Post Aspiration Research Articles

Primary lymphedema of the left lower limb in a new-born boy: a case report

A 7-day-old boy was admitted with a history of swelling involving his left lower limb since birth. He was born normally to a Gravida 1, Para-0, to a 22-years-old mother. Antenatal history was nothing significant. His clinical examination revealed left lower limb swelling and was suggestive of primary lymphedema. It involved from the ankle area up to the groin of the left side of the limb. His right lower limb and both upper limbs were normal. His other systemic examination was also normal. He was treated with aseptic needle aspiration of the lymphatic fluid, and a compression dressing was applied. He suddenly died of an unknown reason while sleeping at around 4.00 AM on the third post aspiration day.

Comparison of the role of ultrasound guided transhepatic aspiration of gallbladder versus conservative management of acute calculous cholecystitis

Background: Gall stone disease remains one of the most common medical problem leading to surgical intervention. Cholecystitis accounts for 3-10% of abdominal pain worldwide. Acute cholecystitis is the most common complication of cholelithiasis accounting for 14 to 30% of cholecystectomies performed in many countries. Symptoms in cholecystitis are due to impaction of stone and subsequent distention of gallbladder with inflammation. Study is aimed to clarify the role of ultrasound guided transhepatic gallbladder aspiration in the early management of acute calculous cholecystitis.Methods: The study was conducted in total of 40 patients presenting with acute cholecystitis. 20 patients underwent ultrasound guided transhepatic aspiration of gallbladder with antibiotics (group A) and 20 patients were given antibiotics only (group B). Data were collected before intervention and post intervention duration of stay, pain according to visual analog scale, leucocytosis and fever were recorded for analysis. No complications were related to aspiration procedure.Results: Both groups were comparable. Group A patients had better pain relief (p=0.0001 day on 2 and p=0.004 on day 3 post aspiration), percentage reduction of leucocyte count (p=0.041 on day 3) and duration of hospital stay (p=0.004) which were statistically significant.Conclusions: Ultrasound guided transhepatic aspiration of gall bladder with antibiotics in acute cholecystitis results in better pain profile, faster reduction in leucocyte count and shorter duration of hospital stay when compared to antibiotics alone.

The effects of barium concentration levels on the pulmonary inflammatory response in a rat model of aspiration.

Barium sulfate (Ba) suspension is the most widely used contrast agent for upper gastrointestinal and videofluoroscopic swallow studies (VFSS). The effect of Ba concentration on lung injury is uncertain. The aims of this study were to explore the effects of different barium concentrations on the respiratory organs and elucidate the underlying mechanisms of these effects in an established animal model of aspiration. Animal model study. Eight-week-old male Sprague-Dawley rats were allocated into three groups (n = 12, each group). Two groups underwent tracheal instillation of low (30%w/v) and high (60%w/v) concentration Ba (low-Ba, high-Ba). A control group was instilled with saline. Half of the animals were euthanized on day 2 and the remaining half were euthanized on day 30. Histological and gene analyses were performed. Both low-Ba and high-Ba aspiration caused inflammatory cell infiltration in the lung at 2days post aspiration with an increase in the expression of inflammatory cytokines. At 30days post aspiration, small quantities of barium particles remained in the lung of the low-Ba group without any inflammatory reaction. Chronic inflammation was recognized in the high-Ba group up to 30days post aspiration. A small amount of high concentration Ba (60%w/v) caused sustained inflammation in the rat lung at least 30days after aspiration. Even with a small amount of low concentration Ba aspiration (30%w/v), Ba particles can remain in the lung over a month, causing sustained late effects.

Use of Gemtuzumab Ozogamicin for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia (AML) or Acute Promyelocytic Leukemia (APL) in an Expanded Access Setting at Our Cancer Consortium

Use of Gemtuzumab Ozogamicin for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia (AML) or Acute Promyelocytic Leukemia (APL) in an Expanded Access Setting at Our Cancer Consortium

Abstract P-004: SONOGRAPHIC APPEARANCE OF PRE-EPIGLOTTIC CYST CAUSING STRIDOR- A CASE REPORT

Aims & Objectives: To show sonographic appearance of larynx before and after aspiration of a pre-epiglottic cyst. Methods Airway ultrasound (US) was performed to asses the airway to find a cause of stridor. We used a high frequency (7.5 MHz), linear transducer of Aloka SSD-90 machine. The patient was in supine position with the neck a little extended, to facilitate the probe. Axial images were taken by putting the probe at the level of hyoid and thyroid cartilage. Images were obtained at two time points, pre and post aspiration. The findings were confirmed on CT scan of the neck. Results A well-defined hypodense round mass measuring 3 × 3 cm with regular margins was seen pre-surgery (left panel figure 1). The margin is very thick and hyperechoic because it is formed by thyrohyoid membrane anteriorly(upper margin); pre-epiglottic space with air-mucosal interface posteriorly(lower margin). This mass obscured laryngeal structures like vocal cords, glottis and arytenoid cartilage. After aspiration of the cyst these structures became visible (right panel figure 1). Conclusions Airway US is a very useful investigation for quick diagnosis of mass lesions of the larynx and epiglottis in children presenting with stridor.

Thyrotoxicosis Following Fine-Needle Aspiration Biopsy of A Thyroid Nodule: Case Report

AbstractFine-needle aspiration biopsy (FNAB) is a simple and generally safe office-based procedure that accurately and cost-effectively improves the diagnostic investigation of nonfunctioning thyroid nodules. Thyrotoxicosis following FNA has been rarely described in the medical literature. A case of post aspiration thyrotoxicosis is described here with the intent of increasing awareness of this likely underreported complication of FNAB.Key works:

A Study on Distribution of Various Morphological Pulmonary Mass Lesions Using Computed Tomography Guided Fine Needle Aspiration Cytology

Background: CT guided Fine Needle Aspiration Cytology (FNAC) isthe first investigation of choice for intra thoracic mass lesions. It is very easy, safe, and provides real time visual access for aspiration of deeper tissues even though few millimeters in size. Objective: Present study was to evaluate the various spectrums of morphological mass lesions in the lung and determine effectiveness of CT guided FNAC.Materials and methods: This was a descriptive, cross sectional study on 50 patients, over a period of 1 year from April 2015 to March 2016, who underwent CT guided aspirationand their diagnoses were confirmed by appropriate methods.The results were analyzed and interpreted statistically.The study was approved by the Institutional Ethics Committee. Results:Out of 50 cases, 76 %( n=38) were males while rest of were females 24 %( n=12). For interpretation of specific diagnosis material was obtained 84 %( n=42) of cases. Most of thelung lesions were malignant 76 %( n=38) with in this squamous cell carcinoma56% (n=28)is most common, followed by adenocarcinoma 12% (n=6) and inflammatory granulomatous 8% (n=4) lesions.Conclusions: CT image guided Fine needle aspiration cytology provide more accurate, a noninvasive technique and extremely valuable in diagnosis of pulmonary mass lesions with minimal post aspiration complications.

The age of recipients does not affect the pregnancy derived from donor oocytes

OBJECTIVE: The use of donated oocytes in assisted reproductive technology has increased in the past years. One of the most common reasons for using donor oocytes as a treatment for infertility is advanced reproductive age of the female partner. However, most of the advanced age women considering using donor oocytes concern about whether their age will affect the pregnancy. The objective of this study was to investigate the impact of recipient age on the pregnancy derived from donor oocytes. DESIGN: Retrospective study of donor oocyte cycles from 2003-2007. MATERIALS AND METHODS: The oocyte donors ranged in age from 21 to 35 years old, with an average age of 28.6 ± 4.5 years. All of the oocytes were inseminated by using intracytoplasmic sperm injection regardless of sperm quality. The recipient ages were within the range of 22 to 48 years. All of the patients used the same protocol for endometrium preparation. Embryo transfers were performed on Day 3 post aspiration. Recipients were retrospectively divided into four groups according to their age: <35; 35-39; 40-44 and >44. Statistical analysis was done by using chi-square test. RESULTS: Results were shown in table 1. High clinical pregnancy rate (50%) and implantation rate (29.5%) were obtained in the group of recipients with >44 years old. There were no statistical differences among four groups in the rates of chemical pregnancy, clinical pregnancy and implantation (p>0.05).Table 1Outcome by age groupsRecipient age< 3535-3940-44>44Number of patients21204720Number of chemical pregnancy (%)12 (57.1)13 (65.0)25 (53.2)10 (50.0)Number of clinical pregnancy (%)10 (47.6)13 (65.0)23 (48.9)10 (50.0)Number of embryos transferred423910044Number of embryos per transfer2.02.02.12.2Number of fetus17203713Implantation rates40.5%51.3%37.0%29.5% Open table in a new tab CONCLUSIONS: Our results show that the age of recipient does not affect the rates of chemical pregnancy, clinical pregnancy and implantation. It is the ability of the aging oocyte that is the most important factor in the decreasing fertility of older women. The endometrial factor in terms of aging was not of importance on the outcome of oocyte donated cycles.

ICSI with minimal ovarian stimulation and follicular monitorization

Objective: In order to reduce the costs of follicular stimulation and monitorization for Assisted Reproductive Techniques in low income couples, we propose a protocol with minimal ovarian stimulation (MOS) and follicular monitorization. Design: Prospective, Controlled and Non-randomized. Materials/Methods: From August 2001 until January 2002, 39 low income infertile couples were scheduled to perform ICSI using MOS with Clomiphene citrate 100 mg days 3 to 7th of the cycle, plus Menotrophins 75 IU day 7 to 10th. We added Indomethacin 50 mg TID, and was started the day of hCG (10,000 IU). Vaginal ultrasound starting day 10th of the cycle. Follicular aspiration and ICSI was performed as used. A statistical analysis was made using a database Excel for Windows 2000, obtained variance analysis (ANOVA), range, standard deviation, percentage and average of the studied variables. Results: The woman age was 30.2 years (23–35) with infertility duration of 5.5 years (0.8–14). The etiology was male or tuboperitoneal factor. 6 cycles (15.3%) were cancelled due to poor response (two or less follicles). The mean number of follicles >18 mm the day of hCG was 3.2. Three cases had spontaneous ovulation. Follicular aspiration was done on day 13th. The mean number of oocytes recovered was 2.4 (0–6). No oocytes were found in four patients (premature luteinization). The fertilization rate was 85.3% (70/82), 12 oocytes (12.7%) were post-mature (not injected). There was no fertilization in two patients. The embryo transfer was made in day 2 post aspiration with a mean number of 2.3 embryos (1–3). In one patient the transfer was cancelled because uterine bleeding. Only four patients had six spare embryos to freeze. The pregnancy rate per cycle was 23% (9/39), per aspiration 27.2% (9/33), per transference 34.6% (9/26) and the implantation rate was 19.6% (11/56). Two of the nine pregnant patients have twins. Conclusions: In a selected group of patients (under 35 years old) an acceptable pregnancy rate can be achieved with MOS and minimal follicular monitorization. Having low incidence of complications: only two twins and no triplets, and absence of severe ovarian hyperstimulation. With this protocol it is expected to have low number of spare embryos to freeze, reducing problems acompannied with their storage. Reducing the cost of the procedure could make it more affordable to medium or low income couples in third world countries. This is our first experience with MOS, in order to reduce the spontaneous ovulation and luteinization in future cases we are going to start ultrasound follicular monitorization before day 10, and in some cases the aspiration before day 13th, expecting higher pregnancy rates. Supported by: Instituto para el Estudio de la Concepcion Humana. Monterrey, Nuevo Leon. Mexico.

Ancillary follicle and secondary corpora lutea formation following exogenous gonadotropin treatment in the domestic cat and effect of passive transfer of gonadotropin-neutralizing antisera

A combination regimen of equine chorionic gonadotropin (eCG) and human chorionic gonadotropin (hCG) was used to stimulate ovarian follicular development in domestic cats. The rate of elimination of eCG from circulation was estimated, and, following follicular aspiration, the formation of ancillary follicles and secondary CL was characterized. The effect of gonadotropin-neutralizing antisera on the development of secondary ovarian structures, CL function and humoral immune responses also was evaluated. After intramuscular injection, initial serum eCG concentrations were variable, with the elimination half-life estimated at 39 to 55 h and eCG persisting in circulation for several days. Following follicular aspiration, queens formed CL equal to the number of aspirated follicles and exhibited a rapid increase in progesterone concentration but developed high numbers of ancillary follicles by 5 d post aspiration. By 15 d post aspiration, all ancillary follicles had luteinized to form secondary CL. Treatment with neutralizing antisera at the time of follicular aspiration slowed (P < 0.05) CL formation but did not decrease (P > 0.05) the number of ancillary follicles or secondary CL. Progesterone concentrations did not differ (P > 0.05) from control queens while secondary humoral immune responses to eCG were qualitatively similar between groups. In summary, eCG was eliminated slowly from cats following intramuscular injection and this persistence in circulation may have contributed to the development of ancillary follicles and secondary CL. However, the administration of neutralizing antisera at the time of follicular aspiration was ineffective in preventing the formation of these secondary ovarian structures.