Needle Type Research Articles

Three Dimensional Printing and Its Applications Focusing on Microneedles for Drug Delivery.

Microneedles (MNs) are considered to be a novel smart injection system that causes significantly low skin invasion upon puncturing, due to the micron-sized dimensions that pierce into the skin painlessly. This allows transdermal delivery of numerous therapeutic molecules, such as insulin and vaccines. The fabrication of MNs is carried out through conventional old methods such as molding, as well as through newer and more sophisticated technologies, such as three-dimensional (3D) printing, which is considered to be a superior, more accurate, and more time- and production-efficient method than conventional methods. Three-dimensional printing is becoming an innovative method that is used in education through building intricate models, as well as being employed in the synthesis of fabrics, medical devices, medical implants, and orthoses/prostheses. Moreover, it has revolutionary applications in the pharmaceutical, cosmeceutical, and medical fields. Having the capacity to design patient-tailored devices according to their dimensions, along with specified dosage forms, has allowed 3D printing to stand out in the medical field. The different techniques of 3D printing allow for the production of many types of needles with different materials, such as hollow MNs and solid MNs. This review covers the benefits and drawbacks of 3D printing, methods used in 3D printing, types of 3D-printed MNs, characterization of 3D-printed MNs, general applications of 3D printing, and transdermal delivery using 3D-printed MNs.

Comparison of the incidence of intravascular injection using the Tuohy and Quincke needles during ultrasound-guided caudal epidural block: a prospective randomized controlled study

IntroductionIntravascular injection of a local anesthetic can lead to life-threatening complications, such as deficits in neurological function after caudal epidural block. This study aimed to determine whether the intravascular injection...

Tissue amount and diagnostic yield of a novel franseen EUS-FNB and a standard EUS-FNA needle-A randomized controlled study in solid pancreatic lesions.

Several types of needles are available for EUS-guided tissue sampling of pancreatic lesions. Whereas fine-needle aspiration (FNA) needles typically provide cytological samples, fine-needle biopsy (FNB) needles are designed to obtain microcores with preserved tissue architecture. The aim of this study was to compare tissue amount and diagnostic yield between a modified Franseen-type FNB needle (TopGain; Medi-Globe GmbH, Grassau, Germany) and a standard FNA needle. We performed a prospective, multicenter randomized controlled study between June 2020 and September 2021, including patients with a solid pancreatic lesion referred for EUS-guided tissue sampling at 3 centers in Denmark. The patients were randomized 1:1 to either FNA needle or the novel FNB needle. Primary outcomes included the number of obtained tissue microcores and total and diagnostic tissue area. Sixty-four patients were included. The median number of tissue microcores procured per pass was significantly higher in the FNB group compared with FNA (3 vs. 2, P < 0.001). Similarly, the mean total tissue area (2.74 vs. 0.44 mm2, P < 0.001) and mean diagnostic tissue area (1.74 vs. 0.28 mm2, P < 0.001) were more than 6-fold larger in the FNB samples compared with FNA. The median number of passes needed for a diagnostic sample was 1 for the FNB needle and 2 for FNA needle (P = 0.12). The novel FNB needle provided a higher percentage of samples of excellent quality (P = 0.002). The novel Franseen-type FNB needle seems to be significantly superior to a conventional FNA needle. The results of this study underline excellent performance of crown-cut needles.

Pre-clinical evaluation of the new veress needle+ mechanism on thiel-embalmed bodies: a controlled crossover study - Experimental research.

Eighteen participants (novices, intermediates, and experts) performed in total of 248 insertions in a systematic way on Thiel-embalmed bodies with wide and small bore versions of the conventional VN (VNc) and the VN+. Insertion depth was measured by recording the graduations on the needle under direct laparoscopic vision. Participants graded the bodies and the procedures as lifelike. Overall, a significant reduction (P<0.001) in average insertion depth was found for the VN+ compared to the VNc of 26.0 SD16 mm versus 46.2 SD15mm. The insertion depth difference in the novice group was higher compared to the intermediates and experts (P<0.001). The average insertion depth for both needle types was less (P<0.001) for female participants compared to male. This study indicated that the VN+ significantly reduced the insertion depth in all tested conditions. Whether the difference between female and male performance can be linked to differences in muscle control or arm mass should be further investigated. Useful technical information was gathered from this study to further improve the VN+.

Design and testing the validity of an inexpensive and accessible sham dry needling protocol

ObjectiveTo use a simple method of needle blunting to produce a placebo dry needling protocol which is indistinguishable from the sensations felt during therapeutic dry needling. MethodsA randomised cross-over design was used to compare the perception of needle skin penetration, pain experienced and types of sensations experienced following a single placebo dry needling and a single therapeutic dry needling application. ResultsThere were no significant differences in the proportions of patients reported ability to perceive needle penetration (p = 0.646), description of needling sensations (p = 0.3) or pain rating (p = 0.405) when comparing placebo needling to therapeutic dry needling. ConclusionNeedle tip bending creates a simple, cost-effective and effective placebo needle for use in comparisons with therapeutic dry needling. This offers researchers a viable alternative to expensive and inappropriate acupuncture sham devices when conducting dry needling trials.

Benign Karaciğer Hastalıklarında Endoskopik Ultrason Eşliğinde İnce İğne Aspirasyonu: Tek Merkez Deneyimi

Background and Aim: To report the efficacy and safety results of our initial experience with the endoscopic ultrasound-guided liver biopsy (EUS-LB).&#x0D; &#x0D; Materials and Method: Retrospective analysis of a prospectively maintained database in a tertiary care referral center. Consecutive patients who had EUS-LB for benign parenchymal diseases, using a 19 gauge fine needle with single-pass, three actuations, and wet suction technique between June 2022 and December 2022 were included. Patient demographics, procedure-related parameters, and the quality of specimens were investigated&#x0D; &#x0D; Results: The technical success was 100%. Of the 16 patients, four had a second procedure due to inadequate sampling. The median total sample length, the median number of pieces and the median length of the longest piece in fragmented samples, and the median number of complete portal tracts were 11mm (range, 0.2-2.5), 9.6 (range 0-20), 0.2mm (range 0.2-1.5) and 3.5 (range 0-19) respectively. None of the patients had any adverse events following the procedure.&#x0D; &#x0D; Conclusion: EUS-LB may be an alternative to other liver biopsy procedures but further studies are needed to determine the ideal needle type and technique.

Application of ultrasound in heat exchanger handling supersaturated CaSO4 solution for reduction of scaling by induced precipitation and in-situ cleaning

Application of ultrasound to the heat exchanger handling supersaturated solution of CaSO4 has been investigated with an objective reducing scale formation and in-situ cleaning. A lab-scale double pipe heat exchanger, equipped with 6 transducers each of 33 kHz, was applied to understand effect of various process and ultrasonic parameters. Application of ultrasound for 10 min at 200 W power at every 4 h resulted in reduction in average fouling resistance by 36.82 %, 42.87 % and 43.74 % at flow rate of 150 ml/min, 300 ml/min and 600 ml/min respectively. Quantity of salts precipitated in the bulk under these conditions were 1.4 to 2.6 times more than without the application of ultrasound confirming intensification. SEM analysis revealed that formed scale was dominated by platelets and needle type of CaSO4 crystals. Application of ultrasound on the heat exchanger surface was elucidated as an effective approach for intensified heat transfer.

In Vitro Fermentation Characteristics of Pine Needles (Pinus densiflora) as Feed Additive

In this study, the fermentation characteristics of pine needles were investigated for the first time and the possibility of using them as plant-derived feed additives was confirmed. Four types of fermented pine needle were prepared: (1) natural fermentation (CON); (2) Lactobacillus plantarum SK4315 fermentation (LPF); (3) Saccharomyces cerevisiae SK3587 fermentation (SCF); and (4) co-culture fermentation (CCF). Fermentation lasted 48 h, and samples were taken at 4-h intervals until 12 h, then at 24 and 48 h. As analysis items, fermentation characteristics, antibacterial, antioxidant, and enzymatic activities were investigated. As a result, all pine needle cultures were fermented with changes in the number of viable cells and pH. LPF inhibited the growth of the most pathogens, and the activity became stronger with fermentation. Total polyphenol content (TPC) was the highest in the 48 h SCF and LPF samples, ABTS radical scavenging ability and intracellular antioxidant activity were higher in SCF. Enzymatic activities were different depending on each pine needle culture medium and the fermentation time. In summary, all pine needle cultures were normally fermented, and as fermentation progressed, LPF strengthened antibacterial activity and SCF strengthened antioxidant activity. This study confirmed the potential of fermented pine needles as a feed additive, showing an enhancement of biological activity.

Comparing per-pass performance of 2 types of needles for EUS-guided fine-needle biopsy sampling of pancreatobiliary masses in a randomized trial

EUS-guided fine-needle biopsy sampling (EUS-FNB) has largely replaced FNA for tissue diagnosis of pancreatobiliary mass lesions. However, the optimal number of passes required for the diagnosis of malignancy is not clear. We aimed to compare the per-pass performance of 2 types of fine-needle biopsy (FNB) needles for the detection of malignancy. One hundred fourteen patients referred for EUS evaluation of solid pancreatobiliary mass lesions underwent randomization between biopsy sampling with a Franseen needle and a 3-prong tip needle with an asymmetric cutting surfaces. Four passes of EUS-FNB were taken from each mass lesion. Two pathologists blinded to needle type analyzed the specimens. The final diagnosis of malignancy was made based on FNB specimen pathology, surgery, or a follow-up of at least 6 months after EUS-FNB. The sensitivity of EUS-FNB to diagnose malignancy was compared between the 2 groups. The cumulative sensitivity of detection of malignancy by EUS-FNB was calculated after each pass in each arm. Other characteristics of the specimens including cellularity and blood contents were also compared between the 2 groups. In the primary analysis, lesions categorized as suspicious on EUS-FNB were considered nondiagnostic for malignancy. Ninety-eight patients (86%) had a final diagnosis of malignancy, and 16 patients (14%) had benign disease. Four passes of EUS-FNB with the Franseen needle detected malignancy in 44 of 47 patients (sensitivity, 93.6%; 95% confidence interval [CI], 82.5-98.7) and with the 3-prong asymmetric-tip needle in 50 of 51 patients (sensitivity, 98%; 95% CI, 89.6-99.9; P= .35). Two passes of EUS-FNB detected malignancy with a sensitivity of 91.5% (95% CI, 79.6-97.6) with the Franseen needle and 90.2% (95% CI, 78.6-96.7) with the 3-prong asymmetric-tip needle. The cumulative sensitivities at pass 3 were 93.6% (95% CI, 82.5-98.6) and 96.1% (95% CI, 86.5-99.5), respectively. Samples collected with the Franseen needle had significantly higher cellularity than samples collected with the 3-prong asymmetric-tip needle (P< .01). However, no difference as found between the 2 types of needles in term of specimen bloodiness. No significant differences were found in the diagnostic performance of the Franseen needle versus the 3-prong asymmetric-tip needle in patients with suspected pancreatobiliary cancer. However, the Franseen needle yielded higher cellularity of the specimen. Two passes of EUS-FNB are required to detect malignancy with at least 90% sensitivity with either type of needle. (Clinical trial registration number: NCT04975620.).

Surgical needles with handles

Having given examples of hand-held surgical needles and of needle holders of various types, we can consider a few needles that are mounted on handles. Greco-Roman and Arabic sources described ornately handled eyeless needles for displacing cataracts for use in the technique of couching. Also of historical origin are the various types of acupuncture needle. In 1564, Ambroise Paré illustrated a robust handled needle, which had an eye part way along the needle, through which were passed gold or lead ligatures, used during hernia repair. Handled needles have sharp or blunt tips, the latter for passing ligatures around structures to be tied off, such as pedicles or individual blood vessels. Hand-held needles have proximal eyes, whereas handled needles have distally placed eyes. This allows ligatures to be applied at some depth by one of two methods: passing ligature-loaded needles through tissues to be ligated or, passing the ‘empty’ needle through tissues and then loading the needle by feeding the ligature into a closed or open eye manually by an assistant or, rarely, by using a mounted ligature holder. The needle then is carefully withdrawn and the ligature tied on each side of the pedicle. These now rather historical instruments were frequently used in pelvic surgery by gynaecologists or urological surgeons. The longer reaching needle is clearly useful when working in other rather inaccessible areas, for example, when repairing vesicovaginal fistulas or cleft palates.

Role of endoscopic ultrasound in the characterization of solid pseudopapillary neoplasm of the pancreas.

Solid pseudopapillary neoplasm (SPN) is an uncommon pathology of the pancreas with unpredictable malignant potential. Endoscopic ultrasound (EUS) assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis. However, there is a paucity of data regarding the imaging assessment of these lesions. To determine the characteristic EUS features of SPN and define its role in preoperative assessment. This was an international, multicenter, retrospective, observational study of prospective cohorts from 7 large hepatopancreaticobiliary centers. All cases with postoperative histology of SPN were included in the study. Data collected included clinical, biochemical, histological and EUS characteristics. One hundred and six patients with the diagnosis of SPN were included. The mean age was 26 years (range 9 to 70 years), with female predominance (89.6%). The most frequent clinical presentation was abdominal pain (80/106; 75.5%). The mean diameter of the lesion was 53.7 mm (range 15 to 130 mm), with the slight predominant location in the head of the pancreas (44/106; 41.5%). The majority of lesions presented with solid imaging features (59/106; 55.7%) although 33.0% (35/106) had mixed solid/cystic characteristics and 11.3% (12/106) had cystic morphology. Calcification was observed in only 4 (3.8%) cases. Main pancreatic duct dilation was uncommon, evident in only 2 cases (1.9%), whilst common bile duct dilation was observed in 5 (11.3%) cases. One patient demonstrated a double duct sign at presentation. Elastography and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable pattern. EUS guided biopsy was performed using three different types of needles: Fine needle aspiration (67/106; 63.2%), fine needle biopsy (37/106; 34.9%), and Sonar Trucut (2/106; 1.9%). The diagnosis was conclusive in 103 (97.2%) cases. Ninety-seven patients were treated surgically (91.5%) and the post-surgical SPN diagnosis was confirmed in all cases. During the 2-year follow-up period, no recurrence was observed. SPN presented primarily as a solid lesion on endosonographic assessment. The lesion tended to be located in the head or body of the pancreas. There was no consistent characteristic pattern apparent on either elastography or Doppler assessment. Similarly SPN did not frequently cause stricture of the pancreatic duct or common bile duct. Importantly, we confirmed that EUS-guided biopsy was an efficient and safe diagnostic tool. The needle type used does not appear to have a significant impact on the diagnostic yield. Overall SPN remains a challenging diagnosis based on EUS imaging with no pathognomonic features. EUS guided biopsy remains the gold standard in establishing the diagnosis.

Individualized acupuncture for unilateral musculoskeletal pain: The advanced mathematical model

Chronic musculoskeletal pain persists for longer than three months and is perceived to emerge from structures like bones, joints, and muscles. This condition interferes considerably in patients’ lives, leading to physical malfunction, psychological suffering, fatigue, social isolation, and job loss, resulting in a decrease in quality of life. Effective treatment remains a major challenge, highlighting the need for research to understand the complex underlying mechanisms. Recent studies have identified central neuroimmune activation and neuroinflammation as key contributors to the development of chronic pain, leading to central sensitization and reduced efficacy of opioid treatments. The number of clinical studies on the use of acupuncture for various types of pain has increased significantly in the last two decades showing a beneficial effect on pain relief and improving functional activities and psychological wellness. In our study, we decided to use a channel system and mathematical reasoning to resolve some chronic musculoskeletal pain. This method is grounded on an investigation of the historically described balancing systems, conducted by Schroeder et al. (2013) thus showing the extreme relevance of integrating psychoneuroimmunology and biopsychosocial details as necessary approaches to completely understand disease and illness. The results showed high efficiency and confirmed that the combination of more than two channels, somatotopic knowledge for the search for the right points on a balancing channel and the use of at least two types of needles helps preserve the balance of the treatment. More work should be done including studies in degenerative osteoarticular conditions.

Electrospinning with curved nozzle spinneret for producing poly (vinyl Alcohol) nanomembrane for filtration

To produce a consistent and fine nanofiber with a higher yield, electrospinning with a redesigned spinneret has been used. The principle that a curved or sharp edge activates a greater electric field intensity that stretches the jet into a thinner and denser electro spinning nanoweb is the subject of this research. In the electrospinning process, a curved nozzle spinneret outperforms a circular nozzle spinneret and a standard needle type in terms of electric field intensity and dispersion. It has been discovered that a high electric field intensity causes a 30% reduction in fiber diameter, the development of a denser fiber web, and an increase in production rate up to 280 mg h−1.For testing as an air filtration material, the electro-spun nano web of Poly (vinyl alcohol) (PVA) is accumulated as a membrane and sandwiched with polypropylene nonwoven fabric. The nonwoven membrane can filter particles down to 2–3 microns, whereas the sandwiched PVA nano-fiber can filter particles into nanometers. This research could lead to the low-cost manufacture of Nano-membranes using a simple electrospinning setup.

The importance of follicular flushing in optimizing oocyte retrieval.

To critically evaluate the use of follicular flushing during oocyte retrieval. The latest meta-analysis evaluating follicular flushing does not favour its use over single aspiration. The randomized controlled trials (RCTs) included, however, are characterized by significant heterogeneity regarding the population analysed, the needle type and lumen used, the aspiration pressure applied and the number of flushing attempts performed. More importantly, information regarding the flow rate used for aspiration is scarce. The only RCT employing a constant flow rate between single aspiration and follicular flushing in women with monofollicular development, suggests that a higher number of oocytes is retrieved after follicular flushing. In order to eliminate clinical heterogeneity that might obscure the detection of the true effect of follicular flushing, randomization to single aspiration and follicular flushing should occur within the same patient. This can be achieved by randomly allocating each patient's ovary to either single aspiration or follicular flushing, maintaining similar flow rates between the groups compared.Given the importance of maximizing the number of oocytes retrieved from a given number of follicles developed, the conduction of properly designed RCTs evaluating follicular flushing is certainly required.

Comparison of Needle Knife versus Scissors Forceps for Colorectal Endoscopic Submucosal Dissection: A Prospective Randomized Study

To evaluate the efficacy and safety of a grasping-type knife, called Clutch Cutter (CC), for colorectal endoscopic submucosal dissection (C-ESD). This was a randomized prospective study. Patients who underwent C-ESD for colorectal neoplasms >20 mm and <50 mm in size were enrolled, dividing into two groups: ESD using needle type of dual knife alone (D-group) and circumferential incision using dual knife followed by submucosal dissection using CC (CC-group). The primary outcome was the self-completion rate. The secondary outcomes were intraoperative complication rate, procedure time, and en bloc resection rate. A total of 45 patients were allocated to the D-group and 43 to the CC-group were allocated. The self-completion rate was higher in the CC-group (87% [39/45] vs. 98% [42/43]). All of the six patients with an incomplete procedure in the D-group were completely resected with CC use. The intraoperative complication rate was not significant in either group (D vs. CC: 2% vs. 0%). The mean procedure time was significantly shorter in the D-group than that in the CC-group (62.0 vs. 81.1 min; p = 0.0036). The en bloc resection rate was 100% in the D-group and 98% in the CC-group. While dual knife use is superior to CC in terms of time efficiency, the use of CC may be a safe and efficacious option for achieving complete C-ESD.

Needle caliber and design are associated with the risk of post-dural puncture headache after diagnostic lumbar puncture

Introduction Post-dural puncture headache (PDPH) is defined as an orthostatic headache that develops within the first few days after performing a spinal tap and it is related to extravasation of cerebrospinal fluid (CSF) into the epidural space, resulting in CSF hypovolemia and hypotension. The risk factors for PDPH are not yet fully understood. Objective To evaluate the risk of spontaneously reported PDPH according to the size and type of spinal tap needle. Methods A total of 4589 patients undergoing outpatient lumbar puncture (LP) were included. All CSF collections were performed at Senne Liquor Diagnostico, a laboratory specialized in CSF collection and analysis. Patients were instructed to report by telephone if they had orthostatic headache during the first 7 days after LP to the medical team of the laboratory. Patients with previous headache were instructed to report any change in the headache pattern during the same period. Needle gauge was classified into two groups: 1) 25G or less and 2) greater than 25G. Two types of needles were used and compared: 1) Pencil point and 2) Quincke. Comparisons of the percentages of spontaneous reports of PDPH were made using the chi-square test. Results 141 patients (3.07%) reported PDPH to the laboratory's medical team. Needles of 25G gauge or less were used in 31.8% of cases. The percentage of patients reporting PHD in the group of 25G or less needles was 1.9% versus 3.6% in the group of larger than 25G needles (P=0.003). Pencil point needles were used in 10.6% of cases. The percentage of PHD among pencil point group was 1.4% versus 3.2% in Quincke group (P=0.026). Conclusion 25G or finer gauge needles as well as pencil point type needles significantly reduced the risk of spontaneously reported PHD.

Transthoracic needle biopsy for diagnosis of lung cancer

Background: Lung cancer is the most common cause of cancer deaths worldwide and accounts for approximately 2 million deaths annually. Despite advances in lung biopsy methods using bronchoscopy, a transthoracic needle biopsy continues to be used widely owing to its excellent accessibility and cost-effectiveness.Current Concepts: Various guidance methods are used during a transthoracic needle biopsy to guide the biopsy needle toward the target lesion. Commonly used modalities include conventional computed tomography, computed tomography fluoroscopy, cone beam computed tomography, and ultrasonography. Complications of a transthoracic needle biopsy include pneumothorax (20.0%), hemorrhage or hemoptysis (11.0%), delayed pneumothorax (1.4%–4.5%), air embolism (0.02%–1.8%), and tumor seeding (0.12%–0.061%).Discussion and Conclusion: Careful selection of the guidance method and needle type, based on the risk factors, the patient’s condition, and location of the lesion is important to achieve high accuracy and low complication rates during a transthoracic needle biopsy. If possible, the bronchoscopic approach should initially be attempted in high-risk groups.

Synthesis of Planar-Type ZnO Powder in Non-Nano Scale Dimension and Its Application in Ultraviolet Protection Cosmetics

ZnO is one of the most widely used inorganic sunscreens, owing to its fine particle size and UV light shielding capability. However, powders at nanosizes can be toxic and cause adverse effects. The development of non-nanosized particles has been slow. The present work investigated synthesis methods of non-nanosized ZnO particles for ultraviolet protection application. By altering the starting material, KOH concentration, and input speed, the ZnO particles can be obtained in different forms, including needle type, planar type, and vertical wall type. Cosmetic samples were made by mixing different ratios of synthesized powders. The physical properties and the UV blockage efficacy of different samples were evaluated using scanning electron microscopy (SEM), X-ray diffraction (XRD), particle size analyzer (PSA), and ultraviolet/visible (UV/Vis) spectrometer. The samples with 1:1 ratio of needle-type ZnO and vertical wall-type ZnO exhibited superior light blocking effect owing to improved dispersibility and prevention of particle agglomeration. The 1:1 mixed sample also complied with the European nanomaterials regulation due to the absence of nanosized particles. With superior UV protection in the UVA and UVB regions, the 1:1 mixed powder showed potential to be used as a main ingredient in UV protection cosmetics.

Comparison between three types of needles for endoscopic ultrasound-guided tissue acquisition of pancreatic solid masses: a multicenter observational study

It is debatable which needle has clear superiority of diagnostic performance in endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) of solid pancreatic masses. This study aimed to compare the performance of three needles and determine the variables that affect diagnostic accuracy. From March 2014 to May 2020, 746 patients with solid pancreatic masses who underwent EUS-FNB using three types of needles (Franseen needle, Menghini-tip needle, and Reverse-bevel needle) were retrospectively reviewed. Multivariate analysis using a logistic regression model was used to identify factors related to diagnostic accuracy. There were significant differences between the groups regarding the procurement rate of the histologic and optimal quality cores (Franseen vs. Menghini-tip vs. Reverse-bevel: 98.0% [192/196] vs. 85.8% [97/113] vs. 91.9% [331/360], P < 0.001 and 95.4% [187/196] vs. 65.5% [74/113] vs. 88.3% [318/360], P < 0.001, respectively). The sensitivity and accuracy using histologic samples were 95.03% and 95.92% for Franseen, 82.67% and 88.50% for Menghini-tip, and 82.61% and 85.56% for Reverse-bevel needles, respectively. In direct comparison between the needles using histologic samples, the Franseen needle showed significantly superior accuracy than the Menghini-tip (P = 0.018) and Reverse-bevel needles (P < 0.001). Multivariate analysis indicated that tumor size ≥ 2 cm (odds ratio [OR] 5.36, 95% confidence interval [CI] 3.40–8.47, P < 0.001) and fanning technique (OR 1.70, 95% CI 1.00–2.86, P = 0.047) were significantly associated with an accurate diagnosis. EUS-FNB using the Franseen needle enables the acquisition of a larger and more adequate histologic core tissue and achieves an accurate histological diagnosis when using the fanning technique.

Mass Reproduction Outbreaks of the Phyllophagous Insects in Forests of the North-West of the European Part of Russia

Data on the species composition and dynamics of outbreaks of needle- and leaf-eating pests that pose a danger to forest stands in the Arkhangelsk, Leningrad and Murmansk regions,as well as in the Republics of Karelia and Komi were summarized and analyzed. A significant decrease in the frequency of reproduction outbreaks of certain types of needle- and leaf-eating pests was shown, which corresponds to the trends for some other regions. For the pine looper (Bupalus piniaria (L.)), the pine beauty (Pannolis flammea), the buff-tip (Phalera bucephala (L.)), the rusty tussock moth (Orgyia antiqua (L.)) and the white satin moth (Leucoma salicis (L.)), who have had a few mass reproduction outbreaks in the aforementioned regions, no significant increase in population density was observed for 25 years or more. An increase in outbreak activity and expansion of the damage area to the north is likely for the winter moth (Operophtera brumata (L.)) and the autumnal moth (Epirrita autumnata). The larch tortrix (Zeiraphera griseana) and the spruce sawfly (Gilpinia hercynia) are in the list of potential dangers as well. These species have only one, but an extremely extensive reproduction outbreak. The red pine sawfly (Neodiprion sertifer Geoffr.) and possibly the common pine sawfly (Diprion pini (L.)) will continue to play a significant role as pests of young stands. The dynamics of their outbreaks, apparently, is determined by climatic changes and, to no lesser extent, by the presence of large areas of conifers’ regeneration. An increase in the fluctuations’ amplitude of the pests populations’ density in urban plantations is likely to occur, especially the miner moths (Phyllonorycter isskii, Ph. populifoliella and Ph. apparella), for which the current climate warming is a fundamentally important factor.