.

  6. Creative Aspirations or Pipe Dreams? Toward Understanding Creative Mortification in Children and Adolescents (United States)

    Beghetto, Ronald A.; Dilley, Anna E.


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

  7. The Realism and Sex Type of Four- to Five-Year-Old Children's Occupational Aspirations (United States)

    Care, Esther; Deans, Jan; Brown, Robert


    Research on career development has focused primarily on adolescents and adults. However, in Gottfredson's theory of circumscription and compromise (2002) it is proposed that career aspirations originate in the preschool years and that the earliest work aspirations of children are sex typed in relation to the activities of same sex adults. This…

  8. Ultrasound guided fine-needle aspiration cytology of breast lesions


    C. Pagani; Coscia, D. R.; Dellabianca, C.; Bonardi, M.; Alessi, S.; Calliada, F.


    Breast biopsy consists in the collection of cells or tissue fragments from a breast lesion and their analysis by a pathologist. There are several types of breast biopsy defined on the basis of the type of needle used: fine-needle aspiration and biopsy performed with a spring-based needle. This article focuses on fine-needle aspiration performed under sonographic guidance.

  9. The Relationship between Career Variables and Occupational Aspirations and Expectations for Australian High School Adolescents (United States)

    Patton, Wendy; Creed, Peter


    This study surveyed 925 Australian high school students enrolled in grades 8 through 12 on measures of occupational aspirations, occupational expectations, career status aspirations, and career status expectations; it tested the association between these variables and career maturity, career indecision, career decision-making self-efficacy, and…

  10. Syringe and Needle Size, Syringe Type, Vacuum Generation, and Needle Control in Aspiration Procedures (United States)

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


    Purpose Syringes are used for diagnostic fluid aspiration and fine needle aspiration biopsy (FNA) in interventional procedures. We determined the benefits, disadvantages, and patient safety implications of syringe and needle size on vacuum generation, hand force requirements, biopsy/fluid yield, and needle control during aspiration procedures. Materials and Methods Different sizes (1, 3, 5, 10, and 20 ml) of the conventional syringe and aspirating mechanical safety syringe, the reciprocating procedure device (RPD), were studied. 20 operators performed aspiration procedures with the following outcomes measured: 1) vacuum (Torr), 2) time to vacuum (seconds), 3) hand force to generate vacuum (Torr-cm2), 4) operator difficulty during aspiration, 5) biopsy yield (mg), and 6) operator control of the needle tip position (mm). Results Vacuum increased tissue biopsy yield at all needle diameters (p aspirate, and resulted in significant loss of needle control (pneedle control (pneedle and maximize fluid and tissue yield during aspiration procedures, a two-handed technique and the smallest syringe size adequate for the procedure should be used. If precise needle control or one-handed operation is required, a mechanical safety syringe should be considered. PMID:21057795

  11. The Influence of Major Ambition Resources on College Aspirations and Attainments: Toward a Comprehensive Model. (United States)

    Spady, William G.

    This paper attempts to design a model that covers a comprehensive range of theoretically relevant variables that focus on the aspiration-attainment process. The discussion is in 4 parts. First, the concept of "ambition" is separated into theoretically and operationally distinct components. Second, educational aspiration and college attainments are…

  12. Debridement for surgical wounds. (United States)

    Dryburgh, Nancy; Smith, Fiona; Donaldson, Jayne; Mitchell, Melloney


    Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. The aim of this review is to determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. We developed a search strategy to search the following electronic databases: Wounds Group Specialised Trials Register (searched 3/3/08) , Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2008, issue 1), MEDLINE (1950 to February Week 3 2008 ), EMBASE (1980 to 2008 Week 09) and CINHAL (1982 to February Week 4 2008). We checked the citations within obtained studies to identify additional papers and also relevant conference proceedings. We contacted manufactures of wound debridement agents to ascertain the existence of published, unpublished and ongoing trials. Our search was not limited by language or publication status. We included relevant randomised controlled trials (RCT) with outcomes including at least one of the following: time to complete debridement, or time to complete healing. Two authors independently reviewed the abstracts and titles obtained from the search, two extracted data independently using a standardised extraction sheet, and two independently assessed methodological quality. One author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Five RCTs were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed (complete debridement). One trial compared an enzymatic agent (Streptokinase/streptodornase) with saline-soaked dressings and reported the time to complete debridement. Four of the trials compared the effectiveness of dextranomer beads or paste with other products (different comparator

  13. Aspiration-based learning promotes cooperation in spatial prisoner's dilemma games (United States)

    Liu, Yongkui; Chen, Xiaojie; Wang, Long; Li, Bin; Zhang, Wenge; Wang, Huifeng


    We study the evolution of cooperation in spatial prisoner's dilemma by proposing an aspiration-based preference learning, under which individuals switch the learning agents only if the achieved payoffs are lower than their aspirations. Both synchronous and asynchronous updates are considered. We find that the aspiration level can substantially influence the evolution of cooperation, with the moderate aspiration level leading to a plateau of the high cooperation level. There exist phase transitions for proper combinations of parameters and we give an analysis for the phase transition points. We also investigate the stationary configuration patterns and the stationary distributions of cooperators and defectors on the square lattice for a comprehensive understanding. The behavior of the well-mixed system of our model has also been discussed. Our results may provide further insights into understanding the role played by individual aspiration in the emergence of cooperation.

  14. Surgical recovery of sperm in non-obstructive azoospermia

    Institute of Scientific and Technical Information of China (English)

    Tomomoto Ishikawa


    The development of intracytoplasmic sperm injection (ICSI) opened a new era in the field of assisted reproduction and revolutionized the assisted reproductive technology protocols for couples with male factor infertility.Fertilisation and pregnancies can be achieved with spermatozoa recovered not only from the ejaculate but also from the seminiferous tubules.The most common methods for retrieving testicular sperm in non-obstructive azoospermia (NOA) are testicular sperm aspiration (TESA:needle/fine needle aspiration)and open testicular biopsy (testicular sperm extraction:TESE).The optimal technique for sperm extraction should be minimally invasive and avoid destruction of testicular function,without compromising the chance to retrieve adequate numbers of spermatozoa to perform ICSI.Microdissection TESE (micro-TESE),performed with an operative microscope,is widely considered to be the best method for sperm retrieval in NOA,as larger and opaque tubules,presumably with active spermatogenesis,can be directly identified,resulting in higher spermatozoa retrieval rates with minimal tissue loss and low postoperative complications.Micro-TESE,in combination with ICSI,is applicable in all cases of NOA,including Klinefelter syndrome (KS).The outcomes of surgical sperm retrieval,primarily in NOA patients with elevated serum follicle-stimulating hormone (FSH) (NOA including KS patients),are reviewed along with the phenotypic features.The predictive factors for surgical sperm retrieval and outcomes of treatment were analysed.Finally,the shortand long-term complications in micro-TESE in both 46XY males with NOA and KS patients are considered.

  15. New Frontiers in Surgical Innovation. (United States)

    Jackson, Ryan S; Schmalbach, Cecelia E


    It is an exciting time for head and neck surgical innovation with numerous advances in the perioperative planning and intraoperative management of patients with cancer, trauma patients, and individuals with congenital defects. The broad and rapidly changing realm of head and neck surgical innovation precludes a comprehensive summary. This article highlights some of the most important innovations from surgical planning with sentinel node biopsy and three-dimensional, stereolithic modeling to intraoperative innovations, such as transoral robotic surgery and intraoperative navigation. Future surgical innovations, such as intraoperative optical imaging of surgical margins, are also highlighted. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. The detection of pharyngeal incoordination and aspiration by radiosalivagram in cerebral palsy

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    Baikie, G.; Reddihough, D.; Olinsky, A.; South, M.J.; Bowe, J.; Cook, D.J. [Royal Children`s Hospital, Parkville, VIC, (Australia)


    Full text: Children with cerebral palsy (CP) may have abnormal respiratory function because of aspiration pneumonitis, chest deformity, upper airways obstruction or central respiratory control abnormalities. The diagnosis of aspiration has long confounded clinicians and is often made indirectly after exclusion of other causes of respiratory disease in susceptible individuals. The radiosalivagram is a technique which permits the demonstration of aspiration of pharyngeal contents in individuals with pharyngeal incoordination. It is a simple procedure which provides both qualitative and quantitative evidence of aspiration. Over an hour and while supine, 20 mL of {sup 99m}Tc-sulphur colloid is instilled into the pharynx via a thin plastic tube using a syringe pump. The neck, thorax and upper abdomen are imaged continuously In normal individuals, radioactivity is demonstrated in the pharynx, oesophagus and stomach; in the presence of pharyngeal incoordination, radioactivity is seen within one or both main bronchi and adjacent lung fields. The rate of clearance from the lungs varies and can be quantified. We have studied 31 children with severe non-ambulant CR The time to first aspiration, maximum quantity aspirated, and retention of aspirated material at 2h have been determined. These data have been compared with measurements of respiratory function. Preliminary results of this ongoing study reveal a broad range of outcomes. Seventeen children (17/31) had aspiration, in 15/17 aspiration was unilateral and in 14/17 there was spontaneous early clearance. The investigation was well tolerated by patients. The radiosalivagram is a simple, quantifiable investigation for demonstrating or excluding pharyngeal incoordination and aspiration in children with unexplained respiratory disease.

  17. The Coventry Award. The value of preoperative aspiration before total knee revision. (United States)

    Barrack, R L; Jennings, R W; Wolfe, M W; Bertot, A J


    The value of routine aspiration of a symptomatic total knee replacement before reoperation was evaluated. The study group consisted of a consecutive series of 69 knees in 67 patients in which preoperative aspiration was performed. All aspirations were performed on an outpatient basis in a clinic setting. Local anesthetics and saline washings were not used. Twenty knees were determined to be infected and 49 knees were not infected. Preoperative aspiration had an overall sensitivity of 55%, specificity of 96%, accuracy of 84%, positive predictive value of 85%, and negative predictive value of 84%. Sixteen patients were taking antibiotics at the time of referral including 12 of 20 (60%) who had infected knees. Seven of these 12 (58%) had no growth on their initial knee aspiration. Four of these had their knees reaspirated at a later date because of a high index of suspicion for infection and the subsequent aspiration revealed the infecting organism in all four cases. Two of the remaining three patients had signs of sepsis develop and reaspiration was not performed because immediate reoperation was indicated clinically. The initial aspiration on the third patient was performed after antibiotic therapy was discontinued for 4 weeks and a repeat aspiration was not deemed necessary. When the results of the reaspirations are included, the overall aspiration results improved to a sensitivity of 75%, specificity of 96%, and accuracy of 90%. The results of the study support the use of routine preoperative aspiration before total knee revision. Previous antibiotic use increases the risk of a false negative result, and reaspiration at a later date can be expected to significantly improve the value of this test in such cases.

  18. Aspirated capacitor measurements of air conductivity and ion mobility spectra

    CERN Document Server

    Aplin, K L


    Measurements of ions in atmospheric air are used to investigate atmospheric electricity and particulate pollution. Commonly studied ion parameters are (1) air conductivity, related to the total ion number concentration, and (2) the ion mobility spectrum, which varies with atmospheric composition. The physical principles of air ion instrumentation are long-established. A recent development is the computerised aspirated capacitor, which measures ions from (a) the current of charged particles at a sensing electrode, and (b) the rate of charge exchange with an electrode at a known initial potential, relaxing to a lower potential. As the voltage decays, only ions of higher and higher mobility are collected by the central electrode and contribute to the further decay of the voltage. This enables extension of the classical theory to calculate ion mobility spectra by inverting voltage decay time series. In indoor air, ion mobility spectra determined from both the novel voltage decay inversion, and an established volt...

  19. Suburbanization, Intra-Urban Mobility and Homeownership Aspirations

    DEFF Research Database (Denmark)

    Andreasen, Manja Hoppe

    is based on case studies undertaken in 2013-2014 of five rapidly growing, peripheral settlements. Urban expansion processes are viewed from the perspective of urban residents buying land, settling and living in the periphery. The overall objective of the research is to understand how urban residents...... are shaping and influencing processes and dynamics of urban expansion through their settlement practices, preferences and aspirations, and based on this analysis to contribute to an emerging scientific debate on how transformations of peripheral spaces of African cities can be conceptualized...... construction of housing, financed, built and inhabited by individual residents, who are predominantly long-term urban residents moving from central parts of the city and who are engaging in urban-based livelihood activities, which are often critically reliant on daily or regular mobility and access to central...

  20. Fine Needle Aspiration Cytology in Diagnosis of Pure Neuritic Leprosy

    Directory of Open Access Journals (Sweden)

    Bipin Kumar


    Full Text Available Leprosy is a chronic infection affecting mainly the skin and peripheral nerve. Pure neuritic form of this disease manifests by involvement of the nerve in the absence of skin lesions. Therefore, it can sometimes create a diagnostic problem. It often requires a nerve biopsy for diagnosis, which is an invasive procedure and may lead to neural deficit. Fine needle aspiration cytology (FNAC of an affected nerve can be a valuable and less invasive procedure for the diagnosis of such cases. We report five suspected cases of pure neuritic Hansen's disease involving the common and superficial peroneal, ulnar, and median nerve, who underwent FNAC. Smears revealed nerve fibers infiltrated by chronic inflammatory cells in all cases, presence of epithelioid cells granulomas, and Langhans giant cells in three cases, and acid fast bacilli in two cases. In conclusion, FNAC is a safe, less invasive, and time saving procedure for the diagnosis of pure neuritic leprosy.

  1. Teaching Strategies for Addressing Poverty Awareness With Aspiring Helping Professionals

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    Othelia Eun-Kyoung Lee


    Full Text Available This study describes the use of guided learning activities that exposed aspiring helping professionals to the challenges and discrimination experienced by individuals living in poverty. Pretest/posttest and qualitative analysis of participants’ reactions to a Poverty Simulation and a Bridges Out of Poverty Workshop were analyzed to explore perceived learning benefits reported by 43 master of social work (MSW students. Incorporating poverty content into masters-level social work curriculum stimulated classroom discussions about how the lived experiences of individuals living in poverty impact the service relationship between helping professionals and clients. This observational study evaluated the effectiveness of the used strategies and methods in impacting individual assumptions about socioeconomic class and illustrated the value of university–community collaborations in supporting diversity education and awareness both on and off campus.

  2. Clinical utility of head and neck aspiration cytology. (United States)

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


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

  3. Social sustainability in urban renewal: An assessment of community aspirations

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    Daniel Chi Wing Ho


    Full Text Available The lack of a proper building care culture has led to serious problems of urban decay in most developed cities, threatening community health and safety. To arrest urban decay, redevelopment is a commonly adopted approach for regenerating rundown areas. Redevelopment often results in negative outcomes such as disturbances to existing social networks and burgeoning construction and demolition waste. On the other hand, building rehabilitation is a more socially and environmentally friendly alternative to redevelopment, but its success depends much on residents’ active participation. With a view towards a sustainable strategy for urban renewal, it is necessary to balance the interests of different stakeholders regarding the choice between these two mainstream approaches to renewal. Although economic and physical issues are important decision making considerations, this study explores the aspirations and preferences of local residents in relation to the two options through a structured survey. The findings are conducive to the development of a balanced and socially sustainable strategy of urban renewal.

  4. Aspiration cytology of ameloblastic fibroma: a diagnostic challenge. (United States)

    Kumar, Neeta; Jain, Shyama


    Ameloblastic fibroma of the jaw is a rare, benign mixed odontogenic tumor, having little tendency for local invasion and a low recurrence rate. Cytologic distinction from ameloblastoma, ameloblastic fibrosarcoma, and intraosseous adenoid cystic carcinoma is necessary, in view of the different biologic behavior. A painful, slow-growing swelling of the jaw in a 5-yr-old child clinicoradiologically considered as a benign cystic lesion was aspirated. Sheets of small monomorphic epithelial cells with peripheral palisading by columnar cells were seen on cytology smears. The striking feature was central hyaline globules in some tubules. A cytologic possibility of adenomatoid odontogenic tumor was suggested. Histopathology, however, confirmed it to be an ameloblastic fibroma. Copyright 2003 Wiley-Liss, Inc.

  5. A randomized controlled trial of peeling and aspiration of Elschnig pearls and neodymium: yttrium-aluminiumgarnet laser capsulotomy

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    Rahul; Bhargava; Prachi; Kumar; Shiv; Kumar; Sharma; Avinash; Kaur


    AIM: To compare surgical peeling and aspiration and neodymium yttrium garnet laser capsulotomy for pearl form of posterior capsule opacification(PCO).METHODS: A prospective, randomized, double blind,study was done at Rotary Eye Hospital, Maranda,Palampur, India, Santosh Medical College Hospital,Ghaziabad, India and Laser Eye Clinic, Noida India.Consecutive patients with pearl form of PCO following surgery, phacoemulsification, manual small incision cataract surgery and conventional extracapsular cataract extraction(ECCE) for age related cataract, were randomized to have peeling and aspiration or neodymium yttrium garnet laser capsulotomy. Corrected distance visual acuity(CDVA), intra-operative and postoperative complications were compared.RESULTS: A total of 634 patients participated in the study, and 314(49.5%) patients were randomized to surgical peeling and aspiration group and 320(50.5%) to the Nd:YAG laser group. The mean pre-procedural log MAR CDVA in peeling and neodymium: yttrium-aluminium-garnet(Nd:YAG) laser group was 0.80 ±0.25 and 0.86 ±0.22, respectively. The mean final CDVA in peeling group(0.22 ±0.23) was comparable to Nd:YAG group(0.24 ±0.28; t-test, P =0.240). There was a significant improvement in vision after both the procedures(P <0.001). A slightly higher percentage of patients in Nd:YAG laser group(283/88.3%) than in peeling group(262/83.4%) had a CDVA of 0.5(20/63) or better at 9mo(P <0.001). On the contrary, patients havingCDVA worse than 1.00(20/200) was also significantly higher in Nd:YAG laser group as compared to peeling group(25/7.7% vs 15/4.7%, respectively). On application of ANCOVA, there was less than 0.001% risk that PCO thickness and total laser energy had no effect on rate of complications in Nd:YAG laser group and less than 0.001% risk that PCO thickness had no effect on complications in peeling group respectively. Sum of square analysis suggests that in the Nd:YAG laser group,thick PCO had a stronger impact on complications

  6. Analysis of surgical intervention populations using generic surgical process models. (United States)

    Neumuth, Thomas; Jannin, Pierre; Schlomberg, Juliane; Meixensberger, Jürgen; Wiedemann, Peter; Burgert, Oliver


    According to differences in patient characteristics, surgical performance, or used surgical technological resources, surgical interventions have high variability. No methods for the generation and comparison of statistical 'mean' surgical procedures are available. The convenience of these models is to provide increased evidence for clinical, technical, and administrative decision-making. Based on several measurements of patient individual surgical treatments, we present a method of how to calculate a statistical 'mean' intervention model, called generic Surgical Process Model (gSPM), from a number of interventions. In a proof-of-concept study, we show how statistical 'mean' procedure courses can be computed and how differences between several of these models can be quantified. Patient individual surgical treatments of 102 cataract interventions from eye surgery were allocated to an ambulatory or inpatient sample, and the gSPMs for each of the samples were computed. Both treatment strategies are exemplary compared for the interventional phase Capsulorhexis. Statistical differences between the gSPMs of ambulatory and inpatient procedures of performance times for surgical activities and activity sequences were identified. Furthermore, the work flow that corresponds to the general recommended clinical treatment was recovered out of the individual Surgical Process Models. The computation of gSPMs is a new approach in medical engineering and medical informatics. It supports increased evidence, e.g. for the application of alternative surgical strategies, investments for surgical technology, optimization protocols, or surgical education. Furthermore, this may be applicable in more technical research fields, as well, such as the development of surgical workflow management systems for the operating room of the future.

  7. BSCC Code of Practice--fine needle aspiration cytology. (United States)

    Kocjan, G; Chandra, A; Cross, P; Denton, K; Giles, T; Herbert, A; Smith, P; Remedios, D; Wilson, P


    The British Society for Clinical Cytology Code of Practice on fine needle aspiration cytology complements that on exfoliative cytopathology, which was published in the last issue (Cytopathology 2009;20:211-23). Both have been prepared with wide consultation within and outside the BSCC and have been endorsed by the Royal College of Pathologists. A separate code of practice for gynaecological cytopathology is in preparation. Fine needle aspiration (FNA) cytology is an accepted first line investigation for mass lesions, which may be targeted by palpation or a variety of imaging methods. Although FNA cytology has been shown to be a cost-effective, reliable technique its accurate interpretation depends on obtaining adequately cellular samples prepared to a high standard. Its accuracy and cost-effectiveness can be seriously compromised by inadequate samples. Although cytopathologists, radiologists, nurses or clinicians may take FNAs, they must be adequately trained, experienced and subject to regular audit. The best results are obtained when a pathologist or an experienced and trained biomedical scientist (cytotechnologist) provides immediate on-site assessment of sample adequacy whether or not the FNA requires image-guidance. This COP provides evidence-based recommendations for setting up FNA services, managing the patients, taking the samples, preparing the slides, collecting material for ancillary tests, providing rapid on-site assessment, classifying the diagnosis and providing a final report. Costs, cost-effectiveness and rare complications are taken into account as well as the time and resources required for quality control, audit and correlation of cytology with histology and outcome. Laboratories are expected to have an effective quality management system conforming to the requirements of a recognised accreditation scheme such as Clinical Pathology Accreditation (UK) Ltd.

  8. ASPIRE: Teachers and researchers working together to enhance student learning (United States)

    Yager, P. L.; Garay, D. L.; Warburton, J.


    Given the impact of human activities on the ocean, involving teachers, students, and their families in scientific inquiry has never been more important. Science, Technology, Engineering, and Math (STEM) disciplines have become key focus areas in the education community of the United States. Newly adopted across the nation, Next Generation Science Standards require that educators embrace innovative approaches to teaching. Transforming classrooms to actively engage students through a combination of knowledge and practice develops conceptual understanding and application skills. The partnerships between researchers and educators during the Amundsen Sea Polynya International Research Expedition (ASPIRE) offer an example of how academic research can enhance K-12 student learning. In this presentation, we illustrate how ASPIRE teacher-scientist partnerships helped engage students with actual and virtual authentic scientific investigations. Scientists benefit from teacher/researcher collaborations as well, as funding for scientific research also depends on effective communication between scientists and the public. While contributing to broader impacts needed to justify federal funding, scientists also benefit by having their research explained in ways that the broader public can understand: collaborations with teachers produce classroom lessons and published work that generate interest in the scientists' research specifically and in marine science in general. Researchers can also learn from their education partners about more effective teaching strategies that can be transferred to the college level. Researchers who work with teachers in turn gain perspectives on the constraints that teachers and students face in the pre-college classroom. Crosscutting concepts of research in polar marine science can serve as intellectual tools to connect important ideas about ocean and climate science for the public good.


    Directory of Open Access Journals (Sweden)



    Full Text Available Thyroid nodules the main indication for FNAC, and the goal of this diagnostic procedure is to detect thyroid neoplasm for surgical resection and to identify non-neoplastic lesions that may be managed conservatively. MATERIAL AND METHOD Three hundred and fourteen patients with thyroid nodules diagnosed on physical examination underwent fine-needle aspiration with 23-gauge needle and 10ml syringe. FNAC results were classified into non-neoplastic lesion and neoplastic lesion for diagnosis. RESULT AND ANALYSIS We included 314 cases; 37 were male and 277 were female with female-to-male ratio of 7.48:1. The age ranged from 8 to 87 years with a median age of 47.5 years. Maximum number of patients were found in age group of 41-50 years. In the present study we found 285(90.76% non-neoplastic lesion and 29(9.23% neoplastic lesions. Out of 285 non-neoplastic lesion, most commonly encountered were colloid goiter 178(56.68% and second most common thyroiditis 100(31.84%. Out of 314,29(9.23% neoplastic lesions, most commonly encountered neoplasm were papillary carcinoma 14(4.45% followed by 9(2.86% follicular neoplasm, Hurthle cell neoplasm 2(0.63%, medullary carcinoma 4(1.27%. AIMS AND OBJECTIVES  To study the distribution of various thyroid lesions among the age and sex groups.  To study the cytomorphological, clinical and biochemical correlation. CONCLUSION Clinical features and serum findings when used alone to diagnose thyroid lesion, diagnosis will be missed in many cases.

  10. Cytological grading of breast carcinoma on fine needle aspirates and its relation with histological grading

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    Jyoti Prakash Phukan


    Full Text Available Background: Grading of breast carcinoma on fine needle aspiration cytology (FNAC is beneficial for selecting patients for neoadjuvant chemotherapy. Aims: To grade the breast carcinoma on FNAC using Robinson grading system and to assess the concordance of cytological grading (CG with histological grading (HG using Elston-Ellis modification of Scarff-Bloom-Richardson grading system. Materials and Methods: The study was conducted for 1-year, comprising of 50 female patients attending outpatient departments (OPD as well as admitted in various surgical wards of a teaching hospital, diagnosed as breast carcinoma. FNAC smears were stained with May-Grunwald-Giemsa and Papanicolaou (Pap stains and CG was done using Robinson system on Pap stained smears. The results were compared with HG system after resection of tumors. Results: Of 50 cases, 14 (28% cases were graded as grade I, 24 (48% grade II, and 12 (24% grade III by CG, whereas 9 (18%, 28 (56% and 13 (26% cases were graded as grade I, II and III by HG. The result showed overall 72% concordance of CG with HG, with grade II and grade III showing highest degree of concordance (83.33%, which is comparable to previous studies. Kappa measurement showed a higher degree of agreement in high-grade tumors compared with low-grade tumors (0.73 in grade III, 0.53 in grade II and 0.39 in grade I. Conclusion: Cytological grading is comparable to HG in majority of cases. Because neoadjuvant chemotherapy is becoming increasingly popular as primary treatment modality of breast cancer, CG could be a useful parameter in selecting the mode of therapy and predicting tumor behavior.

  11. Accuracy of fine needle aspiration cytology of salivary gland lesions: routine diagnostic experience in Bangkok, Thailand. (United States)

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


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

  12. Microbial profile of the vitreous aspirates in culture proven exogenous endophthalmitis: A 10-year retrospective study

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    H Bhattacharjee


    Full Text Available Purpose: To describe the microbiological profile and clinical outcome in the eyes with culture-proven exogenous endophthalmitis. Methods: A retrospective analysis of 495 eyes diagnosed as exogenous endophthalmitis was performed over a period of 10 years. In all, aseptically collected aqueous and vitreous aspirates were cultured for bacteria and fungus using standard microbiological techniques. Gram-stain and KOH preparation of the specimens were also performed. The antibiotic susceptibility testing for bacterial isolates was performed by Kirby-Bauer disk diffusion method. The treatment was modified according to the antibiotic sensitivity profile. The final clinical ocular condition was divided into improved, stable or deteriorated. Results: Of 148 culture-proven endophthalmitis eyes, 137 (92.57% were referred from elsewhere, and 11 (7.43% belonged to our institute. Aetiologically, 76 (51.35% eyes were post-cataract surgery, 61 (41.22% were post-traumatic, 5 (3.38% eyes post-intravitreal anti-vascular endothelial growth factor injection, 5 associated with corneal diseases and 1 bleb-related endophthalmitis. In 31 (20.95% eyes, primary intravitreal antibiotics were given outside. The cultures revealed monomicrobial growth in 92.57% (n = 137 and polymicrobial growth in 7.43% (n = 11. Among the bacteria (n = 121, 81.76%, Pseudomonas species dominated overall (n = 32, 27.11% and post-operative (n = 26, 38.23% endophthalmitis group. Staphylococcus epidermidis (n = 14, 28% was prominent in post-traumatic endophthalmitis group. Ninety-two percent (n = 108 isolates of bacteria were sensitive to vancomycin. In 78 (52.7% eyes, the clinical ocular condition improved or remained stable while deteriorated in 51 (34.46%. Conclusion: A bacterial predominance was observed among causative organisms of exogenous endophthalmitis with Pseudomonas species being the most common. The appropriate surgical intervention improved or stabilised the visual acuity in nearly

  13. Ultrasound-Guided Fine-Needle Aspiration Biopsy in Infracentimetric Thyroid Nodules

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    Kim, Sang Su; In, Hyun Sin; Eun, Choong Ki [Busan Paik Hospital, Inje University School of Medicine, Busan (Korea, Republic of)


    The aim of this study is to determine the efficacy of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules that are equal to or less than 1 cm at the maximum diameter. The US-FNABs performed on thyroid nodules from March to August 2009 were included in this study. We retrospectively evaluated the cytopathologic results as well as any complications associated with the procedure. Of the 241 thyroid nodules (range: 0.1 - 1.0 cm, mean size: 5.8 mm) in 184 patients (female: male = 164:20, mean age: 49.0 years, age range: 18 - 77 years old), the incidence of an inadequate sample was 14.1% (34/241) for the US-FNABs. Eighty six nodules were surgically removed in 62 patients, of which 15 were confirmed to be benign nodules and 71 were confirmed to be malignant nodules. The number of true positive, false positive, true negative and false negative results for US-FNAB were 59, 0, 10 and 3%, respectively, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 95.2%, 100%, 100%, 76.9% and 95.8%, respectively. All the false negative cases were less than 3 mm at the maximal diameter. There were no serious complications in all the patients. US-FNAB was effective for the cases of thyroid nodule under 1 cm at the maximal diameter. However, a false negative result of US-FNAB should be considered for the cases of very small nodules that are less than 3 mm at the maximal diameter

  14. Histopathologic Analysis of Transvitreal Fine Needle Aspiration Biopsy Needle Tracts for Uveal Melanoma. (United States)

    Kim, Ryan S; Chevez-Barrios, Patricia; Bretana, Maria E; Wong, Tien P; Teh, Bin S; Schefler, Amy C


    Perform the first in vivo examination of fine needle aspiration biopsy (FNAB) scleral tracts to determine the incidence of iatrogenic extension of tumor cells. A prospective, consecutive, observational case series. This study was performed in a clinical/surgical setting at Retina Consultants of Houston and Houston Methodist Hospital, Houston, Texas, and included 10 patients who were scheduled for enucleation as primary treatment for uveal melanoma. Treatment included FNAB, enucleation, and histopathologic analysis. The primary outcomes were tumor location and dimension as identified by B-scans and histopathologic analysis. Tumor type was classified by gene expression profile and American Joint Committee on Cancer staging. Twenty-five- or 27-gauge needles were used for FNAB under direct visualization. Cell blocks of acquired specimens were examined using hematoxylin-eosin stain and double immunostain using HMB45 with red chromogen and Ki67 with brown 3,3'-diaminobenzidine chromogen. Mean follow-up after enucleation was 20.4 months (range 9.9-31.7). All biopsy specimens had adequate yields for genomic analysis. No enucleation specimen contained tumor cells within sclera, pars plana, or pars plicata. One specimen contained a small collection of tumor cells within the anterior vitreous in the quadrant of the biopsy site. No patient developed an orbital recurrence. Four patients developed nonorbital metastatic uveal melanoma during the study period. Three of them died, and 1 is alive with hepatic metastasis. No iatrogenic extension of tumor was reported. FNAB is a safe procedure that produces a high cellular yield for cytologic and genomic analyses with minimal risk of extraocular dissemination. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. [Duane vertical surgical treatment]. (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G


    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  16. Diverticulitis: selective surgical management. (United States)

    Rugtiv, G M


    The surgical treatment of complications of diverticulitis remains most challenging. A review of twenty years' experience with one hundred fifteen cases is presented with one proved anastomotic leak and no deaths. Interval primary resection with anastomosis for chronic recurrent disease including colovesical fistula and mesocolic abscess was proved sate with low morbidity. The three-stage procedure for perforated diverticulitis with spreading peritonitis or pericolic abscess was associated with a high rate of complications and morbidity. An aggressive approach with resection without anastomosis in two stages is indicated.

  17. Usefulness of Surgical Media Center as a Cataract Surgery Educational Tool (United States)

    Ogawa, Tomoichiro; Shiba, Takuya; Tsuneoka, Hiroshi


    Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications. Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators. Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery. PMID:26881060

  18. Usefulness of Surgical Media Center as a Cataract Surgery Educational Tool

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    Tomoichiro Ogawa


    Full Text Available Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC (Abbott Medical Optics Inc., a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications. Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators. Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery.

  19. Non-surgical and non-chemical attempts to treat echinococcosis: do they work?

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    Tamarozzi Francesca


    Full Text Available Cystic echinococcosis (CE and alveolar echinococcosis (AE are chronic, complex and neglected diseases. Their treatment depends on a number of factors related to the lesion, setting and patient. We performed a literature review of curative or palliative non-surgical, non-chemical interventions in CE and AE. In CE, some of these techniques, like radiofrequency thermal ablation (RFA, were shelved after initial attempts, while others, such as High-Intensity Focused Ultrasound, appear promising but are still in a pre-clinical phase. In AE, RFA has never been tested, however, radiotherapy or heavy-ion therapies have been attempted in experimental models. Still, application to humans is questionable. In CE, although prospective clinical studies are still lacking, therapeutic, non-surgical drainage techniques, such as PAIR (puncture, aspiration, injection, re-aspiration and its derivatives, are now considered a useful option in selected cases. Finally, palliative, non-surgical drainage techniques such as US- or CT-guided percutaneous biliary drainage, centro-parasitic abscesses drainage, or vascular stenting were performed successfully. Recently, endoscopic retrograde cholangiopancreatography (ERCP-associated techniques have become increasingly used to manage biliary fistulas in CE and biliary obstructions in AE. Development of pre-clinical animal models would allow testing for AE techniques developed for other indications, e.g. cancer. Prospective trials are required to determine the best use of PAIR, and associated procedures, and the indications and techniques of palliative drainage.

  20. Career Barriers and Reading Ability as Correlates of Career Aspirations and Expectations of Parents and Their Children (United States)

    Creed, Peter A.; Conlon, Elizabeth G.; Zimmer-Gembeck, Melanie J.


    Data were obtained from 176 Year 7 children (mean age=12.2 years) on career status aspirations and expectations, career barriers, academic engagement, academic control beliefs, general ability and literacy; and from parents, mainly mothers, on aspirations, expectations and career barriers. Discrepancy scores between aspirations and expectations…

  1. In vitro evaluation of a micro-Doppler catheter for detection and aspiration of venous air emboli. (United States)

    Bigeleisen, Paul E


    Venous air embolism (VAE) is a potentially fatal complication of surgery when open veins at a surgical site are exposed to ambient air pressure which exceeds the pressure in the venous system. Common techniques of detecting VAE are precordial Doppler monitoring and transesophogeal echocardiography. Precordial Doppler monitoring has poor accuracy and transesophogeal echocardiography is expensive and user-intensive. In both methods, a separate catheter must be inserted into the vena cava so that an embolus may be aspirated if it is detected. We created a micro-Doppler assembly using two ceramic transducers fitted over a 5.8F multiorifice central venous catheter. This micro-Doppler catheter (MDC) was tested in vitro using a static tank and an artificial vena cava (AVC). The MDC was also tested for acoustic pressure and current leakage in the static tank and for heat generation and cavitation in the AVC. The MDC was able to detect bubbles more than 2 mm in diameter with 100% accuracy. A blinded observer was able to identify the onset of vapor lock in 10 of 10 trials. The same observer was able to terminate vapor lock in 10 of 10 trials. The acoustic pressures measured were <1.8 MPa. There was no increase in temperature in the AVC over 24 h and there was no evidence of cavitation in the AVC over 4 h. We have created a MDC that can detect air emboli and relieve vapor lock in a simulated vena cava and atrium. This catheter could be placed percutaneously in the vena cava. Based on the measurements of acoustic pressure, temperature in the AVC and lack of cavitation in the AVC, the device appears to be safe for use in humans. More studies are required to determine if the catheter could be used to detect and aspirate VAE during surgeries where VAE is likely, such as sitting craniotomy.

  2. The triage efficacy of fine needle aspiration biopsy for follicular variant of papillary thyroid carcinoma using the Bethesda reporting guidelines. (United States)

    Kurian, Elizabeth M; Dawlett, Marilyn; Wang, Jianping; Gong, Yun; Guo, Ming


    Diagnosis of follicular variant of papillary thyroid carcinoma (FVPTC) by ultrasound-guided fine-needle aspiration (FNA) is challenging. In this retrospective review, we evaluated triage efficacy (i.e., potential for triggering surgical intervention) in 44 archived FNA biopsies of surgically confirmed FVPTC obtained between December 2006 and December 2008. We compared the original FNA diagnoses with reclassified diagnoses based on 2007 National Cancer Institute (NCI)/Bethesda recommendations, and reviewed FNA cytologic features. Original FNA diagnoses included colloid nodule (7%, 3/44), atypical follicular cells (5%, 2/44), follicular lesion (11%, 5/44), follicular neoplasm (16%, 7/44), suspicious for malignancy/PTC (27%, 12/44), and papillary thyroid carcinoma (34%, 15/44). Reclassified diagnoses included indeterminate (5%, 2/44), colloid nodule (7%, 3/44), atypical cells of undetermined significance [ACUS] (7%, 3/44), Hurthle cell neoplasm (2%, 1/44), follicular neoplasm (7%, 3/44), suspicious for malignancy/PTC (25%, 11/44), and PTC (48%, 21/44). Triage efficacy was 77% (34/44) for original diagnoses versus 82% (36/44) for reclassified FNA diagnoses. We frequently observed cytologic features of PTC, such as nuclear grooves and fine chromatin; conversely, intranuclear inclusions, though present in 77% cases, were scant. Our review findings suggest that lack of characteristic cytologic features of PTC,coexistence with other thyroid lesions, and small tumor size arethe major obstacles to FNA diagnosis of FVPTC. Reclassification of thyroid FNA diagnoses does not significantly improve triage efficacy. Furthermore, FNA diagnoses of follicular neoplasm and suspicious for malignancy are valuable in patients with FVPTC because they trigger triage toward surgical intervention.

  3. Gastric tubes and airway management in patients at risk of aspiration: history, current concepts, and proposal of an algorithm. (United States)

    Salem, M Ramez; Khorasani, Arjang; Saatee, Siavosh; Crystal, George J; El-Orbany, Mohammad


    Rapid sequence induction and intubation (RSII) and awake tracheal intubation are commonly used anesthetic techniques in patients at risk of pulmonary aspiration of gastric or esophageal contents. Some of these patients may have a gastric tube (GT) placed preoperatively. Currently, there are no guidelines regarding which patient should have a GT placed before anesthetic induction. Furthermore, clinicians are not in agreement as to whether to keep a GT in situ, or to partially or completely withdraw it before anesthetic induction. In this review we provide a historical perspective of the use of GTs during anesthetic induction in patients at risk of pulmonary aspiration. Before the introduction of cricoid pressure (CP) in 1961, various techniques were used including RSII combined with a head-up tilt. Sellick initially recommended the withdrawal of the GT before anesthetic induction. He hypothesized that a GT increases the risk of regurgitation and interferes with the compression of the upper esophagus during CP. He later modified his view and emphasized the safety of CP in the presence of a GT. Despite subsequent studies supporting the effectiveness of CP in occluding the esophagus around a GT, Sellick's early view has been perpetuated by investigators who recommend partial or complete withdrawal of the GT. On the basis of available information, we have formulated an algorithm for airway management in patients at risk of aspiration of gastric or esophageal contents. The approach in an individual patient depends on: the procedure; type and severity of the underlying pathology; state of consciousness; likelihood of difficult airway; whether or not the GT is in place; contraindications to the use of RSII or CP. The algorithm calls for the preanesthetic use of a large-bore GT to remove undigested food particles and awake intubation in patients with achalasia, and emptying the pouch by external pressure and avoidance of a GT in patients with Zenker diverticulum. It also

  4. Minimally invasive surgical technique for tethered surgical drains

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    Shane R Hess


    Full Text Available A feared complication of temporary surgical drain placement is from the technical error of accidentally suturing the surgical drain into the wound. Postoperative discovery of a tethered drain can frequently necessitate return to the operating room if it cannot be successfully removed with nonoperative techniques. Formal wound exploration increases anesthesia and infection risk as well as cost and is best avoided if possible. We present a minimally invasive surgical technique that can avoid the morbidity associated with a full surgical wound exploration to remove a tethered drain when other nonoperative techniques fail.

  5. Symptomatic nonfunctioning parathyroid cysts: Role of simple aspiration and ethanol ablation

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    Sung, Jin Yong [Department of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Baek, Jung Hwan, E-mail: [Department of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736 (Korea, Republic of); Kim, Kyu Sun [Department of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Lee, Ducky [Department of Internal Medicine, Thyroid Center, Daerim St. Mary' s Hospital, #978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070 (Korea, Republic of); Ha, Eun Ju; Lee, Jeong Hyun [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736 (Korea, Republic of)


    Objectives: To evaluate the outcomes of simple aspiration and ethanol ablation in the management of symptomatic nonfunctioning parathyroid cyst (PC). Methods: We performed simple aspirations for 12 PCs in 12 patients from March 1997 to June 2010. PC was diagnosed if the aspirated fluid was clear colorless and showed an elevated parathyroid hormone (PTH) level. Ethanol ablation (EA) was performed for recurrent PCs. Simple aspirations were performed using 23-gauge needles and EAs using 18-gauge needles with 99% ethanol under ultrasound (US) guidance. We evaluated cyst volume, cosmetic score, symptom score, and complications. Results: Mean follow-up period of all patients was 19.2 ± 12.9 months (median, 15.0 months; range, 7–40 months). Simple aspiration was successful in four patients, and the mean volume reduction after simple aspiration was 98.2 ± 3.5% (range, 92.9–100%). In eight recurrent cases, EA resulted in a significant decrease in volume (P = 0.012), as well as in cosmetic (P = 0.011) and symptom (P = 0.01) scores at last follow-up; however two cases of primary failure of EA was treated by repeat EA. No major complications occurred in any patient. Conclusions: For symptomatic nonfunctioning PCs, simple aspiration could be a first line procedure for diagnosis and treatment, while EA can be a subsequent treatment modality for recurrent cases.

  6. Evaluation of hypopharyngeal suction to eliminate aspiration: the Retro-Esophageal Suction (REScue) catheter. (United States)

    Belafsky, Peter C; Mehdizadeh, O B; Ledgerwood, L; Kuhn, M


    Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter control. The outcome measures were the incidence of aspiration, the NIH Swallow Safety Scale (NIH-SSS), and UES opening. Control trials with no suction resulted in an aspiration rate of 100 % (6/6 trials). Negative pressure through 16, 18, 24, and 30 Fr catheter resulted in an aspiration rate of 0 % (0/24 trials; p suction through a 12-Fr catheter resulted in an aspiration rate of 33 % (2/6 trials; p > 0.05). The mean NIH-SSS improved from 7.0 (±0.0) in the control to 0 (±0.0) with hypopharyngeal suction (18 Fr nasogastric catheter; p suction catheters (>12 Fr) at the level of the UES reduced aspiration by 100 % and significantly increased UES opening in a cadaveric model of profound oropharyngeal dysphagia.

  7. Weight loss and its relation to fat aspiration yields in liposuction: a survey in 48 patients. (United States)

    Boeni, R


    Liposuction surgeons often observe individually fluctuating amounts of aspirated fat. In patients with sagging skin due to previous weight loss there is a tendency of decreased fat aspiration volumes. To study the influence of weight loss on fat aspiration volumes in a series of 48 patients. We matched individuals of the same gender, but with a different weight history from a vast number of patients who had undergone liposuction surgery. The aspirated fat to wetting solution ratio (FWR) of the circumferential abdominal region was evaluated in three groups: A - patients with no weight loss (n = 16; 8 males/ 8 females), B - patients with a history of moderate weight loss (weight loss 5-10% of body weight; n = 16; 8 males/8 females), and C - patients who had a massive weight loss prior to surgery (weight loss exceeding 15% of body weight; n = 16; 8 males/8 females). The aspirated FWR was 3.4 ± 0.5, 1.0 ± 0.3 and 0.4 ± 0.2 in groups A, B and C, respectively. The differences between the groups were statistically significant (p loss in regard to fat aspiration volumes compared to patients without prior weight loss. These findings point to the importance of a weight loss history prior to surgery. Regardless of lower fat aspiration yields in patients with massive weight loss, good results are still achievable. This is not only due to volume reduction but to skin tightening. Copyright © 2012 S. Karger AG, Basel.

  8. Lymphography and percutaneous fine needle node aspiration biopsy in the staging of bladder carcinoma. (United States)

    Boccon-Gibod, L; Katz, M; Cochand, B; Le Portz, B; Steg, A


    Forty-two patients with infiltrating bladder tumor were submitted to pedal lymphography with percutaneous fine needle node aspiration biopsy on an out patient basis. Of 41 evaluable patients, 59% had a positive lymphangiogram. Adequate material was obtained in 81% of the patients. Of 12 patients with a normal lymphography, none had a positive aspiration whereas 40% of the positive lymphangiograms correlated with a positive aspiration. The high rate of positive lymphangiogram negative aspirate is attributed to inflammatory changes due to previous TUR of the tumor. Twenty-one patients were submitted to radical cystectomy: 12 negative aspirations correlated with 11 negative lymphadenectomies, and 4 positive aspirations with 4 positive lymphadenectomies. There was no mortality and only mild morbidity in this series. Lymphography with fine needle percutaneous node aspiration biopsy has a role in the pre-operative staging of bladder carcinoma. Positive pelvic wall lymph nodes upgrade bladder carcinoma from a local to a systemic disease that is no longer amenable to any form of local treatment. Nodal assessment is therefore critical to treatment planning in order to spare the N+ patients unnecessary radical surgery. Pelvic lymph nodes have been evaluated, in the past, radiologically by bipedal lymphography or C.A.T. scanning. The high false positive and negative rates of these procedures (Benson et al., 1981; Boccon-Gibod et al., 1982) preclude their routine use (Correa 1982; Walsh et al., 1980).(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Biopsy needle advancement during bone marrow aspiration increases mesenchymal stem cell concentration

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    Anne E Peters


    Full Text Available Point-of-care kits to concentrate bone marrow (BM derived mesenchymal stem cells (MSCs are used clinically in horses. A maximal number of MSCs per ml of marrow aspirated might be desired prior to use of a point-of-care system to concentrate MSCs. Our objective was to test a method to increase the number of MSCs per ml of marrow collected. We collected 2 BM aspirates using 2 different collection techniques from 12 horses. The first collection technique was to aspirate BM from a single site without advancement of the biopsy needle. The second collection technique was to aspirate marrow from multiple sites within the same sternal puncture by advancing the needle 5 mm 3 times for BM aspiration from 4 sites. Numbers of MSCs in collected BM were assessed by total nucleated cell count (TNCC of BM after aspiration, total Colony-Forming-Unit-fibroblast (CFU-F assay, and total MSC number at each culture passage. The BM aspiration technique of 4 needle advancements during BM aspiration resulted in higher initial nucleated cell counts, more CFU-Fs, and more MSCs at the first passage. There were no differences in the number of MSCs at later passages. Multiple advancements of the BM needle during BM aspiration resulted in increased MSC concentration at the time of BM collection. If a point-of-care kit is used to concentrate MSCs, multiple advancements may result in higher MSC numbers in the BM concentrate after preparation by the point-of-care kit. For culture expanded MSCs beyond the first cell passage, the difference is of questionable clinical relevance.

  10. Murray secretion scale and fiberoptic endoscopic evaluation of swallowing in predicting aspiration in dysphagic patients. (United States)

    Kuo, Chia-Wei; Allen, Clint Tanner; Huang, Chu-Chun; Lee, Chia-Jung


    The objective of this retrospective review is to evaluate the ability of the Murray secretion scale to predict aspiration as determined by fiberoptic endoscopic evaluation of swallowing. Patients with dysphagia undergoing a fiberoptic endoscopic evaluation of swallowing study between January 2013 and November 2015 from a single, tertiary care institution were retrospectively reviewed. The Murray secretion scale and penetration aspiration scale on fiberoptic endoscopic evaluation of swallowing examination were determined. Spearman's correlation analysis, sensitivity, specificity, predictive values, and relative risk evaluating the relationship between the Murray secretion scale and aspiration on fiberoptic endoscopic evaluation of swallowing were calculated. Subgroups of head and neck cancer patients, penetration group, and aspiration group were also analyzed. The mean age of the cases (N = 212) was 62.4 years. Eighty percent were male. There was a strong correlation between Murray secretion scale grade and penetration aspiration scale score (r = 0.785, p Murray secretion scale grade 2 or higher in predicting aspiration were 74 and 90%, respectively. Individuals with a Murray secretion scale grade of 2 or higher were 13.6 times more likely to aspirate than patients with a lower Murray secretion scale grade. All subgroups showed similar trend. Determination of a Murray secretion scale grade, determined by flexible nasopharyngoscopy, may predict patients at high risk for aspiration. In clinical scenarios where more complete assessments of aspiration risk are immediately impossible or impractical, the Murray secretion scale grade may add valuable information to assist in clinical decision-making in patients with dysphagia.

  11. Surgical repair of a pseudoaneurysm of the ascending aorta after aortic valve replacement

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    Almeida Rui Manuel Sequeira de


    Full Text Available We report the case of a patient with a pseudoaneurysm of the ascending aortic clinically diagnosed 5 months after surgical replacement of the aortic valve. Diagnosis was confirmed with the aid of two-dimensional echocardiography and helicoidal angiotomography. The corrective surgery, which consisted of a reinforced suture of the communication with the ascending aorta after opening and aspiration of the cavity of the pseudoaneurysm, was successfully performed through a complete sternotomy using extracorporeal circulation, femorofemoral cannulation, and moderate hypothermia, with no aortic clamping.

  12. Surgical scar revision: An overview

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    Shilpa Garg


    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  13. Relationship between parental aspiration and academic achievement of Xhosa children from broken and intact families. (United States)

    Cherian, V I


    This study concerned the relationship between parental aspiration and academic achievement of Xhosa pupils (369 boys and 652 girls) whose ages ranged from 13 to 17 years (mean age, 15.3 yr.). Children were chosen at random from the Standard 7/Year 9 population of Transkei. A questionnaire administered to parents or parent surrogates identified 242 children of parents divorced or separated and 713 from intact homes and obtained parental aspiration for the education of children. Analysis of variance showed significant effects of parental aspiration on academic achievement of children whether the children were from broken or intact homes.

  14. Aspiration-induced dormancy promotes cooperation in the spatial Prisoner's Dilemma games (United States)

    Chen, Ya-Shan; Yang, Han-Xin; Guo, Wen-Zhong


    An interesting phenomenon is often observed in realistic systems. In the process of games, if the expected payoff from game interactions is not achieved, players would refuse to participate in the games. Inspired by this fact, we propose an aspiration-induced dormant mechanism, in which players quit the games and become dormant if their payoffs are less than the aspiration level. After a dormant period, they continue to play the game with others. Our results indicate an intermediate aspiration value, leading to the highest cooperation level in the spatial prisoner's dilemma games. The effects of the dormant period are also studied.

  15. Prospective study of fine needle aspiration cytology of clinically palpable breast lump with histopathological correlation

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    Ashwin K. Hebbar


    Full Text Available Background and objectives: This study was conducted to compare the diagnostic accuracy of fine needle aspiration cytology in differentiating the benign and malignant lesions of palpable breast lump with histopathological correlation and also to study the accuracy of the needle tip localizing the tumor during fine needle aspiration cytology procedure. Methods: Two years prospective study was conducted in our institution and in that 100 patients underwent fine needle aspiration cytology of the palpable breast lump after thorough physical examination. The cytological diagnosis was classified in to 3 groups benign, suspicious and malignant. After this reporting all the patients were later subjected to open/excision biopsy and its histopathological confirmation. Later diagnostic accuracy of cytology reporting was compared with that of histopathology. Accuracy of the needle tip in localizing the tumor in fine needle aspiration cytology was also studied by comparing the normal glandular cell aspirate with tumor cell aspirate. Repeat cytology was carried out before open/excision biopsy if the pathologist reports the cytology slide as “inadequate”. Results: We had accuracy rate of 100% for benign lesion and 93.10% for malignant lesion with false negative rate of 6.9% and false positive rate of zero with fine needle aspiration cytology in the diagnosis of palpable breast lump. The overall sensitivity of fine needle aspiration in diagnosing the palpable breast lump is 93.10%, specificity is 100%, positive predictive value is 100% and negative predictive value is 90.47%. Since inadequate sampling rate is 2% in our study, the accuracy rate of needle tip in localizing the tumor in fine needle aspiration cytology is 98%. Conclusion: Since our diagnostic accuracy rate and predictive values are very high and comparable to any other published series it can be advised that the patients in which fine needle aspiration cytology is unequivocally diagnostic for

  16. Arterial Bleeding of a Thyroid Mass After Thyroid Fine- Needle Aspiration Biopsy: A Case Report

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    Park, Chul Hi; Byun, Sung Su; Kim, Jeong Ho; Hwang, Hee Young; Kim, Ha Na; Chung, Dong Jin; Kim, Hyung Sik [Gachon University Gil Hospital, Incheon (Korea, Republic of)


    Thyroid fine needle aspiration biopsy is a very common procedure that is used to assess thyroid nodules; any complications from this procedure are rather rare. We report here on an unusual case of active bleeding with the formation of a large hematoma from a branch of the superior thyroidal artery, and this was caused by a thyroid fine needle aspiration biopsy. To the best of our knowledge, this is the first report of active arterial bleeding after thyroid fine needle aspiration biopsy. The active bleeding was successfully treated by interventional embolization

  17. Strain, Psychological Conflicts, Aspirations-Attainment Gap, and Depressive Tendencies among Youth of Mexican Immigrants. (United States)

    Paat, Yok-Fong


    Using Children of Immigrants Longitudinal Study (CILS), this study examined the links between strain, psychological conflicts, aspiration-attainment gap, and depressive tendencies of 755 youth of Mexican origin. Two research questions were raised: (a) What types of strain and psychological conflict induced depressive tendencies? (b) What types of aspirations were relevant to these depressive symptoms? Overall, this study showed that factors implicated by collision of values, perceived discrepancies between aspiration and attainment, and negative appraisal of self could induce depressive mood, feelings, and behaviors, an important finding revealing that this underserved population can benefit from better public health services.

  18. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors. (United States)

    Song, In Hye; Song, Joon Seon; Sung, Chang Ohk; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon; Lee, Jeong Hyun; Baek, Jung Hwan; Cho, Kyung-Ja


    Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

  19. Tophi - surgical treatment. (United States)

    Słowińska, Iwona; Słowiński, Radosław; Rutkowska-Sak, Lidia


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.

  20. Tophi – surgical treatment (United States)

    Słowińska, Iwona; Słowiński, Radosław


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A “clinical mask” suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient’s life improved significantly. PMID:27994273

  1. Neuronavigation. Principles. Surgical technique. (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad


    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  2. Surgical education in Mexico. (United States)

    Cervantes, Jorge


    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital.


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    Full Text Available BACKGROUND: Thyroid swellings are a common clinical presentation. The distribution of benign lesions from malignant lesions cannot be made by clinical judgment. The pathological lesions need morphological workup, Fine Needle Aspirations (FNA being one of the cornerstones. Its limitations are sample inadequacy, low cytomorphologic details and architectural insights with overlapping of cytological features . Cell block is a diagnostic method where material for morphologic evaluation is well recognized as it increases cellular yield, thus improves diagnostic accuracy. It provides excellent cytomorphologic details in concert with architectural insight with much more diagnostic efficacy, thus obviates repeat FNA. AIMS: To analyze the diagnostic utility of cell blocks on thyroid aspirates by taking the histopathological findings as the gold standard and statistically analyzed for diagnostic efficacy of cell block. MATERIALS AND METHOD: The study design was hospital based cross - sectional study. Ninety FNAC samples were taken and cell block was prepared u sing Tissue Thromboplastic method. Cell Block findings were analyzed by looking at the a rrangement of follicular cells size , acini, nuclear cytoplasmic characteristics, colloid, stroma, inflammatory cells, malignant cells, psammoma bodies, haemorrhage, necrosis, calcification, fibrosis, amyloid or any other relevant findings. RESULTS: Out of the 90 cases, 69 cases (76.67% were diagnosed as Non neoplastic lesions and 21cases (23.33% as Neoplastic. Of the Non - neoplastic cases, colloid goiter was the commonest, (64.44%. Among the Neoplastic lesions Follicular adenoma was the commonest (11.11%. Histopathologically, out of the 47 cases, Non - neoplastic lesions were 32 cases (68.09% and neoplastic lesions 15 cases (31.91%. Colloid goiter was the commonest thyroid lesion (53.19%. In Neoplastic lesions Follicular adenoma cases was the commonest (21.28%.There was 0 False Negative case and 2 cases of

  4. Fine needle aspiration cytology of metastatic alveolar rhabdomyosarcoma

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    Abhishek Sharma


    Full Text Available Rhabdomyosarcoma (RMS is an aggressive malignant soft tissue tumor that arises from primitive striated muscle cells called rhabdomyoblasts. RMS is a rare tumor in adults, and involvement of the sinonasal area is extremely rare, comprising only 1.5% of all reported head and neck RMSs. Alveolar RMS, mainly seen in adults, has the worst prognosis. Incidence of lymph node metastases is more common in this type compared with the other forms. Fine needle aspiration cytology (FNAC has been used extensively in the diagnosis of metastatic malignancies. However, metastatic soft tissue sarcomas are often overlooked, primarily due to the low frequency with which they occur. Here, we report a rare case of metastatic alveolar RMS in the cervical lymph nodes of an 18-year-old girl that was detected by FNAC. After 6 months, the patient came with a huge mass involving the nasal vestibule and the upper lip. Histology of both the main mass and the lymph nodes revealed alveolar RMS.

  5. Can we confidently diagnose pilomatricoma with fine needle aspiration cytology? (United States)

    Wong, Yin-Ping; Masir, Noraidah; Sharifah, Noor Akmal


    Pilomatricomas can be confidently diagnosed cytologically due to their characteristic cytomorphological features. However, these lesions are rarely encountered by cytopathologists and thus pose a diagnostic dilemma to even experienced individuals, especially when the lesions are focally sampled. We describe two cases of histologically confirmed pilomatricoma. The first case is of a 13-year-old boy with posterior cervical 'lymphadenopathy', and the second one is of a 12-year-old girl with a lower cheek swelling. Both aspirates comprised predominantly atypical basal-like cells, with prominent nucleoli. 'Ghost cells' were readily identified by cell block in case two, but cell block in case one yielded no diagnostic material. In case two, pilomatricoma was accurately diagnosed pre-operatively. A cytological suspicion of a neoplastic process was raised in case one. Despite being diagnostically challenging, pilomatricoma can be diagnosed with careful observation of two unique cytological features of the lesions: (1) pathognomonic 'ghost cells' and (2) irregular, saw-toothed, loosely cohesive basaloid cells, with prominent nucleoli. The role of thorough sampling of the lesion, with multiple passes of various sites, cannot be overemphasized.

  6. First Generation Students and Post-Undergraduate Aspirations

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    Morgan Teressa Carlton


    Full Text Available Equal access to education is a growing concern throughout the nation. With an increasing amount of programs aimed to support the underrepresented populations on college campuses, first generation college students have grown to be a target population of particular interest. This study examined the relationships between first generation college seniors and applications to graduate or professional programs. The goal of this study was to determine if first generation students are pursuing advanced degrees at lower rates than non-first generation students and if so, attempt to uncover factors contributing to that evidence. Data were gathered from the National Longitudinal Survey of Freshman data set, and variables were analyzed using a binary logistic regression. The results of the study indicate that first generation students are significantly less likely to pursue an advanced degree, even when controlling for race, gender, family income, and cumulative grade point average, suggesting a distinctive impact of first generation status on post-undergraduate aspirations. However, after controlling for the impact of self-reported undergraduate loans, the effect of first generation status was no longer significant. The findings in this study provide an important new perspective in the field of sociology.

  7. Glutamine Attenuates Acute Lung Injury Caused by Acid Aspiration

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    Chih-Cheng Lai


    Full Text Available Inadequate ventilator settings may cause overwhelming inflammatory responses associated with ventilator-induced lung injury (VILI in patients with acute respiratory distress syndrome (ARDS. Here, we examined potential benefits of glutamine (GLN on a two-hit model for VILI after acid aspiration-induced lung injury in rats. Rats were intratracheally challenged with hydrochloric acid as a first hit to induce lung inflammation, then randomly received intravenous GLN or lactated Ringer’s solution (vehicle control thirty min before different ventilator strategies. Rats were then randomized to receive mechanical ventilation as a second hit with a high tidal volume (TV of 15 mL/kg and zero positive end-expiratory pressure (PEEP or a low TV of 6 mL/kg with PEEP of 5 cm H2O. We evaluated lung oxygenation, inflammation, mechanics, and histology. After ventilator use for 4 h, high TV resulted in greater lung injury physiologic and biologic indices. Compared with vehicle treated rats, GLN administration attenuated lung injury, with improved oxygenation and static compliance, and decreased respiratory elastance, lung edema, extended lung destruction (lung injury scores and lung histology, neutrophil recruitment in the lung, and cytokine production. Thus, GLN administration improved the physiologic and biologic profiles of this experimental model of VILI based on the two-hit theory.

  8. Nipple aspirate fluid and ductoscopy to detect breast cancer. (United States)

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


    We prospectively performed cytologic assessment and image analysis (IA) on matched nipple aspirate fluid (NAF) and mammary ductoscopy (MD) specimens to determine (1) the accuracy of these methods in cancer detection and (2) whether the two collection methods provide complementary information.NAF and MD specimens were collected from 84 breasts from 75 women (nine bilateral samples) who underwent breast surgery. Cytologic evaluation was performed on all samples. IA was performed on slides with sufficient epithelial cells.Cytologic evaluation proved more accurate in patients without pathologic spontaneous nipple discharge (PND) than those with PND, mainly because of the potential false positive diagnosis in the latter. While the sensitivity of NAF and MD cytology was low (10% and 14%, respectively), both were 100% specific in cancer detection in the non-PND cohort. Combining NAF and MD cytology information improved sensitivity (24%) without sacrificing specificity. Similar to cytology, IA was more accurate in patients without PND having high specificity (100% for aneuploid IA), but relatively low sensitivity (36%). Combining NAF and MD cytology with aneuploid IA improved the sensitivity (45%) while maintaining high specificity (100%). The best predictive model was positive NAF cytology and/or MD cytology combined with IA aneuploidy, which resulted in 55% sensitivity and 100% specificity in breast cancer detection.Cytologic evaluation and IA of NAF and MD specimens are complementary. The presence of atypical cells arising from an intraductal papilloma in ductoscopic specimens is a potential source of false positive diagnosis in patients with nipple discharge.

  9. Toward improving fine needle aspiration cytology by applying Raman microspectroscopy (United States)

    Becker-Putsche, Melanie; Bocklitz, Thomas; Clement, Joachim; Rösch, Petra; Popp, Jürgen


    Medical diagnosis of biopsies performed by fine needle aspiration has to be very reliable. Therefore, pathologists/cytologists need additional biochemical information on single cancer cells for an accurate diagnosis. Accordingly, we applied three different classification models for discriminating various features of six breast cancer cell lines by analyzing Raman microspectroscopic data. The statistical evaluations are implemented by linear discriminant analysis (LDA) and support vector machines (SVM). For the first model, a total of 61,580 Raman spectra from 110 single cells are discriminated at the cell-line level with an accuracy of 99.52% using an SVM. The LDA classification based on Raman data achieved an accuracy of 94.04% by discriminating cell lines by their origin (solid tumor versus pleural effusion). In the third model, Raman cell spectra are classified by their cancer subtypes. LDA results show an accuracy of 97.45% and specificities of 97.78%, 99.11%, and 98.97% for the subtypes basal-like, HER2+/ER-, and luminal, respectively. These subtypes are confirmed by gene expression patterns, which are important prognostic features in diagnosis. This work shows the applicability of Raman spectroscopy and statistical data handling in analyzing cancer-relevant biochemical information for advanced medical diagnosis on the single-cell level.

  10. Fine needle aspiration cytology of salivary gland lesions: Our experience

    Directory of Open Access Journals (Sweden)

    Pooja K Suresh


    Full Text Available Introduction: Fine needle aspiration cytology (FNAC of salivary glands is one of the most commonly done first line investigations in the head and neck region. Objectives: To study the cytological features of various salivary gland lesions and to correlate with histopathological diagnosis wherever possible. Materials and Methods: All the FNAC slides of salivary gland lesions received at cytology lab of a tertiary hospital for a period of 3 years that is, from January 2011 to December 2013 were reviewed retrospectively. Histopathological correlation was done for cases wherever available. Results: During the study period salivary gland FNAC was done for 100 cases. Among them, 51 (51% were reported as nonneoplastic and 49 as neoplastic (49%. Histopathological correlation was available in 18 cases (18%. The accuracy of salivary gland cytology is 77.7% (14/18 cases. The mean age of presentation of all the salivary gland lesions ranged from 12 years to 92 years with the mean age being 47.7 years. The male:female ratio was 1.5:1. Parotid gland was involved in 74 cases and submandibular gland in 26 cases. Bilateral involvement was noted in 1 case (1%. Conclusion: Being a minimally invasive procedure, FNA of salivary glands continues to be an important diagnostic tool in the preoperative diagnosis of salivary gland lesions in spite of few pitfalls in diagnosing due to cytomorphological overlapping.

  11. Entonox as a sedative for bone marrow aspiration and biopsy. (United States)

    Gudgin, E J; Besser, M W; Craig, J I O


    Bone marrow aspiration and biopsy can be a painful procedure. Sedation techniques may make this investigation more acceptable to patients, but have the potential to cause life-threatening complications, as well as requiring additional staff and equipment for safe administration. We assessed the use of Entonox, a 50 : 50 mix of nitrous oxide and oxygen, as a sedation and analgesic agent, and compared it to previous experience with the intravenous (i.v.) benzodiazepine midazolam. Patients' perception of pain, and both the operator and patient's views on the ease of the procedure and safety factors were recorded. Twenty-two patients who had previously required i.v. midazolam sedation (16), or who requested sedation (6) were studied. Fifteen of 16 (94%) found Entonox better or equal to midazolam, and only one patient (6%) found it worse. There were no serious adverse events due to Entonox. We have shown, in this small group of patients, that Entonox is an effective, safe alternative to intravenous midazolam for sedation during bone marrow biopsy, and is considered acceptable by both patients and staff. It has the major advantage that no additional staff or facilities are required for safe administration or monitoring the patient during or after the procedure.

  12. Aspiration promotes cooperation in the prisoner's dilemma game with the imitation rule (United States)

    Liu, Xuesong; He, Mingfeng; Kang, Yibin; Pan, Qiuhui


    A model of stochastic evolutionary game dynamics with finite population of size N +M was built. Among these individuals, N individuals update strategies with aspiration updating, while the other M individuals update strategies with imitation updating. In the proposed model, we obtain the expression of the mean fraction of cooperators and analyze some concrete cases. Compared with the standard imitation dynamics, there is always a positive probability to support the formation of cooperation in the system with the aspiration and imitation rules. Moreover, the numerical results indicate that more aspiration-driven individuals lead to a higher mean fraction of imitation-driven cooperators, which means the invasion of the aspiration-driven individuals is conducive to promoting the cooperation of the imitation-driven individuals.

  13. Usefulness of Thrombus Aspiration for the Treatment of Coronary Stent Thrombosis

    NARCIS (Netherlands)

    Mahmoud, Karim D.; Vlaar, Pieter J.; van den Heuvel, Ad F. M.; Hillege, Hans L.; Zijlstra, Felix; de Smet, Bart J. G. L.


    Current treatment for coronary stent thrombosis (ST) often lacks satisfactory results and clinical outcome is poor. We investigated the impact of manual thrombus aspiration during percutaneous coronary intervention (PCI) on myocardial reperfusion and clinical outcome in patients with angiographicall

  14. Adjacent central venous catheters can result in immediate aspiration of infused drugs during renal replacement therapy. (United States)

    Kam, K Y R; Mari, J M; Wigmore, T J


    Dual-lumen haemodiafiltration catheters enable continuous renal replacement therapy in the critically ill and are often co-located with central venous catheters used to infuse drugs. The extent to which infusions are immediately aspirated by an adjacent haemodiafiltration catheter remains unknown. A bench model was constructed to evaluate this effect. A central venous catheter and a haemodiafiltration catheter were inserted into a simulated central vein and flow generated using centrifugal pumps within the simulated vein and haemodiafiltration circuit. Ink was used as a visual tracer and creatinine solution as a quantifiable tracer. Tracers were completely aspirated by the haemodiafiltration catheter unless the infusion was at least 1 cm downstream to the arterial port. No tracer was aspirated from catheters infusing at least 2 cm downstream. Orientation of side ports did not affect tracer elimination. Co-location of central venous and haemodiafiltration catheters may lead to complete aspiration of infusions into the haemodiafilter with resultant drug under-dosing.

  15. Girl Friends as Significant-Others: Their Influence on Young Men's Career Aspirations and Achievements (United States)

    Otto, Luther B.


    Girl friends are significant-others who influence young men's career aspirations and achievements. Girl friends and same sex peers evaluate a youth's educational potential using broader criteria than do parents. (Author/MV)

  16. Aspire Project - an integrated wellness coaching model facilitated by an online coaching technology

    Directory of Open Access Journals (Sweden)

    Paul Thomas Pook


    PT Aspire provides personal trainers and coaches with a powerful facilitator of client goal achievement and behaviour change. It encourages an innovative approach to coaching that considers the key elements of wellness delivered via digital technology.

  17. 40 CFR 53.63 - Test procedure: Wind tunnel inlet aspiration test. (United States)


    ... record the precision of the aspiration ratio measurements as the coefficient of variation as: Equation 19... meet or exceed the acceptance criteria given in table F-1 of this subpart. (b) Technical definition...

  18. Framing and conflict: aspiration level contingency, the status quo, and current theories of risky choice. (United States)

    Schneider, S L


    The effect of positive versus negative frames on risky choice was examined for a variety of scenarios and risks. Preferences in the positive domain were strong and mainly risk averse, with notable exceptions. Preferences in the negative domain, however, were marked by their inconsistency, shown both by an overwhelming lack of significant majority preferences and a surprisingly strong tendency of individual subjects to vacillate in their negatively framed choices across presentations. This finding is accounted for by a proposed aspiration level contingency in which aspiration levels are systematically set to be more difficult to achieve in the face of a perceived loss than a gain. The implications of the results, and the aspiration level contingency, are explored with respect to current theories of risky choice, including Kahneman and Tversky's (1979) prospect theory and Lopes's (1987, 1990) security-potential/aspiration theory.

  19. Severe Endobronchial Inflammation Induced by Aspiration of a Ferrous Sulfate Tablet (United States)

    Lim, Sang Youn; Sohn, Sung Birm; Lee, Jung Min; Lee, Ji Ae; Chung, Sangmi; Kim, Junga; Choi, Juwhan; Kim, Sehwa; Yoo, Ah Young; Roh, Jong Ah; Park, Haein; Kim, Won Shik; Sim, Jae Kyeom; Shim, Jae Jeong


    Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation. PMID:26770233

  20. A Feminist Reading of Sister Carrie: Carrie——the Aspiring Cinderella

    Institute of Scientific and Technical Information of China (English)



    Like Cinderella in the fairy tale Cinderella, Carrie is beautiful, innocent and poor. But unlike the traditional Cinderella who mindlessly waits around for a handsome prince to come to her rescue, Carrie, the aspiring Cinderella, resolvedly leaves the men she ever depended on and eventually becomes a successful actress. Sister Carrie, the most impressive heroine of Theodore Dreiser, is a contradictory character. Some accuse her of realizing her ambition with immoral means. However, some others take sympathy with her courage, determination, and aspiration. By analyzing the most distinguished quality of Sister Carrie - her aspiration, this essay is to illustrate from the perspective of feminism that women are not limited by their sex. Ignoring her own sex as well as the conventional attitude toward women in a male-dominated society, sister Carrie, full of aspiration, takes an active pan in creating and determining her own lives and her own futures..

  1. Predicting violent behavior: The role of violence exposure and future educational aspirations during adolescence. (United States)

    Stoddard, Sarah A; Heinze, Justin E; Choe, Daniel Ewon; Zimmerman, Marc A


    Few researchers have explored future educational aspirations as a promotive factor against exposure to community violence in relation to adolescents' violent behavior over time. The present study examined the direct and indirect effect of exposure to community violence prior to 9th grade on attitudes about violence and violent behavior in 12th grade, and violent behavior at age 22 via 9th grade future educational aspirations in a sample of urban African American youth (n = 681; 49% male). Multi-group SEM was used to test the moderating effect of gender. Exposure to violence was associated with lower future educational aspirations. For boys, attitudes about violence directly predicted violent behavior at age 22. For boys, future educational aspirations indirectly predicted less violent behavior at age 22. Implications of the findings and suggestions for future research are discussed.

  2. Understanding gendered aspects of migration aspiration and motives of university students by multivariate statistical methods

    Directory of Open Access Journals (Sweden)

    Đula Borozan


    Full Text Available The paper deals with the application of multivariate analysis of variance and logistic regression in measuring, explaining and evaluating (i gender differences in expressing migration aspirations, and (ii a gender effect on migration motivation of university students in Croatia. The results supported the thesis that migration is a complex gendering process that assumes subjective assessment of the whole set of interrelated motives. According to logistic regression, gender is a significant predictor of migration aspirations among the selected demographic and socio-economic variables. A multivariate analysis of variance showed that gender and migration aspirations in interaction matter when it comes to migration motives, particularly related to the perceived importance of social networks. Females, and especially those who aspire to migrate, assessed these motives as more important than males.

  3. Aspirated pits in wetwood and micromorphology of microbial degradation in subalpine fir

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yaoli; CAI Liping; XU Yongji


    Differentiating from normal wood,pit membranes in wetwood of subalpine fir contain bacteria of water drop shape or orbicular shape,and flaky shape,as observed using Scanning Electronic Microscope.Not only are ray parenchyma cells in wetwood partially degraded but also margo strands in pit membranes are somewhat degraded by bacterial activities.Most of the bordered-pit membranes in normal wood are unaspirated in green conditions and the proportions of aspirated pits in earlywood and latewood account for only 6.8% and 13.4%,respectively.Nevertheless,most of the bordered-pit membranes in wetwood are aspirated in green conditions and the proportions of aspirated pits account for 77.7% and 72.1%,respectively.The problem of hard-to-dry for subalpine fir could be reasoned from the considerable amount of aspirated pit membranes in wetwood.

  4. Accuracy of fine-needle aspiration in early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Jamali Zavarehei M


    Full Text Available Fine-needle aspiration biopsy for the diagnosis of breast lesions has been used for more than six decades and has been established as an effective procedure in Europe for many years. In order to evaluate the accuracy of fine-needle aspiration with histopathologic confirmation, a retrospective study was performed in Iranian Center for Breast Cancer, using a computer database over one year period. All women who had had fine-needle aspiration breast biopsy with histopathologic diagnosis included open excisional biopsy or mastectomy specimen. A total of 49 patients fulfilled the criteria. The test had a 93% sensitivity, 73% specificity, 65% positive predictive value, and 95% negative predictive value. Fine-needle aspiration is a sensitive test that Van be useful as an adjuct in the diagnosis of breast cancer.

  5. Salivary gland anlage tumor: cytologic features in a case examined by fine-needle aspiration. (United States)

    Bondeson, L; Andreasson, L; Olsson, M; Rausing, A


    The cytologic features in fine-needle aspirates from a rare benign nasopharyngeal salivary gland anlage tumor in a newborn boy are described and commented on, regarding therapeutically important differential diagnoses.

  6. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen


    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  7. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart


    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  8. Surgical treatment of acquired tracheocele. (United States)

    Porubsky, Edward A; Gourin, Christine G


    Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

  9. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart


    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  10. Factors associated with educational aspirations among adolescents: cues to counteract socioeconomic differences? (United States)


    Background Our study aims to follow this effort and to explore the association between health, socioeconomic background, school-related factors, social support and adolescents' sense of coherence and educational aspirations among adolescents from different educational tracks and to contribute to the existing body of knowledge on the role of educational aspirations in the social reproduction of health inequalities. We expect that socioeconomic background will contribute to the development of educational aspirations, but this association will be modified by available social and individual resources, which may be particularly favourable for the group of adolescents who are on lower educational tracks, since for them such resources may lead to gaining a higher educational level. Methods We collected data on the socioeconomic background (mother's and father's education and employment status, doubts about affordability of future study), school-related factors (school atmosphere, school conditions, attitudes towards school), perceived social support, sense of coherence (manageability, comprehensibility, meaningfulness) and the self-rated health of a national sample of Slovak adolescents (n = 1992, 53.5% females, mean age 16.9 years). We assessed the association of these factors with educational aspirations, overall and by educational tracks (grammar schools, specialised secondary schools, vocational schools). Results We found statistically significant associations with educational aspirations for the factors parental educational level, father's unemployment, doubts about the affordability of future study, school atmosphere, attitude towards school, social support from the father and a sense of coherence. Social support from the mother and friends was not associated with educational aspiration, nor was self-rated health. Besides affinity towards school, the determinants of educational aspirations differed among adolescents on different educational tracks. Educational

  11. Factors associated with educational aspirations among adolescents: cues to counteract socioeconomic differences? (United States)

    Madarasova Geckova, Andrea; Tavel, Peter; van Dijk, Jitse P; Abel, Thomas; Reijneveld, Sijmen A


    Our study aims to follow this effort and to explore the association between health, socioeconomic background, school-related factors, social support and adolescents' sense of coherence and educational aspirations among adolescents from different educational tracks and to contribute to the existing body of knowledge on the role of educational aspirations in the social reproduction of health inequalities. We expect that socioeconomic background will contribute to the development of educational aspirations, but this association will be modified by available social and individual resources, which may be particularly favourable for the group of adolescents who are on lower educational tracks, since for them such resources may lead to gaining a higher educational level. We collected data on the socioeconomic background (mother's and father's education and employment status, doubts about affordability of future study), school-related factors (school atmosphere, school conditions, attitudes towards school), perceived social support, sense of coherence (manageability, comprehensibility, meaningfulness) and the self-rated health of a national sample of Slovak adolescents (n = 1992, 53.5% females, mean age 16.9 years). We assessed the association of these factors with educational aspirations, overall and by educational tracks (grammar schools, specialised secondary schools, vocational schools). We found statistically significant associations with educational aspirations for the factors parental educational level, father's unemployment, doubts about the affordability of future study, school atmosphere, attitude towards school, social support from the father and a sense of coherence. Social support from the mother and friends was not associated with educational aspiration, nor was self-rated health. Besides affinity towards school, the determinants of educational aspirations differed among adolescents on different educational tracks. Educational aspirations of grammar school

  12. Influence of Ovarian Side and Initiation Time of First Aspiration with Relation of Transvaginal Follicular Aspiration in HF x Sahiwal Cows

    Directory of Open Access Journals (Sweden)



    Full Text Available This study was carried out to observe the influence of ovarian side and initiation time of first aspiration during OPU programme in HF X Sahiwal cows. Eight cows were randomly divided in to two groups (A and B each consisting of 4 donors. Follicular aspiration was initiated on day 4 (first follicular wave and day 13 (second follicular wave of estrous cycle, respectively. From group-A donors, total 200 follicles were aspirated in eight sessions with a mean of 6.25 ± 2.05 per animal per session of which 52.50 (105/200 and 47.50 (95/200 per cent follicles were from left and right ovary, respectively. The mean numbers of small, medium and large follicles aspirated were 2.06 ± 0.87, 2.65 ± 0.88 and 1.53 ± 0.91 with the recovery rate of 33.0 (66/200 (3–5 mm, 42.50 (85/200 (6–9 mm and 24.50 (49/200 (=10 mm per cent, respectively. From group-B donors, total 179 follicles were aspirated of which 48.60 (87/179 and 51.40 (92/179 per cent follicles were from left and right ovary, respectively. The mean number of aspirated follicles per cow per session from group-B donor cows was 5.59 ± 1.03 and the mean numbers of small, medium and large follicles aspirated 1.87 ± 0.96, 2.5 ± 0.66 and 1.25 ± 0.64 with the recovery rate of 34.07 (61/179, 44.94 (80/179 and 21.22 (38/179 per cent, respectively. The number of follicles from left and right ovaries of different categories among group A and B donor cows did not differ significantly (P>0.05. This study showed that there cows no any influence of ovarian side and initiation time on follicular aspiration. [Vet. World 2010; 3(6.000: 286-288

  13. Disk battery aspiration in a young child: a scarcely reported phenomenon. (United States)

    McLarty, Justin D; Krishnan, Miguel; Rowe, Mark R


    Disk (or button) battery ingestion is not uncommon, with an estimated US incidence of 2 to 8 per million annually.(1) Reported serious adverse sequelae include esophageal stenosis, tracheoesophageal fistula, vocal cord paralysis, massive bleeding, and death.(1,2) There are, however, surprisingly few reports of aspirated batteries in the searchable literature; we found only 2. We present the diagnostic workup and treatment of a previously healthy 4-year-old boy with an aspirated disk battery in the bronchus.

  14. Comparison of a novel bedside portable endoscopy device with nasogastric aspiration for identifying upper gastrointestinal bleeding. (United States)

    Choi, Jong Hwan; Choi, Jae Hyuk; Lee, Yoo Jin; Lee, Hyung Ki; Choi, Wang Yong; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok


    To compare outcomes using the novel portable endoscopy with that of nasogastric (NG) aspiration in patients with gastrointestinal bleeding. Patients who underwent NG aspiration for the evaluation of upper gastrointestinal (UGI) bleeding were eligible for the study. After NG aspiration, we performed the portable endoscopy to identify bleeding evidence in the UGI tract. Then, all patients underwent conventional esophagogastroduodenoscopy as the gold-standard test. The sensitivity, specificity, and accuracy of the portable endoscopy for confirming UGI bleeding were compared with those of NG aspiration. In total, 129 patients who had GI bleeding signs or symptoms were included in the study (age 64.46 ± 13.79, 91 males). The UGI tract (esophagus, stomach, and duodenum) was the most common site of bleeding (81, 62.8%) and the cause of bleeding was not identified in 12 patients (9.3%). Specificity for identifying UGI bleeding was higher with the portable endoscopy than NG aspiration (85.4% vs 68.8%, P = 0.008) while accuracy was comparable. The accuracy of the portable endoscopy was significantly higher than that of NG in the subgroup analysis of patients with esophageal bleeding (88.2% vs 75%, P = 0.004). Food material could be detected more readily by the portable endoscopy than NG tube aspiration (20.9% vs 9.3%, P = 0.014). No serious adverse effect was observed during the portable endoscopy. The portable endoscopy was not superior to NG aspiration for confirming UGI bleeding site. However, this novel portable endoscopy device might provide a benefit over NG aspiration in patients with esophageal bleeding.

  15. Linking immigrant parents' educational expectations and aspirations to their children's school performance. (United States)

    Areepattamannil, Shaljan; Lee, Daphnee H L


    The authors examined the relationships of parental expectations and aspirations for their children's educational attainment to children's academic performance in school among 783 immigrant-origin children aged 5-18 years in Canada. The results of hierarchical regression analyses, after accounting for student and family background characteristics, indicated that immigrant parents' expectations and aspirations for their children's educational attainment were positively linked to immigrant-origin children's academic performance in school. Implications of these findings are briefly discussed.

  16. Fine Needle Aspiration Cytology: A Useful Technique for Diagnosis of Invasive Fungal Rhinosinusitis



    Mycotic infections are on the rise globally. Patients with invasive fungal infection of the paranasal sinuses often present with destructive mass lesions and mimic malignancy clinically and radiologically. To assess the utility of Fine needle aspiration cytology for early diagnosis of invasive fungal rhinosinusitis. Fine needle aspiration cytology was performed from the maxillary/ethmoid sinus in patients with a destructive mass lesion in the maxilla. Differential diagnoses were malignancy an...

  17. [Laryngotracheal separation and tracheoesophageal diversion for intractable aspiration in ALS--usefulness and indication]. (United States)

    Mita, Shuji


    To evaluate the usefulness of laryngotracheal separation or tracheoesophageal diversion (LTS/TED), we investigated changes in medical management after LTS/TED. We performed LTS/TED for intractable aspiration in patients with amyotrophic lateral sclerosis (ALS) and patients with other neurological diseases. Most of the subjects had already received a tracheostomy, and all the patients with ALS had tracheostomy positive pressure ventilation. However, they remained at risk of intractable aspiration, had experienced frequent suctioning of aspiration material, and could not eat. In all cases, LTS/TED was performed safely within 3 hours and without any complications. After LTS/TED, there was no aspiration of saliva in any of the patients. In most subjects, the frequency of suctioning by medical staff and caregivers was much reduced. The frequency of aspiration pneumonia was also extremely lowered. Follow-up study demonstrated that complete control over aspiration was achieved in all of the patients. Some of them were completely self-sufficient in their ability to eat. Some of the other patients were at least able to enjoy taste. Nutritional status was significantly improved. All the patients, family caregivers, and medical staff involved in this study were satisfied with the outcome. These results indicate that LTS/TED is a very useful procedure in several aspects: it benefits patients who have a fear of aspiration; it reduces the burden on patients and family caregivers; it promotes their quality of life; and it limits the aspiration-associated demands on medical staff. Based on the results, we have proposed an indication of LTS/TED for dysphasia in ALS.

  18. Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy



    PURPOSE: Determine whether cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy (FNAB) is a significant prognostic factor for death from metastasis. METHODS: Retrospective analysis of cases of clinically diagnosed uveal melanoma evaluated by fine-needle aspiration biopsy from 1980 to 2006. Main outcome evaluated was death from metastasis. Associations between baseline clinical variables and cytopathologic classification were evaluated using cros...

  19. Prevention and management of accidental foreign body ingestion and aspiration in orthodontic practice


    Umesan UK; Chua KL; Balakrishnan P


    Uday Kumar Umesan,1 Kui Lay Chua,1 Priya Balakrishnan21National Dental Centre, 2Kg Kiarong, Bandar Seri Begawan, Brunei DarussalamAbstract: Among the myriad emergencies that could arise in the dental clinical setting there are a few that occur occasionally despite being entirely preventable. Ingestion or aspiration of dental materials, appliances, or instruments comprises this category. Regardless of incidence, foreign body ingestion or aspiration episodes are recognized as potential complica...

  20. Parent Academic Involvement as Related to School Behavior, Achievement, and Aspirations: Demographic Variations Across Adolescence


    Hill, Nancy E.; Castellino, Domini R.; Lansford, Jennifer E.; Nowlin, Patrick; Dodge, Kenneth A.; BATES, JOHN E.; Pettit, Gregory S.


    A longitudinal model of parent academic involvement, behavioral problems, achievement, and aspirations was examined for 463 adolescents, followed from 7th (approximately 12 years old) through 11th (approximately 16 years old) grades. Parent academic involvement in 7th grade was negatively related to 8th-grade behavioral problems and positively related to 11th-grade aspirations. There were variations across parental education levels and ethnicity: Among the higher parental education group, par...