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An automated spring-loaded needle for endoscopic ultrasound-guided abdominal paracentesis in cancer patients

World Journal of Gastrointestinal Endoscopy 2014年第2期6卷 55-59页

作者： Rei Suzuki Atsushi Irisawa Manoop S Bhutani Takuto Hikichi Tadayuki Takagi Goro Shibukawa Ai Sato Masaki Sato Tsunehiko Ikeda Ko Watanabe Jun Nakamura Srinadh Annangi Kazuhiro Tasaki Katsutoshi Obara Hiromasa Ohira Department of Gastroenterology and Rheumatology Division of Medicine Fukushima Medical University School of Medicine Department of Gastroenterology Fukushima Medical University Aizu Medical Center Department of Gastroenterology Hepatology and Nutrition the University of Texas MD Anderson Cancer Center Department of Endoscopy Fukushima Medical University Hospital Department of Pathology Fukushima Medical University Hospital

AIM: To evaluate the feasibility of using an automatedspring-loaded needle device for endoscopic ultrasound(EUS)-guided abdominal paracentesis(EUS-P) to see if this would make it easier to puncture the mobile and lax gastric wall for ***: The EUS database and electronic medical records at Fukushima Medical University Hospital were searched from January 2001 to April 2011. Patients with a history of cancer and who underwent EUS-P using an automated spring-loaded needle device with a 22-gauge puncture needle were included. The needle was passed through the instrument channel and advanced through the gastrointestinal wall under EUS guidance into the echo-free space in the abdominal cavity and ascitic fluid was collected. The confirmed diagnosis of malignant ascites included positive cytology and results from careful clinical observation for at least 6 mo in patients with negative cytology. The technical success rate, cytology results and complications were ***: We found 11 patients who underwent EUS-P with an automated spring-loaded needle device. In 4 cases, ascites was revealed only with EUS but not in other imaging modalities. EUS-P was done in 7 other cases because there was minimal ascitic fluid and no safe window for percutaneous abdominal aspiration. Ascitic fluid was obtained in all cases by EUS-P. The average amount aspirated was 14.1 mL(range 0.5-38 mL) and that was sent for cytological exam. The etiology of ascitic fluid was benign in 5 patients and malignant in 6. In all cases, ascitic fluid was obtained with the first needle pass. No procedure-related adverse effects ***: EUS-P with an automated springloaded needle device is a feasible and safe method for ascites evaluation.

关键词： Ascetic fluid Malignancy Endoscopic ultrasound Paracentesis Fine needle aspiration

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Endoscopic approach for diagnosing autoimmune pancreatitis

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World Journal of Gastrointestinal Endoscopy 2010年第1期2卷 20-24页

作者： Terumi Kamisawa Hajime Anjiki Kensuku Takuma Naoto Egawa Takao Itoi Fumihide Itokawa Department of Internal Medicine Tokyo Metropolitan Komagome HospitalTokyo 113-8677Japan Department of Gastroenterology and Hepatology Tokyo Medical UniversityTokyo 113-8677Japan

It is of utmost importance to differentiate autoimmune pancreatitis(AIP) from pancreatic cancer(PC).Segmental AIP cases are sometimes difficult to differentiate from *** endoscopic retrograde cholangio pancreatography,long or skipped irregular narrowing of the main pancreatic duct(MPD),less upstream dilatation of the distal MPD,side branches derived from the narrowed portion of the MPD,absence of obstruction of the MPD,and stenosis of the intrahepatic bile duct suggest AIP rather than *** infiltration of IgG4-positive plasma cells is frequently and rather specifically detected in the major duodenal papilla of AIP ***4-immunostaining of biopsy specimens obtained from the major duodenal papilla is useful for supporting a diagnosis of AIP with pancreatic head *** endoscopic ultrasonography(EUS),hyperechoic spots in the hypoechoic mass and the duct-penetrating sign suggest AIP rather than *** and intraductal ultrasonography sometimes show wall thickening of the common bile duct even in the segment in which abnormalities are not clearly observed with cholangiography in AIP ***-guided fine needle aspiration,especially EUS-guided Tru-Cut biopsy,is useful to diagnose AIP,as well as to exclude PC.

关键词： Autoimmune pancreatitis Pancreatic cancer Endoscopic retrograde cholangiopancreatography Endoscopic ultrasonography-Fine needle aspiration IgG4

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Solid-pseudopapillary pancreatic tumor,mimicking submucosal tumor of the stomach:A case report

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World Journal of Gastrointestinal Surgery 2011年第12期3卷 201-203页

作者： Satoshi Furuhashi Hiroshi Takamori Shinnya Abe Osamu Nakahara Hiroshi Tanaka Kei Horino Toru Beppu Ken-ichi Iyama Hideo Baba Department of Gastroenterological Surgery Graduate School of Medical SciencesKumamoto University Department of Surgical Pathology Kumamoto University Hospital

Solid-pseudopapillary tumors of the pancreas(SPTs) are comparatively rare and have low malignancy,with a predilection for young *** is difficult when a SPT develops in a boundary region with other ***,we report a 42-year old woman with a SPT of the pancreas mimicking a submucosal tumor of the stomach on *** was admitted to our hospital complaining of abdominal *** suspected a submucosal tumor of the stomach from the f indings of endoscopy,endoscopic ultrasonography and abdominal computed ***,angiography showed that some of the tumor vessels arose from the *** f indings revealed the tumor originated from the ***,distal pancreatectomy was *** pathological diagnosis was SPT of the pancreas.

关键词： Solid pseudopapillary tumor Submucosal tumor Gastrointestinal stromal tumors Endoscopic ultrasonography Fine needle aspiration Cluster of differentiation Somatostatin receptor

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Fractured tracheostomy tube obturator: A rare cause of respiratory distress in a tracheostomized patient

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World Journal of Anesthesiology 2013年第3期2卷 30-32页

作者： Mussarat Afzal Hadi Al Mutairi Ikram Chaudhary King Fahad Specialist Hospital Dammam PC 31444 Eastern Province Saudi Arabia

Foreign body aspiration is a worldwide health problem which often results in life threatening complications. Tracheostomy tube fracture resulting in airway obstruction is a serious condition which has been reported in the medical literature. We report a rare case of a tracheostomy obturator fractured and lodged in tracheobronchial tree in a patient who presented with acute respiratory distress. Rigid or flexible bronchoscopy is frequently necessary for the diagnosis as well as the treatment. In adults, removal of the foreign body can be attempted during a diagnostic examination with a fiberoptic bronchoscope under lignocaine local infiltration with sedation, which may help to avoid any further invasive procedures. Flexible bronchoscopy should always be considered in foreign body aspiration. A periodic review of the techniques of tracheostomy care, including timely check-ups for signs of wear and tear, can possibly eliminate such avoidable late complications.

关键词： Respiratory distress Tracheostomy Foreign body aspiration Bronchoscopy

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Usefulness of continuous suction mouthpiece during esophagogastroduodenoscopy: A single-center, prospective,randomized study

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World Journal of Gastrointestinal Endoscopy 2013年第10期5卷 508-513页

作者： Takao Maekita Jun Kato Yukihiko Nakatani Shotaro Enomoto Ema Takano Masahiro Tsuji Tsuyoshi Nakaya Kosaku Moribata Yosuke Muraki Naoki Shingaki Toru Niwa Hisanobu Deguchi Kazuki Ueda Izumi Inoue Mikitaka Iguchi Hideyuki Tamai Masao Ichinose Department of Gastroen-terology School of Medicine Wakayama Medical UniversityWakayama Department of Internal Medicine Nakaya HospitalWakayama

AIM: To develop a new continuous suction mouthpiece(CSM) and evaluate its usefulness for screening esophagogastroduodenoscopy(EGD).METHODS: A total of 196 patients who were scheduled to undergo screening EGD were assigned to one of two groups: a group using the CSM and a group using a conventional mouthpiece. Extent of salivary flow,frequency of saliva suction, number of choking episodesduring the examination, and incidence of aspiration pneumonia after the examination were evaluated and compared between the two groups. Adverse events during and after EGD were also examined. In addition, the oral cavity was meticulously examined after the ***: The same number of patients was randomly allocated to each group. There were no significant differences between the two groups in sex, age,biopsy procedure, duration of procedure and depth of sedation. aspiration pneumonia and other significant adverse events were not observed in either group. The grade of extent of salivary flow was significantly lower in patients with the CSM than in patients with the conventional mouthpiece(P < 0.001). Although there was no significant difference, less frequent suctioning and fewer choking episodes were observed in patients with the CSM than in patients with the conventional mouthpiece(P = 0.082 and P = 0.084, respectively). In addition, there were no patients in the CSM group who required saliva suctioning during the ***: Use of the CSM during screening EGD can reduce the extent of salivary flow. The device is expected to reduce complications and contamination with saliva.

关键词： Mouthpiece Esophagogastroduodenoscopy aspiration Saliva Suction

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Endoscopic ultrasound in the evaluation of pancreatic neoplasms-solid and cystic: A review

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World Journal of Gastrointestinal Endoscopy 2015年第4期7卷 318-327页

作者： Eric M Nelsen Darya Buehler Anurag V Soni Deepak V Gopal Division of Gastroenterology and Hepatology University of Wisconsin-School of Medicine and Public Health Department of Pathology and Laboratory Medicine University of Wisconsin-School of Medicine and Public Health

Pancreatic neoplasms have a wide range of pathology, from pancreatic adenocarcinoma to cystic mucinous neoplasms. Endoscopic ultrasound(EUS) with or without fine needle aspiration(FNA) is a helpful diagnostic tool in the work-up of pancreatic neoplasms. Its utility in pancreatic malignancy is well known. Over the last two decades EUS-FNA has become a procedure of choice for diagnosis of pancreatic adenocarcinoma. EUS-FNA is highly sensitive and specific for solid lesions, with sensitivities as high as 80%-95% for pancreatic masses and specificity as high as 75%-100%. Multiple aspects of the procedure have been studied to optimize the rate of diagnosis with EUS-FNA including cytopathologist involvement, needle size, suctioning and experience of endoscopist. Onsite pathology is one of the most important elements in increasing diagnostic yield rate in EUS-FNA. EUS-FNA is valuable in diagnosing rare and atypical pancreatic neoplasms including neuroendocrine, lymphoma and metastatic disease. As more and more patients undergo cross sectional imaging, cystic lesions of the pancreas are becoming a more common occurrence and EUS-FNA of these lesions can be helpful for differentiation. This review covers the technical aspects of optimizing pancreatic neoplasm diagnosis rate, highlight rare pancreatic neoplasms and role of EUS-FNA, and also outline the important factors in diagnosis of cystic lesions by EUS-FNA.

关键词： Endoscopic ultrasound-fine needle aspiration Pancreatic neoplasms Pancreatic cysts Review Pancreatic adenocarcinoma

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Role of pancreatic endoscopic ultrasonography in 2010

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World Journal of Gastrointestinal Endoscopy 2010年第10期2卷 335-343页

作者： Ioannis S Papanikolaou Pantelis S Karatzas Konstantinos Triantafyllou Andreas Adler Hepatogastroenterology Unit 2nd Department of Internal Medicine-PropaedeuticAttikon University General HospitalMedical SchoolUniversity of AthensAthens 12462Greece Central Interdisciplinary Endoscopy Unit Department of GastroenterologyHepatology and Metabolic DiseasesCharite University HospitalsCampus Virchow ClinicBerlin 13353Germany

Endoscopic ultrasonography (EUS) was introduced 25 years ago aiming at better visualization of the pancreas compared to transabdominal ultrasonography. This update discusses the current evidence in 2010 concerning the role of EUS in the clinical management of patients with pancreatic disease. Major indications of EUS are:(1) Detection of common bile duct stones (e.g. in acute pancreatitis); (2) Detection of small exo-and endocrine pancreatic tumours; and (3) Performance of fine needle aspiration in pancreatic masses depending on therapeutic consequences. EUS seems to be less useful in cases of chronic pancreatitis and cystic pan-creatic lesions. Moreover the constant improvement of computed tomography has limited the role of EUS in pancreatic cancer staging. On the other hand,new therapeutic options are available due to EUS,such as pancreatic cyst drainage and celiac plexus neurolysis,offering a new field in which new techniques may arise. So the main goal of this review is to determine the exact role of EUS in a number of pancreatic and biliary diseases.

关键词： Endoscopic ultrasonography Fine needle aspiration Acute biliary pancreatitis Chronic pancrea-titis Pancreatic masses Cross-imaging modalities

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针吸细胞学对乳腺肿块的诊断价值探讨

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广西预防医学 2005年第3期11卷 189-189页

作者：黄玲莎沈菁陈艳华广西医科大学附属肿瘤医院南宁530021 广西医科大学医学实验中心南宁530021

目前乳腺癌的诊断研究进展迅速,但最终确诊仍然只能依赖病理学及细胞学,由于针吸细胞学(Fine Needl aspiration Cytology,FNAC)检查具有经济、方便、快速、准确、创伤小的优点,因此仍为乳腺肿块定性诊断的主要方法.现将我院近年来乳腺肿... 详细信息

目前乳腺癌的诊断研究进展迅速,但最终确诊仍然只能依赖病理学及细胞学,由于针吸细胞学(Fine Needl aspiration Cytology,FNAC)检查具有经济、方便、快速、准确、创伤小的优点,因此仍为乳腺肿块定性诊断的主要方法.现将我院近年来乳腺肿块FNAC诊断与病理诊断结果对比分析,探讨FNAC对乳腺癌的诊断价值.

关键词：针吸细胞学乳腺肿块诊断价值 aspiration 结果对比分析 FNAC 诊断研究主要方法定性诊断病理诊断乳腺癌病理学

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细胞学检查在甲状腺肿物诊断中的应用

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微循环学杂志 2006年第2期16卷 77-77,79页

作者：吴穷王国云王明珍湖北省天门市第一人民医院检验科邮政编码天门431700

甲状腺肿是内分泌系统常见病之一,细针针吸细胞学(Fine Needle aspiration Cytoleogy,FNAC)是诊断该疾病的重要方法之一[1].本文对我院自1995年1月至2004年12月间1 462例甲状腺肿物进行FNAC诊断分析,结果报道如下.

关键词：甲状腺肿物诊断分析细胞学检查 aspiration 细针针吸细胞学 Needle 内分泌系统 FNAC 常见病

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大学教育之价

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疯狂英语·高中版 2016年第6期 58-59页

Word of the day:aspiration To have aspirations(from Latin)or aspire to something is to have a desire or ambition to achieve a specific goal,and be willing to strive[奋斗]for *** is often used with"life long,"for example,She had a life long aspiration to be an *** many students in the UK today,deciding whether or not to go to university can

关键词： willing something today strive aspiration deciding desire university passed qualified

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