Hollow Needles Research Articles

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

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

Mechanisms of sampling interstitial fluid from skin using a microneedle patch

Although interstitial fluid (ISF) contains biomarkers of physiological significance and medical interest, sampling of ISF for clinical applications has made limited impact due to a lack of simple, clinically useful techniques that collect more than nanoliter volumes of ISF. This study describes experimental and theoretical analysis of ISF transport from skin using microneedle (MN) patches and demonstrates collection of >1 µL of ISF within 20 min in pig cadaver skin and living human subjects using an optimized system. MN patches containing arrays of submillimeter solid, porous, or hollow needles were used to penetrate superficial skin layers and access ISF through micropores (µpores) formed upon insertion. Experimental studies in pig skin found that ISF collection depended on transport mechanism according to the rank order diffusion < capillary action < osmosis < pressure-driven convection, under the conditions studied. These findings were in agreement with independent theoretical modeling that considered transport within skin, across the interface between skin and µpores, and within µpores to the skin surface. This analysis indicated that the rate-limiting step for ISF sampling is transport through the dermis. Based on these studies and other considerations like safety and convenience for future clinical use, we designed an MN patch prototype to sample ISF using suction as the driving force. Using this approach, we collected ISF from human volunteers and identified the presence of biomarkers in the collected ISF. In this way, sampling ISF from skin using an MN patch could enable collection of ISF for use in research and medicine.

A new method for evaluating the normal rake angle and inclination angle on medical needles.

Hollow needles are the most frequently used medical equipment. The design of a hollow needle that best enables medical procedures requires a better understanding of needle tip geometry. Calculating the cutting angles of a needle for a complex surface topology is difficult. This article proposes a new method based on non-Euclidean geometry for the analysis of biopsy needle tip. The method can be used to calculate the cutting angles on any pipe needle. To verify the validity of this method, the normal rake angle and inclination angle on four types of needles (bias bevel needle, cylinder surface needle, curved surface needle and Cournand-type needle) were investigated. It was found that calculation of the cutting angles was simple and convenient using this method, especially for the curved surface needles. Images of the cutting angles from the Cournand-type needles revealed that the smaller bevel angle [Formula: see text] resulted in a higher normal rake angle [Formula: see text] and inclination angle [Formula: see text]. As [Formula: see text] increased, the range of the normal rake angle [Formula: see text] became larger at first and then became smaller.

Planar binary-phase lens for super-oscillatory optical hollow needles

Optical hollow beams are suitable for materials processing, optical micromanipulation, microscopy, and optical lithography. However, conventional optical hollow beams are diffraction-limited. The generation of sub-wavelength optical hollow beams using a high numerical aperture objective lens and pupil filters has been theoretically proposed. Although sub-diffraction hollow spot has been reported, nondiffracting hollow beams of sub-diffraction transverse dimensions have not yet been experimentally demonstrated. Here, a planar lens based on binary-phase modulation is proposed to overcome these constraints. The lens has an ultra-long focal length of 300λ. An azimuthally polarized optical hollow needle is experimentally demonstrated with a super-oscillatory transverse size (less than 0.38λ/NA) of 0.34λ to 0.42λ, where λ is the working wavelength and NA is the lens numerical aperture, and a large depth of focus of 6.5λ. For a sub-diffraction transverse size of 0.34λ to 0.52λ, the nondiffracting propagation distance of the proposed optical hollow needle is greater than 10λ. Numerical simulation also reveals a good penetrability of the proposed optical hollow needle at an air-water interface, where the needle propagates through water with a doubled propagation distance and without loss of its super-oscillatory property. The proposed lens is suitable for nanofabrication, optical nanomanipulation, super-resolution imaging, and nanolithography applications.

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

Treatment for gynecologic cancers, such as cervical, recurrent endometrial, and vaginal malignancies, commonly includes external-beam radiation and brachytherapy. In high-dose-rate (HDR) interstitial gynecologic brachytherapy, radiation treatment is delivered via hollow needles that are typically inserted through a template on the perineum with a cylinder placed in the vagina for stability. Despite the need for precise needle placement to minimize complications and provide optimal treatment, there is no standard intra-operative image-guidance for this procedure. While some image-guidance techniques have been proposed, including magnetic resonance (MR) imaging, X-ray computed tomography (CT), and two-dimensional (2D) transrectal ultrasound (TRUS), these techniques have not been widely adopted. In order to provide intra-operative needle visualization and localization during interstitial brachytherapy, we have developed a three-dimensional (3D) TRUS system. This study describes the 3D TRUS system and reports on the system validation and results from a proof-of-concept patient study. To obtain a 3D TRUS image, the system rotates a conventional 2D endocavity transducer through 170 degrees in 12s, reconstructing the 2D frames into a 3D image in real-time. The geometry of the reconstruction was validated using two geometric phantoms to ensure the accuracy of the linear measurements in each of the image coordinate directions and the volumetric accuracy of the system. An agar phantom including vaginal and rectal canals, as well as a model uterus and tumor, was designed and used to test the visualization and localization of the interstitial needles under idealized conditions by comparing the needles' positions between the 3D TRUS scan and a registered MR image. Five patients undergoing HDR interstitial gynecologic brachytherapy were imaged using the 3D TRUS system following the insertion of all needles. This image was manually, rigidly registered to the clinical postinsertion CT scan based on the vaginal cylinder of the needle template. The positions of the tips and the trajectory of the needle paths were compared between the modalities. The observed geometric errors of the system were ≤0.3mm in each of the three coordinate planes of the 3D US image and the mean measured volumetric error was 0.10cm3 . In the phantom study, the mean needle tip difference was 1.54±0.71 mm and the mean trajectory difference was 0.94±0.89 degrees (n=14). In the invivo study, a total of 73 needles were placed, of which 88% of needles were visible and 79% of tips were identifiable in the 3D TRUS images. Six of the nine needles that were not visible were due to shadowing artifacts created by the presence of the vaginal cylinder of the needle template. The mean distance between corresponding needle tips in the two modalities was 3.82±1.86mm and the mean trajectory difference was 3.04±1.63 degrees for the five patients. In this proof-of-concept study, the 3D TRUS system allowed for localization of needles not obscured by shadowing artifacts, providing a method for visualizing needles intra-operatively during HDR interstitial brachytherapy of gynecologic cancers and providing the potential for 3D image-guidance.

Getting to the root of fireworms' stinging chaetae-chaetal arrangement and ultrastructure of Eurythoe complanata (Pallas, 1766) (Amphinomida).

Amphinomid species are since long known to cause urtication upon contact with the human skin. Since it has been reported that amphinomid chaetae are hollow, it has repeatedly been suggested that poison is injected upon epidermal contact. To test predictions for the structural correlate of such a stinging device we studied the structure and formation of chaetae in the fireworm Eurythoe complanata (Amphinomida). Neither the structure of the chaetae nor their formation and their position within the parapodium provide evidence for their function as hollow needles to inject poison. The chaetae even turned out to be not hollow, but containing calcareous depositions. The latter most likely cause artificial ruptures of delicate chitin lamellae in the inner of the chaeta when treated with acidic fixatives. Inorganic calcium compounds harden the chaetae and make them brittle so that they break easily. Additional information on the structure of the chaetal sac, the site of formation and the acicula do not contradict the position of the Amphinomida within Annelida as revealed by phylogenomic studies.

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

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

Acidentes ocupacionais com profissionais de enfermagem de um serviço de atenção domiciliar do interior paulista

Trata-se de um estudo transversal com objetivo de identificar e caracterizar os acidentes com material biológico relatado por profissionais de enfermagem de um serviço de atenção domiciliar do interior paulista. Dos 30 sujeitos que trabalhavam no serviço, no período da coleta de dados, 28 concordaram participar e 12 (42,8%) relataram ter sofrido pelo menos um acidente com material biológico durante o exercício profissional no serviço. A maioria das exposições foi percutânea (91,7%), o sangue foi o fluido mais frequentemente envolvido (75%). Em relação ao procedimento, 75% dos indivíduos estava administrando medicamento no momento do acidente e 50% admitiu que estava reencapando agulhas ocas. O presente estudo permitiu identificar as situações relatadas pelos profissionais para a ocorrência dos acidentes com material biológico durante a assistência domiciliar, as quais podem subsidiar medidas preventivas e direcionar futuros estudos que envolvam esse tipo de acidente nos domicílios.

Evaluation of Bacterial Contamination of Equine Cadaver Skin Following Injections Using Different Needle Types and Skin Preparation Methods

To assess bacterial translocation through needle punctures and the impact of preparation protocols using equine cadaver skin and different needle sizes and types. Nonprepared, disinfected, clipped and disinfected, and clipped and antiseptically washed skin specimens were sampled sterilely using swabs and biopsies to compare disinfection efficacy. The skin specimens were punctured using 18G hollow needles (18G), 18G needles with stylet (18GM), and 22G hollow needles (22G) and were flushed with sterile saline solution. The saline was collected in blood culture systems or homogenization test tubes and processed for qualitative (ql) or semiquantitative microbiologic evaluation. Disinfection and antiseptic preparation of skin specimens led to a significant reduction of bacteria (P < .05) sampled with swabs and biopsies, whereas clipping did not produce further significant differences. Bacteria were detected in many needle punctures, depending on the preparation protocols and needle types and sizes used. The highest amount of bacteria was detected with 18GM and the lowest with 22G (ql; nonprepared; nonsignificant). Disinfection and antiseptic preparation reduced bacterial translocation significantly in 18G punctures (ql; P < .05), whereas clipping did not result in any further significant difference. Overall, more bacteria were detected after 18G needle punctures when samples were processed qualitatively. Disinfection before injections reduces the number of bacteria translocated into deeper tissue. Larger needles and needles with stylet increase the number of bacteria translocated through the skin.

Optical method for automated measurement of glass micropipette tip geometry

Many experimental biological techniques utilize hollow glass needles called micropipettes to perform fluid extraction, cell manipulation, and electrophysiological recordings. For electrophysiological recordings, micropipettes are typically fabricated immediately before use using a “pipette puller”, which uses open-loop control to heat a hollow glass capillary while applying a tensile load. Variability between manufactured micropipettes requires a highly trained operator to qualitatively inspect each micropipette; typically this is achieved by viewing the pipette under 40–100× magnification in order to ensure that the tip has the correct shape (e.g., outer diameter, cone angle, taper length). Since laboratories may use hundreds of micropipettes per week, significant time demands are associated with micropipette inspection. Here, we have automated the measurement of micropipette tip outer diameter and cone angle using optical microscopy. The process features repeatable constraint of the micropipette, quickly and automatically moving the micropipette to bring its tip into the field of view, focusing on the tip, and computing tip outer diameter and cone angle measurements from the acquired images by applying a series of image processing algorithms. As implemented on a custom automated microscope, these methods achieved, with 95% confidence, ±0.38μm repeatability in outer diameter measurement and ±5.45° repeatability in cone angle measurement, comparable to a trained human operator. Accuracy was evaluated by comparing optical pipette measurements with measurements obtained using scanning electron microscopy (SEM); optical outer diameter measurements differed from SEM by 0.35±0.36μm and optical cone angle measurements differed from SEM by −0.23±2.32°. The algorithms we developed are adaptable to most commercial automated microscopes and provide a skill-free route to rapid, quantitative measurement of pipette tip geometry with high resolution, accuracy, and repeatability. Further, these methods are an important step toward a closed-loop, fully-automated micropipette fabrication system.

Hollow crystalline straws of diclofenac for high-dose and carrier-free dry powder inhaler formulations

ObjectiveTo crystallize diclofenac (DF) from diclofenac sodium (DFNa), to micronize DF and DFNa, and to evaluate in vitro aerodynamic performance of the jet-milled formulations Materials and methodsFrom the acidic titration of aqueous DFNa, DF crystals were formed and were identified using thermal analysis, spectroscopy, and X-ray powder diffraction. Following the micronization of the DF and DFNa powders, the recovered samples were imaged, and their particle size distributions were evaluated. Samples before and after jet millings were characterized, and in vitro aerodynamic performance testing was performed on the DF sample before jet milling and the DF and DFNa samples following jet milling. Results and discussionHollow needles of DF were precipitated. With similar particle size distributions, the jet-milled DFNa sample from the collection bag, and the DF sample from the cyclone were used for further characterization. Despite different deposition patterns in the Next Generation Impactor, the DF hollow needles had a comparable respirable fraction percentage to the jet-milled DF and DFNa particles. However, the jet-milled DF formulation had the best in vitro aerodynamic performance. ConclusionsHollow, crystalline needles of DF were formed and possessed promising aerosol performance in comparison with the jet-milled powders.

Hollow needle cataract aspiration in antiquity

The dislocation of the crystalline lens or couching technique was the predominant procedure to surgically remove cataracts until the 18th century A.D. However, in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis. Some literary sources attributed the origins of this technique to Antyllus of Alexandria, a Greek surgeon who lived in the 2nd century A.D. in the Roman Empire. Nevertheless, this statement remains unclear and is probably the consequence of posterior interpretations or incorrect translations of the manuscripts. In recent years, the discovery of the hollow needles from Montbellet (France) and Viladamat (Spain), in archaeological settlements dated between the 1st century and 3rd century A.D., has reopened the possibility of cataract extraction as an option in the surgical management of soft cataracts in the antiquity. In any case, these findings are exceptional, and thus, probably this technique was not widely practised and very likely disparaged by the medical community.

Self-Assemblies of Acicular Hollow Fe/C Nanostructures.

Self-assemblies of acicular hollow Fe/C structures were synthesized using D-glucose monohydrate and ferric chloride as precursors by a simple hydrothermal process followed by carbonization at 800 °C. The self-assembled structures with an overall diameter of 15~20 µm composed of radially formed hollow needles from a central core with an average diameter of ca. 1 µm and a length up to 10 µm. The end of the needles was revealed to be a awl shape with a hollow structure formed during the self-assembly process and the subsequent heat treatment. The hollow structure was probably caused by the Kirkendall effect at 800 °C. The materials exhibit ferromagnetic characteristic with saturation magnetization (Ms), remanent magnetization (Mr), and coercivity (Hc) of 22.2 emu/g, 3 emu/g, and 151.22 Oe, respectively, with Ms much lower than that of Fe3O4.

Investigation of the status quo of occupational exposures to skin injuries among undergraduate nursing students

Objective To investigate the occupational exposures to skin injuries among undergraduate nursing students and analyze the causes, so as to provide advices for the standardized pre-service education of occupational protection. Methods To survey 260 students by simple sampling method using self-made questionnaire retrospectively at the end of the internship. The factors influencing skin injuries were analyzed. Results A total of 238 effective questionnaires were obtained. There were 96.64% (230/238) practice students suffered skin injuries, the incidence rate was higher at the initial phase. The injuries-risk factors were using hollow needles and glass ampoule, dispensing and back to the set of the needle cap. The preventive measures which the students executed were squeezing out blood, washing with flowing water and sterilizing with iodine and alcohol. Only 58.47% (473/809) students checked the reports of patients. Most of them were lack of the preventive awareness. Conclusions This study demonstrated that skin injuries occurred frequently among undergraduate nursing students of bachelor degree and their knowledge level about precautions was low. The standard education of pre-service occupational prevention, the occupational exposure post-processing and the reporting system were very necessary. Key words: Nursing care; Occupational exposure; Questionnaires; Skin injuries

A Novel Transdermal Power Transfer Device for the Application of Implantable Microsystems

This paper presents a transdermal power transfer device for the application of implantable devices or systems. The device mainly consists of plug and socket. The power transfer process can be started after inserting the plug into the socket with an applied potential on the plug. In order to improve the maneuverability and reliability of device during power transfer process, the metal net with mesh structure were added as a part of the socket to serve as intermediate electrical connection layer. The socket was encapsulated by polydimethylsiloxane (PDMS) with good biocompatibility and flexibility. Two stainless steel hollow needles placed in the same plane acted as the insertion part of the needle plug, and Parylene C thin films were deposited on needles to serve as insulation layers. At last, the properties of the transdermal power transfer device were tested. The average contact resistance between needle and metal mesh was 0.454 Ω after 50 random insertions, which showed good electrical connection. After NiMH (nickel-metal hydride) batteries were recharged for 10 min with current up to 200 mA, the caused resistive heat was less than 0.6 °C, which also demonstrated the low charging temperature and was suitable for charging implantable devices.

Formation mechanism of polyaniline self‐assembled needles and urchin‐like structures assisted by magnesium oxide

AbstractThe polyaniline (PANI) morphological structure is strongly correlated with the preparation procedure, yielding diverse geometries such as nano‐tubes, belts, rods, fibres and particles. In this study, the synthesis of a novel PANI morphology of consisting of hollow needles and urchin‐like structures is presented and its formation mechanism is explained. The polymer was synthesized by chemical oxidative polymerization of aniline in the presence of magnesium oxide as a structural directing agent. The morphological study of the urchin‐like PANI was conducted using scanning electron microscopy and in situ monitoring of needle growth was done using optical microscopy. The structure and functional groups of these novel structures were characterized using Fourier transform infrared spectroscopy. Additionally, the formation mechanism is modelled based on the multi‐layer theory where a core–shell structure exists between the polymer (shell) and the magnesium oxide particles (core). © 2014 Society of Chemical Industry

Reconstruction of Ear Deformity from Post-Piercing Perichondritis

Reconstruction of Ear Deformity from Post-Piercing Perichondritis

New Records for The Solenogaster Proneomenia Sluiteri (Mollusca) from Icelandic Waters and Description of Proneomenia Custodiens sp. n.

Abstract During August–September 2011, scientists aboard the R/V Meteor sampled marine animals around Iceland for the IceAGE project (Icelandic marine Animals: Genetics and Ecology). The last sample was taken at a site known as “The Rose Garden” off northeastern Iceland and yielded a large number of two species of Proneomenia (Mollusca, Aplacophora, Solenogastres, Cavibelonia, Proneomeniidae). We examined isolated sclerites, radulae, and histological section series for both species. The first, Proneomenia sluiteri Hubrecht, 1880, was originally described from the Barents Sea. This is the first record of this species in Icelandic waters. However, examination of aplacophoran lots collected during the earlier BIOICE campaign revealed additional Icelandic localities from which this species was collected previously. The second represents a new species of Proneomenia, which, unlike other known representatives of the genus, broods juveniles in the mantle cavity. We provide a formal description, proposing the name Proneomenia custodiens sp. n. Interestingly, the sclerites of brooded juveniles are scales like those found in the putatively plesiomorphic order Pholidoskepia rather than hollow needles like those of the adults of this species. Cytochrome c oxidase subunit I (COI) DNA barcode sequences are provided for both species of Proneomenia.

OCCUPATIONAL EXPOSURES TO BODY FLUIDS AND BEHAVIORS REGARDING THEIR PREVENTION AND POST-EXPOSURE AMONG MEDICAL AND NURSING STUDENTS AT A BRAZILIAN PUBLIC UNIVERSITY

A cross-sectional study was conducted to assess the frequencies and characteristics of occupational exposures among medical and nursing students at a Brazilian public university, in addition to their prevention and post-exposure behavior. During the second semester of 2010, a self-administered semi-structured questionnaire was completed by 253/320 (79.1%) medical students of the clinical course and 149/200 (74.5%) nursing students who were already performing practical activities. Among medical students, 53 (20.9%) suffered 73 injuries, which mainly occurred while performing extra-curricular activities (32.9%), with cutting and piercing objects (56.2%), in the emergency room (39.7%), and as a result of lack of technical preparation or distraction (54.8%). Among nursing students, 27 (18.1%) suffered 37 injuries, which mainly occurred with hollow needles (67.6%) in the operating room or wards (72.2%), and as a result of lack of technical preparation or distraction (62.1%). Among medical and nursing students, respectively, 96.4% and 48% were dissatisfied with the instructions on previously received exposure prevention; 48% and 18% did not always use personal protective equipment; 67.6% and 16.8% recapped used needles; 49.3% and 35.1% did not bother to find out the source patient's serological results post-exposure; and 1.4% and 18.9% officially reported injuries. In conclusion, this study found high frequencies of exposures among the assessed students, inadequate practices in prevention and post-exposure, and, consequently, the need for training in “standard precautions” to prevent such exposures.

Retirement on the Line: Age, Work, and Value in an American Factory by Caitrin Lynch (review)

Reviewed by: Retirement on the Line: Age, Work, and Value in an American Factory by Caitrin Lynch Jeffrey A. Johnson RETIREMENT ON THE LINE: Age, Work, and Value in an American Factory. By Caitrin Lynch. Ithaca, NY: Cornell University Press. 2012. American labor, industrial and otherwise, is often thought of according to certain demographic paradigms. Caitrin Lynch’s Retirement on the Line, though, forces us to rethink those norms and, in the process, the nature of work, aging, and employee-employer relationships. It is a fascinating work of contemporary demographic study into modern gerontology. Beginning in 2006, Lynch began visiting the Vita Needle Company in Needham, Massachusetts (and later working at the factory starting in 2008). She conducted interviews and ethnographic research, framing her conclusions well within a myriad of sociological and anthropological frameworks. At first glance, the company is rather typical of a small, family-run business. Since 1932 Vita has manufactured needles, typically hollow needles used for everything from basketballs to surgical procedures. It is hard, tedious, and meaningful work for its approximately forty line workers. What makes Vita Needle so intriguing, however, is its employees. While not exclusively, most of its workers are retirement [End Page 124] age (or well beyond). There are workers in their 70s, 80s, and even the 99-year-old Rosa. Broken into two parts, the text hopes, according to Lynch, to “contribute to scholarship that exposes or probes cultural assumptions about the meaning of the life course; how to make late life meaningful; and how to find, create, and maintain value in life” (21). Part I, “Up the Stairs,” centers on the value and reward Vita workers seem to glean from their days on the shop floor. “Making Money for Fred” (Fred, being the 56-year-old benevolent owner) is seen as worthwhile and non-exploitive. Exemplified by the Christmas party and bonus checks, familial relationships have developed, with Fred as a father figure and Rosa as a maternal one. Vita workers, Lynch discovered, feel a sense of belonging and sameness at work. They also enjoy the flexibility of work at Vita and, rather than a presumed exploitation, its employees see work there—with control over their schedule—as a “value making opportunity,” where they can earn some extra money and “keep busy” (103). Part II, “In the Press,” explores the remarkable media attention, in print and in film (such as the New York Times, 60 Minutes, and several European-produced documentaries), paid to Vita Needle for its unique employment model. Outsiders have seen Vita as part curiosity, but also as a potential archetype for business and policy-making aimed at “humane capitalism” (149). In short, Vita is and has been, according to Lynch, “a sanctuary, an oasis…a place that is comforting and caring, where they can belong” (115). This pleasant picture is an exceptionally convincing one. Some readers might be left wondering if all that occurs at Vita might be too harmonious—particularly in terms of conflict in the context of familial relationships (which Lynch admits occurs). Nevertheless, there is indeed something special about Vita Needle, and Retirement on the Line brilliantly captures that spirit—along the way getting us thinking about what it means to be “old,” job satisfaction, and the value of honest work. Jeffrey A. Johnson Providence College Copyright © 2014 Mid-America American Studies Association