Fine Needle Research Articles

A new genus of chitons (Mollusca: Polyplacophora) from the Barbados and Martinique Islands, Atlantic Ocean

A new genus Barbadoschiton gen. nov. [type species B. bromleyi (Ferreira, 1985)] of the family Ischnochitonidae from shelf near Barbados and Martinique Islands is described. The genus possesses unique features of the tegmentum and girdle. The central area of the intermediate valves and antemucronal area of the tail valve show teardrop-shaped granules arranged in quincunx and have only one pore of aesthete. The marginal fringe of girdle is beset with five kinds of elements, among these long, fine needles, flattened, obtuse pointed spicules with three ribs on one side; spicules with longitudinal groove on one side and with 7 longitudinal ribs, on the other side; numerous, small spicules with 5 longitudinal ribs and one longitudinal groove; flat, obtuse spicules with two warts on upper half. The ventral spicules are of two kinds: main flattened, rectangular spicules with distal appendix and three weak longitudinal ribs on external part; and small distally pointed, smooth on the outer side and with two longitudinal grooves on the opposite side of the spicules. The latter are attached in transverse rows with their proximal part between the main ventral spicules. The major lateral teeth of the radula have a tridentate head, with the middle denticle being longer than others.

Lymphadenopathy Tissue Sampling by EUS-Guided Fine-Needle Biopsy Contributes to Meeting the Conditions for Genomic Profiling.

EUS-guided fine-needle biopsy (EUS-FNB) performed with a Franseen needle or Fork-tip needle enables greater tissue acquisition. However, it is unknown whether EUS-FNB could contribute to lymphadenopathy genomic profiling. The aim of this study was to determine the efficacy of EUS-FNB using a Franseen or Fork-tip needle for tissue acquisition and genomic profiling in patients with lymphadenopathy. Patients with abdominal lymphadenopathy who underwent EUS-guided fine needle aspiration (FNA)/EUS-FNB were included in this study. The amount of acquired tissue and its suitability for genomic profiling were compared between FNA and FNB. Specimen quality was evaluated by a widely used pathologic adequacy scoring system (0: insufficient; 1 to 2: cytologic; 3: limited histologic; 4 to 5: sufficient histologic). The criteria of FoundationOne CDx (F1CDx) and NCC Oncopanel (NOP) were used to assess the suitability for genomic profiling. In total, 72 patients underwent EUS-FNA, and the other 20 patients underwent EUS-FNB. The pathologic adequacy score and suitability for genomic profiling based on the criteria were significantly higher for FNB than for FNA [histologic adequacy score: 5 (4 to 5) versus 3 (0 to 5), P<0.01; F1CDx: 16.7% vs. 0%, P=0.01; NOP: 66.7% vs. 7.5%, P<0.01]. In multivariate analysis, EUS-FNB was identified as the only factor that influenced the suitability for genomic profiling based on the above-mentioned criteria (odds ratio 19.5, 95% CI: 3.74-102, P<0.01). EUS-FNB performed using Franseen or Fork-tip needles may result in greater lymphadenopathy tissue acquisition and thus enhanced suitability for genomic profiling compared with EUS-FNA.

Development and clinical application of lateral segmental positioning plates of the body surface spine

To investigate the clinical efficacy of body-surface guide plates for lateral segmental positioning in the thoracolumbar spine. From March 2018 to March 2021, 768 gerontal patientss underwent percutaneous vertebroplasty with balloon dilatation due to thoracolumbar compression fracturess, 356 males and 412 females. aged from 64 to 92 years old with an average of (77.9±13.5) years old. All patients were treated in hospital within 1 week after injury. All patients underwent preoperative localization, and were divided into localization plate group and locator group according to different localization methods. There were 390 patients in the localization plate group, 180 males and 210 females, aged from 64 to 92 years old, with an average age of (78.4±14.3) years old. There were 378 patients in the locator group, 176 males and 202 females, aged from 64 to 90 years old, with an average age of (77.5±13.4) years old. After preliminary positioning with the above two methods, skin markers were made, cloth was routinely disinfected, and the spinal lateral position was fluoroscopically examined after the fine needle was inserted into the marked point and the vertical body at the near tail end. The accuracy of the original positioning method was evaluated. The number of times, time and accuracy of positioning of the two groups of patients were compared and analyzed. The specific data of patient positioning in the two groups were collected for statistical analysis. The number of times of fluoroscopy in the positioning plate group and the locator group was(3.3±0.5) times and (5.0±1.2) times, and the positioning time was (60.4±9.4) s and (105.0±30.9) s, respectively. The accuracy of fluoroscopy was 97.5% (380/390) and 85.7% (324/378), respectively, with statistical significance (P<0.05). The lateral segmental positioning plate of the body surface spine has the advantages of simple operation, accurate positioning, and reducing X-ray radiation for patients, which is worthy of clinical application.

Feasibility of whole-exome sequencing in fine-needle aspiration specimens of papillary thyroid microcarcinoma for the identification of novel gene mutations.

Genetic profiling is important for assisting the management of papillary thyroid microcarcinoma (PTMC). Although whole-exome sequencing (WES) of surgically resected PTMC tissue has been performed and revealed potential prognostic biomarkers, its application in PTMC fine-needle aspiration (FNA) specimens has not been explored. This study aimed to evaluate the feasibility of WES using FNA specimens of PTMC. Five PTMC patients were enrolled with clinical characteristics gathered. Fine aspiration cytology needle (23 gauges) was used to collect FNA biopsy with ultrasound guidance. WES analysis of FNA specimens from five PTMC patients and matched blood samples was performed. The WES of FNA samples yielded an average sequencing depth of 281× and average coverage of 99.5%. We identified 534 somatic single-nucleotide variants and 13 indels in total, and per sample, we found a mean of 24 exonic mutations, which affected a total of 120 genes. In the PTMC FNA samples, the most frequently mutated genes were BRAF and ANKRD18B, and the four driver genes were BRAF, AFF3, SRCAP, and EGFR. We also identified several germline cancer predisposing gene mutations. The results suggest that WES of FNA specimens is feasible for PTMC and can identify novel genetic mutations.

Fine Needle Aspirate Flow Cytometry's Ancillary Utility in Diagnosing Non-Hodgkin Lymphoma in the Head and Neck.

While ultrasound-guided fine-needle aspiration cell block (FNACB) is a cost-effective, expeditious, and reliable procedure used routinely in the initial evaluation of head and neck masses, it has limited efficacy in diagnosing lymphoproliferative disorders such as non-Hodgkin lymphoma (NHL). Flow cytometry performed on an fine-needle aspiration (FNA) sample [ultrasound-guided fine-needle aspirate flow cytometry or flow cytometry performed on an FNA sample (FNAFC)], has been shown to be a valuable adjunct to FNACB in the diagnosis of lymphoproliferative disorders of the spleen, kidney, and thyroid. The objective of this study was to appraise FNAFC's utility as an ancillary tool to detect NHL arising in the head and neck region in adult patients. This is a retrospective study involving 52 adult patients with head and neck lymphadenopathies and masses suspicious for lymphoproliferative disorders, who underwent ultrasound-guided FNACB and ultrasound-guided FNAFC between January 2017 and November 2022. Patient demographics, FNACB histopathological and immunophenotypic results, postoperative histopathology results (when available), and follow-up information until May 2023 were reviewed. Of the 52 FNACB samples, 23 samples (44.2%) yielded a diagnosis negative for carcinoma, 20 samples (38.5%) were nondiagnostic on account of scant cellularity, 8 samples (15.4%) were suspicious for malignancy, and a single sample (1.9%) was compatible with malignancy. Regarding FNAFC samples, 37 samples (71.2%) were diagnosed as showing no evidence for a lymphoproliferative disorder, 4 samples (7.7%) as nondiagnostic because of insufficient cell count, 4 samples (7.7%) as suspicious for a lymphoproliferative neoplasm, and 7 samples (13.5%) as compatible with a lymphoproliferative neoplasm, most frequently a B-cell lymphoma. 7 of the 11 patients (63.6%) with a suspicious/positive FNAFC result underwent excisional biopsy for additional work up. Postoperative histopathology reports corroborated FNAFC's findings in 6 patients (85.7%), while the remaining patient's (14.3%) suspicious FNAFC result was discordant with postoperative histopathology results. The other 4 patients (36.4%) did not require excisional biopsy as the hemato-oncologist deemed the information provided by the FNAFC as sufficient for the diagnosis and treatment of an NHL in the specific clinical contexts of those patients. All patients with nondiagnostic (due to insufficient cell count), inconclusive, or negative FNAFC (ie, nondiagnostic of a lymphoproliferative disorder) were followed up for a mean follow-up period of 11.9 months (range: 61.2 months; SD: 10.2 months), during which no new lymphadenopathies/masses nor progression was observed. FNAFC is a useful and practical supplementary tool in the diagnosis of lymphoproliferative disorders in the head and neck region, principally B-cell lymphoma. While conventional FNACB offers a valuable insight into the initial work up of head and neck masses, FNAFC can routinely detect small abnormal cell populations. Furthermore, in specific clinical contexts, it can reliably diagnose NHL, thereby averting the need for an excisional biopsy in a subset of patients.

ВЛИЯНИЕ ЭЛЛАГОТАНИНОВ И ПРОБИОТИЧЕСКОГО ПРЕПАРАТА “ЭКОФЛОР” НА ПОКАЗАТЕЛИ НЕСПЕЦИФИЧЕСКОГО ИММУНИТЕТА СТЕРЛЯДИ

The experimental study of the effect of feed additive based on ellagotanins and immobilized probiotic “Ecoflor” on some parameters of non-specific immunity of sterlet Acipenser ruthenus was carried out. Feed additives based on ellagotannins are one of the numerous preparations of natural origin. They have antibacterial and immunostimulating properties. Biologically active additive “Ecoflor” is a consortium of live antagonistically active strains of bifido- and lactobacilli immobilized on enterosorbent. During the experiment, control and experimental groups were kept in flow-through plastic pools. Sterlets were fed 6 times a day. Drugs were added to the feed according to the instructions. Sampling was carried out before the start of the experiment, on 7, 14, 30, 45 and 60 days. Material for the study was taken from 5 individuals from each group. Peripheral blood was taken from the tail vein. After autopsy, tissue pieces of immunocompetent organs (kidney, spleen and liver) were taken from the fish into dry sterile tubes. Blood coagulation and clot retraction were waited for to obtain serum. The serum was then withdrawn with a syringe with a fine needle and transferred into an Eppendorf tube. For further studies, the homogenate was prepared from kidney, spleen and liver with physiological solution in the ratio of 1:6. The level of bacteriostatic activity, C-reactive protein and nonspecific immune complexes was determined in blood serum samples. In homogenates of kidney, spleen and liver the content of immune complexes was determined. The study established high indices of antimicrobial properties of blood serum in all studied fish and the absence of immunodeficient individuals. Lower indices of bacteriostatic activity in experimental groups and zero percent of immunodeficient individuals indicate insignificant influence of preparations on nonspecific antibacterial defense. The majority of the studied fish had a positive level of C-reactive protein, which indicates the presence of inflammatory processes in the body. The content of nonspecific immune complexes in the liver was several times higher than in other tissues, which may be due to the neutralization of components included in the preparations.

Ultrasound guided core needle biopsy results after marking suspicious lesions on mammography with a fine needle

Amaç&#x0D; Mamografi ile meme kanseri taramasının artışı memede saptanan nonpalpabl lezyonların oranını arttırmaktadır. Sadece mamografi ile görülebilen kuşkulu lezyonların tanısında stereotaktik vakum aspirasyon biyopsi (VAB) tercih edilen ilk yöntemdir. Ancak vakum biyopsi ünitesi ve vakum iğnesinin yüksek maliyetli olması nedeniyle bu yönteme erişim sınırlıdır. &#x0D; Bu çalışmada VAB’ ye alternatif olarak mamografide izlenen kuşkulu lezyonun ince iğne ile işaretlenmesi ardından, bu iğne kılavuzluğunda US eşliğinde yapılan kalın iğne biyopsi sonuçlarının değerlendirilmesi amaçlanmıştır. &#x0D; Gereç ve Yöntem&#x0D; Ocak 2021-Nisan 2022 tarihleri arasında, sadece mamografide izlenebilen ve kuşkulu kategoride olan lezyonlara, mamografide ince iğne ile işaretleme ardından, US rehberliğinde iğnenin bulunduğu alana kalın iğne biyopsi yapılan hastalar retrospektif olarak taranmıştır. Hastaların mamografi bulguları, lezyonun BI-RADS kategorisi, biyopsi örnekleme sayısı, spesmen mamografisi, biyopsi patoloji sonuçları, varsa cerrahi eksizyon patoloji sonuçları değerlendirilmiştir. &#x0D; Bulgular&#x0D; Biyopsi yapılan toplam 43 hastanın 39’unda sadece kuşkulu mikrokalsifikasyon, 3’ ünde sadece asimetri ve distorsiyon, 1 ‘inde mikrokalsifikasyon ve eşlik eden asimetri izlenmekteydi. Kalın iğne biyopsi histopatoloji sonuçlarında %58 benign, %9 atipili benign ve %33 malign tanı saptandı. 15 hastada cerrahi eksizyon ile lezyon çıkarıldı, radyoloji patoloji uyumu olan diğer hastalar takibe alındı. 43 hastanın %39.5’i malign, %60.5’i benign gruptaydı. Mamografide yerleştirilen ince iğnenin kılavuzluğunda yapılan, kalın iğne biyopsi işleminin tanısal doğruluğuna bakıldığında; sensitivite %76.5, spesifite %100 olarak saptandı. &#x0D; Sonuç&#x0D; Mamografide saptanan kuşkulu mikrokalsifikasyonlar erken evre meme kanserinin tanısında önemli belirteçlerdir. Kuşkulu lezyonların tanısında mamografide yerleştirilen ince iğnenin rehberliğinde yapılan trucut biyopsi yüksek tanısal doğruluğa sahip, açık cerrahi biyopsi ve VAB’ ye alternatif olarak kullanılabilecek minimal invaziv bir yöntemdir.

The degradation mechanisms of a nanobainitic steel under cavitation erosion conditions

The nanobainitic steel was investigated using a chamber with the cavitating jet at two distances from a nozzle. Fe-0.6C-1.7Mn-1.6Si-1.35Cr-0.4Mo steel subjected to austenitising at 950 °C followed by controlled air cooling and the isothermal heat treatment at 215 °C shows high strength and good plasticity. The microstructure of steel consists of packets of laths of carbide-free bainite and 10 % in volume of retained austenite in the form of laths, plates, and grains (blocky). Due to its very good combination of strength and plasticity, nanobainitic steel is promising for applications under extreme loading conditions. For this reason, it was decided to analyse the behaviour of the steel under dynamic loads with high-pressure amplitude. Such conditions are obtained during cavitation erosion tests. The distance from the nozzle affected the degradation process (type of damage, maximum and final erosion rates). Three types of damage were observed: A) caused by simple collapse of the cavitation bubble, B) caused by splitting of the cavitation bubble into two smaller bubbles, and C) caused by fragmentation of the cavitation bubble into many tiny bubbles. Some similarities in the appearance of the damage were observed: dark rings with a changed structure and a recess in the middle, a dark surface layer, a quasi-etched structure with numerous small recesses, and a structure with fine needles. The “needle” structure was formed only after reaching the maximum rate of erosion. As the distance from the nozzle increased, more and more cavitation bubbles fragmented, which resulted in an increase in erosion intensity and the maximum rate of erosion. Higher erosion intensity affected the higher transformation of austenite to martensite and finally rounding/convexity of the entire surface and a decrease in erosion rate.

Correlation between thyroid fine needle aspiration and pathological examination: a 10 year retrospective study.

To establish the diagnostic performance of fine-needle aspiration in detecting benign and malignant neoplasm in comparison with post-thyroidectomy histopathological findings among patients who received a thyroidectomy. Retrospective observational data collected between 2011-2021 were included from patients who received partial or total thyroidectomy. The Bethesda system was used to classify neoplasms from fine-needle aspiration procedures as benign or malignant. Sample characteristics, diagnostic accuracy, sensitivity, specificity, and predictive values were evaluated. Patients (n=360) who underwent thyroidectomy were analyzed, of whom 142 (39.4%) and 218 (60.6%) had benign and malignant neoplasms, respectively. Using the Bethesda system, 23 (6.4%) were classified as unsatisfactory result (BI), 83 (23.1%) as benign (BII), 50 (13.9%) as atypia of undetermined significance (BIII), 23 (6.4%) as suspected follicular or Hürthle cell neoplasia (BIV), 102 (28.3%) as suspected malignancy (BV) and 79 (21.9%) as malignant (BVI). The fine-needle aspiration diagnostic accuracy for carcinomas was 92%, while the sensitivity and specificity were 94.4% and 86.9%, respectively. The negative and positive predictive values were 87.9% and 93.9%, respectively. Fine-needle aspiration has high diagnostic accuracy, sensitivity and specificity, and is a reliable test for distinguishing between benign and malignant thyroid pathologies.

Prognostic fine needle aspiration biopsy of uveal melanoma: Molecular and genetic factors of metastasis risk

Introduction. Molecular genetic testing is actively used for prognostication in patients with uveal melanoma (UM). Tissue for genetic analysis may be obtained either by surgical excision or through fine-needle aspiration biopsy (FNAB). Performing genetic testing and FNAB in each institution can differ in surgical techniques and laboratory methodologies.Aim. To present our own experience of performing FNAB-based molecular genetic testing for prognostication in patients with uveal melanoma.Materials and methods. Prognostic FNAB (n = 151) were combined with brachytherapy or stereotactic surgery. Genetic testing was performed by methods based on polymerase chain reaction (GNAQ, GNA11, EIF1AX and SF3B1 mutations) and fluorescence in situ hybridization (copy numbers of PPARG and MYC genes); cytology of FNAB material was also assessed.Results. Fine-needle aspiration biopsy material was informative in 91 % of cases. At the median follow-up of 36 months, 12 cases of distant metastases were detected. Occurrence of the assessed mutations and copy numbers were related to other representative studies. PPARG deletion was shown to be a significant prognostic factor for metastasis-free survival (p &lt;0,01), which was demonstrated for the first time; EIF1AX and SF3B1 mutations, MYC amplification and cytological class were not shown to be significantly associated with survival in our study.Conclusion. FNAB-based molecular genetic testing for prognostication in patients with uveal melanoma was shown to be a reliable and highly informative approach. Some of the prognostic factors need to be evaluated further with longer follow-up.

Retrospective Comparison between Pre Operative Fine Needle Aspiration Cytology and Postoperative Histopathological Result after Parotidectomy in Tertiary Hospital Saudi Arabia

Abstract Purpose: To assess the diagnostic accuracy of fine-needle aspiration cytology (FNAC) of parotid gland tumors and to compare between diagnostic accuracy of FNAC and tru-cut biopsy. Materials and Methods: An observational, retrospective noninterventional study including 95 patients who underwent both preoperative fine-needle aspiration biopsy and postoperative surgical pathologies in Aseer Region, Saudi Arabia between January 2015 and November 2022 was conducted. Results: Males (53.7) were more than females (46.3%). The most common age group was found to be more than 50 years (36.8%), followed by 41–50 years (25.3%). Only (1.9%) FNAC result report was described according to the Milan system for salivary gland cytopathology and the result was nonneoplastic II, while (98.1%) was not. FNAC sensitivity and specificity were found to be 60% and 100%, respectively. Tru-cut biopsy sensitivity and specificity were found to be 100% and 100%, respectively. No significant association was found between FNAC and tru-cut biopsy results. Conclusion: Overall, this study can conclude that FNAC is a simple, safe, and cost-effective diagnostic method in the investigation of parotid gland tumors with high specificity and accuracy and can prevent many unnecessary operations as a cheap and reliable diagnostic tool that can be used for preoperative diagnosis of carcinomas. It was found that tru-cut biopsy has more sensitivity and specificity than FNAC.

455 Fine-Needle Aspiration, Ultrasound and Thyroidectomies in Patients with Thyroid Nodules Presenting to a District General Hospital – a Retrospective Audit

Abstract Aim To determine whether fine-needle aspiration, ultrasound and thyroidectomies were being performed appropriately in patients with thyroid nodules, and to compare the percentage of malignant cases for each histological classification with the national standards. Method Patients undergoing thyroidectomy in Northwest Anglia Trust (East of England) between October 2021 – October 2022 was identified retrospectively using the OPSC-4 codes. Medical records of 132 patients were retrieved, and data points extracted. Results We identified 103 female and 29 patients. The female cohort had a younger age distribution (median 52y) compared to the male cohort (59y). 42 patients underwent total thyroidectomy, 89 underwent hemithyroidectomy and 1 underwent lobectomy. 21% of the specimen was reported to be malignant, of which 74% was papillary cell carcinoma, 15% follicular cell carcinoma and 11% Hurthle cell carcinoma. Our percentage of malignancy in the Thy1a/c category was higher (5%) compared to the national figures of malignancy risk reported by RCPath (4%), whilst the rest were lower than the national figures (Thy2 = 0%, Thy3a = 13%, Thy3f = 19%, Thy4 = 50%, Thy5 = 94%). 100% of Thy3, Thy4 and Thy5 patients underwent diagnostic hemithyroidectomy. 15 patients did not have documentation of the U classification prior to thyroidectomy. There was 84% compliance with repeat FNAC requirements prior to surgery and 97% compliance with MDT discussion. Conclusions Current BAETS guideline states that thyroid nodules with benign appearances (U1 and U2) do not need to be followed-up, however we found a 15% of malignancy in these patients. Costs, risks and benefits of regularly undertaking fine needle aspiration in these patients must be considered.

Evaluation of results of pericardial drainage by ultrasound-guided fine-needle aspiration in patients with pericardial effusion after cardiac surgery at hanoi heart hospital

Background: Pericardial effusion is a relatively common complication after cardiac surgery, in which a large proportion of cardiac tamponade causes hemodynamic disturbances, and can have serious consequences.&#x0D; Objective: "Evaluation of the efficacy and safety of pericardial drainage with ultrasound-guided fine-needle aspiration". &#x0D; Method: Cross-sectional, retrospective. Accept all patients with pericardial effusion after cardiac surgery were recruited at the Emergency Department and the Intensive Care Unit who performed pericardial aspiration from May 2021 to October 2022.&#x0D; Results: There were 46 patients included in the study; the average age is 52.04 ± 12.46 years, the youngest is 26 years, the oldest is 81 years old; The group of patients with heart valve disease had the highest rate of pericardial effusion, accounting for 93.4%; patients with atrial septal defect have recurrent pericardial effusion after surgery; there is a higher rate of recurrence and need for surgical conversion with the use of a sheet + pigtail device compared with a catheter; 36 (78.3%) patients did not have recurrent effusion and 10 (21.7%) patients had relapse; 100% of patients are alive after pericardial drainage.&#x0D; Conclusion: The results of treatment of pericardial effusion with fine needle aspiration pericardial drainage under the guidance of ultrasound after cardiac surgery are positive, the use of the catheter is initially shown to be safer than the use of sheat + pigtail.

Leaf spot disease on Juglans regia caused by Ragnhildiana diffusa in China.

Juglans regia L. is commercially important for its edible nuts, which is a major species of walnut trees in Sichuan Province (Luo et al. 2020). In September 2021, brown leaf spot symptoms were observed on roughly 75% of 60 J. regia trees surveyed in an orchard of Chongzhou city (30°40'6''N, 103°40'18''E). Initially, the lesions measuring 2-10 mm were reddish to brown with a yellowish halo, then increased in size and coalesced to cover the whole leaf, eventually resulting in severe defoliation. Six symptomatic leaves from different trees were collected, and a single fungal isolate was obtained from each of the sampled leaves using single-spore isolation (Chomnunti et al. 2014). The isolates were incubated on potato dextrose agar (PDA) with a 12h photoperiod at 25 ℃, and deposited at the Culture Collection of Sichuan Agricultural University. Colonies were identical with black center and reddish-brown periphery, and the diameter reached 2 cm after 7 days. On the host, conidiophores were mostly reduced to conidiogenous cells, with prominent and thickened conidiogenous loci. Conidia were light green to light brown, and curved with a thickened and darked hilum at the base, 0-17 septate, tapering toward the distal end, and measuring 20-120 × 3-5 μm ((x ) ̅= 56 × 4, n = 30). Morphological characteristics fit the description of Ragnhildiana diffusa (Heald & F.A. Wolf) Videira & Crous (Synonym: Sirosporium diffusum (Heald & F. A. Wolf) Deighton) (Poletto et al. 2017). The internal transcribed spacer (ITS) region, the large subunit of the nrDNA (LSU), and RNA polymerase II second largest subunit (rpb2) were amplified by polymerase chain reaction and sequenced with primers ITS5/ITS4 (White et al. 1990), LR0R/LR5 (Vilgalys & Hester 1990), fRPB2-5F/Rpb2-R3 (Liu et al. 1999, Videira et al. 2017), respectively. The nucleotide blast of the two isolates (SICAUCC 22-0077, SICAUCC 22-0078) showed 99.7% and 99.5% (ITS, 472/473 bp, 471/473 bp), 100% (LSU, 725/725 bp, 725/725 bp), 99.8% (rpb2, 866/867 bp, 866/867 bp) identities with the ex-type strain of Ragnhildiana diffusa (CBS 106.14). The phylogenetic tree combined with ITS, LSU, and rpb2 genes and morphological characteristics confirmed the identification as R. diffusa. These sequences of the three gene regions of two isolates were deposited in GenBank with accession numbers ON409525 and ON409526 (ITS), ON409559 and ON409560 (LSU), ON417473 and ON417474 (rpb2), respectively. The isolate SICAUCC 22-0077 was used for pathogenicity test to fulfill Koch's postulates. Three leaves of each walnut seedlings (2-year-old seedlings) were inoculated by placing a mycelium plug onto fresh wounds on the upper leaf surface punctured via a fine needle (0.7 mm in diameter), and three replicate seedlings were inoculated. For the control, a sterile PDA plug was placed on the same number of replicate leaves on the plants. The inoculated and control plants were placed in a growth chamber at 25°C with relative humidity >80% and a 12-h photoperiod. Irregular light to dark brown spots developed on inoculated leaves after twenty days, and no symptoms were observed on controls. The re-isolation and examination of the fungus showed it to be morphologically and phylogenetically identical to the originally isolated pathogen. R. diffusa has been described on J. regia in Mexico (Farr & Rossman 2022). To our knowledge, this is the first report of R. diffusa causing brown leaf spot on J. regia in China. The identification of the pathogen will provide a basis for disease management in walnut planting areas.

Fine-Needle Aspiration Biopsy of Pancreatic Masses: Failure Factors

Objectives: The main objective of this work is to determine the factors affecting the failure rate of pancreatic aspiration cytology, in particular the size, location, and nature of the mass as well as the size of the needle, the aspiration site, the number of passages, and realization of Fanning. Materials and methods: This is a retrospective study conducted in the EFD-HGE department at Ibn Sina Hospital in Rabat from March 2017 to May 2023. 138 patients with a solid or cystic pancreatic mass on imaging were included. A video-linear Pentax-type echoendoscope was used with needles of different gauges: 19G, 20G, 22G, and 25G. Statistical analysis was performed using R software and the level of significance was set at p &lt; 0.05. Results: The sex ratio F/M was 1.35. The average age was 59 years old. The average tumor size was 40.5 mm. Fine needle aspiration (FNA) under ultrasound-endoscopy (EUS) was positive in 70% of cases: adenocarcinoma in 60% of cases, chronic pancreatitis in 9.33% of cases, neuroendocrine tumor in 8% of cases, solid and pseudo-papillary tumor of the pancreas in 4% of cases, mucinous cystadenoma with low-grade (LGD) in 1.33% of the cases, an intraductal papillary mucinous neoplasm (IPMN) in 2.66% of the cases, pancreatic tuberculosis in 1.33% of the cases. Normal pancreatic parenchyma without signs of malignancy in 13.33% of the cases. The failure rate of pancreatic fine-needle aspiration was estimated at 30% of cases (inconclusive result). By univariate analysis, we demonstrated that the risk of having an inconclusive fine needle aspiration increases on the one hand by the location of the mass at the head of the pancreas (p = 0.02), the presence of a cystic component (p = 0.01), the infiltrating character of the mass (p = 0.01), and on the other hand by the absence of Fanning (p = 0.03). However, this study did not show a significant correlation with the other factors, in particular the size of the mass, the size of the needle, the site of fine-needle aspiration, and the number of passages. No complications were noted. Conclusion: The failure rate of fine-needle aspiration biopsy was 30%. We demonstrated that it increases by the location of the mass at the head of the pancreas (p = 0.02), the presence of a cystic component (p = 0.01), the infiltrating character of the mass (p = 0.01), and the absence of fanning. An additional study with a larger sample or a multicenter study seems necessary to confirm our results.

Laparoscopic Pediatric Inguinal Hernia Repair with Percutaneous İnternal Ring Suturing with Finer Needle and Suture; A 5-Year Experience of A Single Surgeon

Introduction: Percutaneous internal ring suturing (PIRS) method is an effective minimally invasive laparoscopic method that was preferred for indirect hernia repair in children. Purpose: The aim of this study is to report the evaluation of surgical results in our PIRS series modified with finer needle and suture with the diagnosis of indirect inguinal hernia, communicating hydrocele and incarcerated inguinal hernia. Methods: This was a retrospective study that included children aged 3 months to 12 years who underwent PIRS technique due to inguinal hernia between 2017 and 2022. Per-operative findings, surgical time, follow-up findings, complications, and recurrence data were evaluated. Results: One hundred patients underwent a total of 129 PIRS procedures. Right inguinal hernias were diagnosed in 63 (63%) of the patients (1 communicating hydrocele and 1 recurrent inguinal hernia). One communicating hydrocele and one recurrent inguinal hernia were present on the left side of 32 (32%) patients. Five patients were diagnosed bilaterally (one incarcerated hernia). 24 patients (29%) with no symptoms were found to have contralateral hernias: 11 on the right (45%) and 13 on the left (55%) side. The average duration of surgery for unilateral PIRS was 13.5 minutes and bilateral PIRS was 24.3 minutes. Average follow-up duration was nine months. There were complications in nine patients (9%). Recurrence was observed in 3 (or 3%) of 100 (or 100) patients. Conclusion: PIRS is a simple and safe alternative to open hernia repair in terms of surgical outcomes for the management of inguinal hernia in children.

Intimal Injury Potentially Plays a Key Role in the Formation of Carotid Artery Dissection: A Novel Animal Model Establishing

Research on the pathophysiological mechanism of carotid artery dissection and its clinical translation is limited due to the lack of effective animal models to simulate the occurrence of this condition. Assuming that intimal injury is an important factor in the formation of carotid dissection, we established a novel method for inducing carotid dissection models by scraping the carotid intima using a fine needle. Scraping the carotid intima with fine needles can induce the rapid formation of carotid dissection. Magnetic resonance imaging and hematoxylin-eosin staining suggest the presence of false lumens and mural hematomas in the vessels. Our model-induction technique, inspired by iatrogenic catheter-induced artery dissections (carotid, coronary, aortic), significantly mimics the pathological process of clinical carotid dissection. The results suggest that mechanical injury may be a significant cause of carotid dissection and that intimal injury is a major factor in the formation of arterial dissections. This approach will provide assistance in the understanding of medically induced arterial dissection.

The use of acupuncture as a complementary treatment for people with neurological conditions

Acupuncture is the insertion of very fine needles at specific points of the body. Originally based in East Asia, acupuncture has been found to be highly beneficial to patients suffering from many diseases and research has found measurable physiological effects. Research evidence shows that acupuncture reduces the experience of pain, stress and anxiety. It also appears to improve digestive problems, helps fatigue, and benefits gait impairments and bladder dysfunction in people with multiple sclerosis.

Forced Convection of Magnetohydrodynamic (MHD)-Boundary Layer Flow Past Thin Needle with Variable Wall Temperature Using Casson Nanofluid

The important goal in the twenty-first century has become to optimiz efficiency. For instance, heating, ventilation, and air conditioning (HVAC), an antifreeze or heat exchange fluid flows in a nuclear power reactor, heat-transfer design, etc. These advancements have been made either through the use of novel materials (duct walls with improved thermal insulation properties) comprising the duct walls, innovative geometric designs, or enhanced working fluids. In parallel with several additional areas of mechanical, medicinal, and energy engineering, nanotechnology has permeated duct design. Inspired by the remarkable potential of nanofluids, a subset of materials is created at the nanoscale. The study of thin needles in fluid flow is a very important aspect of biomedical areas and engineering industries. It is especially used in blood flow problems, circulatory problems, cancer therapy, aerodynamics, and fibre coating. In the current study, a novel mathematical model is created for the movement of the heat on a fine needle with changeable surface temperature using a Casson nanofluid. These governing equations are solved using the 4th order RK method and the collocation formula defined in bvp4c of Matlab software. To regulate the nanofluid, the Tiwari-Das model is used. The solid (metal) nanoparticles are added in the blood (carrier fluid). The momentum, energy, skin-friction coefficient, and Nusselt values are tabulated and displayed graphically. The Casson parameter raises the momentum but lowers the temperature. The Nusselt values are incremented when nanofluid is used instead of conventional fluids. For confined situations, numerical outcomes are compared with the literature and a good level of agreement is discovered.

Endoscopic ultrasound-guided tissue acquisition beyond the pancreas.

Endoscopic ultrasound (EUS) offers the ability to obtain tissue material via a fine needle under direct visualization for cytological or pathological examination. Prior studies have looked at EUS tissue acquisition; however, most reports have been centered around lesions of the pancreas. This paper aims to review the literature on EUS tissue acquisition in other organs (beyond the pancreas) such as the liver, biliary tree, lymph nodes, and upper and lower gastrointestinal tracts. Furthermore, techniques for obtaining tissue samples under EUS guidance continue to evolve. Specifically, some of the techniques that endoscopists employ are suction techniques (i.e., dry heparin, dry suction technique, wet suction technique), the slow pull technique, and the fanning technique. Apart from acquisition techniques, the type and size of the needle utilized play a major role in the quality of samples. This review describes the indications for tissue acquisition for each organ, and also describes and compares the various tissue acquisition techniques, as well as the different needles used according to their shape and size.